Bobbie Wager, MSN, RN, was only 30 days old when her parents learned she had a congenital kidney disorder. Two kidney transplants and years later, she decided to become a peritoneal dialysis nurse. After graduating in 1993 from the University of Texas Health Science Center at San Antonio School of Nursing, Wager began working for Fresenius Medical Care as a peritoneal dialysis nurse/nurse educator, teaching patients about the disease process, dietary requirements, treatment options and hope.

Why did you want to become a nurse/patient educator working with kidney disease?

I was diagnosed with end-stage renal disease (ESRD) 25 years ago. I didn't have anyone who I could talk to or give me hope. I was very blessed to have a donor. I knew I wanted to give back and also to get my voice heard. Through education, we can give hope. Kidney disease is not a death sentence. Yes, it's a change of life. But you can still have a good quality of life. I knew I wanted to work in the renal unit and work with the community.

I was an inservice coordinator for several years when I taught our new staff about chronic kidney disease (CKD), which allowed me to put a face on CKD. These patients are human beings. We have families and we have emotions. In addition to my role as a peritoneal nurse, I also have worked as a kidney outpatient coordinator. I go "above and beyond" to help the patient. I think about the patients even before they begin their dialysis.

What are the joys and challenges of your position?

I enjoy giving back to the patient. I try to inspire hope to let the patient know "I've gone through this and so can you." I feel my personal experience with kidney disease gives me credibility as a patient and as a nurse. However, trying to meet every patient's need is my greatest challenge. I see more than 50 patients per month, which includes one-on-one home visits. I also teach 3-4 classes each week at various locations throughout San Antonio. I also started a mentoring program that allows patients to "buddy" with each other, which has helped in many ways.

Do you have a story of hope about a patient who inspired you?

Yes! When I moved to San Antonio in 1988, I met a patient who started the Kidney Association of San Antonio Foundation, which later merged with the National Kidney Association of South Texas. He died this past February after living with kidney disease for 30 years. During his life, he touched the lives of many kids, from elementary through high school. He was both proactive and positive, and got me involved as well. Even through my nursing school, I relied on him when I was a patient. He was my hero.

How has outpatient dialysis changed in the past 10 years?

Technology itself has changed so much. Patients are living longer and have more options. Today, patients should have an uneventful dialysis. The dialysis is better, not necessarily faster.

When I dialyzed 25 years ago, it was not unusual for me to vomit and cramp. Today, it is very rare. Patients today can dialyze overnight through our two nocturnal dialysis programs. In the future, I hope dialysis will be expedited so patients will only have to dialyze for 2 hours versus 4-8 hours. I hope a larger percentage of patients will live longer. I am hopeful for even more options.

What is your philosophy about organ donation and organ transplant?

Having two transplants, I'm for organ donation. But transplant is not a cure. I'm one who has been very blessed. I take my medication and watch my diet. Some patients are on the transplant waiting list for 8-10 years. On the other hand, some patients don't want a transplant because of possible side effects or they have heard bad things, and they know it's not a cure. I can educate the community about organ donation and about ESRD, and give my patients hope.