Advice needed please

ncbound · Jan 12, 2008

I worked in dialysis for 10 yrs and in my opinion you can do a better job if you have a little med -surg experience under your belt . As a new grad there's a lot you haven't seen that these pts will have. Renal disease affects the entire body not just the kidney -it can be caused by diabetes,htn , trauma etc.These pts are sick .you'll be morecomfortable with more experience also. I worked for Fresenius -they don't pay real well -I make much more as a staff nurse in the hospital than I did even with the differential they pay for working in the acute unit and being the coordinator and I had maxed out .Hope this helps -good luck

jnette, ASN, EMT-I · Jan 12, 2008

There are lots and lots and LOTS of threads/posts on this forum regarding new grads in dialysis, FMC, and the other major dialysis companies.

I would suggest doing a search with those keywords, or perhaps browsing through this forum's past threads.. I'm sure you'll find plenty of info !

Wish you the best ! :)

traveler RN · Jan 14, 2008

I agree with the reply for having some med surg experience. I am a travel nurse of 18 mos. and you will be put in situations that boggle the mind at times. The biggest user of travelers is Fresenius and there are times d/t staffing call outs, you will be expected to function as a nurse in spite of the fact the you are technically still in orientation. I saw one new nurse resign after having to assume med duties/assessments for 9 pts. Turnovers are rapid, you may even have to place needles if your techs are unable. you need to learn fast and learn well. There are times when you have extra pts in addition to your own if you are in some of the larger clinics. When I worked at Davita, I was told I could not be in charge until I had been out of orientation for 6 mos., well guess what. My first day out of orientation, the nurse called off and yours truly was it. Find out who your strong techs are because you will rely on them quite a bit. I have been on with just 1 lpn to take off 14 pts and put 14 on because of poor staffing and call offs This experience has served me well as a traveler, because in some states you must give alll the hep pushes and start all the cath pts( I've had up to 9/day), plus all meds/assessments. When you see the threads that say you WORK, they are not lying!

A lot of places don't like to use travelers because of the costs, I have been cancelled a lot of times, and when you don't work, you don't get paid. You need a backup plan! I have gone as long as 5 wks. d/t cancellations and not willing to take 2 clinics for the price of one, meaning dividing my time between 2 places. when you have to be on the open road in the dark, rain and fog you try to get placed in a good location. The company usually does well for you, but even they are not informed of some things you may encounter.

JillRNColorado · Jan 15, 2008

Thank you all who replied to my initial request about the industry. After researching the specialty site, it makes me think that Dialysis nursing is filled with people who hate their jobs. Is it true? I am entering the nursing field with the idea that I will have to work hard and have seen how many times in clinical settings that the nurses were in very deep. This job is filled with liability and the impact on human lives is amazing. It is the hugest responsibility!

Reading some of the other specialties it seems people love what they do but here it does seem most everyone says run for the hills and "you need med surg experience" as it is so overwhelming. I will definitely consider this. Is there anyone who LOVES what they do and finds the work manageable? The facility I interviewed at had a few people who started as new grads and I even got to meet them. They claim to enjoy their work??? Are they lying to trick me or is possible its not as bad as it seems here? I would love to hear some of those stories if they exsist. Thanks inadvance if you are out there.

Jill New RN

iriskkerry · Jan 15, 2008

Why would you consider taking a job for $22.00 an hour in an area of the country that is DESPERATE for dialysis RNs? Trained or untrained, ask for 26.00 and if you don't get it, walk away and go somewhere else. We must stop working for slave wages honey. Good luck to you.

Lacie, BSN, RN · Jan 15, 2008

Thank you all who replied to my initial request about the industry. After researching the specialty site, it makes me think that Dialysis nursing is filled with people who hate their jobs. Is it true? I am entering the nursing field with the idea that I will have to work hard and have seen how many times in clinical settings that the nurses were in very deep. This job is filled with liability and the impact on human lives is amazing. It is the hugest responsibility!
Reading some of the other specialties it seems people love what they do but here it does seem most everyone says run for the hills and "you need med surg experience" as it is so overwhelming. I will definitely consider this. Is there anyone who LOVES what they do and finds the work manageable? The facility I interviewed at had a few people who started as new grads and I even got to meet them. They claim to enjoy their work??? Are they lying to trick me or is possible its not as bad as it seems here? I would love to hear some of those stories if they exsist. Thanks inadvance if you are out there.
Jill New RN

