Careers in Apheresis
Meet Deanna Duvall: Therapeutic Apheresis Nurse
I am a Therapeutic Apheresis Nurse
What is your nursing specialty? I am an apheresis nurse. That statement is followed by “What is apheresis? Is that like dialysis?”
Apheresis is derived from a Greek word “to take away” or withdraw. The practical definition is a procedure in which blood is removed, a portion is removed or manipulated, with the remaining portions being returned. This approach has been used for thousands of years dating back to the ancient Egyptians who used bloodletting as a medical practice. More recently, apheresis devices were developed with the aim of improving patient care and meeting the increasing demand for plasma and other blood products.
Apheresis procedures are used to collect blood components from healthy individuals (donor) and to treat patients (therapeutic). Donor apheresis collections are performed by community blood services to provide blood products for patients. Therapeutic apheresis (TA) procedures can be classified as blood component exchanges, cell depletions or autologous collections. Diseases that are treated with TA are not heterogenous and include neurologic, renal, hematologic, autoimmune or metabolic. TA is not a benign procedure but has been safely performed on pediatric to geriatric patients in the inpatient or outpatient setting.
As the demand for TA has increased so has the need for apheresis nurses with their expertise in clinical patient care, transfusion medicine and technology. Apheresis nurses provide care to a diversified population ranging from healthy donors to acute or chronically ill patients while adhering to strict, ever-changing regulatory issues. During the apheresis procedure the nurse is managing the donor/patient’s clinical status, the venous access, the infusion of blood components or specialized fluids, but also the apheresis device. Additional responsibilities include donor/patient/family/public education.
After graduating from college, I began a traditional path in nursing by working in the hospital setting for several years. However, I felt something was missing and answered an advertisement to work as a blood collector for the American Red Cross. After my initial training, I felt this was an area of nursing I could grow into. And I did. Through many years and many different moves to different locations, I was able expand my skills and knowledge from drawing whole blood, to collecting apheresis blood components from donors, to performing specialized therapeutic procedures and to participating in clinical trials.
I have so many (too many to count!) memorable patients and experiences. The eight-year-old who screamed “I’m too young to die” during his first treatment, but later gave me a hug every time he saw me. The seamstress who was so appreciative of our staff that she insisted on fixing the “best soul food” ever for our department. The teacher whose central line looked like an antenna behind her ear, so she told her class “It was a direct line to Santa Claus.” The tears I shed when patients I had treated for several years passed away. I had an effect on the lives of patients and families but they impacted me and my practice as well.
I now provide clinical training and support to staff in their apheresis journey. I have also been privileged to be an active participant in the American Society for Apheresis, the professional organization for anyone interested in apheresis.
The clinical environment for donor and therapeutic apheresis continues to evolve with new applications, new technology, new regulations, and changes in the acuity of treated patients. I would encourage anyone to investigate this challenging area of nursing. More than forty years later, I am glad I did.
Deanna Duvall, RN BSN, HP (ASCP), is a Senior Clinical Specialist employed by Fresenius Kabi USA, LLC. The author’s experiences described herein related to her time in clinical practice prior to joining the company. The views and opinions expressed in the article are those of the author and do not necessarily reflect the official policy or position of Fresenius Kabi USA, LLC or its affiliates.
Contact the State Board of Nursing to Learn More
Neurological Disease Indications for Plasma Exchange
ASFA Patient Resource Information Sheets
Information Sheet Glossary