The practice of the Nephrology Nurse is directed toward assessing the health needs of pediatric patients and their families who are experiencing the real or threatened impact of chronic kidney disease (CKD), nephrotic syndrome, glomerular diseases, hypertension or any other type of nephrologic disease. The nurse is responsible for assisting the pediatric Nephrology team by assisting in diagnosing, treating and monitoring their responses to their medical treatment plan. The nurse implements outpatient treatment nursing interventions for nephrology patients and provides continuity for these patients and their families within inpatient, outpatient and community settings. The Nephrology Nurse Coordinator has the advanced knowledge and clinical skills to provide expert care and consultation for pediatric nephrology patients and their families. The nurse must also have at least 12 months experience in providing nursing care. The nurse collaborates with the Pediatric Interdisciplinary Team, including but not limited to, nursing service, nephrology/dialysis and transplant services, social services, nutrition services and outside agencies to ensure high quality comprehensive care for the patients and their families.
Principal Duties and Responsibilities:
The Nephrology Nurse assists the chronic kidney disease (CKD) patient in achieving the outcomes recommended in the KDOQI Guidelines including those for but not limited to: anemia, hypertension, fluid management, nutrition and bone health, urine output, activity and development, coping, family process, self-concept, sexuality (adolescent), and future treatment modality selection.
A. Initial Evaluation: The Nephrology Nurse will assess the patient and/or primary caregiver’s:
- Cognitive and psychomotor skills to manage treatment and emergencies
- Physical condition
- Emotional status
- Caregiver’s cognitive and psychomotor skills, physical condition, emotional status and reliability
B. Patient Education:
1. Update/maintain nephrology educational handouts and binders (English and Spanish versions)
2. Assess patient/caregiver’s current level of knowledge related to disease, diet, medication, current treatment plan and future treatment alternatives
3. Assess patient/caregiver’s ability and readiness to learn
4. Identify barriers to learning
5. Evaluate effectiveness of teaching by verbal feedback, observation/re-demonstration of performance.
6. Develop a multidisciplinary teaching plan when necessary and involve patient/caregiver in development of the plan.
7. Implement an individualized teaching plan when necessary.
8. Assist in ongoing patient care needs, such as:
(1.) Maintenance of home care records.
(2.) Ordering/inventory of supplies, including arranging of delivering of home supplies as ordered by Nephrology team.
(3.) Plans for follow-up appointments, referrals and consults as ordered by Nephrology team.
(4.) Emergency communications systems, how to reach the on-call MD/RN.
(5.) Arranges for lab tests, and diagnostic procedures when indicated in outside facilities as well as at LPCH.
(6.) Arranges for pharmacy services in outside facilities as well as at LPCH.
(7.) Arranges for home visiting nurse services and ancillary services when appropriate.
(8.) Assists in completing the patient’s work-up for kidney transplantation.
C. Ongoing Monitoring:
(1.) Review treatment records on a regular basis.
(2.) Review results of laboratory studies.
(3.) Review current medication regimen.
(4.) Maintain telephone contact with patient/caregiver.
(5.) Assist in scheduling regular follow-up appointments.
(6.) Assist in coordinating appropriate follow-up by other members of the multidisciplinary team.
(7.) Provide patient teaching/re-education based on identified learning needs.
1. Collaborates with the multidisciplinary team to determine patient needs by participating in all outpatient nephrology clinics.
2. Participates in patient care conferences.
3. Communicates with outside agencies (e.g. schools, nursing agencies, PMD offices, labs, pharmacies, insurance companies) to ensure continuity of care.
Pediatric Nephrology Nurse shall be competent and possess current, comprehensive knowledge and skills in pediatric nephrology nursing practice.
A. The professional registered nurse will meet entry-level qualification that include but are not limited to:
1. Graduation from a NLN accredited school of nursing.
2. Current California RN license.
3. BSN (or current enrollment in BSN program) preferred and encouraged.
4. CNN certification, obtained or working towards (Certified Nephrology Nurse - Nephrology Nursing Certification Board within 2 years after starting position with BSN).
5. Clinical experience with Pediatric renal failure patients preferred.
6. Clinical practice knowledge base related to the nursing process.
7. Past experience with pediatric nephrology patients preferred.
8. Basic Life Support Certification / Pediatric Advanced Life Support (PALS) encouraged.
9. Demonstrated organizational skills and the ability to work closely with others as a team member.
10. Ability to work with individuals of a diverse background and experience to create an effective working climate.