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Community health but with an acute care aspect.

Joshua Barnwell, Clinical Coordinator
DaVita Kidney Care
Olympia, WA

"I wish the general public school system would do a better job of educating people about healthcare."

Joshua started his nursing practice in hospitals, specifically in an Intensive Care Unit (ICU). Early in his career, he quickly realized that nursing isn't as much of a rosy picture that is presented during nursing school. What keeps him going is his love for science, quality improvement, and working with people. Now, nearly 16 years into his practice, he describes dialysis as "community health but with an acute care aspect."

"[Dialysis] is as exciting as you can get without working in the hospital," he said. "Patients here can have life-threatening emergencies that you need to have some clinical skills and some critical thinking skills to be able to deal with effectively."

Dialysis in nursing gives you a really unique experience in healthcare

The healthcare industry, including dialysis, grapples with persistent nursing shortages, as the demand for skilled nurses continues to outplace the supply. Factors such as an aging population with more health problems, increased healthcare needs, and a growing number of retiring nurses contribute to this ongoing challenge, highlighting the urgent need for workforce expansion and retention strategies within the field. 

"There are so many things [policymakers] could to to make my life easier, and so many things they do to make it unnecessarily difficult," Joshua said when asked about potential policy solutions to the challenges he sees in the clinic every day. "You have an industry of people - nurses - that we need so badly, so why are there so many unnecessary obstacles? Why is the state making them pay for their nursing licenses every year? That kind of thing."

Setting higher expectations

Joshua has been pushing for years for nursing programs to develop relationships with dialysis clinics. In his view, there needs to be more collaboration between academia and the health care industry to better prepare the future workforce. 

"But it's not just on the schools, it's on the students," he said. 

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