Dialysis Nurse

Sometimes nurses find their callings in the strangest places.

Peggy Depascal works at Satellite Wellbound in San Jose as a Dialysis nurse.   While Peggy admits that she wasn’t necessarily looking to become a Dialysis RN, a lot of times the careers we are all meant for somehow find us.

Peggy began her career as a Registered Nurse (RN) in 1992, and became a dialysis RN in 1998.  She has worked in her unit for fifteen years now, and was willing to share that experience with us.  Thanks Peggy!

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Can you tell us about your career as a dialysis nurse?

Well I didn’t get into it because I thought, “Gee, I’m really interested in dialysis.”

Truthfully, I was working as an RN in a hospital on a medical-surgical unit and had worked every other weekend on night shifts full time for 6 years. My husband worked a regular day job with weekends off so I was looking for something that was more in line with his schedule.

I saw an ad in an RN journal that was for straight days, weekends and all holidays off. Well, that is an RN’s dream that rarely becomes a reality.

They asked for experience in dialysis, which I had none, but I applied anyways. At that time, I didn’t care what the specialty was. I was sure I would never hear from them, but to my surprise I did.

The hiring manager thought I had potential and as there were not enough dialysis RN’s at that time, she took a chance with me and the rest is history. So technically, I did not pick dialysis, it picked me! I have recently hired a new grad RN, who’s developed into a wonderful home-dialysis RN with Satellite WellBound, and told her that it is rare to pick your specialty, it usually picks you.

“Welcome to dialysis, you have just been chosen.”

What are the common cases you see throughout your day? Can you tell us what a 9-5 day looks like working at your facility?

Most dialysis RN’s start in-center and move to home therapies, like Satellite WellBound, but I have always worked in the home therapies so our days are little different. We see our home dialysis patients every month, unlike in-center where patients are seen three times a week. A typical day for me will have some routine monthly lab work and check-ups. However, when you are at a center that has over 100 home dialysis patients, there are bound to be unexpected issues each and every day.

What aspects of your job do you love?

When I first meet a patient, it is usually when they first find out that they need to be on dialysis and have to come to me for education. They have no idea what dialysis really involves, but they do know that it is going to be a life-changing event.

I’m sometimes the first person that fully explains what home dialysis is. That this modality choice gives them the opportunity to do dialysis for themselves at home and they do not have to be reliant on someone else’s schedule or let someone else control their lives. They can still work, travel etc.

If they do choose to do home dialysis through WellBound, we work with them through the learning/training process. We have a very unique relationship with our patients, because so much time is spent one on one during training. We have helped to get them over a very difficult time in their lives and master new skills that they never imagined they would have to do. .

Are there challenges you face as a dialysis nurse that someone looking to get into this profession should know about?

In the dialysis profession there is almost always someone who needs dialysis and with Satellite WellBound, there is almost always someone in training to learn how to do dialysis at home. So routine appointments are challenged with issues from equipment failure, access problems, infections, medication refills, to social problems..

The list of “challenges” is long and just when you think there is nothing you haven’t seen; someone surprises you with something new. There are many times those my “to-do” list we create for the day doesn’t get done, because we were busy all day with helping patients.

Another challenge that comes up frequently is kidney patients not accepting they now need dialysis even when they think they don’t because they have felt the same for so long. The Nephrologists will encourage them to start getting prepared ahead of time, but sometimes they don’t and we have to scramble to get them trained so that they don’t land up having to start their dialysis treatments “in center” while training for home.

In order to get a job in dialysis what kind of experience or qualifications are best to have to get your foot in the door?

When I’m looking at a new candidate to hire as an RN in home dialysis at Satellite WellBound, I’m not looking at dialysis experience as much as I’m looking at enthusiasm and work attitude. I want someone who is smart, who has a passion for teaching and can “go with the flow” . Someone rigid is not going to be effective in this environment. I can teach someone how to do dialysis but I can’t teach enthusiasm or the “get it done” attitude.

Any final words of advice for someone looking to enter into the dialysis nursing career field?

FLEXIBILITY – You cannot expect any two trainings to go exactly the same and you have to be able to adjust your teaching skills to suit the patients learning styles. It also depends on where your patient is in acceptance of the entire disease process. We all would like to start a job, finish it, then move on to the next task, but that is not the life of a dialysis nurse. You have to be able to juggle two, three things at once. If you don’t flourish in a hectic environment, as many do not, the dialysis specialty may not be the best fit for you. But if you thrive in a fast pace environment and from the fulfillment of helping patients find hope in living then this is for you.