Over the past 30 years, nephrology nursing has evolved into a specialty that requires both technical skills, as well as clinical expertise in treating patients with chronic kidney disease (CKD).  The demand for nephrology nurses will continue to grow as the number of patients diagnosed with CKD is expected to reach over one million by the year 2015.

Position Description

Nephrology nursing is a specialized area of nursing practice that treats those patients with kidney disease and educates both patients and families with regard to treatment protocols.  Nephrology nurses assume a wide range of responsibilities from clinical care to administration.  Nephrology nurses practice in the following health care settings:

Community clinics
Out-patient dialysis centres
In-patient dialysis
departments
Transplant units
Home care
Medical device industry
Pharmaceutical industry
Government and nonprofit health care settings

The nephrology nurse coordinates and provides training and supervision for dialysis staff.

Nephrology Nursing Responsibilities

The nephrology nurse must adhere to all applicable state and territory regulations for practice. The nephrology nurse works with both pediatric and adult patients with kidney disease.  The nephrology nurse working in a dialysis unit may be responsible for delivery of primary nursing care for patients with CKS. Specific duties include:

Patient assessment and development of care plan in collaboration with other members of the health care team.
Identification of risk factors
Patient and family education with regard to treatment protocols to help manage expectations
Initiation of dialysis treatment, patient and equipment status during the dialysis treatment, and termination of the dialysis
In-home training to patients and their families with regard to dialysis administration
Provision of nursing care prior to during and post renal transplant

The nephrology nurse may also be involved with the provision of secondary care and case management of patients with CKS. Duties in this area include:

Explaining treatment methods to patients and their families
Coordination of multidisciplinary health care team to provide care for CKS patients and educate families
Provision of nursing intervention to prevent complications of dialysis treatment, thereby decreasing the need for patient hospitalization
Assisting patients toward full rehabilitation    


The nephrology nurse may also be involved with tertiary care of patients with CKD. Such care involves more complicated treatment methods and usually occurs in an intensive care setting. Duties may include:

Acute dialysis, with the goal being to reduce morbidity and extend life
Coordinating care with multidisciplinary health care team

Qualifications

The nephrology nurse must possess knowledge in each of the following areas:

Anatomy and physiology
Nephrology nursing practice
Pharmacology
Nutrition
Psychosocial aspects of CKD
Principles of dialysis treatment
Circulatory process for hemodialysis
Concepts of renal transplant

Education and Training Requirements

Nephrology nurses must hold a registered nurse registration and graduate from an advanced (graduate) training program that will include study in clinical as well as theoretical aspects of CKD treatments.

To become a registered nurse, it is necessary to complete a Bachelor of Nursing program that can be completed in three years of full time study (or equivalent part time attendance) Upon successful completion of the Bachelor of Nursing degree, the graduate will have attained the competency level set by the Australian Nursing and Midwifery Council (ANMC) and be eligible to apply to the Nursing and Midwifery Board (of) Australia (NMBA) for entry into the register. Following registration, the nurse can then enter a professional practice program (Graduate Nurse Program) in Nephrology Nursing.

The post-registration/professional entry degree is studied on a full-time basis over an 18 month period (or equivalent part time study). To gain admittance to a post-registration/professional degree program, candidates must be a registered midwife and hold a current practicing certificate.

Salaries and Work Environment

The nephrology nurse may be required to work 8, 10, or 12 hour shifts and those in acute hemodialysis settings may be on=call 24 hours a day, 7 days per week.

The Australian Nursing Federation is the national union for nurses and midwives in Australia. The main function of the ANF is the industrial and professional representation of nurses and midwives through the main office and branch locations in every state and Territory. 

The salaries and working conditions of nurses in Australia are regulated by various awards and agreements. In general, award of the Australian Industrial Relations Commission or state industrial agencies provided the legal minimum for salaries and working conditions.  Nurses within the public health sector or in private health care settings are covered by an industrial agreement that includes additional salaries and working condition covenants.

While there is some degree of consistency, the salaries and working conditions of nurses can vary depending on the state or territory where the nurse is employed, as well as specialty area.  For additional information regarding salaries and conditions of employment you can visit the website of the Australian Nursing Federation branch in the State or Territory where you wish to work. 

Job Outlook

There is a severe shortage of nephrology nurses throughout Australia.  In New South Wales alone, it is estimated that the number of CKD patients will increase each year at a rate of about 3.6 percent. However, this rate of increase varies from 3.2 percent to 6.8 percent according to specific state and territory risk factors. This situation translates into a high demand for nephrology nurses through the year 2020.