Cheryl Barton wanted to be a pediatrician when she embarked on a health-care career in the late 1970s.
But, as the Hamilton, Ga., resident puts it, God's calling took her in a different direction. An Intensive Care Unit nurse at The Medical Center just after becoming a licensed practical nurse, she spotted a job opening on a bulletin board, applied for it, and entered the world of dialysis."It was interesting. It was evolving," said Barton, 55, now a registered nurse. "Patients had to actually be transported back and forth to Atlanta (in the early days). And the need for dialysis, if you had that, was not generally paid for unless you had private (money)."
Today, the treatment -- be it blood-based hemodialysis at a center or peritoneal dialysis at home -- is covered by insurance companies and Medicare.
And Barton has found a home at the DaVita dialysis center in Phenix City, which will soon move from its longtime location on Old Opelika Road to a state-of-the art center on Riverchase Drive, next to Jack Hughston Memorial Hospital.
She also sees patients at DaVita's dedicated home-dialysis training office at Brookstone Centre in Columbus. Vickie Taylor, group facility administrator for the DaVita centers in and around the Columbus area, said she relies heavily on Barton and her expertise. That will be the case, obviously, when the company breaks in its new center, with 20 dialysis stations, each outfitted with comfortable heated chairs and flat-screen TVs to help patients pass the time during their treatments three days a week, three to five hours at a time
Dialysis is required when end-stage renal disease, or chronic kidney disease, causes poisonous toxins to build up in a person's blood. A person must receive treatment, have a kidney transplant, or simply wait to die.
Nine out of 10 of those opting for dialysis will choose to have it performed in a center rather than do it themselves at home. "At DaVita .. our name means we give life," said Taylor. "That's one aspect in which we try to encourage our patients. Yes, dialysis is life changing. But you can live and live well on dialysis. We're here to make sure that we give you quality care so you can live well -- have more birthdays, see your daughter get married, see your grandchildren graduate from high school and things like that.
The Ledger-Enquirer talked recently with Barton about her job. This interview has been edited for length and clarity:
Let's start with the career progression of a dialysis nurse.
As far as registered nurse, they can be hired and trained on site to treat dialysis patients. And then they can move through the ranks -- if they want to be a charge nurse, a facility administrator, or want to move into training patients for home dialysis. That's a key part of your job, training patients and their families to do peritoneal dialysis at home. Describe that.
The no blood (process) is when the patient has a catheter inserted into their abdominal cavity and they periodically put fluid in there and allow it to sit there, and you have a permeable membrane in there that has blood vessels on it. That fluid hits it and it's just a different way of urinating. It pulls the poisons into the peritoneal cavity and then it is drained out
Flexibility is a major plus for peritoneal dialysis at home over hemodialysis here at the center?
Yes, (patients) can work, they can go to school; if they don't work, that's fine. They can do whatever they want to throughout the day. It's more normal
For the hemodialysis at the center, what's the general process when a patient comes in?
(Technicians) are going to do their clinical assessment, check their blood pressure, their weight, vital signs and that type of thing, and just ask them how they're doing. They're going to connect them to the dialysis machine per the physician's orders, monitor them throughout their treatment, take care of any medications if they need them. And if they have problems -- dropping blood pressure or cramps or getting sick -- they do what they need to do and make sure the patient is safe and secure on the machine. When they're through, they disconnect and send the patient out as long as they're stable.
So nurses assist multiple patients in a shift?
We do. Generally the registered nurse has about 10 patients (depending on each state's guidelines).
Since you focus quite a bit on home dialysis, please talk about that.
I probably see about six to eight home dialysis patients one or two days a week. They're coming to see me and to make sure their lab work is monitored. They may need what they call an epogen injection to keep their blood count up (to counter anemia). And then they come in to get their weight monitored to make sure they're doing the therapy properly to pull off the extra fluid.
You must see a range of emotions from the patients?
They go through anger and denial. We just try to be positive. I'm a very spiritual person and, of course, sometimes you have to pick and choose who you talk to. But I try to let them know in encouraging words that everything's going to be OK and we're here to help them. And that it's not the end of the world.
Have you gotten close to someone here and lost them, and how do you cope?
Oh, yes, multiple times. And like any normal person would, I grieve, I cry, because a lot of times there's no reason. They're fine one day and then you get a telephone call and they're not.
What's the difference between technicians and nurses?
Technicians are basically allowed to set up the dialysis machines and notify the nurse of any problems they're having with the patients once they connect, and follow them through their treatment and their vital signs. The nurse has to oversee the process.
What's the most challenging aspect of your job?
The most difficult part would probably be losing a patient. It's hard to try to readjust once you find that out, because most of the time it's when you're in the working environment. But you have to learn how to handle your emotions and still go through the day and help the other patients.
What's the number one thing home patients fail to grasp properly?
It's infection control. They have to make sure that they are connecting properly and doing their therapy treatment connections and disconnections just like they're taught. And report any problems that may occur, because things can be handled if they stop what they're doing and call and say: 'I'm just not sure.'
Is there any burnout with this job?
There is. It can be so stressful sometimes that you turn around and think, what am I doing, where do I want to go, let me try something different. But then it pulls you back in, kind of like a yo-yo.
What's the most rewarding aspect of your job?
My most rewarding feeling is when I'm training a patient and the light bulb finally goes off, it clicks, and they have it, and they go home and are taking care of themselves the way they are taught.
I understand kidney transplants can be difficult to get?
(On the) UAB transplant list right now, you can go and be evaluated and be put on a four- to five-year wait hold list, before you're even on the active list to be called, because the list is so long of people waiting for a transplant. The younger (applicants) are going to get called sooner, because they say they can be more productive in society with work and everything.
Do you feel like a leader here at DaVita?
They call me a leader. But I do what I can for the facility, because I've been around for a long time and I'm here for the patients and want to make sure that they're taken care of regardless of what modality (form of dialysis) they are on.
Name: Cheryl Barton
Hometown: Mobile, Ala.
Current residence: Hamilton, Ga.
Family: Husband, Duwayne, and four grown children Christopher, Gina, Mikel and Anthony
Education: 1976 graduate of Spencer High School in Columbus; earned licensed practical nurse degree from Columbus Techical College in 1977; earned registered nurse degree from Southern Union in Valley, Ala., in 1991
Leisure time: Enjoys working in the yard and swimming and shopping for antiques all over the Southeast. She buys cookie jars and antique furniture and other trinkets