Dialysis Nursing Outlook

Dec 6

Dialysis nursing has grown in scope and popularity over the past few years. This specialty is a subset of nephrology, which deals with the study of the kidneys and the care they require to function.

What is the outlook for dialysis nurses in 2019 and beyond?

What is Dialysis?

Dialysis is an important process that is performed on patients suffering from either chronic kidney disease (CKD), or other renal complications. CKD encompasses a spectrum of various functions that result in a reduction in kidney function. According to a 2018 study, the prevalence of CKD is growing at a rate of 8% globally each year. Dialysis is the most common method of treating CKD, and is an artificial way of replicating the kidney’s natural function by filtering the blood through a machine. Dialysis nurses help to assist patients receiving this treatment, and are responsible for providing care, documentation, and monitoring throughout.

Dialysis services

Additionally, a dialysis nurse will also maintain and examine patient reports, and will monitor patients throughout the dialysis process. They may also administer medication, consult with physicians, and create a care plan for their patients.

There are two primary types of dialysis: hemodialysis and peritoneal dialysis. Dialysis can also be intermittent or continuous (called continuous renal replacement). The type of dialysis needed may vary depending on the patient’s needs and preferences.

Care settings

Dialysis nurses typically find career opportunities in one of two settings: clinic and acute. In clinic dialysis, a nurse works with patients who have chronic kidney issues. These patients usually require dialysis on a regular basis (often multiple times a week), so the nurses tend to develop closer relationships with their patients and their schedules tend to be fairly routine.

Related, some dialysis nurses find work in home health, and will visit patients where they live. However, unlike home health, dialysis nurses who provide in-home care typically have more regular schedules since patients will require treatment at specific times of day each week.

By contrast, acute dialysis nurses work in a hospital setting and will provide care to patients requiring emergency dialysis services (usually due to some kind of trauma or damage to the kidneys). This position tends to be more fast-paced and unpredictable and more similar to an ICU or critical care nursing job.

What Does the Future of Dialysis Nursing Look Like?

According to the CDC, 30 million people in the U.S. have some kind of chronic kidney disease, and roughly 600,000 of those people require dialysis, which means that the outlook for these jobs is good. Additionally, the National Institute of Diabetes and Digestive and Kidney Diseases estimates that this number will only grow over the next few years.

The U.S. population is aging rapidly, so the skills of a dialysis nurse are more necessary than ever. A 2018 article in Nurse Journal reports that the Bureau of Labor Statistics estimates a 26% growth in the field over the next ten years. This is likely because roughly 10% of the population is affected by conditions like liver disease, diabetes, or high blood pressure, all of which affect the function of the kidneys. Further, the aging population may also have an effect on the need for dialysis nurses.

How Does the Aging Population Affect Dialysis Services?

In a recent article examining job outlooks for home health care, researchers write that over the next five years, those 65 and older will outnumber the number of people under the age of five. As the population ages, so does the number of people affected by kidney disease. A study on chronic kidney disease in elderly patients writes, “As life expectancy continues to improve worldwide, there is a rising prevalence of comorbidities and risk factors such as hypertension and diabetes predisposing to a high burden of CKD in this population.” Further, this same study adds that the likelihood of chronic kidney disease among Medicare patients ages 75 and 79 is 40% higher than those between the ages of 65 and 74.

Additionally, factors like diabetes and liver disease further contribute to CKD among the geriatric population. In fact, the total number of people with diabetes is estimated to rise from 171 million in 2000 to 366 million in 2030. Since 40-50% of diabetic patients end up with CKD, this means that the need for capable dialysis nurses will only increase.

Innovative Companies and Trends in Dialysis Nursing

In addition to providing dialysis services, many companies are actively working to integrate new technologies and innovations in the space to provide more tools for nurses and better outcomes for patients. For example, Fresenius recently acquired NxStage, a company that makes it easier for patients to receive at-home dialysis care. Many patients, especially those who are older or who have mobility issues may find it difficult to travel to a hospital or clinic to receive treatment, so having more in-home dialysis devices can vastly improve quality of life for these patients.

Further, other innovations are being made to improve the dialysis process itself. Azura Vascular Care is developing new solutions to improve vascular access and reduce complications. These new types of vascular access are bioengineered from human cells, and are designed for long-term use, making them safer and and more durable than synthetic options.

In addition to technology, some companies are actively working to improve the lives of young patients needing dialysis. For example, for many years, Dialysis Clinic, Inc. (DCI) has been operating Camp Okawehna and Western PA Kidney Kamp, both designed specially for children affected by kidney disease. For many of these kids, summer camp was never an option, as their dialysis treatments prevented them from attending. DCI’s camps are equipped with dialysis units, so that campers can receive the treatments they need while enjoying activities and independence.

How to Have a Career in Dialysis

As with other nursing specialties, a career in dialysis can be highly rewarding, as nurses have the opportunity to provide life-saving services on a regular basis. If you are considering a career in dialysis, here is what you’ll need to thrive in this specialty.

Education Requirements

In order to become a dialysis nurse, you’ll need to obtain your RN certification, or become an advanced practice nurse. Many nurses find it helpful to obtain their bachelor’s in nursing or even their masters. Additionally, you’ll need to pass the NCLEX exam in order to obtain your nursing license.

Nurses specifically interested in pursuing dialysis will find it helpful to take classes in nephrology, pharmacology, and nutrition. Some programs also offer courses specifically in dialysis. You can compare and contrast nursing schools to discover which one is a fit for you.

Finding Success in Dialysis

One of the unique aspects of a dialysis nursing career is the opportunity to interact with the same patients and form relationships with them. In an article in Daily Nurse, Denise Delos Santos, a hemodialysis nurse, states that, “My favorite part of being a nephrology nurse is getting to know the patients and working with my team...We are a big part of their lives as we are their ‘lifeline’ in providing dialysis. I believe that creating an environment of comfort and feeling at home is an important part of what we do.”

Nurses who are high energy with the ability to get along with diverse groups of people tend to thrive in a dialysis setting, as it requires interacting with and forming relationships with many patients and their families. Additionally, a dialysis nurse must enjoy having a set routine. Because dialysis treatments must occur regularly, nurses will typically see the same patients at the same times throughout the week. The exception to this is if the nurse is working in an acute care setting where emergency dialysis is required. However, many nurse enjoy having more traditional working hours, as well as having weekends off.

Challenges in Dialysis Nursing

Because dialysis nurses form such strong relationships with patients (and often the patient’s family as well), it can be a challenge to maintain professional boundaries with them, which can sometimes lead to the patient not complying with directed medication, fluid, and dietary requirements. In a study that examined burnout and job satisfaction among dialysis nurses, one participant stated, “I really tried to do the boundary settings as well as possible. But it was like hanging around with, yeah, a bunch of fun uncles and aunties that sort of care about you and look out for you and treat you like a family member.” While this was primarily a source of satisfaction among the nurses surveyed, it also caused stress as the nurses would sometimes be drawn into family issues or squabbles.

How To Find A Job in Dialysis Nursing

There are a number of ways to find a job in dialysis. First, consider whether your preference is working for a clinic or in acute care. If you’re just starting your career, working in a clinic can be a way to get a sense of whether the dialysis nursing might be a good fit for you.

If you’re interested in pursuing a career in dialysis, you can browse open dialysis positions on the Relode platform here.

Molly Powers