Nephrology Nurse at The African Medical Centre of Excellence (AMCE)

Job Objective

• The Nephrology Nurse provides specialized, patient-centered nursing care to individuals across the spectrum of kidney disease, including those undergoing hemodialysis, peritoneal dialysis, or preparing for/recovering from kidney transplantation. This crucial role involves expert clinical assessment, meticulous treatment administration, comprehensive patient education, and seamless coordination of care within an interdisciplinary team. We are seeking a compassionate and highly skilled nurse with a deep understanding of nephrology, exceptional attention to detail, and a profound commitment to empowering patients through their chronic disease journey, enhancing their quality of life.

Key Accountabilities/Responsibilities

Patient Assessment & Care Planning

• Conduct comprehensive initial and ongoing patient assessments, including physical, psychosocial, and emotional status, specifically focusing on renal system integrity, fluid balance, and vascular access patency.
• Accurately assess and monitor patient vital signs, weight changes, and fluid balance before, during, and after dialysis treatments, identifying any deviations from baseline.
• Collaborate with nephrologists and the interdisciplinary team to develop, implement, and evaluate individualized care plans for patients with acute and chronic kidney disease, including those undergoing dialysis or preparing for transplant.
• Review and interpret laboratory results pertinent to renal function (e.g., BUN, creatinine, electrolytes, GFR, albumin) and adjust care plans or report critical values as necessary.
• Provide holistic care for patients, addressing not only their physical needs but also their psychosocial well-being, common comorbidities (e.g., hypertension, diabetes), and quality of life concerns.
• Implement nursing interventions to manage symptoms associated with kidney disease, such as fatigue, pruritus, restless legs, and nutritional deficiencies.

Dialysis Treatment Management

• Prepare and ensure the proper functioning of hemodialysis machines, dialyzers, and all associated equipment before each treatment, including performing mandatory alarm tests.
• Perform accurate pre-dialysis patient assessments, including vascular access assessment, and cannulate (insert needles into) arteriovenous fistulas, grafts, or prepare central venous catheters for connection to dialysis equipment aseptically.
• Initiate and expertly manage hemodialysis treatments according to prescribed orders, carefully monitoring blood flow rates, dialysate flow rates, and patient responses throughout the procedure.
• Monitor patients continuously during dialysis treatment for any adverse reactions, complications (e.g., hypotension, muscle cramps, air embolism), and machine alarms, intervening promptly and appropriately.
• Safely discontinue dialysis treatments, perform post-dialysis assessments, ensure hemostasis at access sites, and discharge patients when stable, providing clear post-treatment instructions.
• Administer prescribed intravenous and oral medications during dialysis, such as heparin, iron, erythropoiesis-stimulating agents, and antibiotics, adhering strictly to medication administration protocols.
• Train and support patients and their families in performing home dialysis modalities (peritoneal dialysis or home hemodialysis) if applicable, ensuring competency and safety.

Medication Administration & Management

• Administer all prescribed medications accurately, safely, and in a timely manner, including complex intravenous therapies, adhering to the "5 Rights" of medication administration.
• Thoroughly educate patients and families on their medication regimen, including purpose, dosage, administration, side effects, and importance of adherence, especially concerning renal medications.
• Perform medication reconciliation upon admission and discharge, ensuring continuity of medication management and addressing potential drug interactions.
• Monitor patient responses to medications, specifically noting efficacy and any adverse drug reactions relevant to kidney disease and promptly report findings to the physician.
• Manage and maintain accurate medication records, ensuring all administrations are documented precisely in the patient's chart.
• Collaborate with pharmacists to clarify medication orders, resolve discrepancies, and optimize patient pharmacotherapy.

