A special calling

When COVID-19 came to our community, Janis Tener and the entire dialysis team leapt into action.

A veteran nurse of more than 40 years, Janis Tener, RN, BSN, CDN, has a passion for helping chronically ill patients.

“You put your own concerns aside when you come in the door,” says the nurse manager for the UI Dialysis Program. “You know you’re here to serve the people you work with and the patients you care for.”

Janis Tener, RN, BSN, CDN, has a passion for helping chronically ill patients.

While a typical patient may get a physical once a year, dialysis patients must receive treatments three times a week, sometimes for the rest of their lives. This unique patient group lends itself to unique relationship building.

“You get to know them more as a person,” says Tener, who was recognized as a top 100 Great Iowa nurse in 2019. “In our unit, they’re living their normal lives. You help them with the illness they have been given.”

Tener manages seven dialysis clinics, which include locations in Muscatine, Washington, Grinnell, North Liberty, along with the UI Hospitals & Clinics dialysis unit, home dialysis clinic, and inpatient dialysis unit.

In addition to building relationships, Tener enjoys the technical side of her job, setting up and troubleshooting the dialysis machines. She also appreciates being part of an interdisciplinary team, working in collaboration with fellow nurses, nephrologists, dieticians, social workers, and physicians.

Ramping up for COVID-19

Before COVID-19 made its appearance in our local communities, the dialysis team was preparing and thinking ahead.

“The statistics across the country were that 10-20% of patients with COVID-19 went into acute renal failure,” says Tener. “We knew the hospital was preparing with a certain number of ICU beds, so our best guess was to plan for about 20 percent of that,” she says.

That 20 percent was equal to about 40 bedside patients per day. In comparison, on a typical “busy” pre-COVID-19 day, the dialysis team would treat just five to six bedside patients, in addition to all their regular clinic clients. If a surge happened, the unit would need to dramatically scale up care.

Tener and her team of 50 leapt into action.

The dialysis clinic team administers about 135 dialysis treatments each day.

In addition to planning safety protocols, maintaining staffing levels, and educating staff about personal protective equipment (PPE) and cleaning procedures, Tener had to be innovative about supplies.

“We had to order more than what looked like the appropriate amount. Stores, vendors, and offsite warehouse personnel were very helpful in acquiring the desired supplies,” she says. “Due to the allocations that were in place, it took several conversations to obtain additional supplies.”

It also took a few extra trips by Tener and her staff to pick up those supplies, errands they eagerly ran to keep their patients safe.

At the ready

Fortunately, the surge predicted for up to 40 beside dialysis patients each day has not materialized. But Tener and her staff remained prepared.

In the meantime, Tener’s team continues to administer their normal 135 daily dialysis clinic treatments.

“Patients have been much more resilient than we anticipated, and it’s been good to see them get through this and recover and transition back to their normal dialysis time,” she says.

As the U.S. population continues to age, the need for dialysis is critical.

“As people with diabetes live longer, more of them develop renal failure,” she says. “We need to grow to meet the demands of that need.”

Though Tener is considering retiring in a few years, until then, her patients keep her coming back to the dialysis unit.

“I fell in love with the patients,” she says.