acute dialysis RN- a day in the life...

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This may seem like a silly question, but do any of you guys leave during the day between treatments?

thanks!

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This may seem like a silly question, but do any of you guys leave during the day between treatments?

thanks!

If the docs haven't written HD orders I'm liable to leave. LOL... We're fussy like that.;)

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Not between patients but if we are waiting for a line to be placed, then we clock out and go eat or something but never leave. Our docs are pretty good at getting the ball rolling so there isn't much down time. We are a busy acute program with 4 hospitals so there really is never any down time..especially when on call!!

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Specializes in Med/Surg, Psych, Medical ICU, Dialysis.

I've absoulutely left the hospital during downtime or wait-time. I just clock out and let someone know or let the docs know. Especially if I'm waiting for 45min plus. Which I did a lot of in the program that I worked in. I guess it depends on how busy you are.

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Specializes in RN, BSN, CHDN.

I am supposed to be starting acute dialysis soon and I was wondering if anybody could give me a run down of a basic day?

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I can't answer the question about leaving, but I do like to ASK a question regarding dialysis nursing.

I am a brand new grad fro an RN nursing program. Nursing is my second career. I had a very good clinical experience (though a brief one) in a dialysis center. Now, as soon as my licence is avilable, I will look for a job, needless to say. What does it take to be able to work as a dialysis nurse, and find a job?

Any feedback is greatly appreciated!:yeah:

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I can't answer the question about leaving, but I do like to ASK a question regarding dialysis nursing.

I am a brand new grad fro an RN nursing program. Nursing is my second career. I had a very good clinical experience (though a brief one) in a dialysis center. Now, as soon as my licence is avilable, I will look for a job, needless to say. What does it take to be able to work as a dialysis nurse, and find a job?

Any feedback is greatly appreciated!:yeah:

It takes getting hired. Many units want M/S or ICU experience. Maybe a year. But others are desperate and will take you without that experience. They will train you for 6-8 weeks. It's a grueling orientation. I don't want to discourage you just trying to give you the facts. ;)

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Thank you Onekidneynurse! It seems to me that everything about nursing is a grueling experience, especialy the clinicals. I'll be lying if I said that I wasn't scared! Everything new in life is scary. What is encouraging for me is the fact that I liked the experience. I would actually prefer to start that way, with on-site training. I know that I have to have my RN license first, for sure.

If you don't mind me asking, I suspect that you are yourself a dialysis nurse.

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Thank you Onekidneynurse! It seems to me that everything about nursing is a grueling experience, especialy the clinicals. I'll be lying if I said that I wasn't scared! Everything new in life is scary. What is encouraging for me is the fact that I liked the experience. I would actually prefer to start that way, with on-site training. I know that I have to have my RN license first, for sure.

If you don't mind me asking, I suspect that you are yourself a dialysis nurse.

I started in HD in 87 as an LPN. I worked a 20 station unit for 2 1/2 years until Epogen came along and I couldn't give it. I went back to school. Got my BSN in 1997 and went back into HD. Worked in 3 different clinics for 5 years. Then traveled in 13 states for 6 1/2 years. Now I'm back "home" but traveling for my original company.

I've done chronics for years until June. I am now doing acutes. I don't particularly like acutes but the $$$ is good and I am doing HD. My niche.

Good luck on your search. I'd suggest you ask to shadow a nurse for a period of time and see what it's like. Also, I'd suggest 1 year of chronics before you go to acutes. In many acute programs you are alone in the middle of the night and you better know your stuff. How to troubleshoot the machines and maybe even "fix" them to get you through a treatment.

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Going back to the original question about leaving, I am wondering because I know some of you must have pets that you would like to let outside in the middle of 12-16 hour days. It seems like if you know you are doing at least two ICU treatments in a day, who would really care if you started the second one at 2pm instead of 1pm?

And as madwife wanted to know, can anyone give a typical day run down? Or variety of how it may be?

Thanks!

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Going back to the original question about leaving, I am wondering because I know some of you must have pets that you would like to let outside in the middle of 12-16 hour days. It seems like if you know you are doing at least two ICU treatments in a day, who would really care if you started the second one at 2pm instead of 1pm?

And as madwife wanted to know, can anyone give a typical day run down? Or variety of how it may be?

Thanks!

The problem with delaying an acute treatment is that you don't know what's at the ED door. Some days we go to plan Z. That's the nature of acutes. Sometimes we don't go to lunch until 1600. And we dialyze until we are done. Some patients we can put off until tomorrow but many we can't. We work around IR for cath placements etc. Fistulagrams get bumped. So I wouldn't plan on leaving on any given day at any given time. Dog walker.

12-16 hour day. If I'm on call it could be a 24 hour day.

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Specializes in ICU, ER, Hemodialysis.

The acute dialysis day in MY experience....

I arrive to work at 7am and take a look at the assignment sheet. We are either in the hd unit or doing "outs" (meaning one to one, as in an icu patient that can not come to the hd unit.).

So, I see I am doing "pt a" and "pt b" (so far, of course). The tech brings up the RO room, does the water checks, and makes the bicarb for the day. I set up my machines and prime based on the md's order. Then, I put my machine in test. At this point, I normally will get my paperwork filled out (just one run sheet, nothing major). After the test passes, I check the pH and conductivity of the dialysate (hd bath).

Now the tech may go get the pt, the tech may go and assist me in getting the pt, or someone may bring the pt to the hd unit. At this point though, I am ready to run my pts. I hook up "pt a" and "pt b."

Now, hopefully I am just in monitor mode (ie: no machine or pt problems). If so, we write down v/s and machine numbers every 30 minutes. I will also get my meds together (zemplar, epo, and na citrate or heparin for packing catheters) during this time. Most of our runs are for 4 hours, with SOME 3'15" to 3'45" runs. New starts are normally 2-2 1/2 hours. If labs needed to be drawn, I will draw them while putting the pt on. I will call labs to the md for hd bath changes if needed.

After the runs are over, I will get each pt off the machine and back to their rooms. At this point, I will either go to lunch or get my next run on (two more pts) and have one of my co-workers watch my patients. Normally, we only have a first shift run and a second shift run (that being 2 pts for the first run and 2 pts for the second run). We do have late nurses and an oncall nurse for late runs and emergencies. As someone said, you never know what's coming through the ER (overloaded, hyperkalemia) or the outpt special procedures (perhaps a declot? that has to be run). Some days you come in and your first and second shifts are already filled up; other times, you may have only one pt, and you end up waiting on the nephrologists to get there and start writing orders for your hd patients. Sometimes you are delayed because the orders state "hd after surgery" or the pt is in radiology or the pt demands that he eat his breakfast first, etc.

After the second run, I will normally go home. Sometimes, we will start a third run and the late or on-call nurse will take over when they get there.

If you are doing "outs" then the day is the same except you just have one pt for first shift run and one pt for your second shift run. You do not have anyone to relieve you, so, you will go to lunch in between these two runs. Some people love doing "outs" some people hate them. Same goes for being in the hd unit, some love it, some hate it. I like a little of both.

I hope that helps. It is my typical day, anyway.

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