Fresenius called me today...

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    and it was quite out of the blue. I had applied for a position with them several months ago, but there was a lot of travel involved and on-call hours on top of the full-time hours so I turned down an interview.

    Today my phone rang and it was Fresenius wanting to know if I am interested in an inpatient RN position where I would be working in two different hospitals' inpatient dialysis units for Fresenius. It would only be three days a week. I am currently a Med/Surg Tele nurse of 23 years who works on a contingent basis in an internal RN float pool of a large healthcare company but needs to find benefits very soon due to my husband's new employer only covering him and not me or our two kids.

    In one way, I am intrigued and flattered that they found me and want me for this position. OTOH, I am nervous that my years of Med/Surg and Cardiac Intermediate nursing will not have prepared me to be a dialysis nurse because I have never worked critical care, although I do have my ACLS certification.

    Questions:

    How is Fresenius to work for? Has anyone here done this type of dialysis nursing for an outside company within a hospital setting, and if so, how was it?

    Is it hard to learn dialysis nursing? It seems so complicated to me, but I know that all of you had to go through that learning curve at some point. Do you think Med/Surg and Cardiac Intermediate will be an adequate background for learning to be a dialysis nurse?

    Lastly, can you list some of the pros and cons of being a dialysis nurse, and more specifically, an inpatient dialysis nurse?

    Thanks!

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  2. 13 Comments...

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    I have worked in dialysis 15yrs all at fresenius. First of all your experience in med/surg and cardiac qualifies you to work in dialysis. But my suggestion is if you want to work in dialysis don't go to fresenius. I resigned 2mo ago. And started with Davita much better.
    Nurse9
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    Thanks for your reply. If you don't mind my asking, what is it that you like better about Davita? I have no connection with either company, I just don't want to make a huge mistake, as the company that I currently work for is huge and offers a lot of different types of opportunities besides bedside nursing, including their own inpatient dialysis unit which I applied for but haven't heard back from yet. If I jump ship to Fresenius and then find that I hate it, I doubt if this company would take me right back.

    I also have an interview this morning to work in one of our hospital's ER. It's a Level III trauma center, so it would be an easier transition into ER nursing than a Level I trauma center. I am seriously considering that option too.
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    Quote from sonhot
    I have worked in dialysis 15yrs all at fresenius. First of all your experience in med/surg and cardiac qualifies you to work in dialysis. But my suggestion is if you want to work in dialysis don't go to fresenius. I resigned 2mo ago. And started with Davita much better.
    Nurse9
    Working for fresenius or davita doesn't matter, they're both great companies, it all comes down to management and coworkers. I have worked for great programs and poor programs for both companies. If they operate their acute program efficiently and fairly, you will like your job. As an acute travel dialysis nurse, I have had awful inpatient jobs and okay ones. The number one complaint you will have is the hours. You will not know what time you will get off. You may go in at 6am and not come home until midnight. Good questions to ask would be: how much call time is required? How long is a typical shift? Do you hire late nurses or night nurses to take over late treatments? Maybe ask to shadow a day? Most people either love dialysis or hate it.

    Your experience is more then enough. I started in dialysis as a new grad, and did fine. Ask if the treatments are done at the bedside or in an acute room? If done bedside, you always have a floor nurse or ICU nurse for help. If done in a dialysis room, will there be techs or other nurses helping you? How much orientation will you get? 12 weeks minimum would be best! I think it is a great change of pace. I used to run in circles at the clinic and I see how nurses run around on the floors. This could be a nice change for you. But you will not be off work until all treatments are complete. Who knows what time, what if the patient has a surgery beforehand? You have to wait. They may not get back from surgery until 4pm, then you start treatment at 5 and may not be clocking out until 10 or 11. That's just how acutes are. Something to consider...
    MJB2010 likes this.
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    Wow! Thanks for all of the good information. I actually was wondering about getting off on time in the evening, because my floor experience has taught me that dialysis patients are never on a set schedule and so many things can delay or postpone their treatment. I was told that the hours are "about" 7 am-5 pm, but "about" is a vague gray area sometimes.

    Thanks again for the pointers on what to ask. I called them back last night and left a message that I may be interested and so far I haven't received a call back, but if I don't, no big deal because my ER interview went really well today so I may just take that route.
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    Former dialysis nurse here. I worked outpatient chronic but worked with many staff that did both acute inpatient and chronic. From my experience Davita or Fresenius does not define the culture, the manager does. If you have a good manager and good team your golden. Every unit has its own culture. Some good others ugly. If the one they are hiring you for is often hiring, run for the hills. For me all the things I enjoy about dialysis go with chronic. I Like knowing my patients and their history. I like knowing their normal and knowing their fistula/graft. I like having Sundays and Holidays off. I like not working nights. In acute you have to do call. You will not know your patients. You will work nights and weekends. But, you will have a lot less patients at once. In chronic they treat you like a robot. The understaffing and ridiculously long shifts were what lead me to leave, but I really miss my patients.

