Dialysis nursing is a sub-specialty within the specialty of nephrology nursing. Nephrology nurses specialize in the care of patients who have kidney disorders or diseases. One of the most serious kidney problems is renal failure--the kidneys stop working suddenly or over a period of time. In either case, the treatment for renal failure is dialysis, a complex procedure in which the body's liquid wastes are removed with special machinery and liquids called dialysates.
Nephrology nurses begin their education with a nursing degree. Although some hospital-associated nursing schools offer nursing school diplomas, most registered nurses today begin with an associate or bachelor's degree in nursing. After graduation from an accredited nursing program, a nurse is eligible to take the NCLEX-RN, a national licensing exam. RNs must be licensed to practice in all states, and experienced nephrology nurses may also choose to become certified in that specialty. Some employers prefer or require certification.
Patients who have renal failure receive dialysis in hospital settings as well as outpatient centers, dialysis centers and even at home. In addition to hemodialysis, in which wastes are removed from a patient's blood by a special solution, filter and machinery, patients may also undergo peritoneal dialysis, which uses the lining of the abdomen to filter a patient's blood. Nephrology nurses who perform dialysis must be expert in both types of dialysis. A nephrology nurse must know how to assess a dialysis patient, plan and deliver his care and determine whether the care is effective or must be modified. Nephrology nurses also train and supervise other dialysis staff and may coordinate care provided by multidisciplinary teams of health care professionals.
Patients who need long-term hemodialysis undergo a special surgical procedure to create a vascular access, or shunt, through which a dialysis needle is inserted. A nephrology nurse who performs dialysis must be able to set up and prime the machine, access or insert the needle into the shunt, manage the dialysis process and prevent complications. Careful patient monitoring is critical to dialysis nursing. Nephrology nurses also perform routine nursing tasks related to the dialysis process--they manage intravenous lines, change dressings and administer medications.
In addition to the technical tasks of dialysis, a nephrology nurse must be able to recognize and treat complications such as fluid overload, dehydration, bleeding or medication reactions. She also teaches patients and family members or caregivers about dialysis-related topics such as nutrition or home care. Nephrology nursing, like most other kinds or nursing, is physical work. A nephrology nurse must be able to spend many hours on her feet, lift patients and move equipment. Although dialysis centers usually schedule patients for routine dialysis, emergencies can occur at any time, so nephrology nurses can expect to work night shifts, weekends and holidays.
- MedlinePlus: Dialysis
- Discover Nursing: Nephrology Nursing
- Davita: Find the Nursing Career that is Right for You
- General Healthcare Resources: GHR Job Description Position-Dialysis Nurse
- National Kidney Foundation: Renal Career Fact Sheet -- Nephrology Nurse
- American Nephrology Nurses Association: Scope of Practice for Nephrology Nursing
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