As the US population ages, renal disease is entering many families. There is a growing need for nurses skilled in caring for these often-times very complex patients. Many disease processes including hypertension, nephropathies, nephritis as well some congenital anomalies.
SpecialtiesUrologyArticle
When chronic kidney disease (CKD) or acute renal failure (ARF) intrudes on a patient's life, dialysis can provide a life-extending option. Hemodialysis involves cleaning the blood by means of a thrice-weekly treatment usually obtained at an outpatient hemodialysis unit. Other options for hemodialysis include home as well as nocturnal outpatient hemodialysis units. Hemodialysis is achieved via a perm-cath which is a central line meant for temporary access. Permanent hemodialysis access consists of an arteriovenous fistula (AVF) or gortex graft (AVG) placed under the skin usually in an arm. There are variations of these dialysis accesses.
Acute renal failure patients most often receive dialysis in a hospital, oftentimes in an ICU. Continuous renal replacement therapy (CRRT) is the means that patients are continually dialyzed. When a patient is very ill with uremia, sepsis, or shock, they may require CRRT and it is the dialysis nurse that monitors and often changes the systems.
Peritoneal dialysis (PD) cleans the blood by means of a catheter placed in the peritoneal space. Through the use of specially formulated solutions, waste products are cleared either by intermittent "dwell" cycles or via a "cycler" that is used at night.
Renal nursing is the care of the patient who has kidney disease. Also, it usually encompasses the treatment of hypertension as this is one of the main reasons patients end up with chronic kidney disease.
Work Environment
Outpatient hemodialysis usually takes place in a free-standing building. Dialysis in the US lasts for approximately four hours and there are usually three shifts of patients per day. This means that hours of operation can be from 0500 to 2200, Monday through Saturday.
Home hemodialysis and peritoneal dialysis require nurses to train and monitor these patients and support them with their home dialysis needs.
Acute dialysis nurses are based in one hospital but may travel to other hospitals depending on need. They are on-call 24/7 on a rotational basis for the needs of acute dialysis patients or chronic hemodialysis patients who are acutely ill.
Education Requirements
Graduate from accredited Registered Nurse (RN), Licensed Practical/Vocational Nurse, or Nurse Practitioner (NP) nursing program
Successfully pass NCLEX-RN or NCLEX-PN
Current, unencumbered RN or LPN/LVN license in U.S. state of practice
Certification (LPN, RN, NP)
The American Nephrology Nurses Association offers certification for the RN, LPN, and NP as well as Technicians. They are also the organization that lobbies for support of dialysis care in the United States. They are a good resource for new dialysis nurses.
The outlook for dialysis and renal nurses is bright. Most hemodialysis patients receive their care via Medicare, regardless of their age. This is due to the high cost of treatments. As the US population ages, many people are now living to an age where renal failure is more common. And, as home dialysis care advances, there will be more opportunities for nurses able to train and monitor home dialysis patients.
Salary
According to salary.com, the average U.S. salary is $79,215. The range typically falls between $71,389 and $96,537.
