I agree with the obove post. Even within the same company, dialysis clinics may be very different. Ask about staffing for the facility you will work for, number of nurse to pt. ratios, tech.s in unit. Personally, I feel the corporate take over by large dialysis companies like Davita, and FMC has made dialysis nursing very stressful. High pt. to nurse ratio, excessive paperwork and a mentality where MBA's and administrators are valued more than nurses. There are multiple layers of management , i.e , team leader, clinic manager, area manager, operations managers, vice presidents.... The companies are for profit and managers WILL get their bonuses. At the facility I'm employed, we count syringes, bandaids, and boxes of gloves, dressings. We have patient care technicians that are responsible for non patient care responsibilities because the company eliminated techs. who were responsible for stock and other ancillary care duties. Registered nurses are responsible for patient care, performing dialysis treatments if a tech. calls in sick, completion of care plans
, supervision of patient care technicians and problems their patients may experience during hemodialysis treatments, and implementing a series of what they call algorithms to achieve medicare outcomes or goals. The algorithms are policies and procedures nurses follow to administer medications to manage anemia, bone disease, etc.. according to the patients blood test results. I feel some nephrologist basically come in to the facility to make rounds, or wave at the patients because the nurses are indirectly (through algorithms) changing medications dosing etc... God forbid you make a mistake with an algorithm. They have compliance policies that dictate when to wear mask gloves, face shields, mask, when to touch and not touch dialysis machines, wash hands etc.. and depending on your clinic manager, failure to comply, will get you a verbal or written warning.
In the acute care area, be prepared to take on call, also driving to multiple facilities, working pm's or nights. In the peritoneal area, you will also take on call,and sell or market the program. If you patient census is low, they will decrease your working hours or move you throughout different facilites. Again, here there are numerous algorithms to follow and non compliance by patients is blamed on nurses failure to train or educate. Nurses are also responsible for billing for services, treatments, insurance forms etc... because these nurses work independently and don't get much help from secretaries, techs, etc...
Compensation for on call is poor at a flat rate, but not compensated for time spent on the phone. Patients on peritoneal dialysis will require some home visits. Recently, the dialysis companies have also decreased social work and dietitian hours to meet theri profit incentives.
In this economy, we are lucky to have a job and I wonder if the work loads for all nurses is difficult everwhere. I guess it comes down to what you consider to be stressfull, but I thought I send you some specific info. to help you decide. Good luck.