What Does a Dialysis Nurse Do? Exploring Nephrology Nursing

Becoming a nurse certainly seems like a rock-solid career choice. There’s steady demand, good earning potential and a lot of interesting nursing specialties to potentially focus your work in. While it’s easy enough to find information about working in the emergency department or the intensive care unit, you want to make sure you explore all your options, including niche specialties like nephrology.

A nephrology nurse (sometimes called “renal nurse”) works with patients who have kidney disease, including assisting in dialysis treatments and even kidney transplants. But what does a dialysis nurse do all day? You know there has to be more to being a renal nurse than this brief description!

In this article, we’re exploring this important nursing specialty, including the variety of job duties you may encounter, what it takes to become a certified dialysis nurse and the benefits and challenges of this nursing career.

What is a nephrology nurse?

The nephrology specialty relates to the kidneys, so these nurses focus on treating patients who have (or are at high risk for developing) kidney disease. Kidneys filter waste and extra fluid from the body. When the kidneys aren’t working properly, nephrology specialists step in to treat patients.

Kidney disease can affect people at any age, so nephrology nurses need to be comfortable working with children, the elderly and everyone in between. Not all kidney disease is the same, either. Some are rare hereditary diseases while others can be brought on later in life by infections or other conditions. Nephrology nurses have a scope of knowledge that allows them to care for this wide variety of patients.

Treating patients in the nephrology field doesn’t necessarily mean healing them and sending them on their way. Kidney issues are often chronic, lifelong conditions that patients must learn to navigate in their daily lives. “The nurse's role is to help patients manage their lives—succeed at school or work, socialize, maintain relationships, or enjoy hobbies—while effectively dealing with their health issues,” according to the American Nephrology Nurses Association (ANNA).¹

What do nephrology nurses do?

A nephrology nurse’s job duties can differ quite a bit depending on their care setting and their specific role. Nephrology nurses have many job titles available to them, such as dialysis nurse, nurse manager, vascular access coordinator and organ recovery coordinator.

With that in mind, here are some of the job duties of the most common nephrology nurse subspecialties.

Dialysis nursing

Dialysis is a life-saving procedure for patients with end-stage kidney disease. When the kidneys stop functioning as they should, dialysis clears the waste and maintains balanced chemicals in the body. Dialysis nurses oversee this process, which involves an artificial kidney (hemodialysis) or an abdomen catheter that allows blood to be cleaned inside the body (peritoneal dialysis).

Nurses oversee every aspect of this process including:

• Verifying that the dialyzer and other equipment are working properly
• Discussing patient concerns or changes in health and keeping accurate records
• Providing patient education
• Preparing and placing vascular access and/or catheter

Kidney transplant nurses / transplant coordinators

Patients with kidney failure typically need to undergo dialysis their entire lives—unless they receive a kidney transplant.

Kidney transplant nurses, sometimes called transplant coordinators, play a large part in making sure patients receiving this life-saving treatment. Some of their job duties may include:

• Educating patients and their families about the transplant procedure and aftercare
• Preparing the patient for surgery
• Preparing the operating room to ensure a safe and sterile environment
• Providing care for the patient after surgery, including wound dressing and monitoring for signs of infection or other complications

Where does a nephrology nurse work?

There are many work environments for nephrology nurses to choose from. ANNA shares that renal nurses are needed anywhere patients experience kidney problems, from clinics and hospitals to inpatient or outpatient facilities—and even patients’ homes!¹

Home dialysis allows patients more flexibility and independence as they (or their care partner) perform their own dialysis treatments at home. Home dialysis nurses train their patients in performing this complex task, along with being a resource available to answer questions and provide help.

In this setting, nurses also act as a care coordinator. They work as part of a team to make sure that patients receive treatments as necessary, there is a backup plan in case of emergency and the rest of the patient’s care team stays informed of their condition.

Nurses working in a hospital setting, on the other hand, are more likely to work with acute kidney conditions. These are kidney problems that arise suddenly, often due to an accident or injury. A day in the life of an acute nephrology nurse may include providing urgent dialysis to just a few patients a day as they recover.²

What are the benefits and challenges of being a nephrology nurse?

Every nursing specialty comes with its own set of unique rewards and challenges. One of the benefits that sets nephrology nursing apart is that long-term patients are more common. This gives nephrology nurses the opportunity to get to know and develop a more supportive relationship with their patients, especially in settings like home dialysis where they may also get to know patients’ families.

However, this rewarding aspect of nephrology nursing can also be part of what makes it challenging. Without a true cure for kidney disease, nurses must be prepared in case their patients worsen over time. They don’t always get to experience the fulfillment of seeing a patient get better—their goal is to help patients maintain their health as best they can.

How do you become a nephrology nurse?

If you think it sounds like nephrology nurses need lots of specialized knowledge, you’re right. This specialty may seem intimidating, but there are opportunities for dialysis and nephology nurses at both the licensed practical nurse and registered nurse credential level—though there may be more opportunities for RNs in this specialty overall.

That said, to get started in nephrology nursing, you’ll need to complete either a RN or LPN nursing program, pass the appropriate NCLEX licensure exam and meet any other state requirements needed to practice as a nurse. Once you’ve achieved this milestone, you should have a clear path to start applying for dialysis and nephrology-related nursing roles.

Additionally, registered nurses may want to consider pursuing an optional professional certification in this field. The Nephrology Nursing Certification Commission offers a variety of options potentially worth your consideration.

Do you have what it takes to be a nephrology nurse?

Now you know the answer to “What does a dialysis nurse do?”—as well as all the other details about a specialty as a nephrology nurse.

If this nursing field sounds right up your alley, there’s no time like the present to get started. Start planning your next steps in our article, “How to Become a Nurse: A Beginner's Guide."

¹American Nephology Nurses Association, The Nephrology Nursing Specialty – Background Information [accessed December, 2020] https://www.annanurse.org/professional-development/practice/scope-of-practice/background-information
²American Nephrology Nurses Association, A Day In the Life: Acute Dialysis Nurse, [accessed December, 2020] https://www.annanurse.org/download/reference/practice/acuteDay.pdf