When chronic disease or acute injury robs the kidneys of their ability to function, an artificial kidney, or hemodialyzer, is used to remove waste from the blood. This procedure is called dialysis.
The kidneys are fist-sized organs located on either side of the spine at the bottom of the rib cage. They clean the blood of impurities, which are then excreted as urine.
When chronic disease or acute injury robs the kidneys of their ability to function, an artificial kidney, or hemodialyzer, is used to remove waste from the blood. This procedure is called dialysis. Acutely ill patients are dialyzed in the hospital. Chronically ill, but stable, patients are usually treated at a freestanding dialysis center.
"Dialysis makes a real difference because it helps a patient feel better," says Michele Boncher, a staff nurse in dialysis services at the University of Minnesota Amplatz Children's Hospital (www.uofmchildrenshospital .org).
Dialysis In The Hospital
In a critical care setting like the intensive care unit, the dialysis nurse sets up the machine and matches the settings to the size of the patient. The nurse must also monitor medication levels and understand how dialysis will affect other conditions, such as acute heart failure.
"Dialyzing a patient in the ICU who is also on a left ventricular assist device, for example, is very complicated," says Grace Glander, also a dialysis nurse at the hospital.
Some complex patients return to the hospital several times a week to receive dialysis in the outpatient center. "Working with these patients is satisfying because we get to know them so well," Glander says.
Centers And Other Settings
Most dialysis nurses work in freestanding centers, where 30 to 40 outpatients are dialyzed at a time. Because these patients are stable, most of the hands-on care is done by technicians under the supervision of the nurse.
Opportunities for experienced dialysis nurses also exist in patient education and in the pharmaceutical industry, where they are employed as sales representatives or clinical specialists who provide information to clinicians about new drugs.
Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.