I have been a SICU/open heart RN for 8 yrs and was recently offered a job by one the Renal physicians that round in the hospital I work in, for acute care dialysis. I have been really thinking about a change lately, but don't feel I have enough info on this particular area to make a decision. He is offering to train me to the specifics (which I know almost nothing), but I'm afraid of wasting his time and mine. Has anyone else made this transition? And if so, how do you like it? I feel so confident in my skills and knowledge base in my current setting and worry about starting back as a novice at something completely different. Any thoughts or comments appreciated.

If you have that much critical care experience, you would do fine in dialysis. Hemodialysis really makes alot of sense when you break it down into what chemical processes are happeining. If you

study up on renal failure, you will be able to understand what processes go on. I am sure you have had the CABG pt that went bad and went into shock and lost their kidneys. If they survive the ordeal, they become chronic dialysis pts, which make up a big % of the pts you will be dialyzing in the acute unit. You will be starting new patients, but also have to dialyze the patients that usually dialyze at the outpatient clinics, so you have to know about the chronic things they go through, ie phosphorus control, out of control PTH, etc...

The skills of dialysis are easily learned and become routine after a while. After you get the basics, you just have to apply them to the particular situations you encounter. I am sure you would have at least a 4 wk orientation and then 4-6 wks with a preceptor, gradually letting you do more and more until finally you are on your own.

You can do it. Come on over and join us Nephrology/Dialysis nurses. I work acutes, the only thing bad is the odd hours and having to take call.

Hope this helped

Thanks for taking the time to reply. I'd like to hear more about the odd hours, since I've been on 12 hr nights for the last 8 yrs I think anything involving daylight will be really different And if you don't mind me asking, do you get paid extra for call? I havn't interviewed formally yet and I'd like a baseline idea of what others are doing/getting. Again, appreciate any info you could share.

I too went from 12 hr nights to this "day" position and was thrilled to death to see daylight while I was working. What I mean by odd is that we are scheduled to work 0800-1830, that is 10 hrs + 30 min lunch break. Sometimes we get off earlier than 1830, and sometimes we get off much later. Just never know when you are going to get off. You really can't make any plans for the evenings on a day that you work, because you cant be promised that you will be off on time. Other than that, the hrs are ok. The odd hrs are when you get called in at 0200 from a deep sleep and have to work until 0630 or 0700 and pray you aren't scheduled for that morning to work!! My boss is real good and so are my co-workers, they usually work something out where you end up being off.

We get a $3/hr "acute care differential" vs working one of the out patient chronic units, call pay $15/night during the wk and $25 on weekends....which really equates to $1/hr call pay. They are working on giving us time and 1/2 anytime we are called in. We also get an evening differential of $2/hr if we work until 2000, it goes retro back to 1700, so if you work until 2000, it is an extra $6 for that. All in all, acute HD is great. Give it a try.

Hope this helps you more!!

Some acute programs pay $4.00 dif. Call pay is about the same. I worked in the acute program in our company but found that even though I was going to work during the day I was seeing less daylight than when I was working nites. Make sure the staff of the program is steady without a lot of turnover. My worst day was when I had no other nurse to back me up and worked 21hours. Needless to say I left the acutes after that. Burnout is high unless you are staffed.