Evelyn's story

Evelyn knew that Shared Haemodialysis Care was something their unit was expected to do. Without fully understanding what it meant and how it could be presented to interest patients and gain their co-operation, the concept was difficult for her to grasp.

Evelyn and her staff did not feel competent to approach this new way of working and lacked the knowledge of how to motivate their patients. They were not confident to manage some of the negative responses they received. Patients thought they were trying to get them to do their jobs! How could they persuade them otherwise?

Without a full understanding, you don’t have belief in the cause.

It felt like Shared Haemodialysis Care was being pushed upon staff as an expectation. Spreadsheets had to be completed for the number of tasks they persuaded patients to do. It was difficult to be positive when the staff were not feeling ready.

Consequently, the idea of shared haemodialysis care quickly established itself as difficult and negative rather than something that could really benefit patients and be passionately embraced by staff.

Yes, we were involving the patients but we were told we had to do this, the patients were told they should do this... it was meaningless

What changed for Evelyn?

Listening to patients talking about shared haemodialysis care and its positive impact, it was entirely different from what we expected it to be. Hearing how they enjoyed learning gave me confidence that it was beneficial. I can use what patients say to more easily promote it.

Knowing that she had engagement, support and a knowledgeable team keen to practice Shared Haemodialysis Care gave her the encouragement to persevere with this new way of working.

I can see my staff are really good and want this.

Understanding that involvement is not just about physical tasks. Measures can be deceiving as there are many ways to involve patients that are not quantifiable but still engage them in their own care.

We knew how to talk to patients after the course and understood it was important to give them choice and be positive about what they can do not just focus on the spreadsheet tasks.

It can be about having conversations that allow patients to be honest and open about their struggles and to understand their dialysis and health. Some of the patients are not mobile but they say they are doing Shared Care when they press the button on the weight machine and look at the number.

Evelyn’s advice for others

The manager must be engaged first to understand it properly and be able to support their team. Give staff chance to explore Shared Care as a concept and help them to understand what it means from a patient perspective so that they feel it is a positive step forwards not just an expectation. This way, they can ask how best to approach it with patients. It doesn’t need to be so time consuming as it is the little things that matter. Showing it works means staff don’t have to keep telling patients about the benefits as they can see for themselves.
Having a patient who is doing some of their own care has really helped influence others.
Find ways in which it can be incorporated into your working life.

Establish engagement from more than one person so that you have a team. Changing the minds of established staff and patients already affected by the negativity takes a lot of time and effort. Training as a team helps to establish a group passion for Shared Care and change people’s minds to make it a positive experience.

When you have more understanding yourself, it is still not easy to change people’s minds, but you can implement Shared Care with new staff and new patients and that is much simpler.