Kidney disease is a way of life for Bobbi Wager, RN, MSN. Born with a congenital malformation, the San Antonio nurse draws on her life experiences and clinical expertise to help nephrology patients learn to live with renal disease.
Educators are able to empower patients to make decisions, and live longer and with a better quality of life, says Wager, 50, an educator at Fresenius Medical Care.
When she was only 30 days old, Wagers parents learned she suffered from a congenital kidney disorder in which urine backed up through her ureters into her kidneys. Subsequent infections destroyed the renal tissue. By 12 years of age, only 25% of her kidney function remained. Doctors told her and her parents she would need a transplant. She was able to hold off for 12 more years.
Fearing potential damage to a new organ, surgeons removed her kidneys in preparation for a transplant. She began hemodialysis. On June 4, 1983, she received a kidney from her brother.
I woke up from the transplant. I was urinating. The kidney was working, and in all my life, I never felt that good, Wager says.
That kidney kept her off dialysis for more than 15 years. The donated kidney sustained trauma during an auto accident, and she received a second transplant from her husband.
Interacting with the nurses and physicians caring for her during the first transplant convinced Wager to pursue a health career. The former secretary at first considered medicine but later switched to nursing.
I thought, I would like to give back to patients. Wouldnt it be neat to hear it from another patient and a nurse in the field that you can go on dialysis? You can live a good quality of life. You can have a transplant, Wager recalls.
After graduating in 1993 from the University of Texas Health Science Center at San Antonio School of Nursing, Wager began working for Fresenius as a peritoneal dialysis nurse. She now serves as a nurse educator, teaching patients about the diseases process, dietary requirements, and their treatment options.
It empowers patients to take control to help make decisions and transition into whatever renal replacement therapy they and their physician decide on, Wager says. Although a patient has been diagnosed with end-stage renal disease, having to choose a renal replacement therapy is not the kiss of death.
Patients can receive hemodialysis for three to five hours three days a week or overnight for eight hours while they sleep at the dialysis center. Nocturnal dialysis doubles the amount of filtration that can take place. Some patients also may choose to dialyze at home using daily peritoneal or thrice weekly hemodialysis.
Nephrology nurses provide physical and psychosocial care to their patients. They typically develop long-term relationships with their patients due to the chronic nature of the disease.
Many patients opt for a transplant. Some have family members or friends who volunteer to donate a kidney and are found to be a good match. But others must hold of until a cadaver donor becomes available. About 75,000 patients are currently on a waiting list for a kidney. On average, they wait five years before finding a match. At that point, they may no longer be candidates if their health has deteriorated. Although Wager reports 25% of patients who start dialysis will die within a year, she says patients can live for 30 years or longer without a transplant.
Wager emphasized the need for more kidneys and that nurses can play a role in educating the community about the value of organ donation and about the realities of renal disease.
Patients can still live a good quality of life, Wager says. We need to give these patients hope.
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