First of all I LOVE what I do. I loved the first day I walked into critical care areas and loved it ever since. After 28 years I decided to try something else. Dont get me wrong as I also found I love dialysis the only thing I hate about it was working in chronics for the larger companies is more like an assembly line. The roles of the RN and the PCT is way toooooo gray for my liking and most of all when I feel I'm putting my license on the line every time I walk in the door was too much for me. I'm moving to acutes and am hoping from what I know and have seen will be a much better experience. Personally I think it comes down to the management you have to work with. This doesnt necessarily mean the direct management within a facility but the upper management who dictates the bottom dollar. You will find in chronics for the "larger companies" that bottom dollar means alot more than pt care or the happiness of thier staff. I took that $22.00/hr offer with Davita and boy did they get that $22.00/hr and more out of my tail!!!! I was immediately offered 26./hr with a new facility and not owned by one of those "large companies". The one I'm going to the CEO is an RN and so is the Financial officer. I shadowed and seen pt care meant more then where I was currently employed at which most the time I was the only licensed person in the building with 3 shifts of 14 chairs. They had told me the same thing "6 months or more and you'll not be charge" I was charge 1 week before I got off orientation and was every day after that I worked!! Also look at that 401K, do they match? Where I'm goiing now does where davita/fres didnt. Look at those overall benefits. Do you have to buy thier stock to make anything for retirement? No thanks particularly if that stock is dropping everytime you check it. Hmm wonder why the CEO/VP just dropped a whole crap load of thier stock??? Look up Forbes.com and search for the company and also google it. My best advice - get some Critical care experience first. I did as a new grad and have never regretted it. Chronic dialysis I regret well at least the company as they didnt follow thier own philosophy or goals they preach. When you see a 40 year old man waving a pirate sword and doing back flips yelling the "Davita way" run the other way lol. I'd rather see a company put dollars into pt care and staffing rather than the academys which are nothing more than a 2 day drunk fest. From what I have seen Fresenieus isnt much different. That profit has to come from somewhat to pad that 28.million/year compensation package the big wig got. If it means pts bringing thier own bandaids then that's what they do. Oh yes they bring thier own bandaids now LOL.

traveler RN · Jan 16, 2008

Don't for a minute think that nurses don't love their jobs, we have been in the trenches and know what the reality of it really is. You still have on your rose colored glasses for now as we all once did. But, consistently working understaffed, underpaid, mandatory overtime, and working with newbies who can't take the stress of it and leave, takes its toll as time passes. We renew our licenses yearly because we are that pt.s lifeline to his/her existence, we fight for that person' s right to safe and good nursing care no matter how busy you are. You are just like the Marines, first ones to hit the beach. You go the extra mile everyday and when you sit down for maybe the first time at the end of the day after 15-17 hr shifts, you need to feel that you have done your best.The feedback from your pts. at times makes it worthwhile. And when mistakes happen and they will, you are the first one called on the carpet! So why would you work for Volkswagen prices when you can drive a Cadillac. Nursing is a business, and we need to be compensated like the heroes we are. Nurses have had to go on strike to get better wages for all. Florence Nightengale would have probably carried a picket sign.

CocoaGirl · Jan 17, 2008

I have been in chronic outpt dialysis for over 12 years, I hate the business aspect of working for a large company (FMC), but I truly do like the patients, families & for the most part my PCT'S. I am the lone nurse in our unit, no other RN's or LPN's. I know that Fresenius provides training in the classroom & then you go along with a preceptor. Do not think for a moment that you will not be put in charge for 6 months, if they need an RN for charge & you are the only one working because of call offs or poor staffing you WILL be the nurse put in charge. It happens time and time again. It is no wonder that RN's who are new to dialysis quit. It can be overwhelming for the seasoned staff, let alone a new grad. Please give yourself some time in another area first, because when a patient goes bad, they go quickly & you will be the one to have to make the decisions. IMO, some new grads are intimidated easily and the PCT's & Management will not cut you a break. I always hate to see a good nurse leave because of the bulls***t. FMC does not care about direct pt care employees, just making sure that the management is well taken care of & making a profit.

jdethman · Jan 18, 2008

They should be starting at more than 22$ try for more than that. How many chairs does your unit have?

DeLana_RN, BSN, RN · Jan 18, 2008

I have to agree with others, although I love dialysis I did not love the chronic, outpatient environment. The reasons have been mentioned before and include a lot of responsibility (on Saturdays, I was the only RN), few or no other RNs to learn from and/or confer with when problems with pts arise, unsupportive/diabolical (I'm referring to my last regional director here) management, horrible hours (I had to get up at 4:00, which is midnight as far as I'm concerned), disrespectful/insubordinate PCTs, unethical/illegal activies (e.g., med pushes by UAPs encouraged/condoned by other RNs and LPNs), difficult/verbally abusive patients... I could go on.

On the flipside, I had many wonderful patients I got to know well and develop a relationship with; some wonderful PCTs (few, sadly); the pay was fair and benefits exceptional (that was Gambro, I hear that it does not apply to DaVita, who bought them).

Why am I still in dialysis? Acutes, or hospital inpatient dialysis is very different, and very nice (call is the only drawback, but you can't have everything However, you should have chronics experience before even considering this, and you should have med/surg or critical care experience before even considering dialysis. And before you travel, you really need a lot of experience because they don't pay the big money for nothing.

Sorry to say this, and we all know some who started out as new grads and did well, but that's the exception, not the rule and not recommended by those who know the specialty.

To summarize, we don't hate our jobs any more or less than nurses in other specialties. All nursing positions have their challenges, and people tend to post about their problems/gripes, not joys.

I wish you well in your first job and your nursing career.

DeLana

young068 · Jan 20, 2008

Go to your nearest hospital and get trained in the ICU areas for at least 1 year. You will then have a better chance at succeeding in dialysis. If you decide you want to travel, you will have more options and make more money if you can do the critical care areas. Acute and chronic dialysis are pretty much being run by the big three private companies, and their bottom line is money...to the point where you have to count 2X2's! Also, since ICU patients get bedside dialysis, you might have an opportunity to learn a little "on the job" and find out if you like it. Believe me...you either love it or hate it!! Good luck and be assured that any decision you make will not be wrong...it will just change your path a little. I am a seasoned nurse and have been travelling in dialysis for 5 years. :up: