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Answers From Our Expert: Work & Employment

Q: I am a social worker in a dialysis clinic. We have patients who are interested in returning to work. What can I do to help orient vocational rehabilitation counselors about our patients?

A: 1) Find out if their office has received "Effective Strategies for Improving Employment Outcomes for People with Chronic Kidney Disease." If not, encourage them to request one from the state office or from the Region VI Rehabilitation Continuing Education Program at (501) 623-7700.

2) Request copies of the brochure for vocational rehabilitation counselors published by the National Kidney Foundation at (800) 622-9010.

3) Have a meeting with vocational rehabilitation counselors at the dialysis clinic.

This serves two purposes: First, counselors can actually see where patients come for treatment, a dialysis machine, needles, etc. and second, it provides an opportunity for patients and counselors to get to know each other and could serve as a way for counselors to recruit motivated clients.

VR counselors may never have known anyone with kidney failure. They may believe that kidney failure is fatal because it is called "end stage renal disease." They may believe blood is everywhere in the clinic. To reduce fear, describe the "look" of the dialysis clinic and what patients and staff do during treatment. Ask a nurse to present information on the clinical aspects of hemodialysis and peritoneal dialysis. Talk about the psychosocial aspects of kidney disease. Ask a willing patient who is working or wants to work talk with the VR counselor. Explain work barriers—dialysis schedules, medical appointments, anemia, occasional health setbacks—and how the clinic can help patients feel well enough to work and staff can collaborate with VR counselor to help achieve better outcomes.

This works. In Texas a vocational rehabilitation counselor started attending CNSW meetings, became a member, and recruited clients from dialysis clinics in the Dallas area. She had the highest number of ESRD referrals and the highest placement rate of any of the VR counselors in the state.

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