A day in dialysis

TEXASWAG, MSN, RN · May 3, 2019

Acute dialysis? Loved it because with all the overtime I made good money. Loved the autonomy. Loved only dealing with one physician...the nephrologist. Now there's a catch though. It's called "being on call". A question I suggest you ask during your interview is what's their call schedule. Is it going to be 1 day a week? Are you expected to work your dayshift schedule then be on call afterwards? Is there a night shift nurse to help alleviate being on call during the week?

A couple of ICU nurses who switched to acute dialysis couldn't handle being on call and not knowing what time they would be getting off. For example, one of the nurses told me that one time she did not finish her day until 2 a.m. She had clocked in at 7 a.m. that day. Eventually, both of those nurses went back to the ICU.

I'm not trying to scare you but that is the reality of acute dialysis, and sometimes nurses have to float to other hospitals to do the treatments.

meg5 · May 3, 2019

I appreciate your honesty. I have call days now but not that intense. I will definitely ask those questions! Thank you!

Ashley_SF, BSN · May 3, 2019

I have worked in chronic outpatient dialysis for almost 5 years and recently switched to working outpatient pediatrics/acutes and adult acutes. Because I'm per diem I'm not required to be on call, so I can't speak to that.

But, I love being in the hospital! I still work per diem outpatient and the difference for me is mind blowing. Going from being responsible for 12 patients per shift with 3 patient care technicians working under your license, to now working 1:1 with patients, and support staff only setting up machines, is amazing.

I can more closely monitor my patients and tailor their dialysis treatments. I have more access to tools to help facilitate fluid removal and assist with hemodynamic monitoring.

In the outpatient unit I am constantly moving between people and trying to stay on top of medication administration, lab monitoring, notifying physicians, adjusting dry weights and getting people out the door in a stable condition.

It feels good knowing I am knowledgeable about a specialized, life-saving treatment. I enjoy the time I have to sit down and get to know my patients and their families. I'm still busy, but in a more focused way which feels more manageable to me.

I'd make sure to ask about how your coworkers function and how approachable your physicians are. The most challenging periods for me have been when I haven't felt part of a cohesive team.

Best of luck!