Dialysis nurses care for patients during a procedure that filters a patient’s entire blood volume through a machine that acts as an external kidney. Patients who need dialysis have severe kidney disease and need help cleaning the toxins out of their blood. Normally done three days a week, dialysis takes an average of four hours each session.
Most patients with severe kidney dysfunction are in the adult or older adult age range, but some pediatric patients may also need these treatments. Dialysis nurses can work in an outpatient clinic or hospital. They perform dialysis treatments and contact patients with reminders and follow-up questions. Patients sometimes skip dialysis sessions because of transportation or even because they don’t understand the necessity. Dialysis nurses work hard to educate their patients and ensure no outside factors get in the way of patients receiving treatment.
Where Do Dialysis Nurses Work?
Dialysis nurses can work in a few different healthcare settings:
Dialysis clinics
Hospitals
Home health care
Long-term care
Nursing homes
Skilled nursing facilities
Universities
Dialysis clinics are dotted throughout communities to provide treatment close to home. These are privately operated healthcare companies where patients can go to receive dialysis.
Patients who normally need dialysis are sometimes admitted to the hospital and still require the procedure while there. Almost every hospital has a dialysis department, or at least nurses on staff who can perform dialysis at their bedside. In the hospital, some dialysis nurses also perform continuous renal replacement therapy, which filters the blood over a longer period (about 24 hours). This option is used for unstable patients, as it’s hemodynamically gentler.
Dialysis nurses can’t perform hemodialysis in patients’ homes, but they can do peritoneal dialysis (dialysis through the abdominal cavity). Many patients can complete their own peritoneal dialysis after thorough education from their home dialysis nurse. Some nursing homes or skilled nursing facilities hire a full- or part-time dialysis nurse if they have enough patients that require this treatment.
What Does a Dialysis Nurse Do?
When a patient arrives at a hospital dialysis suite or a private clinic, dialysis nurses must first access their fistula, which is a large two-channel IV in the patient’s arm or chest. During the next three to five hours, the patient’s entire blood volume is filtered through a machine, which does what a kidney would normally do.
The patient may not have much to do during this time, but their dialysis nurse must monitor the patient’s vital signs, intravenous access, and electrolyte counts. They also address their patients’ basic needs, such as toileting and meals. Some typical tasks for dialysis nurses include:
Collaboration with physicians, nurse practitioners, patients, and families
Collecting blood and body fluid for laboratory testing
Emergency resuscitation
Identifying dialysis reactions
Maintaining nursing care plans
Medication administration
Patient and family education
Patient hygiene
Pre- and post-procedure care
Priming dialyzer and bloodlines
Scheduling dialysis treatments
Troubleshooting dialysis equipment
Vital signs monitoring
Dialysis nurses often manage more than one patient at a time and must learn how to address the needs of each patient concurrently.
How Do I Become a Dialysis Nurse?
For those who wish to become dialysis nurses, the first step is to graduate from an accredited nursing program with a Bachelor of Science in Nursing (BSN). After graduating with this degree, which typically takes four years, nurses can work in health settings as graduate nurses (GNs).
Many hospitals and dialysis clinics hire nurses as GNs and train them until they pass their state licensing exam, the National Council Licensure Examination (NCLEX-RN). After they pass the NCLEX, GNs become registered nurses (RNs), and after their orientation period, can practice nursing independently.
After some experience, dialysis nurses can further their education with an advanced practice degree and become nurse practitioners (NPs). Dialysis nurses can accomplish this by earning a Master of Science in Nursing (MSN). It’s possible to graduate with an MSN in two years, but it may take longer to complete this degree while working full-time.
Complete a minimum of 3,000 hours of experience in multiple areas of dialysis nursing within the three years before application
Have a BSN or MSN degree
Have completed thirty contact hours of approved continuing education credit in dialysis nursing within the last three years
For nurses who work in an outpatient hemodialysis facility, at least 750 hours of their 3,000 hours of experience must be in at least one of these settings:
Apheresis
CKD management NOT on kidney replacement therapy
Home hemodialysis
Home peritoneal dialysis
Inpatient acute kidney injury on kidney replacement therapy
Inpatient critical care on kidney replacement therapy
Kidney transplant
How Much Does a Dialysis Nurse Make Per Year?
Dialysis nurses can expect to earn the same as any other RN, which is an average of $81,220 per year as of 2022, according to the U.S. Bureau of Labor Statistics (BLS). Salaries can vary depending on location and experience, from a low-end average of $61,250 to a high-end of $129,400. Depending on your workplace, your employer may be able to offer higher or lower compensation:
General Medical and Surgical Hospitals: $90,600
Outpatient Care Centers: $97,200
Home Health Care Services: $82,920
Nursing Care Facilities (Skilled Nursing Facilities): $77,190
Salaries also vary depending on which state a dialysis nurse practices. The West Coast, New England states, and Alaska pay their nurses the best, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
Dialysis nurse practitioner salaries can start higher than RNs’, with average annual earnings of $121,610, according to BLS data from 2022. The low-end average was $87,340, and the high-end was $165,240. Salary can also change based on employment type:
General Medical and Surgical Hospitals: $129,330
Offices of Physicians: $121,880
Offices of Other Health Practitioners: $112,660
Outpatient Care Centers: $134,030
Home Health Care Services: $148,960
The location of employment can affect nurse practitioners as well, with differences similar to RNs.
The top paying areas for dialysis nurses and nurse practitioners include:
San Jose-Sunnyvale-Santa Clara, CA
San Francisco-Oakland-Hayward, CA
Napa, CA
Vallejo-Fairfield, CA
New York-Newark-Jersey City, NY-NJ
Yuba City, CA
Sacramento–Roseville–Arden-Arcade, CA
Dialysis nurses with a specialty certification can earn more than nurses who are not certified. The more experience a dialysis nurse has, the more they can earn.
Are Dialysis Nurses in High Demand?
According to the National Institutes of Health (NIH), one out of every seven adults in America has chronic kidney disease (CKD). Over 800,000 people in the U.S. live with end-stage renal disease (ESRD) and almost 70% are on dialysis.
Nurses from all specialties are in short supply in the United States. The U.S. Department of Health and Human Services reports that 24% of U.S. hospitals have critical staffing shortages. As a large volume of the American population ages, dialysis nurse demand may continue to rise.
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