A dialysis nurse is an expert in treating patients with acute and chronic kidney diseases. For this kind of treatment, additional training is required since nursing patients with a kidney disease is different from nursing patients in a hospital ward like most of us know. Being a dialysis nurse includes the support and monitor of a patient as well as to medicate and educate the patients. This kind of nursing field, like every other kind of specialty, will make a difference in the wellbeing of a patient and extend their lifespan.

In this article we will interview one of three dialysis nurses working in Africa. Our goal is to find out what it is like to be a dialysis nurse and which challenges they have to deal with.

 

Nurse, please introduce yourself

My name is Nicola Ferreira and I’m a Clinical Technologist. I have been blessed to work in the dialysis world for about 10 and a half years. In South Africa a dialysis nurse can either be a clinical technologist or a registered nurse.  Some nurses specialise in Nephrology to gain more knowledge on Nephrology. For 7 years I worked on different kind of renal replacement therapies as a dialysis nurse. Ranging from acute renal replacement therapies, Haemodialysis and Peritoneal dialysis.  After that I became a Clinic Manager where my responsibility was to look after a clinic holistically ranging from the patients to the staff.  2 years later my role changed to a Regional Manager where I was responsible to lead a few clinics.  Currently I am a quality auditor and my main role is to ensure that quality is adhered to in clinics. I have to support staff to ensure better patient care.

Why did you choose a job in this field? Why are you interested in this particular job?

In Clinical Technology one must choose between 7 fields and I chose Nephrology.  I love to work with people, to help sick people and to make a difference in the world. In our second year of study, students have to rotate to all different specialities to see where they will fit in and in what career path, they want to grow in.  I loved Nephrology from the beginning. The first time I walked into a dialysis clinic, I knew I was home. To walk and support this difficult journey with a patient that is diagnosed with a chronic illness must be a passion and not seen as a job.  Dialysis is such an interesting field with so many different kinds of angles and therapies.  Dialysis truly gives people with chronic kidney disease a second chance and a quality of life. With dialysis treatment, you grow a bond with a patient, you are a piece of their life puzzle and they will always remember how you made them feel.  To help people get better and to be part of their journey is what I’m living for.

 

Are there any desirable personality traits that a dialysis nurse should have?

  • Accurate and precise recording keeping.
  • Clinical skills.
  • Cope well with change.
  • Dedication and passion for what you do.
  • Empathy.
  • Excellent interpersonal skills.
  • Experience and thorough knowledge of renal anatomy and physiology of the renal disease and treatment modalities and equipment used.
  • Flexibility.
  • Hard worker.
  • Patience.
  • Polite, Professional patient orientated, empathetic manner.
  • Professional attitude.
  • Proven ability to cope with conflict, stress and crisis situations.
  • Team player.
  • Willing to go above and beyond work of scope.

Describe the position of a dialysis nurse.

Overall Responsibility:

  • To assist and improve the quality of life in patients that is diagnosed with end-stage renal disease and to conduct their renal replacement therapy.
  • Frequent patient education.
  • Nursing Competency in Renal Replacement therapies like Haemodialysis and Peritoneal dialysis to ensure quality care and improving patient’s quality of life.
  • Nursing care according to individuals’ scope of practice and quality operating practice according company/country specific protocols.

Dialysis Duties:

  • Admission of the patient into the acute or chronic treatment clinic. Obtain patient information and medical history and updating this information as the need arises.
  • Preparation to initiate treatment procedure and preparation of the machine as per prescription.
  •  Monitoring and recording of baseline vital signs as well as vital signs throughout the treatment.
  •  Clinical management of patient throughout treatment.
  •  Any other orders as per doctor’s prescription or clinic protocols.
  •  Administration of prescribed medication as per doctor’s orders.
  •  Doctor’s round and implementation of doctor’s orders.
  •  Disinfection of equipment as per protocol.

 

As a team leader, how would you lead your team?

Firstly, by example, practice what you preach, people and patients will respect you for that.  To be open and honest at all times. To be approachable and to be open for change. To involve the whole team as each member of the team has attributes that contributes to quality care. Daily communication is a vital key. To work collaborative as a team, to be reliable, to be proactive in all you do and to be excellent in what you do.  As a team leader one has to manage the clinic as a whole and all aspects has to be looked at to ensure quality patient care.

Overall Responsibility:

  • Directs, administers, and coordinates the internal day-to-day operational activities of the clinic in accordance with policies, strategic goals, and objectives established.
  • Driving team performance and controlling training and development of staff.
  • Ensure patient care is adhered to.
  • Leads and directs the delivering growth.
  • Maintaining and increasing standards of customer service and other areas across the clinics.
  • Providing a stimulating and supportive environment.

Qualities and skills of a team leader:

  • Ability to anticipate, evaluate risks and propose solutions.
  • Assurance and charisma.
  • Customer orientated and good decision-making skills.
  • Excellent interpersonal and communication skills.
  • Leadership.
  • Management style encouraging delegation and polyvalence.
  • Strategic vision.
  • Good negotiation skills, problem solving and critical thinking abilities and stress management.

How flexible is your schedule?

As a dialysis nurse one works as per operational need. Each clinic has different operating times so each nurses’ schedule will be as per their specific clinic. I’m available 24 hours per day for telephonic support.

 

What is most challenging about dialysis patient care?

To manage patient care well, one has to manage the patient holistically and all angles involved. Some of these angles are out of the patient’s control like support at home, financial support, etc. It’s difficult to support a patient if there are factors outside their control that can’t be managed as it does have an influence on their health care.  One can only support a patient emotionally in that regard.

 

Working with patients for a long time, you build up a relationship. How close do you get to the patients?

Patients become like family. You interact with them on a weekly basis and as a dialysis nurse you are part of all major parts of that patient’s life. You are there through graduations, weddings, birthdays, etc.  One has to learn to be professional at all times.

 

How do you deal with difficult patients?

I listen. I validate what they say and try to help to resolve the problem at hand. I don’t think there are difficult patients. One must ask yourself why the patient is difficult?  What is the need of that person and how can you assist that person? Dialysis is difficult, to be diagnosed with a chronic disease is difficult, sometimes people just want to be listened to, supported and cared for.

How are you handling the dialysis treatment during the corona crisis?

  • Dialysis is a life sustaining treatment, so foremost treatment must continue.
  • Daily communication with patients and staff.
  • Daily vitals of all patients and staff.
  • Emotional support for staff and patients, mental health is key.
  • Ensure policies are in place for if you do have a staff member or patient that gets diagnosed with corona.
  • Implement more hygiene measures in your clinic. For example, no eating, wearing of masks, hand hygiene, disposable foot wear, etc.
  • Nephrologist involvement is key.
  • Patient education is key.
  • To educate staff about procedures.
  • To ensure enough personal protective equipment.
  • To reassure patients that you will still be there even if they do get sick.
  • To talk to your patients, to reassure them that you are there for them during this time.

 

Thank you, Nicola Ferreira, for your time to do this interview with us. All the best of luck to you and your colleagues in making a difference in your patients’ life.

Keywords: Dialysis Nurse, Clinical Technologist, Dialysis Patient Care, Corona Crisis

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