I’m facing a new team of healthcare professionals. What are their roles?

There are many people who will be involved with your care. This “team approach” is helpful to make sure all your needs are met. Although helpful, it can be confusing to sort out “who is who” and “who does what.” Each of these “team members” is responsible for certain areas of your care. You, however, are the expert on you and your family. You need to be part of the team to help everyone understand what you need. You need to let the team know how chronic kidney disease (CKD) affects you and your family. Working together as a team will help you to receive the treatment and care that will work best for everyone. Below is a summary of some of the members of your healthcare team.

• Specialist - Whether you have high blood pressure, diabetes, lupus or any condition that will put you at risk for kidney failure, you are most likely seeing a specialist for this primary condition. This specialist is aware of your health condition and CKD. He or she will work with you to help preserve kidney function and maintain your health. The specialist is there to answer questions you and your family may have. Take a list of questions when visiting your doctor to help remember your questions. Remember to take notes of your doctor’s answers.

• Nurses - The experienced registered nurse (RN), licensed professional nurse (LPN) or nurse practitioner (ARNP) is an excellent person to answer questions about CKD and daily care. Most nurses realize that answering your questions will help you make healthy choices. If you have a question, don’t hesitate to ask it.

• Dietitian - Your doctor may refer you to a dietitian. Since one way to preserve kidney function is to modify your diet, a dietitian will help you make good food choices. Watching what you eat and drink may be one of the hardest changes you make. A dietitian can help you make meal choices, which will help keep you healthy. Dietitians aren’t there to “police” you, but to work with you to make the best choices possible. If your doctor hasn’t recommended a dietitian and you’re interested in finding one in your area, visit the American Dietetic Association’s Web site at www.eatright.org.

• Social Worker - If you’re referred to a social worker, he or she can provide a great deal of information, from financial resources to coping and support systems. A social worker can explain hard to understand information in easy to understand words. They can help you with work, insurance and rehabilitation issues. The social worker can help you adjust to the feelings you’re experiencing.

• Nephrologist - The nephrologist is a doctor who has had special training on how to treat kidney disease. Your nephrologist will work with you and the rest of the healthcare team. A plan to treat your disease and manage your health will be developed. You’ll see your nephrologist on a regular basis. Your nephrologist will monitor your health. He will make changes as needed to help you stay healthy. 

• Diabetes Educator - Diabetes educators are health professionals, nurses, dietitians, pharmacists, exercise specialists, doctors and social workers, who specialize in the treatment of diabetes. They help you learn to live a healthier, more productive life with diabetes. Diabetes educators work in a variety of settings. You will find many in hospitals teaching patients in group classes or working with patients individually. They also may be found in doctor’s offices, nursing homes or neighborhood clinics.

• Pharmacist - A professional who fills prescriptions, and in the case of a compounding pharmacist, makes them. Pharmacists are familiar with medication ingredients, interactions, cautions and hints. Pharmacists are trained to prepare and distribute medicines and to give information about them. Let your pharmacist know you have CKD. Many medications, including over-the-counter medications, are cleared from your body by your kidneys. Your pharmacist can check each medication and ensure their use with CKD is appropriate.

A Friendly Note: That’s a lot of healthcare people to remember. It should also make you feel safer. Look at how many people are available to help you maintain your health. The important factor to remember is that you should always feel comfortable asking your healthcare team questions. The more questions you ask, the more informed you become.

How do I talk to my healthcare team?

Many people find it helpful to have a notebook where they write down questions for the healthcare team. If you’re like most people, you have questions that you think of at home, and then when you see the team, it’s hard to remember those questions. A notebook that you carry with you can be a good way to make sure your questions are answered. Sometimes, when there’s so much to learn, it’s hard to know what questions to ask. Remember when you were in school and you had to keep notes on all the information you learned? Having CKD is a learning process, too.

A Friendly Note: It’s important to remember that you can ask more than one healthcare professional the same question. If you ask someone a question and aren’t satisfied with the answer, you should ask someone else. It’s OK to get a second opinion.

What questions should I ask at my doctor visits?

To keep yourself as healthy as you can be, it’s important to understand your condition and how it affects your health. The following is a list of some questions that many people have. You can use this list to check off questions you would like to have answered.

• What has caused me to develop CKD?
• What medical tests have I had done?
• What medical tests can I expect to have done in the next three months?
• What medicines have I been prescribed? What does  each one do? What side effects might I have?
• What medicines, vitamins and/or herbs should I  avoid?
• Should I be following a special diet?
• Should I be exercising? What types of exercises can I do?
• How often should I be seeing my nephrologist?
• Who do I contact in an emergency?
• How will CKD affect my sex life?
• Who can I talk to about the emotions I’m having?
• What Web sites, books and other resources can I use to learn more about my health?

You may find it helpful to have a list of phone numbers and medications posted by the phone and on the inside of your “question notebook.” In addition, the notebook is a good place to keep track of medical records. This notebook is also a great place to keep track of how you’re feeling and what you’re experiencing.

This article was obtained from AAKP’s Kidney Beginnings: A Patient’s Guide To Living With Reduced Kidney Function. To request a copy of this book, call the AAKP National Office at (800) 749-2257.

This article appeared in the December 2004 issue of Kidney Beginnings: The Magazine, Vol. 3, No. 4.

Back