For more than 10 years Dolores (Dolly) Ramsamy has been dedicated to improving health outcomes and the quality of life for people living with chronic kidney disease.
Dolly is a Nurse Practitioner at Mackay Base Hospital specialising in renal care providing comprehensive support to Mackay HHS renal teams.
She commenced her health career in 1999 as an advanced care paramedic with the Queensland Ambulance Service (QAS) which included four years remote service in the Torres Strait.
“After completing my paramedical degree, I moved my family to Thursday Island where I was part of the QAS helicopter retrieval team in the Torres Strait and Northern Peninsular regions,” Dolly said.
“Remote patients with end stage kidney disease (ESKD) needed to be transferred to Cairns for renal treatment as there were no haemodialysis services available in the area at the time.
“This is where I first developed an interest in kidney disease prompting a return to university to complete my Bachelor of Nursing.”
Dolly completed her nursing degree while working fulltime as a paramedic and was offered a post-graduate position at Mackay Base Hospital in 2008.
She commenced her nursing career in the Surgical Unit with a passion to specialise in renal replacement therapies and kidney disease.
“After my post-grad year I started working with the hospital’s renal team across all facets of renal care, including haemodialysis, peritoneal dialysis, home haemodialysis, chronic kidney disease, renal transplant and as Acting Nurse Unit Manager,” she said.
“In 2015 there was an opportunity to join the team rolling out Thursday Island Hospital’s first renal unit, so I relocated back to the Torres Strait for 10 months to help establish this new service.
“This was a significant milestone for the Thursday Island community as it meant people with kidney disease could receive care closer to home.”
With Thursday Island’s Renal Unit up and running, Dolly returned to Mackay keen to expand her qualifications to meet the growing need for renal replacement therapy options across Mackay HHS.
“I could see our renal patient numbers increasing yearly and only two nephrologists (doctor who specialises in kidney conditions) to manage over 1300 patients,” she said.
“It was clear a nurse practitioner role would improve patient outcomes by offering an alternative supported care option for patients who do not wish to receive haemodialysis, are not able to do dialysis or those who want to withdraw from dialysis.
“Receiving renal replacement therapy can be very stressful and exhausting, especially for elderly patients and their loved ones as they are at the hospital for up to six hours a session, three times a week.
“Returning to university once again, I completed my Master of Nurse Practitioner specialising in renal care.”
On completion of her Masters in 2021, Dolly was successful in gaining the nurse practitioner role with Renal Services the following year.
Dolly’s first project was implementing the Mackay HHS Kidney Supportive Care Program (KSCP) which commenced in September 2022. There are currently 85 patients with the program.
“The Kidney Supportive Care Program provides regular monitoring, management of physical symptoms and aims to anticipate patient care needs to minimise hospital presentations,” she said.
“Specific and culturally appropriate patient care plans are developed to support the patient’s changing clinical needs and we work closely with community care providers to help the patient stay at home for as long as possible, preventing acute hospital admissions.”
Becoming a nurse practitioner has enabled Dolly to provide autonomous, clinically focused individual patient centred care.
“A typical day for me usually involves reviewing current haemodialysis patients, monitoring and regulating in-centre haemodialysis patients’ care plans, attending to medication changes, referring patients to additional services, conducting weekly outpatient clinics and attending multidisciplinary meetings,” she said.
“I provide a clinical knowledge resource to nursing staff within the unit assisting with prompt interventions and educational in-services.”
A large component of Dolly’s role includes working closely with nursing homes, GPs and community pharmacists to ensure continuity of care for patients and, importantly, being available to patients and their families as situations change.
“I am a strong patient advocate and believe in empowering my patients through education on how they can slow the progression of kidney disease. Planning for end-of-life is also a priority so having the conversations and implementing Advanced Care Planning is crucial for families to be aware of their loved one’s final wishes,” she said.
“My work is busy yet incredibly rewarding seeing the benefits and outcomes the Kidney Supportive Care Program provides for patients and their families.”
This week is Nurse Practitioner Week (11 to 17 December) presenting an opportunity to acknowledge the important work nurse practitioners carry out in our hospitals and health care settings.
Mackay HHS has 10 nurse practitioners working in our Emergency Department, Hepatology, Hospital In The Home, Sexual Health and the Women’s Health, Mental Health and Renal Units.
