Miss Lucy Stevens1, Mrs Vicki Smith1, Mrs Rosemary Simmonds1
1Barwon Health, Geelong, Australia
Biography:
Lucy is Clinical Nurse Specialist with 5 years experience in dialysis, including over 2 years experience in home haemodialysis at Barwon Health in Victoria, Australia. Prior to this she worked in General Medicine. In 2024 she completed her Graduate Certificate in Renal Nursing with the University of Tasmania.
Abstract:
Background:
Home dialysis nurses play a critical role in supporting patients to successfully transition to home haemodialysis (HHD). Understanding the patient experience during this transition is essential to delivering effective, patient-centred education and care. This case study explores one patient’s perception of his journey to HHD, illustrated through a series of weekly cartoons, and highlights the pivotal role of the home dialysis nursing team.
Description:
The patient experienced multiple perceived barriers to HHD participation, including older age, comorbidities, difficulties establishing vascular access, limited health literacy, anxiety, and perceived medical bias. An individualised, collaborative, and inclusive education package delivered by the HHD nursing team enabled successful completion of training and transition to home therapy. Following commencement of HHD, the patient shared weekly ‘Friday Funnys’—cartoons reflecting both positive and challenging aspects of his experience. These cartoons provided insight into his evolving understanding of dialysis and served as a reflective tool for the nursing team.
Discussion:
Recurring themes included feelings of being overwhelmed, dialysis burden, the importance of the therapeutic nurse–patient relationship, the value of on-call nursing support, and access to respite dialysis. The cartoons also demonstrated the patient’s comprehension of dialysis and available resources, offering meaningful feedback on the effectiveness of the training program.
Conclusion:
This case highlights the central role of the nurse–patient relationship and the importance of individualised, non-judgemental education in overcoming barriers to HHD. Creative patient expression can provide valuable insight into patient experience and reinforce the impact of high-quality nursing care in home dialysis programs.