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With the difficulties faced in providing care during the COVID-19 pandemic, many nurses have faced burnout and challenges in maintaining work-life balance, especially as staffing shortages have affected many organizations. This has led to increased interest in finding novel and rewarding approaches to practicing nursing in a post-pandemic world. 

Dialyze Direct has had the opportunity to shine in this environment, as a source of a unique nursing role for experienced dialysis nurses that is unlike others. Being a nurse with Dialyze Direct is not just a chance to be on the forefront of a growing specialty in healthcare; it also offers nurses an opportunity to advance their skill set in a new modality of care that positively impacts the patients they treat.

If you’re a nurse looking for an exciting challenge, a change of pace, and better work-life balance in a healthcare setting that values your experience and skills in dialysis nursing, you’ll be interested to learn more about a career with Dialyze Direct.

Dialyze Direct nurses: on the leading edge of healthcare

Dialyze Direct’s primary modality of care involves bringing treatment to an underserved population of frail, often medically complex patients residing in skilled nursing facilities (SNFs). Rather than sending these patients to lengthy treatment at outpatient facilities three times weekly, Dialyze Direct offers more frequent dialysis (MFD) in short treatment sessions five days per week onsite at the SNF (pursuant to a physician’s order). 

MFD has been shown to be gentler, with shorter recovery times for these patients. To deliver these treatments, Dialyze Direct nurses use the NxStage system, and receive specialized training on this modality and equipment. 

Dialyze Direct nurses: impacting patients’ lives for the better

Patients who need skilled nursing care and rehabilitation often fall into a category of subacute care needs. When these same patients are referred for outpatient hemodialysis, it places a great burden on those who are already struggling to recover from serious illness and have underlying chronic medical concerns beyond end-stage kidney disease. 

Dialyze Direct nurses manage a smaller contingent of patients than would typically be expected in an outpatient setting. Rather than 30-40 patients per shift being the norm in an outpatient setting, a Dialyze Direct nurse can expect a treatment den with six chairs on average and a highly trained patient care technician (PCT) working with them to provide more personalized care to this population of patients. In instances where a Dialyze Direct den has more than six treatment chairs, additional PCTs (or LVNs in the state of TX) are added. In the course of a shift, this means far fewer patients than a traditional dialysis setting, resulting in more individualized and specialized care.

Dialyze Direct patients who receive MFD experience recovery times of less than two hours, without the added stress and time devoted to transportation to and from treatment. They finish their treatment and can immediately return to their room, with less disruption of routines like meals and medications. Ultimately, this also results in a better ability to participate in rehabilitation and other activities at the SNF, instead of skipping them due to fatigue and hemodialysis side effects.

Better work-life balance for Dialyze Direct nurses

Along with the benefit of a smaller nurse-patient ratio, nurses working with Dialyze Direct typically expect a five-day work week with shorter shifts (8.5-9 hours) than would usually be the case for an outpatient dialysis center. 

In Dialyze Direct facilities where conventional dialysis is also offered onsite, nurses can expect a three-day work week and ten-hour shifts. In most cases, nurses do not typically work weekend shifts, another added bonus.

PCTs are responsible for getting patients set up on the dialysis machines for their sessions, and providing direct patient care, while nurses focus on assessments, lab results, medications, and other nursing tasks. This results in more time spent with patients, rather than a high-volume arrangement that leaves nurses feeling they are not able to provide dedicated care to each patient.

Experience the Dialyze Difference as a nurse

The combined effect of improved work-life balance, advancing nursing skills in an innovative environment, and the ability to positively impact patients’ lives makes a career move to Dialyze Direct a rewarding experience. If you’re interested in joining our team, you can browse available jobs here https://www.dialyzedirect.com/ddjobs/ or fill out our form at https://www.dialyzedirect.com/contact/ for more info.

About the Author


Susan Markovich, MBA, RN, CNN is a certified nephrology nurse with more than 40 years’ experience in both critical care and nephrology. As Senior Vice President of Clinical Services at Dialyze Direct, she leads a workforce of regional managers, educators, and clinical services teams across multiple states and locations. Susan is closely involved in the mentorship and development of both clinical and non-clinical personnel and enjoys sharing her knowledge of nephrology nursing with others seeking to improve the lives of patients.

