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• long-term relationships • compassionate care •
higher level of practice • professional growth
• recruitment and retention • collaboration • rich with The American
opportunity • networking
• professional commitment •
• ongoing challenges
nursing leaders Nephrology Nurses’
• make a difference • diversity • save lives daily •
rewarding and challenging • advocacy • long-
term relationships • compassionate care • continuity
• fulfilling career • collaboration • professional
goals • certification • ANNA • autonomy • professional
growth • diverse career paths • save lives • make
a difference • collaboration • holistic care
• long-term relationships • high-tech • professional
growth • compassionate care • continuity •
support system • mentoring • collaboration •
diverse • saving lives • collaboration • mentoring
• challenges and rewards • long-term Mission Statement
relationships • compassionate care • continuity of care
ANNA will advance nephrology nursing practice
and positively influence outcomes for patients with kidney or other
• bonding with patients and families • professional
disease processes requiring replacement therapies through
resources • leadership opportunities • advocacy, scholarship, and excellence.
diverse • save lives daily • long-term relationships
• compassionate care • bonding with patients and
Your career is your choice...
ANNA is here to help.
Nephrology Nursing is a dynamic,
diverse, and holistic practice. For more
than three decades, the specialty has
grown in scope and numbers.
Nephrology nurses use the nursing
process to care for patients of all ages
who are experiencing, or are at risk
for, kidney disease.
The broad scope of nephrology
nursing practice is what makes
the specialty both challenging and
ANNA’s mission is to advance the You’re in great company.
nephrology nursing specialty and to “The teamwork, the sense of family and “What I find most exciting and interesting about
camaraderie that can occur among dialysis the speciality is that we are truly dealing with every
nurture every ANNA member. We caregivers is phenomenally strong. I have seen this organ system. Nephrology nurses must be able to
achieve these goals by providing the spirit over and over again.” understand and recognize the pathophysiology of
Sybil V. Tomlinson, Regional Quality Manager many diseases.”
highest quality educational products, Birmingham, AL Anne E. Harty, Nurse Practitioner, Nephrology
programs, and services. Our members “Nephrology nursing is so diversified. You can Omaha, NE
are leaders who advocate for patients, choose from a variety of practice settings and roles; “Nephrology nurses save lives every day. That says
each has unique rewards and challenges.” it all.”
mentor each other, and lobby Jenny Bell, Transplant Coordinator Caroline Counts, ANNA President, 2003-04
legislators, all to inspire excellence. Scottsdale, AZ Charleston, SC
If you are a . . .
◆ Nursing student eager for a challenging and rewarding career
◆ Medical-surgical nurse who enjoys specialized patient care
◆ Nurse in another practice setting looking for a change
. . . nephrology nursing is perfect for you.
Nephrology Nursing Practice
Definition. Nephrology nursing involves Knowledge Base. Nephrology nursing
both preventing disease and assessing the practice requires a common knowledge base
health needs of patients and families. to care for pediatric, adult, and geriatric
patients with kidney disease.
Care spans the life cycle and involves
patients who are experiencing the real To provide optimum care tailored to
or threatened impact of acute or chronic each patient’s needs, specialized areas of
kidney failure. These patients need well- nephrology nursing have evolved, along
educated, highly skilled, motivated with nurses’ knowledge and skills.
These skills primarily relate to modalities of
Technological and educational advances therapy. These include:
make it a dynamic field, rich with a wide • Hemodialysis
variety of career opportunities for a new • Peritoneal dialysis
graduate or an experienced practitioner. • Transplantation
• Continuous renal replacement therapy
History. Nephrology has been recognized • Conservative management
as a specialty for over 35 years. In 1973,
• Other extracorporeal therapies
treatment for end stage kidney disease
by hemodialysis, peritoneal dialysis, or Nephrology nursing practice overlaps
transplantation was funded by the federal the boundaries of other specialty areas.
government and became more readily For example, transplant nurses now care
available. for patients who receive multi-organ
transplants. This diversity is one of the most
Since then, the role of the nephrology
appealing aspects to practitioners.
nurse has greatly expanded and practice
Unique to this specialty is the variety
of practice settings and roles.
