Is this what being an RN in dialysis is like?

Specialties Urology

Published

Well, this is my first RN job and I don't really know what to think. I started working in a 24 chair facility. We do two shifts a day, Monday through Saturday. The first part of my training has been learning the tech's job. I'm out of training now and either work as a float RN or have a station of 4 patients. The days I work vary but the hours are all over the place. Sometimes I'm in at 4 am, others at 5, then sometimes 6am, depending if I'm running a station or floating.

I'm being told that after about 6 months from my hire date I'll be a charge nurse. The charge nurse sometimes has to help put patient's on and take them off, depending on staffing.

I feel like I am a chicken running around with my head cut off. I am so tired by the end of my shift that I can barely walk when I get home. My feet hurt constantly, even on my days off. I need to exercise on my days off but I'm usually so tired trying to recover from work I simply don't have the energy. I bought a great pair of work shoes but I'm still dog tired and my feet kill me.

Going in at 5am one day, 4am the next, 6am the other is wrecking havoc on my sleep. The charge nurses usually come in at 5am so at least that would be consistent.

Does it get better? One day I feel like I'm doing great, then the next I forget to do something and the day goes down hill. Why is change over such a nightmare? We're given 15 minutes between patients to get them weighed, assessed, etc, and put on the machine. Lord help you if they have to be moved to the chair using a lift. There are maybe 2 people I work with that can get someone on in that time; they've been doing this job for several years. And that's if everything goes right with the patient.

Coworkers are scared to death to call in sick, so they come in when they shouldn't. They all say they don't want to get chewed out. I understand some people abuse taking off. I've been told by my coworkers if I call in to have a doctor's note ready to hand in.

I chose dialysis because I liked that it was a small work-place setting where you don't feel you get lost in the crowd at say a big hospital. From day one the people I work with have told me "give it at least 6 months" so I'm trying. And most everyone I work with has been wonderful and very helpful. But I have found myself the past few days not wanting to go to work and that's not me. Sorry if this sounds whiney. This is only the tip of the iceberg with my questions/concerns about my chosen career and employer. Just wondering what I got myself into.

Specializes in Nephrology, Dialysis, Plasmapheresis.

I worked in the outpatient setting for 2 years. It was my first job out of nursing school. I never felt like crying in my car, but I talked to other new employees that did. They were not all new nurses either. The people that told me they cried in their car before they clocked in usually didn't last long. I don't think anyone hour feel this unhappy about their job. But I do think you should give it a fair chance. If you start to get anxiety attacks, forget it! Not worth it. Some people thrive in this type of environment. Some prefer something a little more controlled or autonomous. This is a very hate it or love it type of job. I loved the chaos! I still do. I think that's what makes it a right fit. I used to almost cry going into my labor and delivery clinical because I just hated it! Made me so uncomfortable and sick to my stomach. I know it's been a couple months since you posted so hopefully it's either gotten better or you're looking for new employment. I just don't think anyone should hate their job that much. Consider an eye opening, good experience. One that you would never want to relive :)

I used to have that feeling that my legs are burning at the end of every shift.. I know there's a lot to do.. but always try to sit down whenever you can, even for a few minutes at a time.. If your documenting and you can pull up a chair, do so. It really does help. Long shifts, you have to sit down. If your prepping the meds, do some squats. :yes: It may seem silly, but it helps with circulation. And wear high socks and comfy shoes. Dialysis, especially outpatient, is chaotic and seems like there's no time to sit down, but try. It will also help calm you down. If it feels like there's so much to do, think about one thing at a time. I used to get very anxious thinking about the stuff that needs to get done before turnover that it takes me so much time to finish one task. Focus on one thing, finish it, then move on to the next.

Organization is good but be flexible. If you can prep for the next shift, as much as you can, do so during downtime. But don't feel that you have to prep if there's no time. Just prep for one patient at a time, if that's all the time you have. ALso, even though there's a rush to get patients on, you have to plan ahead, timing is key. Don't put your 3:30 pts all at the same time that they all come off the same time. Patients tend to become impatient when they hear the alarm that tells them their treatment is done. If you can, put the 3 hr pt first before the 3:15 so that you have enough time to take off and start prepping the machine for the next one before your next take off.

Lastly, do not let the patients rush you. One, it is not safe for you or for them. ALso, you have to set boundaries with them. If they know they can rush you, they will do it all the time and then you'll feel bad because they're disappointed or upset that you cannot put them on at a certain time. They know things happen that you cannot foretell that messes the entire schedule.

I, too, used to get anxious before my shift starts, and never leave on time the first few months. But, if you stay, you'll learn which patients are stable and those that need their BP checks more often than required, you'll have an idea of which patient BP starts high and drops the first hour, or who starts cramping at how high a goal. That's the good thing about chronic, you get to expect about the same from certain patients during their treatment, be it complications or lack thereof.

About being charge, if you're not comfortable, then tell your superior. Especially if you still don't know how your facility runs, transportation, MD orders, labs, the details, etc. and if you're not familiar with almost all patients yet.

I started as a new grad rn in an outpatient chronic dialysis unit 2 years ago. I was also trained as a patient care tech for the first couple months and then became charge nurse after my first year. For me the first 3 months were the most trying as dialysis is a specialty, there was a whole lot to learn from the water, machines, patient complications, and work flow. It was at about 6 months that I began to become more comfortable with the job. I have to say that the support of the other nurse you're working with is critical, they can either make it or break it for you. As far as energy is concerned, I do get pretty tired by the end of the day and sometimes just want to pass out and go to bed when I get home. Nowadays, I am still tired but it's manageable. Invest in some great shoes, the lightest weight stethoscope available, eat healthy, drink plenty of water, and pressure stockings have helped tremendously.

Do NOT let the techs talk you into calling somebody in early or switch pt put-on schedules. It will just screw up the turn around & as the nurse you will be the one to suffer every time! I don't know why they want to do it; you just work twice as hard to finish 15min early..it's not worth it and you'll be frazzled the rest of the day.

Boy don't I know it. I work with good techs but I don't understand that. Working at that pace just opens for mistakes. Nurse9

Boy don't I know it. I work with good techs but I don't understand that. Working at that pace just opens for mistakes. Nurse9

How bout some feed back from Fresenius RN's how ya being treated ?

My thoughts exactly

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