SPECIALTIES
Dialysis Nurse

WHAT IS A Dialysis Nurse

 Dialysis nurses, also called nephrology nurses, manage the care of patients who have impaired kidney function. Dialysis filters the blood to remove toxins, returns needed electrolytes, and removes extra fluid that the kidneys normally would excrete. Dialysis nurses deliver care to both adults and children who have developed kidney disease. 

 

Many of the patients have end-stage renal disease. This condition can be treated using hemodialysis or peritoneal dialysis. Dialysis nurses are skilled technicians in both running the machines that provide this life-saving treatment and carefully monitoring patients to make sure they tolerate the procedure. In addition, they anticipate changes in the patient’s blood pressure from shifts in blood volume and must always be on alert for other potentially serious reactions.   

 

Dialysis nurses also manage the care of those with acute episodes of renal failure, such as those in the ICU recovering from a severe illness or other medical conditions that have overtaxed their kidneys. Whether dialysis is needed temporarily or long-term, the dialysis nurse must teach patients and families what to expect and how to manage changes in their daily lives. 

 

Dialysis nurses often receive advanced training to improve their skills. Some become advanced practice registered nurses (APRNs) either as certified nephrology nurse practitioners (CNN-NPs) or clinical nurse specialists (CNSs).

WHAT DOES A Dialysis Nurse Do?

Dialysis nurses perform some of the same activities as other nurses, but they are mainly focused on renal care. Dialysis care can be divided based on the technique used. Each has separate duties, though dialysis nurses are experienced in managing multiple methods. 

Hemodialysis

  • Run dialysis machine, usually for 4 hours, to remove toxins, wastes, and fluid from the body
  • Access fistulas and monitor for bleeding
  • Monitor blood pressure, fluid balance, electrolytes, transfuse blood and give antibiotics  

Peritoneal Dialysis

  • Access peritoneal catheter using sterile technique
  • Administer dialysate or drain used fluid from the abdomen and monitor for sepsis
  • Hook up a cycler machine for overnight runs
  • Teach patient and family how to self-administer

Continuous Renal Replacement Therapy

  • Monitor machines that are hooked up 24 hours a day, usually on ICU patients
  • Check that the access remains intact through the neck or groin
  • Monitor that heparin levels are appropriate to prevent clotting and observe for signs of bleeding
  • Check lab work, fluid balance, electrolyte balance, and machine pressure levels

WHAT SKILLS DOES A Dialysis Nurse NEED?

Dialysis nurses deliver care that supports a patient’s lack of renal function. Since they use multiple types of machinery, they need advanced technical skills to set parameters and monitor readings. Accessing a fistula or shunt must be done with great care to avoid clot formation. Heparin is used to prevent clotting but exposes the patient to the risk of bleeding. Dialysis nurses must have sharp assessment skills to anticipate patient risks inherent to being attached to any dialysis machine. Closely tracking the patient’s blood pressure will ultimately help decide if the patient can tolerate an entire dialysis cycle.  

Dialysis nurses must communicate the patient’s status with the physician in case changes are needed in the solutions used to dialyze them. In addition, dialysis nurses need strong teaching skills to instruct families and patients on lifestyle practices to reduce more injury to their kidneys and how patients must protect their access sites from injury.

Work settings for Dialysis Nurses

Dialysis nurses often work in dialysis clinics, transplant centers and hospitals. Sometimes dialysis nurses travel to see patients in their homes to do teaching and dialyze patients.

Common Cases Dialysis Nurse Encounter

Adult, pediatric, or neonatal settings all have different types of cases, as do surgical ICU or medical ICUs. Any patient with a life-threatening medical or surgical condition, regardless of age, is sent to an ICU.

How to Become a Dialysis Nurse

1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes two-to-four-years based on the program 

2. Pass the NCLEX-RN exam and apply for your RN license after graduation

3. Apply as a new grad or from another medical-surgical setting

4. Become certified as a Certified Dialysis Nurse (CDN) or Certified Nephrology Nurse (CNN) after meeting the prerequisites and gaining work experience.

HOW TO ADVANCE YOUR CAREER AS Dialysis Nurse

You can advance your career by getting an MSN or doctoral degree with a renal disease focus. Alternatively, you can become a nurse practitioner and earn certification as a Certified Nephrology Nurse-Nurse Practitioner (CNN-NP) or a Clinical Nurse Specialist (CNS) in renal disease and become an educator or manager.

Education requirements & Helpful Certifications

Dialysis nurses must be BCLS certified, some facilities also want ACLS certification, and it is highly encouraged that they become additionally certified after gaining experience. 

 

The Nephrology Nursing Certification Commission offers two certifications: 

 

Certified Dialysis Nurse (CDN)

Certified Nephrology Nurse (CNN)

 

Each certification requires a different number of hours and experience.

Average salary for Dialysis Nurses

Dialysis nurses typically make between $68,455 - $108,767, with a median salary of $82,583, according to Salary.com.