Evolving and Expanding Roles
Nurses practicing in all areas of nephrology Opportunities
find exceptional opportunities and rewards. Nephrology nursing positions
are available in dialysis clinics,
Constant improvements in technology, new
hospitals, physician practices,
and superior medications, and advances in
transplant programs, and many
patient care challenge the mind. New career
paths open continuously. Learning never
ends. Standards of Practice
Practice is guided by the
Roles of the Nephrology Nurse ANNA Standards and Guidelines of Clinical
• Staff nurse, hospital or outpatient settings Practice and ANNA Scope and Standards of
• Hemodialysis/peritoneal dialysis nurse Advanced Practice in Nephrology Nursing
• Nurse manager (www.annanurse.org, “Publications”).
• Transplant coordinator Resources
• Organ recovery coordinator Sources of knowledge to support the wide
• Office nurse variety of nephrology nursing roles are found
• Nurse practitioner in many ANNA publications including the Core
Curriculum for Nephrology Nursing and
• Clinical nurse specialist
Contemporary Nephrology Nursing.
• Pharmaceutical representative
• Nurse researcher Certification
• Quality management Certification in nephrology nursing recognizes
an individual’s expertise in the specialty.
• Nurse educator
Certification can be achieved through the
• Corporate/sales Nephrology Nursing Certification Commission
• State or federal surveyor (www.nncc-exam.org).
• Approximately 20 million • The direct economic cost for
Americans have kidney disease. treating kidney failure is at least
• More men than women, more $20 billion a year in the U.S.
elderly than young, and more • The number of people diagnosed
African Americans and Hispanics with kidney failure has doubled
than Caucasians develop chronic each decade for the last 2 decades
kidney disease. and will likely continue to do so.
(Sources: National Kidney Disease Education Program, American Nephrology Nurses’ Association)
People of all ages, socioeconomic groups,
and races may develop some form of kidney Trends in Incident Rates
disease. When this progresses and >85% of by Primary Diagnosis
kidney function is lost, it is known as end stage
renal disease (ESRD). In these patients, the 350
kidneys are no longer removing waste products ALL
of metabolism and excess fluids, balancing 300
electrolytes, or regulating hormones.
Rate per million population
When patients reach ESRD, they must receive
replacement therapy either in the form of dialysis 200
Medicare Coverage or kidney transplant in order to survive.
One of the most significant At the end of 2000, over 450,000 patients were 150
factors influencing the growth of being treated for ESRD and 96,000 new patients
nephrology nursing was the 1973 started kidney replacement therapy that year. 100 Hypertension
(Source: United States Renal Data System 2002
extension of Medicare to cover Annual Data Report.) 50 Glomerulonephritis
treatment of kidney failure. This
helps pay the costs for dialysis Most patients receiving renal replacement Cystic Kidney
therapy undergo dialysis. While kidney transplant 0
or transplantation, regardless of 1992 1994 1996 1998 2000
is a treatment option for many ESRD patients,
the patient’s age. unfortunately, the need for donor organs U.S. Renal Data System, USRDS 2002 Annual Data Report: Atlas of
End-Stage Renal Disease in the U.S., National Institutes of Health,
exceeds the supply and results in long waiting National Institute of Diabetes and Digestive and Kidney Diseases,
times for those who do not have a living donor. Bethesda, MD, 2002.
spans a lifetime,
making nephrology nursing
an art and science of
Patients and Settings
Populations. The broad scope of The nurse’s role is to help patients manage
nephrology nursing practice reflects the their lives – succeed at school or work,
socialize, maintain relationships, or try a new • Patients often critically ill
diverse and challenging patient groups
nurses may encounter. hobby – while effectively dealing with their • Fast-paced practice
health issues. • Challenging
Patients include pediatric, adult, and
geriatric individuals from a variety of ethnic Practice Areas. Nephrology nursing
groups. They have acute or chronic kidney practice occurs in primary, secondary, and
failure, or are at risk for kidney disease. tertiary care settings and in the home – • Care of complex patients
wherever individuals experiencing or at risk • Nurse is integral member of
Care may be extremely complex: patients a multidisciplinary team
for kidney disease receive health care.
