Ramon (Ray) Duarte:  

assembled the dialyzers (artificial kidney filters); these artificial kidney filters were primed with formaldehyde and rinsed with sterile normal saline. Because they were using plate dialyzers no blood pumps were required for patients with Scribner Shunts (patients with Cemino Fistulas and Grafts did use blood pumps). The technology for air foam detection was non-existent, and therefore the nurses, technicians and patients were ever vigilant and fearful for air in the lines with blood flows at a rate of 300 to 500 cc a minute. The patients were taught to know, as much as possible, and in some cases as much as the nurses and technicians knew to participate in their own care. Ruptured membranes in the dialyzers (or kidney filters) were a common occurrence and the blood loss was so great that blood transfusions were always required. Training in this area was frightening. There were so many steps to learn in the care of the patient; nothing in the way of equipment was automated, and the nurse had to react competently and without hesitation in all emergencies even if still not fully trained;“ they were incredibly short of staff. "I felt fear as I began my training, cognizant of the many things that could go wrong", says Duarte. "My hands would not shake, my concentration intensely focused, I would then begin to perspire profusely." It was a non-verbal physiological response that, though most uncomfortable, communicated to his patients without any words that he cared and wanted nothing but the best for them. The only way he could promote his comfort and more importantly maintain the integrity of his sterile field was too design a system that now has become his trademark. Ergo the Gray Hat! At County they had Green surgical hats “ a sweatband with one of these hats over it took care of Duarte's needs, and maintained the integrity of a sterile field. In 1971 there were many unanswered questions in renal replacement therapies dialysis was still much in its infancy with research being done at every level. It is because of Duarte's strong background in Critical Thinking that he started designing research projects to attempt answering some of the questions. He has approximately 30 abstracts presented at regional and national conferences, nine manuscripts in print, and has been successful in acquiring one research grant. But his first love, his forte if you will-is to be at the bedside with the patient. In the last analysis, "none of my accomplishments" says Duarte "would have occurred without the help and support of the many professionals I work with." Duarte's research work impresses significance. Post cards calling for reprints start arriving from all over the world. It was only then he realizes the significance of his research work in his effort to help the dialysis patient. "I believe in growing F A T with passion", says Duarte. " F - A - T - FOCUSED, ATTENTIVE, and committed to a TEAM effort. This has always been my formula for success." Ray Duarte, Clinical Instructor, Registered Nurse and Nurse Researcher, has been recognized for showing dedication, leadership and excellence in health care research. He is an innovative Santa Barbara nurse, dedicated to kidney-impaired patients. Since becoming a registered nurse 38 years ago, Ray Duarte has been beset with a difficult challenge: How to improve the quality of life for kidney-impaired patients. To this experienced nephrology specialist, the current dialysis machine is a miracle of modern technology, and he has participated in the research process to improve it. After much exploration with fluid removal models, Mr. Duarte developed the first in vivo ultrafiltration rate monitor. This prototype device allowed for the first accurate projected fluid removal techniques. Mr. Duarte's equations of projected fluid removal (utilized in every computerized dialysis machine) have reduced the many discomforts normally felt by earlier kidney patients when too much or too little of the required water was removed. A steady, quiet working specialist and researcher, Ray has excelled in a field often troubled by severe shortages of funding in research for nurses. His many letters of commendation describe him as knowing as much about nephrology as most physicians in the field and he became the first nurse to be invited to join a medical honor society, the American Society for Artificial Internal Organs. The California native has published several articles in medical journals and lectures at national physician and nurse conferences as often as his personal finances will permit. His valuable research and compassionate bedside manner have earned him the respect of his professional colleagues and the affection of his patients. "They are the most courageous people I know," says Mr. Duarte of kidney-impaired patients who must undergo three- to four-hour dialysis treatments three times a week. Mr. Duarte's article "Seismic Risks in Nephrology, published in October 1988, established the first guidelines for the practice of nephrology in earthquake disasters and was referenced in the March 1990 issue of the New England Journal of Medicine. His article published two months prior to the Armenian Earthquake in December 1988 helped him coordinate an airlift response. In 1976, Mr. Duarte received the Dedicated Services Award from the Hemodialysis Foundation. In 1986, he was named Allied Health Professional of the Year by the National Kidney Foundation of Southern California. In addition, he was nominated at the 1991 New York Academy of Sciences™ Scientific Awards. He is also a recipient of a $10,000 grant from the Santa Barbara Cottage Hospital Research Committee. Looking forward, Mr. Duarte intends to continue to write and publish innovative work in both the health care and creative genres. For more information about Mr. Duarte's professional accomplishments, please visit by searching for his web site under Ray Duarte, RN.