From Ashley Kliewer, PA-C, Director, Advanced Practice
What led you to become a CRNP in nephrology?
I graduated from Lancaster General School of Nursing in 1993. I worked as a nurse for a few months in New Jersey, then came back to Lancaster General. There was only one opening at that time, as a second- shift dialysis nurse. I took that position with the goal to transition into critical care nursing; however, I ended up enjoying dialysis and loved being the acute dialysis nurse for ICU treatments for seven years. I then pursued my Bachelor’s in Nursing through Immaculata University. The physicians within Hypertension & Kidney Specialists encouraged and supported me as I pursued my nurse practitioner training, with the goal of becoming part of their team. I graduated from University of Pennsylvania in 2001 as an Acute Care Nurse Practitioner and became the first advanced practice clinician for HKS. I completed my certification as a certified nephrology nurse and was the second CRNP in Pennsylvania to do so. Dr. Marc Weiner has been my primary collaborating physician and was instrumental in developing me in my role as a nephrology CRNP.
What are some of your career highlights?
I participated in the phase 3 trial for Sensipar (cinacalcet) approval, which is now part of clinical practice. I was a speaker at the American Nephrology Nurse Association National Conference and have presented at the LGH Grand Rounds. I currently serve as the lead APC for HKS and sit on the Penn Medicine LG Health Advanced Practice Steering Committee. In 2018, I received the LGH Medical Staff Advanced Practice Award.
How has your role as a CRNP for HKS evolved, and what are future growth opportunities?
I began my role completing hospital and dialysis rounds, and after a year, I developed a chronic kidney disease clinic in the office setting. I used the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines and implemented them into our practice.
To date, we have grown to six APCs. We complete hospital follow-ups and see chronic kidney disease patients in the office setting. In the hospital setting, we manage the ESRD and AKI pts receiving dialysis. Most notably, the HKS APCs cover all of the dialysis units in Lancaster County, located at the Suburban Pavilion, King Street in Lancaster, Leola, Denver, Elizabethtown and on Manheim Pike.
Kathryn Couch, CRNP, and I teach a monthly chronic kidney disease class targeting early Stage IV CKD to discuss renal replacement therapy options as well as palliative non-dialysis approaches. At our DaVita Manheim Pike unit, we now offer a Transitional Care Unit, where new dialysis patients are dialyzed four days per week while receiving education on renal replacement therapies and home modality options to help develop the best plan for the patient.
APCs are present in the hospital on weekends and take call for the dialysis units. In the future, I would like to continue to evolve the onboarding process for new hires to our practice so they have a good foundation as they transition into their roles.
What do you enjoy doing outside of work?
I love attending various sporting events for my sons, Tyler, 17, and Ryan, 14. I also share two stepsons, Andrew, 25, and Alex, 21, with my husband Dr. Jim Groff. I am Vice President of the Manheim Central Soccer Booster Club. Our family enjoys boating the Chesapeake and visiting towns along the bay. Jim and I have a long-term goal to take our boat to Florida using the intercostal waterway.