Question About Returning to Dialysis

Guttercat, ASN, RN · Apr 14, 2016

1.) Welcome back to the dark side mwhahahahaaahaaaa.

2.) I took a year and a half break, and it took two or three weeks to get enough mojo back to function well (enough). You'll be fine.

westieluv · Apr 14, 2016

Thanks, Guttercat.

It's not 100% certain that I will return to dialysis, I have a few other applications out there. A couple of them are with insurance companies doing phone case management from home. If I can get one of those, I probably won't go back to dialysis, but it would be the next best thing, since the small FMC clinic in my small town actually has a full-time RN position open, which does not happen very often. Two minutes from my house, MWF only, of course Sundays and holidays off...so not a bad opportunity at all.

Thanks for the encouragement. If they give me 2-3 weeks of shadowing/having a preceptor, I should be fine. Anything less, I will have to turn it down. I also applied to a couple of Davita clinics, just for the heck of it, and I'm not sure how they would do my orientation since I have a FMC background.

Glad to see you're still at it. :)

Guttercat, ASN, RN · Apr 15, 2016

Thanks, Guttercat.
It's not 100% certain that I will return to dialysis, I have a few other applications out there. A couple of them are with insurance companies doing phone case management from home. If I can get one of those, I probably won't go back to dialysis, but it would be the next best thing, since the small FMC clinic in my small town actually has a full-time RN position open, which does not happen very often. Two minutes from my house, MWF only, of course Sundays and holidays off...so not a bad opportunity at all.
Thanks for the encouragement. If they give me 2-3 weeks of shadowing/having a preceptor, I should be fine. Anything less, I will have to turn it down. I also applied to a couple of Davita clinics, just for the heck of it, and I'm not sure how they would do my orientation since I have a FMC background.
Glad to see you're still at it. :)

Insurance work is something that I would find interesting, but perhaps in the future. Right now I am still enjoying Acutes.

My fingers are crossed for you that you find the right fit, dialysis or otherwise.

westieluv · Apr 15, 2016

Insurance work is something that I would find interesting, but perhaps in the future. Right now I am still enjoying Acutes.
My fingers are crossed for you that you find the right fit, dialysis or otherwise.

Thank you. I'm glad that you enjoy acutes, it seems like something that you either love or hate. I am still in awe of the guy who trained me on acutes back in 2013. He had the best attitude of any acute nurse I have ever known. Never in a hurry to get out, never complained if he had an extra treatment added on at the last minute...he was amazing. I think you have to be a pretty laid back, take it as it comes, kind of person to deal with the crazy and the unexpected situations that pop up in acutes, and I am way too type A and high strung. As an example, I would start checking the ER situation by about 2 pm when I was working in a hospital so that I could anticipate whether or not I would be getting an add-on treatment that day. As an acutes nurse, you know that you cannot anticipate anything, it just sort of happens, sometimes on a dime.

Suffice to say that acutes was not a good fit for my personality type. ; )

Erikadawn RN · Apr 15, 2016

After I left Freaenius and reapplied, because I had been gone over a year, they wanted me to do the whole training again.

westieluv · Apr 15, 2016

That would be awesome, I would definitely take it if offered. Better to repeat than to not get enough.

Davita is also requesting a phone interview with me as of today. Does anyone who has worked at both have any feedback as to which is better to work for if I am lucky enough to have a choice? Would it be easier going back to Fresenius since I've worked for them in the past?

Guttercat, ASN, RN · Apr 16, 2016

Thank you. I'm glad that you enjoy acutes, it seems like something that you either love or hate. I am still in awe of the guy who trained me on acutes back in 2013. He had the best attitude of any acute nurse I have ever known. Never in a hurry to get out, never complained if he had an extra treatment added on at the last minute...he was amazing. I think you have to be a pretty laid back, take it as it comes, kind of person to deal with the crazy and the unexpected situations that pop up in acutes, and I am way too type A and high strung. As an example, I would start checking the ER situation by about 2 pm when I was working in a hospital so that I could anticipate whether or not I would be getting an add-on treatment that day. As an acutes nurse, you know that you cannot anticipate anything, it just sort of happens, sometimes on a dime.
Suffice to say that acutes was not a good fit for my personality type. ; )

No, Acutes are definitely good for type A's ,too! We're ringmasters! I constantly check the census, and stay in contact with hospital staff and docs to ward off surprises, and keep the day flowing as best as I can. That's part of the fun of being (relatively) autonomous. Do I love multiple add-on's and having my plan go to heck? Of course not, and I've been known to moan and whine with the best of them when "my" plan is thwarted.