may have cardiovascular disease, diabetes,
• Long-term care of chronically
hypertension, infectious disease, bone Conservative Management. Not all ill patients
disease, or drug addiction. In addition, patients with kidney disease require dialysis.
many face psychosocial issues. Patients learn • Nurse is advocate, educator,
Some diseases that affect the kidneys are consultant, direct caregiver
to cope with these problems over time, treatable and potentially curable. In these
especially with the help of an interested, • Nurses can have a positive
cases, one of the nephrology nurse’s primary
knowledgeable, and compassionate health roles is to educate patients about their impact on the quality of
care team. diseases, prognoses, and treatments. patients’ lives
Hemodialysis. Hemodialysis removes and the patient to manage clinical,
accumulated metabolic waste products nutritional, and psychosocial needs.
from the blood using an artificial kidney. • Analyzes monthly laboratory tests.
Hemodialysis is considered a life-sustaining • Teaches patient and family to perform
treatment for acute and chronic kidney PD at home.
failure. • Must have good assessment skills to
evaluate education needs and assess
The hemodialysis nurse: response to dialysis therapy.
• Works within a standardized protocol.
• Uses a general knowledge base of Renal Transplant. Patients who meet
medical-surgical, pediatric, geriatric, and the medical criteria may choose the option
psychiatric nursing. of kidney transplantation. With the new
• Cares for chronic kidney failure patients
There is a wide variety
immunosuppressive medications, transplant
on a long-term basis. is now a very successful therapy. The
• Functions as educator, direct caregiver,
of career opportunities in and coordinator.
problem continues to be the shortage of
available organs for those who do not have
every setting. • Must have technical knowledge an acceptable living donor.
of dialysis equipment and good
communication skills. The transplant nurse:
• Has a varied and extensive role that
Peritoneal Dialysis (PD). Like requires continuous education and
hemodialysis, PD removes metabolic waste clinical training.
from the blood. Primarily, a self-care option, • May function as a staff nurse, transplant
PD patients manage their own treatment via or organ recovery coordinator.
a flexible, permanent, indwelling catheter. • Uses the nursing process to meet the
The peritoneum serves as the dialysis unique needs of transplant recipients and
membrane. PD is used to treat both acute living donors.
and chronic kidney failure. • Monitors patients for rejection, infection,
and other complications.
The PD nurse:
• Performs physical assessments.
• Collaborates with the medical team
Opportunities in Nephrology Nursing
Education. There are many options Advanced Practice Nursing. Advanced
available for nurses pursuing a career practice nurses (APN) in nephrology include
in nephrology education. In the work clinical nurse specialists (CNS) and nurse
setting, the educator is a valuable resource practitioners (NP). The APN provides care
as a coach for new staff or for nurses for patients along the continuum of kidney
in other disciplines. In the academic disease and in all treatment modalities. Both
setting, educators may choose to teach the CNS and NP roles are utilized in the
basic nursing, master’s, or doctoral level inpatient and outpatient settings with the
programs. nurses working as clinicians, consultants,
educators, and researchers.
Management. Strong leaders and skilled
communicators are ideal for the many Corporate/Government. There are
management and administrative positions many opportunities for the nephrology
now available. Superior patient care skills nurse seeking a change from traditional
are needed, and most settings prefer nursing roles. Corporate employers include
a BSN or advanced degree. The role is national and international manufacturers
challenging, evolving, and exciting. and distributors of dialysis and related
equipment, as well as pharmaceutical
Research. A data-driven society and the companies. In government settings, nurses
goal of evidence-based quality care has may find work at the local, state, or federal
broadened this area for nephrology nurses. levels.
To help improve nephrology treatments
and support advances in practice, ANNA Pediatric Nephrology. This is a growing
has joined other corporations to make funds subspecialty, with pediatric nephrology
available for nephrology nursing research. nurses practicing in all treatment modalities.
