Dialysis nurses work in a fast-paced environment, supervising technicians who care for patients suffering from kidney failure.
At a larger clinic such as DaVita’s in St. Louis Park, each nurse is responsible for up to 14 patients at a time. Patient care technicians do most of the direct care, taking patients’ weights and pre-treatment vital signs and monitoring the dialysis equipment and patients’ blood pressure during each treatment, which may last three to six hours. Nurses perform patient assessments, administer medication and intervene as patients’ needs arise, according to Kaylene Krauter, RN, a nurse at that clinic.
Krauter, who previously worked at a kidney transplant clinic, trained for dialysis on the job. She currently works a rotating schedule, either Monday-Wednesday-Friday or Tuesday-Thursday-Saturday.
“Either way we put in about 12 hours a day,” Krauter explains. “We always need help so we always have the opportunity to pick up hours.”
While the pace is challenging, Krauter enjoys the patients. “They’re there three days a week, so you get to know them pretty well,” she explains. “When they’re feeling good, you know you’re doing a good job.”
That much patient contact may pose its own challenges, according to Lynne Hamilton, RN, clinic manager at Fresenius Dialysis in St. Paul. “There sometimes can be boundary issues,” Hamilton says. “Sometimes they treat you like a family member and they can vent their anger at you, and it’s not intentional.”
Hospital Experience Counts
Nurses with hospital experience have an easier time adjusting to the dialysis environment, according to Hamilton, a 33-year veteran. “There's a lot of independent thinking,” she says. “You have to be confident in your nursing assessment skills, because unlike the hospitals, we do not have a physician here every day. Plus, you have to be comfortable working with equipment and able to interpret what’s going on with the patient and what's going on with the machine. And you have to multitask effectively.”
Physicians visit only once or twice a month, and must rely on nurses’ assessments. “It’s a cohesive relationship,” Hamilton says. “They listen to your recommendations.”
Pay for dialysis nurses is commensurate with hospital nurses’ pay in the Twin Cities. The current job outlook may be tight, but Krauter believes there’s a good future in dialysis. “There’s always going to be kidney failure so there’s always going to be a need for it,” she says.