For Jana Van Haaften, shift work at a hospital just wasn't working. She needed something that would make mothering small children while working as a nurse more manageable.

Van Haaften found a career in caring for patients with kidney disease, or nephrology nursing. A nurse for 23 years, she is based at the South Minneapolis office of Kidney Specialists of Minnesota (kidney-mn.com).

Van Haaften especially enjoys the opportunity to work in a variety of dialysis centers and getting to know her dialysis patients, whom she sees regularly. "I know about their families; I know when their daughters are getting married and their grandkids are graduating," she said.

As a certified nurse practitioner, Van Haaften spends about 75 percent of her time educating patients, and the rest diagnosing and treating. She assesses dialysis patients and the access ports in their arms, writes orders to address any issues and goes over their blood work. In the clinic, she sees patients with chronic kidney disease who are not receiving dialysis, and prepares good candidates for transplant.

Becoming a nurse practitioner made a big difference in her career. "It gave me more freedom to treat rather than having to call the nephrologist to get orders," she said. "It frees up the physicians to work more closely with some of the very sick patients."

Nephrology nursing is learned on the job, according to Sylvia Moe, a retired nephrology nurse who is past president of the Southeast Minnesota chapter of the American Nephrology Nurses Association (annanurse.org). The chapter covers the Twin Cities, southeast Minnesota, western Wisconsin and northern Iowa.

Nephrology nurse practitioners help dialysis patients manage their hemoglobin, bone health, blood pressure, medications and the comorbidities of heart disease and diabetes, Moe said.
Nurses who work in chronic kidney disease clinics educate patients early to help them stay healthy and transition them to transplant rather than dialysis, she added. Other nurses work in transplant units on patient care, medication management and follow-up treatment. Some nephrology nurses are even training patients to do dialysis at home, Moe said.

The patient population is growing about 7 percent nationally each year due to increases in hypertension, heart disease and morbid obesity, Moe said. She advised job-seekers who want to learn more about the career to visit the ANNA website and that of the National Kidney Foundation (kidney.org).

"This is a very specialized blending of science and art," she said.