Q & A with Mary Lewis, Patient Educator, Home Hemodialysis, Providence Health Care
Mary Lewis is currently based out of the East Vancouver Community Dialysis Unit. The unit is run by Providence Health Care, one of six regional health authorities that are part of BC Renal’s provincial network of kidney care providers. Mary has been in nursing for an inspiring 40 years, and for the past 17 years has been a patient educator in home hemodialysis.
In addition to connecting with Mary, we asked Sarah Thomas for some extra insight into Mary’s career. Sarah, who currently works with BC Renal as Project Manager, Renal Clinical Projects, previously worked with Mary for 20 years during her own nursing career and is very impressed by Mary’s contributions:
“Mary has demonstrated multiple creative solutions to improve patient care. As you can imagine, home dialysis is very different in each patient’s home. Many patients live remotely, without access to the essentials that patients have in the urban centres. Mary has made sure that every patient who has demonstrated a desire to get home returns to their community. She has formed relationships with GPs, remote nursing stations, local bands and local community members so patients have all the necessary supports in their communities to ensure equitable care to all home dialysis patients.”
Sarah continues with a story that illustrates Mary’s dedication:
"A patient was dialyzing at home in their remote, coastal community. Mary needed to get to the patient to help set them up for home dialysis. She was unable to fly in due to fog. She was determined to get there, so she hitched a ride with the BC Hydro workers on their boat. She was able to get the patient set up, and stayed in a nearby lodge to ensure that the first few dialysis runs went smoothly."
We are very pleased to have connected with Mary to be able to share some of her thoughts about her career, more details of her experiences, as well as a few things she enjoys outside of work.
I developed a strong interest in renal nursing after working with kidney transplant patients at the London Bridge Hospital in England. Since moving to Vancouver, I have held various positions in nephrology but have always found patient teaching the most rewarding. Teaching in the pre-dialysis clinic and then training patients for self-care hemodialysis was a perfect segue into home hemodialysis (HHD).
In broad terms, the patient educator assesses the patient’s suitability for HHD, trains the patient to safely self-manage their dialysis and then acts as the primary nurse/first point of contact for the patient once they are home.
The patient educator also plays an important role in raising awareness about HHD, educating health care staff as well as patients and dispelling myths about perceived barriers to home therapy.
Pre-pandemic, we used to host in-person open house information sessions for patients and family members to come and meet the HHD team and our vendors. In person has been replaced by virtual presentations, which has made access to such sessions more equitable.
Offering extended hours and/or more frequent dialysis has made a huge improvement in health outcomes for our patients. Most of the HHD patients dialyze either for short daily treatments, alternate days or nocturnal 8-hour treatments, which results in much improved bloodwork and fluid status. This greatly reduces the pill burden for patients, enables them to enjoy a more liberal diet and offers unlimited scheduling flexibility.
Secondly, the introduction of the NxStage System has made it possible for HHD patients to travel with their machine. It is portable and can fit on a car seat or can be flown free of charge as a medical device.
A strong background in nephrology has been invaluable. I obtained my nephrology nursing certification whilst working at Guys Hospital, London.
During my nursing undergrad, I was taught that knowledge can empower a patient and result in better outcomes and quality of life.
Learning to be adaptable and being able to tailor training to the patient’s individual needs and learning style is essential in this job.
Caring for patients in remote communities in BC and Yukon and making valuable connections with their local health care teams has been a privilege and provided great learning for me. Understanding how these communities manage with limited medical resources has been inspiring. Working out how to coordinate the delivery of dialysis machines and supplies to remote communities in the frozen North is always interesting for a Welsh gal!
When I first put on my starched, white apron in London, England 40 years ago I never would have believed that I would one day be in Dawson City, in a sub-zero Parka, advising my home patient to rinse his used bloodlines with vinegar to keep the bears out of the garbage!
My patients have taught me how important it is to offer treatment choices and not to judge how people choose to live with their chronic illness.
HHD patients are resourceful and resilient.
I have a creative patient who removed the washing machine from his Winnebago so he could plumb in his NxStage dialysis machine in order to spend the winter in Palm Springs. Another patient taught me to keep the residual bicarbonate from the Bicart to clean the bathroom!
I am a keen gardener. I also enjoy pilates and playing tennis. My husband Richard and I are very happy to be “grand fur” parents taking care of my daughter’s dog part-time. Pixie is my pressure release valve!
We are proud of our two daughters - a teacher and an almost-qualified nurse. My replacement for my much anticipated retirement!We extend a big thank you to Mary for her contributions to kidney care and for sharing her experiences and thoughts with us for this profile!