Caring for a renal dialysis patient with COVID-19

Healthcare workers have given an insight into the efforts to save the life of the first dialysis patient in Australia to become critically ill after contracting COVID-19 two years ago.

The woman was undergoing dialysis three times a week at Epworth Richmond, when she contracted COVID-19 in the community in March 2020.

Emma Taylor, Nurse Unit Manager, Renal Dialysis said even before COVID-19, a temperature check was routinely done for renal patients.

“The woman came in with a high temperature and had a few cold-like symptoms,” Ms Taylor said.

“Renal patients do get temperatures because they have needles in their arms, three times a week, so they are prone to infection, but we didn’t think she would be our first positive patient.”

The woman was the first COVID-19 patient to be transferred to the Intensive Care Unit (ICU) at Epworth Richmond.

While she was conscious in ICU, the COVID-19 patient still had to be moved three times a week to the dialysis unit, in a military style operation, involving ~-50 staff to ensure there was no spread of the virus during the transfer.

In ICU, nurse Danielle McPherson was allocated to look after the patient, the first COVID-19 patient she cared for.

“She was in the room with glass all at the front looking at us and we were all looking in,” Ms McPherson said.

“I waved at her and pulled my mask down a little bit so she could see my face. I probably had three people run over and check I was as covered as I could be. I remember standing there looking at her door for a good 30 seconds, deep breathing, and eventually I thought ‘she was just like any other patient, just go in and say hi’.”

Within hours the woman deteriorated.

“It was the most awful thing I had probably ever witnessed,” Ms McPherson said.

Dialysis Nurse Unit Manager, Emma Taylor, said it was distressing for staff.

“We had known this patient for two years, treating her three times a week. For our team, it was distressing to see her at the point where she required intubation and then discussing end of life possibilities for her”.

Kidney specialist, Dr Ana Chrysostomou managed the treatment for the woman and said there were real concerns the patient would die.

“There was a period when she went to ICU and she was going to die. It was quite clear. They had thrown everything at her,” Dr Chrysostomou said.

“There was an article that came out in The Lancet about a medication and I thought we should try it because we had nothing to lose.”

“She got this drug and she went from being on 100 percent oxygen to where you knew she was just going to make it. That felt good to advocate for her to get this treatment”.

Dialysis Nurse Unit Manager, Emma Taylor said the care of Dr Chrysostomou was vital.

“She fought for her to the end. She fought for the medication because they were still trial drugs. She fought for different teams to get her treated. She fought for her to live”.

As the woman improved, she was moved from ICU to a special COVID-19 ward where she was treated for several weeks.

Jacqui Dingle, Nurse Unit Manager, COVID-19 ward said the day the woman was discharged was special.

“The day she was discharged it was in the afternoon so I remember one of the managers and one of the staff got her ready to take her downstairs and she said ‘no, I am not going in a wheelchair’ so she walked out,” Ms Dingle said.

“Her husband was at the exit and he was in his full suit and he was just beaming. That was just the best moment.”


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