 

The May 2021 Bureau of Labor and Statistics report shows which states have the highest and lowest wages for nurses. They do not list by nurse specialty, but dialysis nurse salaries would likely follow suit. The highest-paid states are California, Hawaii, and Oregon. The lowest-paid states are South Dakota, Alabama, and Mississippi. 

 

Specialty Organizations & Communities

Ideal Personality Traits

  • Enjoys and possesses advanced technical skills
  • Empathetic, compassionate, and patient
  • Precise and organized to monitor renal patients
  • Strong interest in the function of the kidney
  • Enjoys patient teaching about nephrology conditions

The Pros of Being a Dialysis Nurse

  • Can work in a variety of settings
  • Have a more predictable schedule
  • Gain technical skills using dialysis machines and applying nephrology knowledge
  • Develop close relationships with the patient and family

The Cons of Being a Dialysis Nurse

  • Difficult to care for patients with chronic diseases, sometimes for years
  • Must stay with patients one to one, even if patients are difficult
  • Limited help to troubleshoot machines if alone in a hospital setting or at a home

Specialty groups and communities

American Society of Nephrology
Cost:
Free-$395, annually.

Perks:

Access to publications, educational discounts, funding opportunities, and more.

Mission:

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

American Nephrology Nurses’ Association
Cost:
Cost: $70-80, annually.

Perks:

Access to educational resources, career-building opportunities, networking, leadership development, and more.

Mission:

The American Nephrology Nurses Association (ANNA) improves members' lives through education, advocacy, networking, and science.

Back to Nurses

Dialysis Nurse

Dialysis nurses work in the field of nephrology nursing. These nurses have advanced knowledge about kidney disease and the use of dialysis to reproduce kidney function in those with chronic and acute renal failure. Dialysis nurses closely monitor patients with kidney disease during dialysis, administer their medications, and provide them with teaching about how to manage their kidney disease.

Education Requirements

Dialysis nurses must be BCLS certified, some facilities also want ACLS certification, and it is highly encouraged that they become additionally certified after gaining experience. 

 

The Nephrology Nursing Certification Commission offers two certifications: 

 

Certified Dialysis Nurse (CDN)

Certified Nephrology Nurse (CNN)

 

Each certification requires a different number of hours and experience.

How to advance/career pathway

You can advance your career by getting an MSN or doctoral degree with a renal disease focus. Alternatively, you can become a nurse practitioner and earn certification as a Certified Nephrology Nurse-Nurse Practitioner (CNN-NP) or a Clinical Nurse Specialist (CNS) in renal disease and become an educator or manager.

RESPONSIBILITIES

There are two types of dialysis: hemodialysis and peritoneal dialysis. Dialysis nurses must be skilled at administering, monitoring, and providing patient teaching for both. 

  • Patient assessment and monitoring: vital signs, lab work, foot checks, administer medications and watch for adverse changes in status
  • Safely administer dialysis by ensuring the machine is set up correctly and operates accurately
  • Patient teaching about how to self-administer dialysis if used in a home setting
  • Collaborate with nephrology physicians and notify them immediately for status changes

MOST COMMON CASES

Adult, pediatric, or neonatal settings all have different types of cases, as do surgical ICU or medical ICUs. Any patient with a life-threatening medical or surgical condition, regardless of age, is sent to an ICU.

How to become a

Dialysis Nurse

1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes two-to-four-years based on the program 

2. Pass the NCLEX-RN exam and apply for your RN license after graduation

3. Apply as a new grad or from another medical-surgical setting

4. Become certified as a Certified Dialysis Nurse (CDN) or Certified Nephrology Nurse (CNN) after meeting the prerequisites and gaining work experience.

Specialty Groups and Communities

The Pros

  • Can work in a variety of settings
  • Have a more predictable schedule
  • Gain technical skills using dialysis machines and applying nephrology knowledge
  • Develop close relationships with the patient and family

The Cons

  • Difficult to care for patients with chronic diseases, sometimes for years
  • Must stay with patients one to one, even if patients are difficult
  • Limited help to troubleshoot machines if alone in a hospital setting or at a home
smily face illustration

Personality Traits

  • Enjoys and possesses advanced technical skills
  • Empathetic, compassionate, and patient
  • Precise and organized to monitor renal patients
  • Strong interest in the function of the kidney
  • Enjoys patient teaching about nephrology conditions
piggy bank illustration

Average Salary

Dialysis nurses typically make between $68,455 - $108,767, with a median salary of $82,583, according to Salary.com.

 

The May 2021 Bureau of Labor and Statistics report shows which states have the highest and lowest wages for nurses. They do not list by nurse specialty, but dialysis nurse salaries would likely follow suit. The highest-paid states are California, Hawaii, and Oregon. The lowest-paid states are South Dakota, Alabama, and Mississippi. 

 

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Certifications

Nephrology Nursing Certification Commission (NNCC)

  • Certified Dialysis Nurse (CDN)
  • Certified Nephrology Nurse (CNN)
  • Certified Nephrology Nurse-NP (CNN-NP)
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Work Setting

Dialysis nurses often work in dialysis clinics, transplant centers and hospitals. Sometimes dialysis nurses travel to see patients in their homes to do teaching and dialyze patients.