The idea of bringing services to patients, instead of the other way around, is not a new concept. However, since the COVID-19 pandemic highlighted exposure to infection risk when transporting patients to offsite facilities, onsite dialysis at skilled nursing facilities (SNFs) has only seen increased demand.

Dialyze Direct has been providing onsite dialysis in SNFs since 2015. Currently, we serve 175 SNFs in 14 states and counting, a testament to the expertise and resources we bring to the table for SNFs desiring to implement this service at their facilities. Dialyze Direct has developed a robust strategy and a highly skilled team to create exceptional onsite dialysis care.  

This care team is highly capable of both collaborating with the SNFs they are partnered with and delivering only high-quality care to their patients. By bringing a Dialyze Direct care team to an onsite dialysis program, SNFs can have confidence that their population of end-stage kidney disease (ESKD) patients will experience excellent treatment outcomes, and that providers will have the confidence to lean on SNFs within their network for this vital service.

Meet the Dialyze Direct care team

Our comprehensive team of professionals is part of every onsite dialysis program, and our innovative approach to treatment attracts top talent in the ESKD field. Our care providers receive specialized training to address the unique needs of the dialysis patient population, especially geriatric patients. Here are the healthcare experts who provide dialysis care to ESKD patients in our partner SNFs: 

How the Dialyze Direct team works with the SNF 

Dialyze Direct’s care is deeply integrated with the SNF, instead of separated. Patients enjoy the benefit of walking to their treatments (if they are able) or simple wheelchair transport, instead of lengthy and expensive transportation to and from an outpatient center. 

Because we offer more frequent dialysis (MFD) in many of our locations, which is provided in shorter sessions lasting less than three hours five times per week (pursuant to a physician’s order), our patients see faster recovery times – with the majority reporting recovery in less than two hours. They experience fewer complications of dialysis and are better able to participate in activities like rehabilitation as well, thus getting them home faster.

To achieve these outcomes, our care team works closely with the SNF to coordinate patient care. There are some key elements involved in this:

How the Dialyze Direct team helps hospital discharge planners

Collaborating with SNFs is only one part of the greater patient care effort coordinated by Dialyze Direct. Prior to SNF admission, we work with the SNF hospital liaisons and hospital discharge planners to facilitate patient placement. Our automated process supports the ability to expedite ESKD patients with subacute needs into SNFs for dialysis instead of hospital discharge planners struggling to find outpatient dialysis placement. 

This includes patients with comorbidities that often exclude them from outpatient treatment, necessitating longer hospital stays. For example, Dialyze Direct is able to accept ventilated and tracheostomy patients in several of our locations throughout the country.

By working closely with SNF hospital liaisons and hospital discharge planners, we are able to quickly identify and accept patients to Dialyze Direct partner SNFs with available beds, reducing the workload for these providers.

How the Dialyze Direct team works with providers

Understandably, external providers need to remain involved in their patients’ care coordination, especially since patients will need to continue their course of treatment with their primary nephrologist post-discharge from the SNF. 

Dialyze Direct recognizes this and works in collaboration with these providers, rather than in competition. Our open-door policy allows primary nephrologists to follow their patients in the SNF if they prefer, and in the event they choose to hand off care to another nephrologist in our program temporarily, we work to coordinate post-discharge follow-up with these providers so that patients can seamlessly return for care after completing their stay in the SNF.

Onsite dialysis with our care team advances treatment for all

This overall exceptionality and ability to work with SNFs, discharge planners and providers is advancing dialysis care for patients and everyone involved in their care. In the process, our care teams improve patient outcomes and reduce costs. Multiple insurers and more than 200 SNFs have trusted Dialyze Direct to help them be at the forefront of dialysis care.

To learn more about how the Dialyze Direct care model can increase quality of care at SNFs, relieve hospital capacity strain and improve patient outcomes, contact hello@dialyzedirect.com or visit www.dialyzedirect.com.

About the Author


Susan Markovich, MBA, RN, CNN is a certified nephrology nurse with more than 40 years’ experience in both critical care and nephrology. As Senior Vice President of Clinical Services at Dialyze Direct, she leads a workforce of regional managers, educators, and clinical services teams across multiple states and locations. Susan is closely involved in the mentorship and development of both clinical and non-clinical personnel and enjoys sharing her knowledge of nephrology nursing with others seeking to improve the lives of patients.