There are basically two different types of hemodialysis jobs — nurses and technicians. Dialysis nurses generally have a registered nursing (RN) license and are certified in nephrology. They monitor patients before, during, and after the procedure, as well as supervise technicians. Being responsible for observing patients also, dialysis technicians deal more with operating the machines.
A replacement therapy for those with renal failure, hemodialysis is a procedure by which the blood is cleansed of waste products, primarily in the form of urea and creatinine. Kidneys usually handle this important job, but, when these organs fail, it can be fatal. The dialysis machine is a substitute for them.
Under the nephrology nursing category, there are several titles, any of which are a qualification for hemodialysis jobs: certified nephrology nurse (CNN), certified dialysis nurse (CDN), and certified nephrology nurse practitioner (CNN-NP). While practice settings vary, most nurses with these credentials typically work in acute care settings. Some also provide treatment in the home.
It is possible for nurses to get started working in hemodialysis without certification or prior experience, as many chronic dialysis centers and units will even hire new graduates. Acute care dialysis, on the other hand, is different because the patients are very ill and their cases are more complex. Hemodialysis nurses staffing acute care units always require certification and a background in critical or intensive care.
When a patient undergoes dialysis, the nurse does an initial assessment and starts the procedure. Anticoagulants are administered, drugs given to prevent the formation of blood clots. Patients are then monitored closely for problems, as the machine is not as proficient as the human kidney. All care and treatment details are documented in the patient's record.
Technicians occupy hemodialysis jobs at the entry-level, and completion of a degree is not required. Training programs are short, lasting only a few weeks to several months, depending on the school. Most of the time, longer-lasting hemodialysis technician programs qualify students to take the certification examination. The Board of Nephrology Examiners Nursing and Technology (BONENT) is the agency that certifies dialysis technicians.
Besides observing patients, technicians monitor vitals as well as the machine's operation to ensure proper functioning during treatment. Weight measurements are taken before and after the procedure and recorded. Setting up and cleaning the equipment after its use is also the technician's responsibility.
In the past, dialysis centers let technicians work without certification while getting trained on the job. That has changed for the most part, as it is now a minimal requirement for hemodialysis jobs. State certification is necessary in certain places in the United States, in addition to the one provided through BONENT.
