Acutes

NurseRies, BSN, RN · Mar 12, 2013

Are the acutes really as horrible as people say it is?? I currently work chronic in center dialysis and I know one acute nurse who sometimes comes to help our unit out and she talks of acutes as being hell on earth lol. She says that you are always on call but as an LPN you will be the first person to go home if things get slow. She also says your day starts early but you never know when it ends.. You could go home after working 16 hrs go to sleep then get called in again. I love dialysis and have been doing it for 2 years but I am thinking of doing something else within the dialysis world after I get my RN license ( currently an LPN in a bridge program) I also work hospice PRN. I guess I don't k ow what I want to do after school because I won't neccesarily have to do crisis care with hospice after my role changes.[/quote']
If it were me, I would stay full time in chronics and do pen work for acutes. She you are a full time acute nurse you dedicate your life to the program. On call 3-5 days a week most of the time and you never know when you're going in or coming home. I would just do prn, that way you could see if you like it, and still have a life. If it seems like something you want to do and you don't like to have dinner plans, full nights sleep, or a life, go for it! Maybe you will be lucky and fall into a good program where they don't overwork you and don't require 18 hour shifts.

dialysisnurseLC · Mar 13, 2013

Hmmm something to think about... I am married and I have two small children and I would like to spend time with them. I would not like being on call ALL the time!

NurseRies, BSN, RN · Mar 13, 2013

Hmmm something to think about... I am married and I have two small children and I would like to spend time with them. I would not like being on call ALL the time!

I prefer chronics for a number of reasons. I hate getting up at 4am, but At least I know that I'll be done by 5. I have been doing full time acutes for about a year, mostly in my travel contracts. The most sickening feeling is looking down at your ringing phone at 6pm when you're wrapping up your day, and seeing the hospital calling you. Or your employer begging you to stay for "just one more treatment". One more treatment can take 5-7 hours. If I were to go back to being a staff nurse somewhere, it would be a clinic. On call is not for me.

dialysisnurseLC · Mar 14, 2013

Wow!!! Do u get days off?

NurseRies, BSN, RN · Mar 14, 2013

Wow!!! Do u get days off?

Sometimes you get home at 1am and have to be back to work again at 6am. But yeah there's days off. Some programs give you 3-4 days off, which is reasonable. One I did in San Antonio, you were just thankful to be on call on Sundays. That was your day off. It just depends on how short staffed they are and the census is really unpredictable.

Chisca, RN · Mar 23, 2013

Acutes are different because they are sicker. You will need to be able to assess and react quicker than in chronics. You can't just call 911. And you will need to have plumbing skills for the portable RO machine. The call can be rough but I work 7 on and have 7 days off. I love acutes.

NurseRies, BSN, RN · Mar 23, 2013

Acutes are different because they are sicker. You will need to be able to assess and react quicker than in chronics. You can't just call 911. And you will need to have plumbing skills for the portable RO machine. The call can be rough but I work 7 on and have 7 days off. I love acutes.

Where can I find this schedule? What state are you in, if you don't mind?

Chisca, RN · Mar 28, 2013

Volunteer state.

Guttercat, ASN, RN · Mar 30, 2013

It really depends on the program.

Generally, the smaller and more sporadic the volume of patients, the more you will be on call-- if that makes sense.

Big players (in major metro areas) are running acute patients around the clock, 24/7/365. Those larger facilities often schedule RN's on shift-work, like any other position. And, with more RN's, the call time is therefore spread out.

I was fortunate that my call time was usually limited to one day a week, and one Sunday every four to five weeks.

Yes, call stinks in dialysis. Someone above mentioned the "sickening feeling." The only thing worse is to get home after a 13 hour day; collapse on the pillow, and then have the phone ring.

However, I loved acutes. It is one of the last autonomous RN positions in the hospital.

A lot of people hate it because in my estimation, they're simply afraid. It takes a while to feel comfortable. I hated it at first, but grew to love it.

Same with a coworker who was forced by circumstance to work acutes non-stop for three months. She hated acutes, and avoided it all costs. But, by the end of that time, she decided acutes was way better than outpatient and she never looked back. The autonomy, knowledge gained, and getting to collaborate with so many departments, docs, and RN's throughout the hospital is wonderful.

Love love love acutes!

dialysisnurseLC · Mar 31, 2013

@guttercat thanks for the positive light on acutes! Where I live it's considered rural so

I probably would be in call a lot

NurseRies, BSN, RN · Mar 31, 2013

@guttercat thanks for the positive light on acutes! Where I live it's considered rural so
I probably would be in call a lot

I was one of 3 nurses for a while at a small hospital, one of those being my manager. So, I was on call 3-4 days a week. My problem with it is, I like to run, I am a foodie (out to eat), I like to go to the beach, I like to drink wine, I like to go on day trips.. Etc.. The only safe thing to do while on call is to sit at home, by the phone, clean and showered. I've gotten called in while on a run, while at the grocery store, while on the way to Sunday brunch, while at the pool, while at a restaurant, and while dead asleep. Of course when I sit at home and wait, no one ever calls. I can't see myself doing long term. I like my freedom and I like to be out and about and active while not at work.