Nurses in this area find tremendous
ANNA members are
Case Management. The nephrology fulfillment from working with children and
nurse case manager oversees the quality,
outcome, and cost of patient care. Patient
their families. leaders in the
advocacy and continuity of care are two nephrology health care
vital components of this role.
for complete information on ANNA membership.
Advancing the Practice of Nephrology Nursing
About ANNA Educational Opportunities
Since it was established as a nonprofit ANNA Member Benefits Nephrology Nursing Journal (NNJ).
organization in 1969, the American ANNA membership includes
Nephrology Nurses’ Association (ANNA) • Nephrology Nursing Journal NNJ, the association’s official
has been serving members who span the • Nephrology nursing publications publication. This bimonthly
nephrology nursing spectrum. peer-reviewed journal contains
• Numerous education programs
original articles, research, special
ANNA has a membership of over 11,000 • Networking and mentoring features, and editorials. NNJ
registered nurses and other health care
• Volunteer leadership opportunities presents the latest advances
professionals at all levels of practice.
in practice and is an essential
Members work in such areas as conservative • Professional development clinical and academic resource.
management, peritoneal dialysis,
• Special Interest Groups (SIGs) Members also receive ANNA
hemodialysis, continuous renal replacement
Update, ANNA’s bimonthly
therapies, transplantation, industry, and • Scholarships, grants, and awards newsletter, and other special publications.
• Discounts for programs and publica-
Programs. Education at all practice levels
Because ANNA offers programs to mentor tions is offered annually through the National
newcomers and develop leaders, the
• Legislative representation Symposium and the Fall Meeting for
association has been extremely successful in
• Local chapters Nephrology Nurse Managers, Advanced
helping members attain their goals.
Practice Nurses, and Clinicians. There are also
ANNA serves its members through a legislative and leadership workshops; audio
national structure separated into four conferences; distance learning courses; and
regions. Within these regions are over 100 Become an Active Member numerous chapter programs.
local chapters. The association also offers Any registered nurse licensed in the United
Networking. ANNA members identify
top quality education services, products, States, Canada, or Mexico who is interested
networking within the association as one
conferences, and programs. State-of- in the care of nephrology patients is eligible
of their most valued benefits. ANNA keeps
the-art technology provides networking for active membership. Annual dues are listed
members connected through its publications,
opportunities and supports a vast array of in the membership application (insert, next
page). International membership is available to e-newsletter, Web site, and national/regional/
member services and resources on the Web
site, www.annanurse.org. registered nurses living outside of North America. local programs.
Two Easy Ways to Join
Complete the membership application. Visit us online at www.annanurse.org.
Simply fill out the Join ANNA online today.
application attached below.
Return by mail or fax.
OR It’s fast and easy!
Questions? Call ANNA at (888) 600-2662 or (856) 256-2320.
You may also e-mail us at email@example.com
By reading this brochure and filling out the
attached application, you have taken the first
step to a fulfilling new career!
If the membership application is missing, you may obtain one on our Web site,
www.annanurse.org, or call our toll free number at (888) 600-2662.
• make a difference • advocacy • mentoring
• long-term relationships • compassionate care •
higher level of practice • professional growth
• recruitment and retention • collaboration • rich
with opportunity • networking • rewarding
and challenging • professional commitment •
achieve goals • nursing leaders • make a
difference • diversity • save lives daily • rewarding
and challenging • advocacy • long-term
relationships • compassionate care • continuity •
fulfilling career • collaboration • professional
goals • achieve certification • ANNA • autonomy•
long-term relationships • advocacy • diverse
career paths • collaboration • achieve goals • save
Advocacy. Scholarship. Excellence. lives • collaboration holistic care • reach
www.annanurse.org new goals • keeping pace with new technology
• professional growth • compassionate care •
American Nephrology Nurses’ Association continuity • support system • mentoring •
East Holly Avenue/Box 56 collaboration • diverse • saving lives • collaboration
Pitman, New Jersey 08071-0056
(888) 600-2662, (856) 256-2320 • mentoring • challenges and rewards
Fax (856) 589-7463 • long-term relationships • compassionate care
• continuity of care • bonding with patients and
families • professional resources • leadership
opportunities • diverse • save lives daily •