Hemodialysis nursing is a specialty for those who manage patients with renal dysfunction and require dialysis. The process of hemodialysis is performed to rid the body of toxic substances, a job that is normally done by the kidneys. The hemodialysis nurse manages the entire procedure and guides the patient through the process, ensuring most importantly that every step involved is performed in a sterile manner.
The kidneys play a vital role in the removal of toxins from the body. Renal failure may be acute or chronic and, if severe, may require dialysis, either hemodialysis or peritoneal dialysis, both of which will require hemodialysis nursing, in conjunction with specialist intervention. Acute renal failure may occur due to a number of causes including a renal stone blocking the tubules, severe dehydration, as a side effect of some medications or due to major blood loss. It may require short-term dialysis until kidney function improves.
Chronic renal failure has numerous causes, including genetically-inherited disorders or as a long-term side effect of diabetes or inflammation. Once the kidneys become too damaged to cope with the removal of waste products, dialysis, sometimes long-term, may become necessary. The kidney function is monitored by measuring the creatinine and urea levels in the blood. These are waste products that should be removed by the kidneys, so if their levels go up, it is a sign of renal dysfunction. When specializing in hemodialysis nursing, the nurse will learn how to read these results.
The process of hemodialysis involves the removal of the patient's blood and its passing through the dialysis machine, where toxins will be removed through a filter on the other side of which is a fluid called diasylate, which extracts the toxins. This leaves the blood clean and it is then returned into the body. Hemodialysis nursing encompasses all these processes - from the setting up of the machine, ensuring the correct diasylate is used and, most importantly, making sure that sterile procedure is followed throughout, to prevent any infection.
When choosing to specialize in hemodialysis nursing the nurse will already have completed her nursing training and, usually, have some experience working in a renal unit. Training is normally done on-site in the dialysis unit. Dialysis is most commonly performed in a hospital. In some chronic cases, it may be done in the home, so hemodialysis nurses may choose to be involved in home visits where they will both assist the patient and educate them and their carers.