Candidate card · Renal outpatient clinic
You are a nurse in a renal outpatient clinic. The patient has just been told by the doctor that they have stage 3 chronic kidney disease linked to long-standing high blood pressure. The doctor has asked you to talk to them about lifestyle changes.
Task
- Find out what the patient understands about their diagnosis.
- Explain in simple terms what stage 3 kidney disease means.
- Advise on reducing salt and following any fluid advice, and why blood pressure control matters.
- Respond to the patient’s fear that they will need dialysis soon.
- Encourage them to attend regular blood tests and bring a blood pressure diary.
Preparation: 3 minutes · Role-play: about 5 minutes
What to expect from the patient
- The patient believes dialysis is inevitable and may be tearful or say “What’s the point?”.
- They eat a lot of processed and takeaway food because they work long shifts.
Sample phrases for each stage
Opening
“Before I go through anything, could you tell me what the doctor explained to you today?”
Explaining
“Your kidneys are still working, but not as well as they should — at about half their usual capacity. The aim now is to protect what you have.”
Empathising
“It’s completely understandable to be worried about dialysis. Many people with stage 3 never need it, especially if their blood pressure is well controlled.”
Advising
“One of the most helpful changes is cutting down on salt. Ready meals and takeaways are often the biggest source — could we look at a couple of easy swaps for your work days?”
Closing
“So, to summarise: less salt, a blood pressure diary, and your blood test in three months. Is there anything you’d like me to go over again?”
Common mistakes on this card
- Overloading the patient with renal physiology instead of checking what they already know.
- Dismissing the fear (“Don’t worry”) instead of acknowledging it first.
- Giving a long list of foods to avoid instead of agreeing one or two realistic changes.
Say it out loud — with an AI patient
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