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In recognition of the dialysis care she provided in the wake of Hurricane Katrina's darkest days, Sue McManus, MSN, CFNP, CNN, was given the Board of Directors Award by the American Nephrology Nurses' Association (ANNA) this past April.

Figure. Sue McManus ... - Click to enlarge in new windowFigure. Sue McManus (center) receives the Board of Directors Award at the 2006 ANNA National Symposium in Nashville in April. From left to right are Sue Cary, Southeast Regional vice president, McManus, and Suzanne VanBuskirk, ANNA presiden

She hadn't originally intended to become a nurse, but after 18 years in home and business equipment sales, McManus-then in her 40s with grown children-was looking for something to do. She wanted an outlet that "offered something where I could always learn, that would never stop, and that I could do till I die."


While this choice perplexed her family, her husband supported it. McManus and her husband moved from Texas so she could attend Louisiana State University at Eunice, a two-year community college, where she earned an associate's degree in nursing in 1996. She began working on a medical-surgical unit at Our Lady of Lourdes Regional Medical Center in Lafayette, Louisiana, for six months. Following the advice of colleagues from school, she then started working for a dialysis company.


"I had found my niche," says McManus. "I loved caring for nephrology patients. They are amazing. They have to come in at least three days a week, be hooked up to machines, and get this treatment. They don't feel well, but they go on with life in spite of this and people around them don't even know it. I found an appreciation for life in dialysis that I had not found anywhere else."


In 2004 McManus relocated to Opelousas, Louisiana, to work at the Miller Dialysis and Kidney Treatment Options Center, a Dialysis Clinic, Incorporated (DCI) affiliate about 250 miles from New Orleans.


In August 2005, with New Orleans bracing for Hurricane Katrina, McManus and nephrologist Paul Miller dialyzed their patients ahead of schedule that weekend so they could make as many dialysis units available as possible, "just in case."


Just in case became an understatement. Volunteering at a shelter set up at the Cajundome in Lafayette, Miller and his wife came upon three buses of dialysis patients who had gone days without dialysis. Miller obtained permission to send the buses north to the dialysis facility in Opelousas.


During the hours after she received Miller's 8:30 pm phone call, McManus organized the staff, who reopened the clinic, even though they had just finished their shifts. She also reached out to two other local dialysis clinics, Fresenius Medical Care in Opelousas and a DCI facility in Eunice. These facilities also mobilized staff to prepare for the buses.


When the 60 patients arrived, many told McManus that they had been sitting on the buses for more than 12 hours without food. The number of patients normally dialyzed at both of the dialysis centers in Opelousas is from 20 to 24 at a time.


"They were scared," McManus recalls. "Some of them were still wearing the paper scrubs they had on when they were picked up from the hospitals. No shoes. What they had with them is what they had, which was very little. We were dialyzing in horrible situations, people coming in with sores, with fungus growing on their ears from being in the water for days." By 2:30 am all the patients had undergone treatment, but the buses were taken by the authorities. There was no transportation, and there was no place to send the group. McManus turned her effort to finding beds.


McManus worked with the pastor at the local Methodist church, turning that church and another one down the road into shelters for the dialysis patients. The patients were transported as a group in vans from a local Baptist church to the DCI clinic in Eunice and continued to receive dialysis until they were relocated.


Through the use of two-way radios and other means, and with Miller scouring the makeshift health stations, dialysis patients entering Baton Rouge were directed north to McManus and her coordinated "triage, treat, and transfer" program. When Hurricane Rita made landfall several weeks later, the process began again, with patients from Texas and Louisiana.


Weeks passed and communication lines slowly began to be repaired, reuniting family members. Some patients left by plane or bus for new destinations, a result of the organizational efforts of McManus. But some patients stayed. Marriages were celebrated in the shelters, as well as births, and some evacuees eventually settled down in the area.


McManus also cared for fellow nurses. "Some of the nurses who came to us had lost everything," she says. "They had been in the evacuated area and they came to work."The pharmaceutical company AMGEN donated funds through the ANNA to provide small grants for these displaced caregivers. Months later, again through work by McManus, the ANNA, a local pharmacy, and a medical supplies company held a dinner for the nurses and other health care providers who had accomplished these admirable feats.


A year later, McManus is pursuing a doctoral degree through Indiana University, while she continues as a part-time faculty member at the University of Louisiana at Lafayette.


Her memories of the aftermath of Hurricane Katrina include one woman she met in a van in one of the shelter's parking lots. Pregnant, in need of dialysis, and accompanied by her boyfriend and 12-year-old daughter, the woman and her family were taken in without hesitation. A year later, the couple is married and employed at a local hospital, living in a nearby apartment with their two children.


"I think I always had a servant's heart," McManus says of nursing in those trying times. "I think that it's an honorable thing to use your talents or whatever you're blessed with in the service of others. Nursing has given me an outlet to do that."


Nephrology nursing was recently recognized as a nursing specialty

With the invention of the arteriovenous shunt in 1960, the long-term treatment of renal failure through hemodialysis had become a reality, necessitating more nurses than ever. The American Nephrology Nurses' Association (ANNA) was established nine years later at a meeting attended by 50 nurses in Atlantic City, New Jersey. According to the ANNA Web site, its mission is to "advance nephrology nursing practice and positively influence outcomes for patients with kidney or other disease processes requiring replacement therapies through advocacy, scholarship, and excellence."


Today, the ANNA boasts more than 12,000 members in 115 chapters nationwide. Nephrology nursing has been designated recently as a nursing specialty by the American Nurses Association, through its Congress on Nursing Practice and Economics.


Hemodialysis, peritoneal dialysis, conservative management, continuous renal replacement therapies, organ procurement, and nonrenal transplantation are some of the areas in which ANNA members work. More information about the ANNA is available at