Praktek klinik residensi keperawatan medikal bedah kekhususan ginjal urologi memberikan bekal kemampuan pemberi asuhan keperawatan secara langsung, clinical case manager, penerapan evidence-based nursing, dan penerapan inovasi. Asuhan keperawatan diberikan dengan pendekatan Teori 14 kebutuhan dasar Virginia Henderson pada kasus utama Unilateral non-functioning kidney dan 30 kasus resume. Pengelolaan nyeri akut dan manajemen kesehatan ginjal menjadi fokus pada kasus utama. Peran sebagai clinical case manager tampak pada pengelolaan kasus resume. Masalah kelebihan cairan menjadi masalah keperawatan yang paling banyak diangkat pada kasus resume. Intervensi yang diberikan berfokus pada manajemen cairan dan pemberian konseling untuk pembatasan cairan dan konsumsi garam. Peran sebagai peneliti tampak dalam literature review evidence-based nursing. Hasil literature review menunjukkan bahwa passive leg raising bermakna (p<0,05). Peran sebagai inovator dan kepemimpinan tampak pada pelaksanaan proyek inovasi. Proyek inovasi berupa buku harian HD meningkatkan proporsi Interdialytic weight gain baik (<2,5 kg) sebesar 14,8% di akhir penerapan inovasi.

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Clinical practice phase of medical surgical nursing specialist in nephrology gives basic skill in delivering nursing care, clinical case manager, implementing evidence-based nursing, and innovation project. We used 14 basic needs Virginia Henderson theory towards one main case-study and thirty resume case. In the main case-study, the focus is managing acute pain post-operatively and preserve the remain kidney. The role as clinical case manager was gained from managing 30 resume cases. Excess fluid volume is the most prevalent problem across resume cases. The intervention then focused on fluid management and counselling about fluid and sodium intake. The role as researcher was gained from evidence-based nursing project. The literature review showed that passive leg raising could increase blood pressure among intradialytic hypotension case. Passive leg raising showed significant results (p<0,05). The innovation project gave experience as innovator and leadership. The implementation of HD diary book showed improvement of the proportion of good Interdialytic weight gain (<2.5 kg) 14.8% at the end of observation.