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How does your facility handle patients with acute or chronic depression?

By Angela Taylor-Smith posted 03-07-2018 23:42

  
I have been very concern with how depression is handled in our ESRD patients. Do you see an increase in depression in your population of ESRD patients? I am seeing an increase depression in my patient population. I am very concern.  The patients are referred to social worker. The physician has been notified but the patient  need more help. I have seen patients receive a list of counselors, but some will not call. The patient  may say I have already seen a counselor in the past and I feel that talking to someone does not help. I find myself spending extra time listening to patient's problems by phone or face to face.  Some patients I have helped bounce back but some patients need more (and not  just a pill). Patients complained about receiving RX for an antidepressant and complaint about taking another pill or its side effect. Patients have said a pill does not fix my financial problems, my kidney disease, family problems, .... and the list goes on. 
Have you seen an increase in suicide or increase in missing treatments, medication non adherence? Have you seen patients who was very concern with his or her health, never skip a treatment, and then in a few months change?  What do you do?   Some patients may not show s/s of depression and make everything in life a bundle of joy until you talk with a family member. I have cared for patients with a history of mental illness. Some mentally ill patients are not being treated or does not continue therapy after starting on dialysis. I have been face with situation that I felt was above my expertise. I had to figure out to handle the situation or find ways to help the patient calm down.
Do you have patients who will not talk with the social worker? I spend the extra time listening to the patient concerns or expression of anger.  I'm hoping I can help the patient discover how to solve his or her problem.  Is it enough? I believe it is not. I believe its not enough focus on depression. As a nurse, I can only do but so much and sometimes not sure if I handle the matter correctly. I believe more training should be provided to nurses in handing depression and routine facility visits by counselors or psychiatrists for our ESRD patients. 
How are you handling depression in your facility?
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