National Nurses Week: Dialysis nurses take pride in administering life-saving treatment

Registered nurses Tamra Swain and Ashley Dunning, left, along with clinic manager Luke Moll and home therapies manager Casey Mirly pose for a photo next to the Fresenius Kidney Care clinic sign.

J.C. Reeves ~ Southeast Missourian

According to the Centers for Disease Control and Prevention, 15% of adults — approximately 37 million people — in the United States suffer from chronic kidney disease, which can lead to end-stage renal disease or kidney failure, requiring dialysis treatments to filter blood.

When a patient with kidney failure undergoes dialysis treatments, nurses are responsible for ensuring the patient receives the needed care to keep them alive and improve their quality of life.

But a dialysis nurse’s job isn’t just to hook a patient up to the dialyzer and unhook them at the end of treatment. Nurses also consistently check their patients' vital signs, provide medication, educate patients on their condition and even help arrange transportation to and from the facility.

At Fresenius Kidney Care’s Cape Girardeau clinic, a nurse’s day starts early and ends late. Nurses arrive for work every day at 5 a.m. and typically work 10 to 12-hour shifts five days per week to provide appropriate care for their patients. Clinic manager Luke Moll said the nurses help take some of the pressure off of him.

“I think they make my job easier,” Moll said. “It's a learning process. I'm trying to pass down knowledge that I've gained over the past two to three years so that they can increase their's and know how to handle certain situations. We have doctors that round, and we have their orders and all that, but there's not always a doctor in the building. … You have to have a lot of faith and trust in your nurses when they're here that they're going to oversee good care for the patients.”

Tamra Swain and Ashley Dunning are two of the five registered nurses who oversee patients at Fresenius Kidney Care’s Cape Girardeau clinic. Swain is a Dexter native with 14 years of nursing experience while Dunning, a Jackson native, has 10. Both have spent the past two years working at the clinic.

Swain has been a jill of all trades during her nursing career. While she was in nursing school at Southeast Missouri State University, Swain worked in Southeast Hospital’s — now Mercy Hospital Southeast —  medical lab before moving to a clinical teaching unit (CTU). Following her education, she worked in the hospital’s cardiac progressive unit, emergency room and cardiac rehabilitation before deciding to take the job at Fresenius.

“I worked with Luke (Moll) in the emergency room,” Swain said. “I had applied at other dialysis centers, but one was too far away, and I didn't want to drive that far. When I came here, I knew Luke and lots of other people here. They were my family from the emergency room, we had all worked together, and it just felt like home.”

Before becoming a nursing major, Swain studied environmental science. After realizing her limitations with an environmental science degree, she decided to begin studying nursing due to the abundance of job opportunities.

“Basically, I can go anywhere and find a job,” Swain said. “It's limitless with nursing. So I decided to switch my major.”

Dunning’s desire to become a nurse, however, began as a child when her uncle suffered a stroke while babysitting her. Not knowing what to do, Dunning called her grandmother, who called emergency services.

“I got to kind of watch the whole process of them taking him, and I wanted to be able to help him. but I didn't know how to help him other than to call my grandma,” Dunning said. “Since then, I’ve kind of thought, ‘Maybe this is what I need to do with my life.’ Whenever we did (career assessments) in high school, it always said nursing was what I needed to do. So I finally decided to do it.”

Dunning’s interest in dialysis treatment ultimately led her to Fresenius after spending eight years working elsewhere. While she worked with patients who were on dialysis before Fresenius, she had never administered the treatment herself.

“I kind of just wanted to learn the dialysis side of nursing,” Dunning said. “I also work on the hospital side, and we have a lot of dialysis patients there that rotate through, and I never fully understood it. I got the basic process of what dialysis was, but I wanted to learn the actual administration of the whole treatment.”

A nurse’s relationship with their patients plays a major role in their treatment. Since most dialysis patients require ongoing treatment for the rest of their lives, they tend to develop a camaraderie with their nurses.

“In a hospital setting, you'd see them for a week or two and that was it,” Dunning said. “Here, I’m two years in, and I still have the same patients, and you can get that personalized experience where everybody has their likes and dislikes. You kind of feel like you’re a family in a way, and you just get to build that bond with them.”

The ultimate goal for a patient suffering from kidney failure is to receive a transplant. When it happens with patients at the clinic, the nurses feel a sense of pride while the clinic's other patients develop hope for themselves.

"Sometimes we can see them going downhill, just getting worse and worse. All of a sudden, they get a phone call, and they go and get their kidney and then they're done," Dunning said. "That's probably the best part of it, knowing we allowed them to stay alive until they got to that point. Now they have all this extra time with their family. They can fulfill the rest of their life and do whatever is left for them to do."