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Dialysis and Renal Nursing

Urology Article   (10,969 Views 30 Comments 577 Words)

traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

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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. You are reading page 2 of Dialysis and Renal Nursing. If you want to start from the beginning Go to First Page.

traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

You must live in a big city. I go to four dialysis units and they are 11, 25, 55, 62 miles from my house.

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24,672 Visitors; 1,336 Posts

Trauma,

You cover four units? I'm assuming you are travelling to each one twice a month? That's a heavy load.

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traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

Lol guttercat.... I see every pt three times per month. I drive approx 40-100 miles everyday. Rural area. I have 210 pts.....would love to hear how many other APNs see and with what amt of driving.

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24,672 Visitors; 1,336 Posts

Lol guttercat.... I see every pt three times per month. I drive approx 40-100 miles everyday. Rural area. I have 210 pts.....would love to hear how many other APNs see and with what amt of driving.

Do you also cover clinic (office) hours?

I've been in dialysis (as an RN) for 15 years, and am pursuing advanced degree/practitioner role. My "gig" is nephrology, I love it, and I'd like to stay in it. However, the cattle call that is nephrology practice these days is not entirely enticing....

The docs/providers don't have it any easier than the RN's on the frontlines, and indeed, practice brings on a whole new set of headaches. Squared.

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traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

I only see dialysis pts....lol. I drive a lot and see my 200 plus pts every week

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24,672 Visitors; 1,336 Posts

I only see dialysis pts....lol. I drive a lot and see my 200 plus pts every week

Does this mean you are exclusively in outreach, or are you also doing consults and call?

I think outreach only, would put me over the edge. If this is the case, my hats off to you even more.

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madwife2002 has 26 years experience and works as a Director of Nursing Services.

3 Likes; 1 Follower; 74 Articles; 120,013 Visitors; 4,777 Posts

I drive a lot too Trauma, I cover 15 clinics with over 800 patients, who rely on me to make sure the quality of care they get is second to none! It is a hard job which involves a lot of traveling but I love it!

Last month I drove 2500 miles

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just keep swimming works as a Nephrology NP.

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So I am 10 months away from finishing my FNP and have two offers with neph groups in the area. They are going back and forth, sweetening the pot so nothing is final, but this is what I have been offered so far:

Group A (academic setting): Said I can write my own job description. What it is looking like is two half days in CKD clinic doing mostly education and HTN followups, one half day in bone and mineral clinic learning a new specialty (being mentored by one of the few specialists in the area with hopes of eventually running this clinic with him), and 3.5 days of dialysis rounding in multiple clinics. I would start with 130 HD patients and then branch to outlying units as I get more proficient. When I say outlying, all clinics are within a 30 minute drive and my total patients would be about 170-200 with 1-3 visits each, depending on what the docs get in since that third visit is not paid if there is no fourth.

Group B (private practice): Has also said I could write my own job description. This group only has about 200 HD patients and have one other NP so I would have about 100. I would see patients in CKD clinic as well. In addition, they want to train me in consults and renal service and want to train me in procedures such as central line placement.

Both groups offer a ton of opportunities for professional growth and I have known the docs in both groups for 10 plus years. I don't know which way to go! The recruiting process sure is fun, though! For those of you who have experience on the APN side, what do you think about those offers? Salary has not been discussed yet, however I hear I am looking between 90-105K. This is the hardest decision I have ever had to make! Thoughts????

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just keep swimming works as a Nephrology NP.

8,020 Visitors; 172 Posts

I drive a lot too Trauma, I cover 15 clinics with over 800 patients, who rely on me to make sure the quality of care they get is second to none! It is a hard job which involves a lot of traveling but I love it!

Last month I drove 2500 miles

You must be a CSS, LOL! I couldn't do your job, hats off to you!

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madwife2002 has 26 years experience and works as a Director of Nursing Services.

3 Likes; 1 Follower; 74 Articles; 120,013 Visitors; 4,777 Posts

You must be a CSS, LOL! I couldn't do your job, hats off to you!

Yes I am LOL

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traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

Just keep swimming:

Group A how many docs? Reimbursement for CKD education is slim to none. In my area FMC has taken over the CKD education. Bone and mineral education is provided in the FMC supported piece. As to HD rounding: it is more profitable for the practice to have you do 3/4 visits in order to get the full reimbursement. 130 pts might be doable in three days but if they have a third shift six days per week it gets to be miserably long days.

Group B sound ok on paper but 100 HD pts plus consults, line placement....that's another long day.

I'm not sure where you are located but in central IL that pay rocks!!!

Our practice manager (MBA) is extremely business savy and since she came 5 yrs ago, has restructured the PAs, NPs. There is only one PA that does hospital rounding now with the president of the practice. All the rest of the docs have to see their own pts. The four of us that are left (plus one additional full time) APN joining us in JAn do HD rounding...PERIOD!

FNP full time sees 150 pts in four clinics spread over about 80 miles

CNS (me) full time sees 210 pts in three clinics over 60 miles

PA 4days per week sees 126 pts in three clinics about 90 miles radius

FNP 3 days week sees 150 pts in 2 clinics 9 miles apart

As APNs we need to get into business mindset of how can we bring more profit to the practice. For me, that knowledge was sorely lacking...

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traumaRUs has 25 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

485 Likes; 14 Followers; 127 Articles; 184,898 Visitors; 20,496 Posts

Guttercat - yep only dialysis pts. I do take dialysis call every four weeks which is for about 20 dialysis pts....

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