About 650,000 Americans are currently affected by End Stage Renal Disease (ESRD), and this number is increasing by 5% annually. The primary causes of kidney failure leading to ESRD are poorly managed diabetes and high blood pressure, the treatment options for which are limited to kidney transplant and dialysis. Unfortunately, there are currently more than 93,000 potential recipients on the kidney transplant waiting list and 80% of those individuals are on kidney dialysis while they wait.
Demand for Nurses is Growing
The specialty of nephrology and dialysis nursing continues to grow with these rising ESRD numbers. In fact, nephrology nursing is expected to grow over 25% within the next 10 years. These nurses can expect an attractive salary and a diverse working environment. Nephrology nurses might work on a typical hospital unit, but those who perform dialysis also work in dialysis centers, nursing homes, inpatient hospice centers, and even in-home health.
Nurses Develop Deeper Relationships with Patients
Renal failure is a chronic condition, so those who suffer from it must access care frequently. This means nephrology nurses will see their patients regularly. Dialysis nurses often have the ability to work with patients one on one, providing an opportunity to give care in a much more personal, attentive way. They also care for their patients through the continuum of the disease progression, so they get to know their patients quite well.
Certification and Advanced Education for Leadership
A nephrology nurse may elect to pursue certification or even further education and their Nephrology Nurse Practitioner certification. These nurses take their practice deeper, providing primary care for their patients who battle ESRD during dialysis and even after transplant—if and when that becomes possible.
There are plenty of worthwhile opportunities for nurses to make a difference in the lives of renal patients whose prognosis can be dire. Examples of such opportunities and further information on dialysis nursing can be found here.
Many student nurses become enamored with Labor and Delivery nursing and the infectious joy surrounding most births. This specialty, however, is not without its challenges to effective care. It requires nurses to remain vigilant and current on the advances in obstetrical care while working with pregnant patients from all walks of life.
Be Prepared to Teach
Many expectant women and young girls arrive unprepared for childbirth, having foregone prenatal instruction or obtained their childbirth education from the internet and YouTube. They may have misconceptions that foster unrealistic expectations for delivery.
For example, in an effort to have a “painless birth,” an expectant mother may request an epidural in order to feel nothing at all. If not properly educated beforehand, she may panic as the loading dose of the epidural begins to wear off and she feels the pressure of the baby moving down. The primary responsibility for re-educating these women falls on the L&D nurse.
Go With the Flow
The pace of activity on the L&D unit can vary to extremes. There can be long lulls of relative inactivity suddenly interrupted by a dash to the operating suite. Potential emergencies can be as dire as a patient delivering prematurely due to deliberately rupturing her own membrane. Therefore, nurses must be able to perform well with the ebb and flow of activity and under a variety of circumstances. A nurse who needs constant stressors to stay sharp may not adapt well to these fluctuations. Fostering good teamwork is critical to staying attentive at all times.
Put Your Game Face On
Nurses in Labor and Delivery must also be capable of maintaining a calm demeanor and appearance even in the face of tremendous stress and even fear. For example, they must have the fortitude to deliver a stillborn infant and care compassionately for the mother, despite this being the most unpleasant outcome.
On most Labor and Delivery units, the nurses will look out for each other. They may take measures to protect each other emotionally where stillbirths are involved by sharing those assignments. This ensures that no one nurse is assigned a disproportionate number of stillborn deliveries.
To learn more about the ins and outs of Labor and Delivery nursing, go here.
Forensic nursing involves working with the aftermath of violent situations. Violence is both a health care and a legal issue, so this places forensic nurses in a unique leadership position to connect health care, science, and the legal system. Forensic nurses partner with law enforcement and other agencies to investigate and resolve events such as domestic violence, sexual crimes, child and elder abuse, homicide, and suicide.
What Education and Certifications are Required?
Registered nurses with an associate degree or a BSN and a good foundation of clinical experience can pursue this specialty through a certificate program or an advanced degree (MSN, DNP, PhD) and board certification. Forensic nurses also have their own professional association, the International Association of Forensic Nurses (IAFN), which provides opportunities for networking and professional development as well as education and certification resources. The Commission for Forensic Nursing Certification (CFNC) currently offers two certification options: Sexual Assault Nurse Examiner-Adult/Adolescent (SANE-A) and Sexual Assault Nurse Examiner-Pediatric (SANE-P).
What Do Forensic Nurses Do?
These specialized nurses work in emergency rooms, coroner’s offices, police departments, and even the FBI. They examine the victims of violent crime, collect and analyze evidence, and document injuries. How the nurse treats the patient—the victim of violence or the family left behind—can have a tremendous influence on the ability of that individual, their families, and loved ones to recover post-trauma.
Success Through Adaptability
Forensic nursing requires the ability to cope well with the stressors of working around extreme circumstances. The work involves public health, behavioral health, pediatrics, geriatrics, and even medical legal consulting. The versatility of the highly trained forensic nurse enables them to better care for those citizens who are most vulnerable in our society.
Interested in exploring various career paths for nurses? Visit the DailyNurse nursing specialties directory to learn more.
Do you love patient care but long for some autonomy in your nursing practice? Perhaps a leadership position in wound care nursing is the answer. Wounds are often the domain of one or more wound care nurses, as they are especially problematic for nursing departments, particularly those acquired during a hospital or facility stay. A wound care coordinator supervises these nurses, providing organizational leadership and management.
What Additional Certifications Are Required?
Wound care nurses focus solely on prevention and healing. The coordinator holds specific certifications in wound, skin, and ostomy care and is responsible for supervision of the wound care nurses. Wound care nurses may also have advanced certifications in this area, but their task is solely the everyday management, assessment, and treatment of wounds as ordered by the physician.
Wound Ostomy Continence Nurse (WOCN) certification is the highest available to registered nurses. It is obtained through the Wound Ostomy Continence Nurses Society, which requires completion of a formal WOC program. These require a bachelor’s degree or higher, at least one year of clinical experience following RN licensure, and clinical experience within five years of beginning the WOC program.
The Certified Wound Specialist (CWS) certification is sponsored by the American Board of Wound Management and is available to Registered Nurses and several other non-nursing health professions. Certification requires that the candidate have a bachelor’s degree and three years’ experience in wound care, or completion of at least a year-long fellowship that has been certified with a credentialing organization.
The National Alliance of Wound Care and Ostomy offers the Wound Care Certification (WCC) to RNs and LPN/LVNs, as well as NPs and other allied health professions with an active unrestricted license. This certification requires completion of an education course that meets the Alliances criteria but does not specifically require a bachelor’s degree.
What Are the Responsibilities of a Wound Care Coordinator?
Wound care coordinators evaluate the success of treatment modalities, discuss nutritional needs with dieticians, and consult with medical directors, physicians, and plastic surgeons on healing progression and complications. Wound care coordinators develop and implement programs that focus specifically on skin and wound care. They also conduct interdisciplinary rounds with other departments whose areas of expertise intersect and potentially affect the patient’s potential for wound healing. Wound care coordinators and nurses usually meet regularly with the administration and nursing to update on the status of wounds as well.
How Do Patients Benefit?
Wound care nurses and the coordinators who manage them elevate the level of care for wounds by making that their sole focus. Without the full responsibility for a patient’s overall primary care, wound care nurses and coordinators are better able to focus on bringing their patient to an optimum state to facilitate healing. That’s a win for the facility, the physicians, the nursing department, and especially the patient.
Learn more about wound care nursing here.