Acute Dialysis RN: A Day in the Life

Are you looking for a nursing specialty with variety, autonomy, and more time to educate your patients? Consider becoming an acute dialysis nurse. Dialysis nurses specialize in caring for patients who have kidney disease.

Dialysis nurses work in two main settings: chronic and acute. Chronic dialysis nurses work in outpatient clinics and provide scheduled hemodialysis treatments to patients. Acute dialysis nurses provide dialysis treatments in the hospital to patients with new-onset kidney failure. They also provide treatments to previously established dialysis patients in the hospital.  

In the hospital, dialysis treatments are provided one-on-one or in a dialysis treatment room. Acute dialysis nurses often learn how to provide treatments in addition to hemodialysis, such as peritoneal dialysis, continuous renal replacement therapy (CRRT), and plasmapheresis. Plasmapheresis treatments may overlap with other specialties, such as neurology or rheumatology.

Three Advantages of Being an Acute Dialysis Nurse:

1.     Variety: No two days are the same. Depending on the location of your patients, you could provide treatments in critical care or a wide variety of floors, including telemetry, general medicine, neurology, orthopedics, pediatrics, and post-partum. Many acute dialysis programs provide coverage to multiple regional hospitals, and you may travel between them. For example, in my area, I travel to seven local hospitals for a total of more than thirty possible floors.

2.     Autonomy: As a highly specialized and trained acute dialysis nurse, you will often be the only dialysis nurse on the floor or in the entire hospital on any given day. You are responsible for setting up the patient's dialysis treatment and then carefully monitoring their blood pressure and other vital signs during the treatment. You must notice subtle changes in your patient's well-being and adjust the treatment as needed. This responsibility can be stressful but can also create a tremendous sense of job satisfaction.

 3.     More time with patients: In the hospital setting, patients are often new to dialysis and have many questions. Because dialysis treatments typically last 3-4 hours, you have extended time to provide thorough education and ease their concerns.

A “Typical” Day for an Acute Dialysis Nurse:

Although each day is different, the following is an example of a possible day as an acute dialysis nurse. During a 12-hour shift, you might round on a patient in intensive care to ensure the CRRT treatment is going well, then provide a three-hour long hemodialysis treatment to a patient with acute kidney injury. After lunch, you might drive to a different hospital and perform a plasmapheresis treatment on a patient with an autoimmune condition. Finally, you might set up an overnight treatment for a peritoneal dialysis patient. You will end your day knowing that the care you provided for each patient was crucial.

 Three Essential Skills for the Acute Dialysis Nurse:

1.     Adaptability: You must be very adaptable to change in order to provide such a variety of treatments for patients in so many different settings. You will learn many charting systems and undoubtedly memorize many passwords!

 2.     Perseverance: 12-hour shifts are long. Sometimes, the days can be even longer if more patients need dialysis treatments. Dialysis patients in the hospital frequently have many comorbidities and are critically ill. It is helpful to focus on the importance of the life-saving treatment you are providing and to take designated time away from work to recharge. 

 3.     Communication: As an acute dialysis nurse, you will work closely with a multidisciplinary team. It is essential to establish a good working relationship with the primary nurse and communicate with the nephrologist about changes in the patient's condition.

How to Become an Acute Dialysis Nurse:

Dialysis employers often prefer nurses to have 1-2 years of nursing experience before becoming an acute dialysis nurse, although some employers may occasionally hire new graduates. Once hired, the dialysis training process can last up to six months with a designated preceptor. You will likely have intensive training on hemodialysis first and then learn about the other treatments. Gradually, you will become an integral member of a life-saving team of nurses!

EARN Cares offers a free, confidential, and friendly evaluation for every nurse! During this evaluation, they learn who you are as a nurse and what roles may fit you best. If ambulatory nursing seems like a good fit for you, let them know.

Author:

Written by Liz Balleweg, MSN, FNP, RN. She is a nurse practitioner, nephrology nurse, and freelance medical writer at Med Writer RN.

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