In no small way was my decision to pursue nephrology influenced by the incredible nurses I met, learned from, and worked side-by-side with during my training. More than most—if not all—other medical disciplines, nephrology nurses act as advocates to ensure our patients live their best possible lives. 

During the past year of the pandemic, it was clear not only to me—but to the world—that our nephrology nurses are superheroes. Converting dialysis units to care for COVID-19 patients, our nurses placed kidney and lifesaving care for patients ahead of their own personal safety. As nephrologists, we are privileged to work with these exceptional team-members. 

I asked Walter Aguilar, RN, CNN, who is clinical coordinator for the Renal Dialysis Unit at Northwestern Memorial Hospital, to share some of his thoughts. I am forever grateful to him, his incredible team, and to all nephrology nurses around the world for their dedication and commitment to improve the lives of patients with kidney diseases.

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ASN appreciates Mr. Aguilar taking the time from his very busy schedule to answer a couple questions. His responses below illustrate why so many professionals and patients revere nephrology nurses and their contributions to advancing care.

How did you get started in nephrology nursing?

I have been working in nephrology for about 25 years. I have worked in different dialysis roles and settings, ranging from chronic dialysis to my current position in acute dialysis. 

My career in dialysis started when I first worked as a dialysis technician in the dialyzer reuse room. Then I moved to the dialysis floor and started working as a patient care technician and had close contact with patients. As a dialysis technician, I found it rewarding to work with patients and their families. I developed close bonds with the patients I served on the floor during my time there. The job required me to be alert and attentive. Although the work was demanding, I enjoyed knowing that my work was ultimately assisting my patients. 

My relationship with my patients and their families was eventually what pushed me to pursue a nursing degree because I wanted to be able to help them in a larger capacity. My skills as a patient care technician helped me with my nursing career in the care needed for a dialysis patient. Also, I noticed that there was a great need for bilingual nurses since many of the patients at the clinic were Hispanic and English was often their second language. I felt that these patients needed my help and they trusted me to provide them with great care and diligence due to my cultural competency. Supporting this difficult journey of a patient diagnosed with a chronic kidney disease (CKD) became my passion over the years. Dialysis truly gives people with CKD a second chance and a quality of life.

What are some of the biggest challenges for the people you and your team care for?
 
Dialysis nurses are crucial in assisting patients with CKD. I have seen many challenges through my years as a dialysis nurse. 

CKD patients requiring dialysis face depressing lifestyle changes. Dialysis patients often struggle to keep up with their care plan. There are times where patients underestimate the severity of their symptoms and prolong seeking care, which can have negative consequences to their overall health. In addition, dietary guidelines must be followed; prescriptions need to be refilled and taken accordingly. For new patients, their diagnosis can be stressful. This might lead to instances of denial or depression. 

In my career as a dialysis nurse, I have learned the value of educating patients, guiding them in regaining control of their care and decision-making, and enabling them to engage actively in their dialysis treatment. A good relationship between the patient and their healthcare provider is important. Patients need to know that they can be open and honest about their needs and concerns so that nurses can better advocate for them.