    Your background will be great. But dialysis is a whole nother animal. You will be starting at square 1 and building from there. It takes a minimum of 6 months to a year to feel comfortable. It is completely different than what you are used to. The 2 big dialysis companies have excellent training. My clinic bent some rules that made me uncomfortable, so your manager will play a major role in how much support you have. As a new dialysis nurse you are not supposed to be alone for 6 months after classroom training. My clinic tried to leave me alone my first day out of class. I had to speak up. I found that I had to speak up a lot. But our manager was one that liked to disappear.


    You need to ask to shadow before accepting a position. Go see the unit and see f the staff are miserable or happy.
    Last edit by MJB2010 on Apr 21, '13
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    Thank you so much for the informative reply, I really appreciate all the information.

    One thing that is a bit of a red flag to me is that this position has been posted for at least a couple of months. Maybe that isn't anything, but in my area, as in most areas, there are a lot of burned out floor nurses who would give anything to do something other than bedside nursing, so to my thinking, someone should have jumped on this position by now.

    The other thing is that I was told that it is every other Saturday and one Sunday a month. That could equate to working three weekends out of four. Yuck, why would I want to do that? I have a family and that would screw up a lot of fun weekend events. The ER position that I interviewed for is every third weekend, which is a lot better for someone with a family.

    If I do decide to consider this position, I will definitely ask to shadow one of their nurses. Thanks for that suggestion, I honestly hadn't thought of it. If they are reluctant to allow that, that would be a huge red flag too.

    Thanks again. You have really given me a lot to think about. : )
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    Quote from westieluv
    Thank you so much for the informative reply, I really appreciate all the information.

    One thing that is a bit of a red flag to me is that this position has been posted for at least a couple of months. Maybe that isn't anything, but in my area, as in most areas, there are a lot of burned out floor nurses who would give anything to do something other than bedside nursing, so to my thinking, someone should have jumped on this position by now.

    The other thing is that I was told that it is every other Saturday and one Sunday a month. That could equate to working three weekends out of four. Yuck, why would I want to do that? I have a family and that would screw up a lot of fun weekend events. The ER position that I interviewed for is every third weekend, which is a lot better for someone with a family.

    If I do decide to consider this position, I will definitely ask to shadow one of their nurses. Thanks for that suggestion, I honestly hadn't thought of it. If they are reluctant to allow that, that would be a huge red flag too.

    Thanks again. You have really given me a lot to think about. : )
    If family and time is important to you, you may not want to do acute dialysis. If you like to plan or know when you're getting off work, yikes, you will hate it! I work with lots of people that have kids, most of them end up quitting within a year because they're tired of telling their kids that they don't know what time they'll be home. Some people make it with a family, but they are usually prn or are just really really awesome! Probably workaholics. If its a small hospital, may be better, but then again, you may not get ENOUGH hours at a small place. The predictability of the job is .. Well.. Nonexistent.

    Just yesterday I was supposed to go home at 2 pm bc I am in overtime, well we had 2 add on treatments and I had to stay. I had already made dinner plans with grandma. I didn't get home until 9:30. And I only did 1 of those extra treatments.
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    Wow, good to know, and thanks for even more helpful information, NurseRies! I am a pretty (okay, VERY) type A person who is a big planner and likes to be everywhere, not just on time, but extra early. I HATE when my schedule gets messed up by unforeseen circumstances, so it sounds like this job would not be the greatest fit for me. I do fine with shift nursing, because no matter how rough my night goes, there is always someone coming to take my place so I never end up having to stay extremely late, and definitely not seven hours late! I would either have to forget about this job or work very hard to become more flexible, wouldn't I?

    Once again, you guys are a wealth of knowledge and experience, and I cannot tell you how much I appreciate you! : )
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    Quote from westieluv
    Wow, good to know, and thanks for even more helpful information, NurseRies! I am a pretty (okay, VERY) type A person who is a big planner and likes to be everywhere, not just on time, but extra early. I HATE when my schedule gets messed up by unforeseen circumstances, so it sounds like this job would not be the greatest fit for me. I do fine with shift nursing, because no matter how rough my night goes, there is always someone coming to take my place so I never end up having to stay extremely late, and definitely not seven hours late! I would either have to forget about this job or work very hard to become more flexible, wouldn't I?

    Once again, you guys are a wealth of knowledge and experience, and I cannot tell you how much I appreciate you! : )
    I also love to plan. I usually just don't plan anything unless I'm off work. Even if I'm on call overnight and off the next day, I warn people that I may cancel if I get called in at midnight. It's no way to live to be honest. I think I can only do it for so long. How wonderful it would feel to work 7-7, and never be on call .. :-/ but as I always say, I can't complain about my job. Some nurses think it's a dream job bc when I do ICu treatments, sometimes I can sit and read. Actually a patients daughter told me yesterday that I have got to have the easiest job on the planet. WOW! She had some nerve to say that. I smiled and said its easy because I know what I'm doing. But truthfully, it can be a pretty great dream job sometimes. 1:1 ratio is fantastic!!


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