Thinking of Working Dialysis-But I Have CKD

Ruby Vee, BSN · Aug 21, 2016

Working as a dialysis nurse is interesting and challenging. I have only done acute dialysis in the ICU setting, which can be very technical at times. A friend who works in the outpatient setting tells me that once you learn the machine, you've learned the machine. Unlike ICU, there's only the dialysis machine to learn. Perhaps other dialysis nurses will chime in, but I believe you'd be responsible for monitoring more than one patient at a time, with the most intense attention being when you put the patient on dialysis (including accessing shunts and fistula a with those really big needles, which is what kept me from wanting to work outpatient) and when you take them off.

In addition to the fatigue, I'm wondering if you've considered the emotional aspects of working with CKD patients. You would know better than me how prepared you are, and some folks handle it better than others. As a young oncology nurse, I suffered cervical cancer. One of the reasons I left oncology was the emotional difficulty in watching others with the same diagnosis and very different outcomes. I elected to leave oncology. You may have no problem with the emotional aspects; many nurses even feel they have more to contribute to a patient population with the same disease they're living with. But I urge you to at least consider whether the emotional aspects would be a plus or a minus to you.

Guttercat, ASN, RN · Aug 23, 2016

I would (putting myself in your shoes) steer clear of renal nursing.

Working in psych, I'm sure you've seen your share of docs, therapists, and nurses that enter that field because they have issues themselves.

It rarely ends well.

Along the lines of what Ruby said, be very careful about entering a field in which you are working through the emotional component of yourself.

I knew a dialysis patient that became a dialysis technician after her transplant. She didn't last long. It was just too much.

SunnyPupRN · Aug 23, 2016

I would (putting myself in your shoes) steer clear of renal nursing.
Working in psych, I'm sure you've seen your share of docs, therapists, and nurses that enter that field because they have issues themselves.
It rarely ends well.
Along the lines of what Ruby said, be very careful about entering a field in which you are working through the emotional component of yourself.
I knew a dialysis patient that became a dialysis technician after her transplant. She didn't last long. It was just too much.

Yes, you are spot on when it comes to nurses and doctors entering psych and often having related issues. Sometimes I have seen coworkers be more understanding, but more often, they are just as harsh and backwards toward the professions who is suffering as most of the world is. The emotional aspect of entering dialysis is what I'm most concerned about. I have no plans to do dialysis when the time comes, personally. But maybe I just don't need to focus so much of my time on CKD.

Guttercat, ASN, RN · Aug 24, 2016

Yes, you are spot on when it comes to nurses and doctors entering psych and often having related issues. Sometimes I have seen coworkers be more understanding, but more often, they are just as harsh and backwards toward the professions who is suffering as most of the world is. The emotional aspect of entering dialysis is what I'm most concerned about. I have no plans to do dialysis when the time comes, personally. But maybe I just don't need to focus so much of my time on CKD.

No plans to do dialysis when the time comes? Do you mean as a patient?

Definitely that is your choice, one that should be respected, and one that I'm sure you've mulled over and over in your head.

The majority of patients you see on dialysis usually have multiple comorbidities related to (in order of prevalence) poorly managed diabetes, uncontrolled hypertension, and autoimmune disorders. When they finally land on dialysis, it is often not a pretty picture, so I understand your fears. But, please realize many dialysis patients were already quite ill with sequelae from underlying diseases and lifestyle choices long before they were ever on dialysis.

Someone such as yourself without these conditions can do exceedingly well on dialysis. Often those patients hold regular jobs and active lifestyles.

Yes, renal failure and dialysis sucks, but very likely not nearly bad as is in your imagination.

SunnyPupRN · Aug 26, 2016

No plans to do dialysis when the time comes? Do you mean as a patient?
Definitely that is your choice, one that should be respected, and one that I'm sure you've mulled over and over in your head.
The majority of patients you see on dialysis usually have multiple comorbidities related to (in order of prevalence) poorly managed diabetes, uncontrolled hypertension, and autoimmune disorders. When they finally land on dialysis, it is often not a pretty picture, so I understand your fears. But, please realize many dialysis patients were already quite ill with sequelae from underlying diseases and lifestyle choices long before they were ever on dialysis.
Someone such as yourself without these conditions can do exceedingly well on dialysis. Often those patients hold regular jobs and active lifestyles.
Yes, renal failure and dialysis sucks, but very likely not nearly bad as is in your imagination.

Yes, sorry I should have clarified that. I meant as a patient. Thanks for a bird's eye view about dialysis.

I don't know...I'm stage three and apparently ' stable ' but I do not want want tons of medical debt and be tethered to the procedure. I don't have a support system [no family] and it's just too lonely to do it for myself. But thank you.

Guttercat, ASN, RN · Aug 29, 2016

Yes, sorry I should have clarified that. I meant as a patient. Thanks for a bird's eye view about dialysis.
I don't know...I'm stage three and apparently ' stable ' but I do not want want tons of medical debt and be tethered to the procedure. I don't have a support system [no family] and it's just too lonely to do it for myself. But thank you.

As a person facing potential dialysis, you do *not* need to go into massive debt to be on dialysis.

Have you discussed long-range contingency plans (in the event your kidneys eventually give up) with your nephrologist and renal team?

There is hope!!! Dialysis is not a death sentence!

P.S., if you have no family as a support system, yes, that can make the journey lonlier. But... you would be amazed at how much your nephrology and dialysis team (and fellow patients) fills in that gap and stands alongside you. Will we be perfect? No. Will we sometimes let you down? Yes. But you will never be alone in the journey.