The Dialysis Team at Memorial Sloan Kettering Cancer Center
March 2023
The Dialysis Team
at Memorial Sloan Kettering Cancer Center
ICU
Memorial Sloan Kettering Cancer Center
NEW YORK
,
NY
United States
Elizabeth Kong, MSNed, RN, CEN, CDN
Mariea Casas Gibbs, MHA, BSN, RN, CCRN, CEN, CDN
Marjorie Guanco, BSN, RN
Mariea Casas Gibbs, MHA, BSN, RN, CCRN, CEN, CDN
Marjorie Guanco, BSN, RN
Tucked within the Intensive Care Unit at Memorial Sloan Kettering Cancer Center are two small treatment rooms run by a powerhouse team of certified dialysis nurses doing extraordinary work. Elizabeth Kong CN IV, Mariea Casas CNIV, and Marjorie Guanco CNII are highly accomplished, well-respected, compassionate professionals. These three nurses provide an average of fifty hemodialysis treatments monthly to inpatients in our 524-bed hospital. They also play an integral role in training and supporting the critical care nurses who provide Continuous Kidney Replacement Therapy (CKRT) in our 20-bed Intensive Care Unit. Their actions have demonstrated how they embody MSKCC's nursing values of compassion, advocacy, relationship-based care, and excellence to carry out Dialysis operations seamlessly and effectively consistently.
Nurses throughout the inpatient units who send patients for dialysis treatment have seen the impact of their compassionate care. They are essential in these patients' treatment journey, seeing them three times a week. As a result, their patients know exactly when to expect their calls and who will be providing the treatment based on the time of the call. The relationships they form with their patients are unique, and they often earn praise from patients and their loved ones, citing their excellent specialized care and attention to the patient's comfort and emotional needs.
This small team of highly accomplished nurses, Elizabeth, Mariea, and Marjorie are widely respected by their nursing and physician colleagues. The Chief of the Renal Service stated, "…we have called our nurses in to dialyze patients after hours, often in the middle of the night. They have never complained about this and are more than happy to come in." He recounted an instance when the nurse on-call overnight had difficulty safely commuting to work due to extreme weather conditions. Her colleague, who had a shorter and safer journey, voluntarily came in on her night off without being asked. This is just one of many examples of how they collaborate and care for their nursing colleagues. The doctor also spoke of how they have advocated for their patients by speaking up when a problem is identified and working to fix it.
In addition to their hard work, their commitment to this unique niche of patients, both Mariea and Elizabeth received their third nursing certification as certified dialysis nurses. The Dialysis nurses play an essential role in training and educating every ICU nurse to perform CKRT and presenting a didactic course for ICU fellows and APPs. Marjorie, Elizabeth, and Mariea provide didactic courses and hands-on training for the ICU nurses. They also play an integral role in ensuring staff maintains competency after completing orientation. The ICU nurses also seek out their expertise and assistance when troubleshooting problems. This expertise was especially crucial at the start of the pandemic when many patients critically ill with COVID-19 required dialysis in the ICU. In fact, their poster, "Strategic Implementation for Providing Kidney Replacement Therapy during COVID-19," was accepted by the Oncology Nursing Society (ONS) 47th Annual Congress.
They have demonstrated that their concerns extend beyond the walls of the hospital. The dialysis nurses proactively working to reducing the environmental impact of medical care. They successfully implemented the recycling of dialysate jugs, coordinated the installation of light dimmers in the dialysis storage and dirty utility rooms, and motion water sensor faucets to reduce water waste.
The Dialysis Nurses are a small but mighty team. They continuously demonstrated their commitment to best practices by proactively researching and implementing processes designed to prevent the transmission of bloodborne pathogens among patients. They provided input to ensure this standard requirement was implemented safely and with minimal interruption in patient treatment schedules. They have improved our hospital's documentation structure to ensure that the treatment provided is clearly understood and communicated to all the care teams. They are true role models who exemplify the excellence our institution values.
Nurses throughout the inpatient units who send patients for dialysis treatment have seen the impact of their compassionate care. They are essential in these patients' treatment journey, seeing them three times a week. As a result, their patients know exactly when to expect their calls and who will be providing the treatment based on the time of the call. The relationships they form with their patients are unique, and they often earn praise from patients and their loved ones, citing their excellent specialized care and attention to the patient's comfort and emotional needs.
This small team of highly accomplished nurses, Elizabeth, Mariea, and Marjorie are widely respected by their nursing and physician colleagues. The Chief of the Renal Service stated, "…we have called our nurses in to dialyze patients after hours, often in the middle of the night. They have never complained about this and are more than happy to come in." He recounted an instance when the nurse on-call overnight had difficulty safely commuting to work due to extreme weather conditions. Her colleague, who had a shorter and safer journey, voluntarily came in on her night off without being asked. This is just one of many examples of how they collaborate and care for their nursing colleagues. The doctor also spoke of how they have advocated for their patients by speaking up when a problem is identified and working to fix it.
In addition to their hard work, their commitment to this unique niche of patients, both Mariea and Elizabeth received their third nursing certification as certified dialysis nurses. The Dialysis nurses play an essential role in training and educating every ICU nurse to perform CKRT and presenting a didactic course for ICU fellows and APPs. Marjorie, Elizabeth, and Mariea provide didactic courses and hands-on training for the ICU nurses. They also play an integral role in ensuring staff maintains competency after completing orientation. The ICU nurses also seek out their expertise and assistance when troubleshooting problems. This expertise was especially crucial at the start of the pandemic when many patients critically ill with COVID-19 required dialysis in the ICU. In fact, their poster, "Strategic Implementation for Providing Kidney Replacement Therapy during COVID-19," was accepted by the Oncology Nursing Society (ONS) 47th Annual Congress.
They have demonstrated that their concerns extend beyond the walls of the hospital. The dialysis nurses proactively working to reducing the environmental impact of medical care. They successfully implemented the recycling of dialysate jugs, coordinated the installation of light dimmers in the dialysis storage and dirty utility rooms, and motion water sensor faucets to reduce water waste.
The Dialysis Nurses are a small but mighty team. They continuously demonstrated their commitment to best practices by proactively researching and implementing processes designed to prevent the transmission of bloodborne pathogens among patients. They provided input to ensure this standard requirement was implemented safely and with minimal interruption in patient treatment schedules. They have improved our hospital's documentation structure to ensure that the treatment provided is clearly understood and communicated to all the care teams. They are true role models who exemplify the excellence our institution values.