The effects of acute renal failure on the family

This paper will explore the effects of Acute Renal Failure (ARF) on the family of the patient. The patient's needs are the concern of the health care team and are more medically orientated than those of the family, whose needs are prevailingly social ones. However, the family's reactions do affect the patient and his/her response to their illness. The diagnosis of any major illness is devastating for the patient and his/her family, and in discussing ARF and its effects, it is possible to realise the common needs of the relatives of all acutely sick people. There is little written about the family's needs when ARF is diagnosed because of the commonalities with the diagnosis of any sudden critical illness. However it is in the relationships between the families and the specialist renal nurse where the differences lie. The partnership which develops in chronic renal care between the renal nurse and his/her patient translates onto the acute unit and makes the care that the specialist acute nurse provides different to other wards in a hospital. On diagnosis, the patient will be treated either on an Intensive Care Unit or in the acute haemodialysis unit depending on the causes of the renal failure and the co-morbidities. The personnel treating the patient will differ depending where the treatment is delivered; but wherever the patient finds themselves the needs of the family are generally the same (1). There is much debate about where is the best place to treat people with ARF (2) but most patients are moved to the acute haemodialysis ward as soon as possible, where the specialist nursing staff have great influence over the treatment and care of the patient. It is here, where the expert nurse and his/her skills are most in evidence and the skills of the nurse are vital, as s/he will spend the most time with the patient (3). It is the time spent during treatment when the family can relate to one caregiver and relationships develop.