I think the biggest problem is when one is expected to do extended shifts repeatedly. I can do anything for 12-14 hours, as long as I know my day is done when it's done. I'm happy to bust a hump as long as I know I can pass the baton at some pre-determined point. It sounds like the program you are in did not allow that luxury. I am very lucky to be where I am, at present. I do love my job here.

westieluv · Apr 16, 2016

No, the program that I was in worked like this: you were assigned to a specific hospital(s) starting at 6 am. You were also, unfortunately, on call for this hospital or a different one until 6 am the next morning. So after working until, say, 6 pm and calling it a day for sure, You could get home after that twelve hour shift, or often times still be driving home from that twelve hour shift, and get called right back for a five hour add-on treatment. Sure, we could pass the baton...after 24 hours.

I called my manager one evening when I was driving home at 9 pm after starting at 6 am and got called back to do a treatment in the ICU. I told her that I had just worked 15 hours and I was too tired to do another treatment and was concerned about fatigue/patient safety issues. I was told to "put on your big girl pants because there's no one else to do it." I ended up doing it because, well, there was no one else to do it. I was SO angry at my manager. She had worked a few hours that day, I felt that as the manager it was her job to relieve me in an extreme situation like this. I ended up working 20 hours that day. Thankfully, I had the next day off, because if I didn't I would have been expected to be back ready to go, although they would have been "generous" and let me start closer to 8 am. We took on call 3 nights during the week and all weekend every other weekend.

I left acutes shortly after that episode. I want to believe that all acutes programs aren't like this and that this was just very poorly, and unsafely, run, because there were a few things that I liked about acutes. I liked the autonomy, I liked only running 1-2 patients at a time, and I loved the feeling of literally saving someone's life when they would come in with a K+ of 7.3 and it would be 4.0 after I got done with them.

Chisca, RN · Apr 16, 2016

I called my manager one evening when I was driving home at 9 pm after starting at 6 am and got called back to do a treatment in the ICU. I told her that I had just worked 15 hours and I was too tired to do another treatment and was concerned about fatigue/patient safety issues. I was told to "put on your big girl pants because there's no one else to do it." ended up working 20 hours that day.

The difference between management and leadership. What she really was saying is you are expendable and any warm body will do. I read in your posts a love of nursing but a fear of crawling back in to the same swamp you were in. I wish I could say it has changed since you left dialysis but it has not.

westieluv · Apr 16, 2016

Thanks, Chisca, that is how I feel. I actually really love renal patients and enjoyed working in dialysis. What caused me to leave in the first place was because the acutes environment I was in was not sustainable and the chronic unit I went to to escape acutes gave me a case load of 22 patients to do everything for, including running some of the treatments. I could not keep up with the care plans that we were required to do because I was either busy running treatments or the patients who were due didn't show up on days I could actually find the time to do them.

The chronic clinic I am interviewing at on Monday only has 18 total patients and I would not be the only RN, so already it is better, although I already have a list of things I want to ask before I jump back into the fire, so to speak.

As far as acutes, there is one program about 30 min. from my house (a FMC unit) that runs patients in just one busy hospital and has two full shifts of RNs so they are actually done at a scheduled time. This would be heaven as an acutes nurse (my previous acutes program had no second shift to relieve us), but they rarely need help, for obvious reasons. People tend to stay when the working conditions are decent.

BTW, I worked for FMC before, which is where my interview is on Monday, but I also have an upcoming phone interview with Davita, just in case. Would you suggest sticking with FMC since I'm familiar with them, or would it not be a huge deal transitioning to Davita if the conditions sound better? I have no knowledge of Davita except that one of my previous co-workers in FMC acutes left to go there and he says he likes it better.

Thanks!

Chisca, RN · Apr 16, 2016

. Would you suggest sticking with FMC since I'm familiar with them, or would it not be a huge deal transitioning to Davita if the conditions sound better?

I've never worked for either one so I can't say which is better. Keep focused on what matters to you and which ever one hits the most of your needs go with that. I'm so lazy I always work at the place that is closest to me. Right now that's 5 minutes away. Makes on call a little easier.