Patient Education & Empowerment

• Develop and deliver comprehensive education to patients and their families regarding chronic kidney disease stages, progression, and available treatment options (conservative management, hemodialysis, peritoneal dialysis, transplantation).
• Provide detailed counseling on specific dietary restrictions (e.g., low sodium, potassium, phosphorus), fluid intake management, and the importance of nutritional compliance in renal disease.
• Educate patients on proper care and management of their vascular access (fistula, graft, catheter) to prevent infection and maintain patency, fostering self-care practices.
• Counsel patients on lifestyle modifications, exercise, smoking cessation, and comorbidity management (e.g., diabetes, hypertension) to slow disease progression and improve overall health.
• Empower patients to actively participate in their care by encouraging questions, addressing concerns with empathy, and supporting informed decision-making regarding their treatment journey.
• Provide education on emergency preparedness for dialysis patients, including signs and symptoms to report and immediate actions to take.

Documentation & Reporting

• Maintain accurate, detailed, and comprehensive patient records, including assessments, treatment parameters, medication administrations, vital signs, and progress notes, adhering to all legal and institutional standards.
• Document all dialysis treatment parameters, patient responses, and any complications encountered during treatment promptly and precisely in the electronic health record (EHR).
• Promptly and thoroughly report any changes in patient condition, adverse reactions, or critical laboratory results to the nephrologist or appropriate healthcare provider.
• Complete all necessary documentation and reports promptly and efficiently, including pre- and post-dialysis summaries, incident reports, and referral forms.
• Ensure all patient education provided, including patient comprehension and any barriers to learning, is meticulously documented in the patient's record.
• Participate in medical record audits to ensure completeness, accuracy, and compliance with documentation standards.

Infection Control & Safety

• Strictly adhere to and promote rigorous infection control practices, including hand hygiene, aseptic technique for vascular access, and environmental disinfection within the dialysis unit.
• Ensure proper handling, processing, and storage of dialyzers and all medical equipment according to manufacturer guidelines and hospital policy to prevent cross-contamination.
• Regularly monitor the dialysis water treatment system and dialysate to ensure quality standards are met, reporting any deviations immediately.
• Identify and promptly report any potential hazards, equipment malfunctions, near misses, or adverse events through established safety reporting systems.
• Ensure proper handling, segregation, and disposal of biohazardous waste, sharps, and contaminated materials according to hospital policy and environmental regulations.
• Maintain a clean, organized, and safe clinical environment within the dialysis unit or assigned patient care area at all times.

Collaboration & Professional Development

• Collaborate effectively and maintain open communication with all members of the interdisciplinary team, including nephrologists, dietitians, social workers, pharmacists, and dialysis technicians, to ensure holistic patient care.
• Actively participate in patient care conferences, team meetings, and rounds to discuss patient progress, care plans, and discharge planning.
• Engage in continuous professional development and continuing education specific to nephrology nursing to stay updated on the latest advancements, research, and best practices.
• Seek opportunities to enhance clinical skills and knowledge relevant to kidney disease management and specialized renal therapies.
• Adhere to all organizational policies, procedures, and professional nursing standards, contributing to a cohesive and compliant work environment.
• Participate in quality improvement initiatives aimed at enhancing patient outcomes, safety, and efficiency within the nephrology unit.
• Must have skills
• Certified Nephrology Nurse Certified Dialysis Nurse
• Good to have skills
• electronic health record (EHR) systems emergency department information systems

Qualifications

Education, Skills and Competencies

• Bachelor of Science in Nursing (BSN) from an accredited institution OR Diploma in Nursing with post-basic training
• Valid nursing license.
• Specialized certifications in Nephrology Nursing (e.g., Certified Nephrology Nurse - CNN, Certified Dialysis Nurse - CDN, or equivalent international certification).
• In-depth knowledge of nephrology nursing principles, acute and chronic kidney disease pathophysiology, and various dialysis treatment protocols.
• Exceptional critical thinking, problem-solving, and decision-making skills under pressure.
• Excellent communication, interpersonal, and teamwork skills.
• Proficiency in electronic health record (EHR) systems and emergency department information systems.
• In-depth knowledge of international patient safety standards and emergency care guidelines.