Do YOU Want to Be a Home Dialysis Training Nurse?

This blog post was made by Beth Witten, MSW, ACSW, LSCSW on April 18th, 2014.
Do YOU Want to Be a Home Dialysis Training Nurse?

Have you read about how home dialysis offers people with kidney failure a greater sense of control and better physical health and emotional well-being? Have your colleagues told you how rewarding it is to work with people who take an active role in their care by doing home dialysis? Do you want to be part of the action? The ESRD Conditions for Coverage explains how you can make it happen.

First, if you're an RN and licensed in your practice state, you need at least 12 months of work experience as an RN with at least 3 months working with peritoneal and/or hemodialysis patients to independently teach patients.1 The Condition for Care at Home states that the clinic where training is provided must be Medicare certified for home training and support and must teach:

  • Management of ESRD
  • How to do the procedure
  • What to report
  • Resources and how to access them
  • How to monitor and record health status
  • Handling medical and non-medical emergencies
  • Precautions for infection control
  • Proper waste storage and disposal for that locale.2

The Condition for Patients' Rights specifies that you must give information in a way patients can understand, keeping in mind their learning style and any learning barriers.3

There's more. As a home training nurse, you must document in the patient's medical record when the patient and care partner (if applicable) finish training and demonstrate competency. And, you will have to receive and review the patient's treatment records at least every 2 months. As part of the clinic's interdisciplinary team, a home training nurse provides "support services" including:

  • Monitoring the home through a first home visit and follow-up visits as needed
  • Serving as the patient's "care coordinator" or working with that person
  • Participating in the development, review, and revision of the plan of care
  • Being available for consultation with the patient in-person at clinic visits and/or by phone, or email to meet his/her individual clinical needs
  • Assuring that the home HD patient's water and dialysate quality have been tested and found to meet AAMI RD52:2004/Annex C standards
  • Assuring that patients get all of the medically necessary equipment and supplies their doctor prescribes
  • Identifying and arranging for back-up dialysis in medical and non-medical emergencies or when the patient or partner need respite4

Do you have the right personality type? Because home training nurses are expected to provide training and ongoing support, they often form close yet respectful professional relationships with their patients, understanding patients' right to self-determination while encouraging them to follow their treatment plan and/or honestly report why not. Home training nurses must be able to answer questions (sometimes more than once) and individualize their responses to fit with the patient's ability to understand, educating others who can help the patient as needed. They need to be inside and out-of-the box thinkers to troubleshoot common and not-so-common problems. If you meet these criteria, you may want to choose to be a home training nurse and make a world of difference in a patient's life by encouraging success in a treatment that allows a greater chance to live a full life on dialysis.

To learn more about the requirements for home dialysis, read the ESRD Interpretive Guidance on the Dialysis Survey & Certification site at http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Dialysis.html.

References

  1. 42 CFR 494.140
  2. 42 CFR 494.140(a)
  3. 42 CFR 494.70(a)(2)
  4. 42CFR 494.140(b)

Comments

  • Beth Witten

    May 7, 2:48 PM

    If you work for a dialysis corporation that offers home training and support at a sister facility nearby, you might ask how you could gain the 3 months of experience you'd need in home PD and/or home HD to be a home training nurse. If your clinic doesn't currently offer this, maybe having a nurse interested in doing home training would help the clinic decide to seek certification for home training and support for one or both treatment options. If you work for an independent dialysis clinic that doesn't offer home dialysis, you could use the Find a Clinic database from the Home Dialysis Central homepage to locate clinics in your area that offer home dialysis and see if one of them would be willing to have you work under their home training nurse's supervision to gain the dialysis experience required in addition to the RN experience you already have. Having a Master's in Education could be very helpful as I suspect you know more about adult learning theory that the average dialysis staff member. Good luck!

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    • Manuel

      May 7, 3:10 PM

      Glad of your fast response. I've been working in hemodialysis in clinic setting for more than 3 months already. I just want to know more about home dialysis options.

      Thank you and have a great day!

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      • Beth Witten

        May 7, 5:09 PM

        Check out the options for home dialysis on the homepage under Home Dialysis Basics. You will learn about the two types of peritoneal dialysis as well as multiple types of hemodialysis that can be done at home.

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  • Manuel Caday

    May 7, 12:48 PM

    I want to know more information about being a home training dialysis nurse. Although I am quite new working in a dialysis setting, but I've been an RN for more than 7 years. I have my BSN and a Master's in Education and I would want to experience home training during weekends.

    Please let me know when you have the chance.

    Thank you.

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