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).
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
Peritoneal Dialysis
Continuous Renal Replacement Therapy
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.
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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.
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The American Nephrology Nurses Association (ANNA) improves members' lives through education, advocacy, networking, and science.
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.
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.
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.
There are two types of dialysis: hemodialysis and peritoneal dialysis. Dialysis nurses must be skilled at administering, monitoring, and providing patient teaching for both.
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.
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.
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.
Nephrology Nursing Certification Commission (NNCC)
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.
