Help. Acute dialysis nursing

TheCommuter, BSN, RN · Mar 20, 2016

Moved to the Dialysis nursing forum for more replies.

AcuteHD · Mar 21, 2016

I don't get paid per treatment, just hourly, but expect feast or famine. In my personal experiance I've never had a problem getting enough hours and have plenty of PTO banked up if needed.

I work 4 days a week and take call on Sunday, your schedule will be site specific.

As for when you can go in for a single treatment, that will depend on the doc you are working with (they have to see the pt while on the machine so do they want to come in early or stay late), the condition of the patient (if K is high you better get there before ER doc gets excited and orders kayexalate), what else is going on with pt (d/c after dialysis, procedure before or after dialysis). Rule of thumb, never put off a treatment that you can do now because you never know what later is going to look like.

PTO and sick day benefits I guess are site specific, I get PTO. I don't have any experiance with 1099, sorry.

I usually work by myself with 2-3 patients at a time, I would love to have a tech but that's been a non-starter since I've been doing acutes. If you have a tech, you'll need to justify it by taking on more pts per shift.

I try to call for pts at 0800. This gives them time to have breakfast, labs resulted and docs are coming in. I am on call from midnight to midnight the day I work, but very rarely get called in. I may have to stay late if there are a lot of patients, but usually don't get called in.

Good luck.

NurseRies, BSN, RN · Mar 22, 2016

If you work full time for an acute program you can not work whenever you want. You usually have expectations, I work 6-6 right now but have also done 7-7, 10-10. Depends on the program and their needs. You can't pick and choose how many treatments you want or when you work at all. Even the per diem acute nurses must do as their told and have expectations of when they need to show up. I have work for 6 acute programs in 5 states as a traveler. There are not usually techs in acutes unless you have a very busy inpatient unit with 4-10 stations. Most of the time I am by myself in an ICU or in an isolation room. Getting paid per treatment is a thing of the past. It's actually no longer compliant with billing in the US is what I understand. Dialysis nurses used to bank but now they all make hourly. When you're on call, which can be any variety of hours, you are expected to be available at any time and must be on site within 30 minutes after the Doctor calls you. With any full time job there are regular benefits. It sounds like you're looking for some kind of dream gig where you go in whenever you want and get paid based on how much you work/how many treatments you do. This is not the case at all. You will have set hours and high expectations, you will be paid hourly and will be expected to take you fair share of the load for the team. If you want to work whenever you want you will have to do per diem and likely will have no benefits.

nutella, MSN, RN · Mar 23, 2016

Hello. I am looking into acute dialysis nursing. How does getting paid per treatment work? how does being on call work? Can I work one day a week or five days a week? Can I go in whenever I want and just run for one treatment? What about sick days or PTO? How does a 1099 work? Would you preferto work with a tech or by yourself what shift is the best shift to work or is it any time because it is on call? So sorry for all the questions but I am moving across the country to Los Angeles and I need to make sure everything will work out. Thank you

If you are new to acutes you will need to be trained and get some solid experience first.

That usually means full time and you will be scheduled and have to show up to your shift and work your hours/tx.

Once you are trained, you will be expected to take call.

With experience you could work per diem but of course that means no guaranteed hours and no benefits. I did work per diem at some time and would commit to a full day, meaning 2-3 tx depending on how much cases they had in total. But there were also days where I was only able to do one treatment or they would call me to see if I could jump in to do one treatment.

Smaller programs usually mean less per diem and less flexibility. Large programs have more possibilities.

simplelee · Apr 1, 2016

Hi ,i just got a job with Davita acute care , however was wondering if this will be too much the working long hours and being on call , as i want to start the FNP program in August , so my question is should i remain @ a bedside nurse or take the acute care job, thanks

NurseRies, BSN, RN · Apr 4, 2016

I think it's a very demanding job and does not work well with someone who needs predictable hours. I recommend staying where you are if you want school to get most of your energy. Acute dialysis is a job for those that don't mind overtime and are constantly asked to stay late.

Chisca, RN · Apr 4, 2016

Acute dialysis is a job for those that don't mind overtime and are constantly asked to stay late.

If this isn't part of every acute dialysis job description it needs to be.