[luv_acute_HD]

We have to have in depth knowledge of dialysis! Ex:1)the effects of dialysis on the body 2) the "normal" abnormal lab values of these patients 3) we dialyze patients in ICU who are already in very serious condition BEFORE we put them on the "machine" and it definitely takes expertise to "run" these patients.------------- There is so much to know to actually be a dialysis nurse----over and above the things we have already learned in nursing school. It seems to me, however, that lots of the time the pay is even less than a floor nurse---I have done both----Both jobs are extremely difficult and both jobs are equally important----I am not putting down the "floor nurse"--- I just want to know why it is difficult for us to be paid as well.------------------I also feel that being a dialysis nurse is a specialty------other specialty nursing offers a slight raise in pay, but not dialysis. As an acute dialysis nurse in my part of the country,,,,,,I have to accept a cut in pay,,,, so now I have went back to Med-Surg,,,,,,,,,because I refuse to accept the unfair cuts in pay.....I love acute dialysis nursing,,,,,especially in ICU,,,,but I choose not to do it,,,,,,,,because I know we deserve at least the same as other specialty nursing. I would appreciate feedback on this subject. I cannot be the only person who has noticed this. Thanks-------- E-mail me at: nurse_traveller@yahoo.com

[kewlnurse]

Our Dialysis nurse get paid the same as icu and or nurses which is slightly more than floor nurses. In my experience dialysis nurses do dialysis, period. They'll draw a ptt on a pt on heparin, they won't look up the labs or adjust the pump. I have written up many nurses for this to no avail. (non cc dialysis). They won't give meds if you don't send them to dialysis, nor will they call the floor to get them. They won't do dressing changes. The won't give pain meds, they call the floor and tell the nurse who is on that assignment to bring them down. They only take off orders that pertain to them at that very minute. Forget about calling the pharmacy or filling out the assesment sheet. No note unless the patient codes, and even then it's rare. I actually had a dialysis nurse call me on the floor and tell me i had to write a note about a patient that had a med reaction while in dialysis, I almost peed myself laughing. Thats my take on dialysis nurses. I'm sure they are not all like that, but in the facility where i work about 90% of them are. As far as knowing the effects of dialysis and lab values, that basic nursing stuff.

[TELEpathicRN]

I am transferring from a chronic dialysis unit to an acute one and was told that the acute nurses make a substantial differential per hr + call pay.

as far as the comment about dialysis nurses not giving meds, etc.. I was told that it was "policy" that they not keep PO/IM/IV pain meds in the dialysis unit and it was "policy" that the floor nurse come to the dialysis unit and give the PRN. I would hate to be the floor nurse that has to go all the way to the dialysis unit to give a med!! But....they say this is the way they do it. It is a Fresennius unit and if you have ever worked for them, you know it is their way or the highway!!!!

about writing notes, we have flowsheets that have assessments on them, so no need to write a narrative note on the pt.

P.S. The nurses in this unit are required to check the pts daily labs, etc... and they give ALOT of blood and antibiotics during dialysis...at least the floor nurses don't have to be tied up with that!!

[ageless]

As an acute dialysis nurse I would like to comment on a few points made by Kewl nurse.
My employer is a private company under contract to do dialysis. Therefore, I can only legally take orders and/or carry out orders from a nephrologist. Check to see if this isnt the situation in your facility. I do my own assessment and report it to the physician and fill out my own paperwork. When the patient returns to the floor, you are welcome to use this form as a reference.

I have a patient for 2-5 hours and do not take orders off (even from a nephrologist) that I will not be present to carry out. Too easy for the order to be missed.

I do not do dressing changes other than those pertaining to dialysis for the simple reason that the floor nurse needs to see the wound. I won't be available to talk with any other physician/ surgeon that might want that information.

I give all meds necessary for patient safety, comfort, condition unless they interfer with dialysis. Many of those are kept on the floor and need to be transported to me. I can't leave the patient's side. This does become a problem.

Renal nursing is a specialty with its own set of knowledge, stressors, and responsibilities. It not basic nursing stuff.

By the way, I make a five dollar an hour differential for my specialty.

[patadney]

Dialysis nurses are not floor nurses and Acute Dialysis nurses may not even be employed by the hospital where the pt is hospitalized. When the pt is taken to a Dialysis Unit for treatment the nurse does not have access to his /her meds,that is why the floor nurse must bring them over.Of course,they do not write on the assessment or Nurse Notes for the floor any more than the x-ray tech does. The info they gather is in their own paperwork,just as other dept of the hospital such as PT,RT,Xray,etc.Dialysis is a specialty and as such,the pay is a little higher in most areas,But all of nurses here in the Midwest are vastly underpaid-so do what appeals to you.

[TELEpathicRN]

I have just transferred to acutes now and LOVE it!!!! Would like to hear from other acute nurses!!!

[patadney]

Welcome-we need all the help we can get!We are all getting older and may need help ourselves sometime. I like dialysis because of the patients. You get to know them and their families. Not as much as in the chronic unit,but the ones with problems get to be old friends and you get to save a few lives!

[Sonya G]

In the area where I work, dialysis is considered a specialty. I work for a company that is contracted to do acute dialysis only. This company does not own a chronic unit. In this area dialysis nurses are hard to find. Our pay is much better than what the area hospitals pay.

[gambroRN]

I am an RN working in a chronic HD clinic in FL. We are paid a little bit more than hospital RN's (non-specialty). There is a big turnover in dialysis nursing, probably due to poor management. There is always a need for dialysis nurses, esp in Florida - but the pay for all RN's is deplorable in this state (and they wonder why there is a shortage - duh!)
Shaybub

[Brownms46]

Originally posted by Sonya G
In the area where I work, dialysis is considered a specialty. I work for a company that is contracted to do acute dialysis only. This company does not own a chronic unit. In this area dialysis nurses are hard to find. Our pay is much better than what the area hospitals pay.

There is a shortage of dialysis nurses all over, and there are some places with travel contracts for Dialysis nurses. I have considered taking a position...but figured it would be a little too slow paced for me. But I do like the idea of not working on Sunday....AND 3 OR 4 days a week. What do most of you who work in this area love about it??