What are the typical responsibilities of a Dialysis Nurse?
Hemodialysis is the process of using a machine to filter a patient’s blood and remove excess fluid when their kidneys aren’t functioning. Dialysis nurses have a wide skill set and varied responsibilities that make their job both challenging and rewarding.
Nurses start their day by preparing the clinic for the patients who will receive hemodialysis. This includes setting up individual dialysis machines for each patient and preparing each bedside with the necessary pre-treatment and post-treatment supplies.
Nurses are responsible for assessing the patients prior to dialysis treatment. This includes a set of baseline vital signs, assessment of the vascular access (patients can receive treatment through fistula, artificial graft, or central venous line), and obtaining the patient’s weight to determine the necessary fluid volume to be removed.
During treatment, nurses are responsible for assessing frequent blood pressure, heart rate, and other symptoms to ensure that proper hemodynamics are maintained throughout the treatment. The nurse is also responsible for communicating any symptoms to the physician or advanced practice nurse/nurse practitioner (APRN) that would require changes in treatment.
What should nurses entering this specialty expect to encounter on a regular basis?
Nurses should expect to encounter close communication with their patients regarding their treatment and responsibilities to continuously educate patients and their families on dietary and fluid restrictions to follow. Nurses should also expect daily communication with the physician and advanced practice nursing staff regarding treatment updates for their patients.
Dialysis patients require treatment at least three days per week. This could be a daily treatment, depending on the type prescribed. Nurses should anticipate both providing frequent treatment for their patients and staying in constant communication with patients and families regarding this treatment.
My experience as a Dialysis Nurse
After spending almost a decade away from bedside nursing to raise my family, I sought to use my nursing skills again. To my surprise, I encountered a great deal of hesitation from many recruiters and clinical managers I spoke to. Knowing that I still wanted to maintain my nursing practice in the pediatric world, I broadened my search beyond the NICU nursing specialty that I was familiar with. After submitting more applications with no luck, I noticed that a new position was posted in a pediatric dialysis clinic.
The first sentence of the job description was “Are you looking for a work/life balance?” With five kids and a husband with a demanding career, I was definitely looking for a work/life balance. I applied, interviewed with the clinical manager, and attended a second interview with the staff nurses. Finally, I was offered a position caring for hemodialysis patients.
I currently practice in a pediatric outpatient dialysis clinic located in a major metropolitan children’s hospital.
What are some of the benefits of working as a Dialysis Nurse?
Being a dialysis nurse is a very rewarding specialty. Due to the frequency of treatment and constant communication with patients and families, nurses often experience the reward of seeing patients and families triumph through their diagnosis of chronic kidney disease with proper management of their disease process and successful treatments.
It is immensely rewarding to see patients successfully take care of their health. In my personal experience as a pediatric dialysis nurse, it’s particularly rewarding to see families learn how to manage their child’s health and put them on track for kidney transplant.
Dialysis nurses also enjoy the benefit of increased autonomy in their daily practice as well as daily utilization of well-honed critical thinking skills. Patients that receive hemodialysis treatments often have significant volumes of excess fluid removed from their body, which makes it critical for nurses to assess their patients frequently and make changes at a moment’s notice if necessary.
I recently experienced the joy of having my first patient receive a kidney transplant through organ donation. While this hopefully means the patient will no longer need to visit our clinic three days a week, and we will miss him and his family, it was the most rewarding event to-date during my time as a dialysis nurse.
What are some of the not-so-great parts of working as a Dialysis Nurse?
Although dialysis nursing is rewarding, it has its drawbacks and challenges just like every job. Since a dialysis patient requires frequent treatment, there is not much variety in the patient population. The same patients and families enter the clinic every week.
While this is a positive factor for creating relationships and building trust with patients and families, it is difficult (if not frustrating) to see certain patients continually make poor decisions toward their own health—even after thorough and frequent education on daily meditations and practices.
Share your favorite piece of advice for nursing new grads or students looking to become a Dialysis Nurse
For registered nurses interested in working as a dialysis nurse, my advice is to gain experience by working in a nursing unit that offers experience in frequent assessment, management of hemodynamics or titrating medication drips, or management of patients who require mechanical ventilation. Positions in an ICU setting, operating room, or progressive care units are all great areas to gain the proper skill set for managing dialysis patients.
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