Can you share your experience in dialysis?

[jmtm17, BSN]

I just got an offer to work as a Dialysis nurse in Davita. I did my research and I’m aware of the negative reviews about the company but I applied anyway since I would prefer to start my career in dialysis than in a facility (since I can always apply there anytime if I realize dialysis isn’t for me). I couldn’t apply to most hospital positions since they’re looking for a minimum one to two yrs of acutes experience and I have yet to hear back from those residency programs I applied for.

I also just sent in my two weeks notice. I’ve been working with them for over 3years as CNA/Home health aide. However, my employer called in to give me some advice about the company because he’s genuinely worried and he thought there might be better opportunities out there for me. He was kind enough to offer to reach out to some of his connections (in hospitals here in San Diego) to get myself an opportunity to work in a hospital. It’s a long shot but honestly, this just made me unsure about everything? 

If you’re working in dialysis as an RN now, or have previously worked in the same company mentioned above, could you share some your experiences and how do you like it so far? Pros and cons? 

[kbrn2002, ADN, RN]

I switched to dialysis nursing  a little over a year ago after 25 years in a SNF. I left a job I truly thought I would retire from so the idea of such a drastic change was a little traumatic for me but I took a leap and am glad I did. 

I don't work for Davita so I can't offer insight there, I work for the other big company in dialysis.  I was impressed with their extensive training, in my experience they do support new nurses and new to dialysis nurses. I never felt pushed to proceed at a faster pace than I was comfortable with. By the time I was able to practice without supervision I felt reasonably comfortable doing so. 

I still have plenty of times I run into questions I just don't know the answer to  and help is always available. If my manager isn't around that day I know I can always reach out to another clinic so an answer is always just a phone call away. I've found it to be an overall pretty supportive work environment.

I've worked in two clinics after transferring to one closer to my home. Both clinics I have experience in have good teamwork and equally if not more important good clinic managers.  I realize that may not be the case everywhere, maybe I've been lucky in that regard. 

A big pro for me in deciding on dialysis when I made a career move is the schedule. The clinic opens in the morning and closes at end of day. No more mandated overtime when the next shift calls in!  My clinic is strictly days though, I do know there are clinics out there in bigger cities that operate 24 hours, even a few that are nights only.

Also no Sunday's as we are closed with the rare exception of adjusting schedules for Holidays, at this point the only Holiday's we close for are Christmas and New Years so the schedule will adjust then. Thanksgiving is an optional closure, the clinic I worked for was open Thanksgiving last year but the clinic I am at now has always closed that day. Though the staff I am always scheduled with is willing to work that day so we may talk our manager into running that day. Too soon to make that decision yet. 

I don't know if it's the case everywhere but our district does do block scheduling which I love. So easy to plan around a set schedule! We do a week on week off rotation.  My particular schedule is 4 days on, 1 off then 2 on followed by a full week off.  This also means taking a week off gets me 3 weeks off so extended travel is real possibility again! 

The typical day is between 10  and 11 hours in my current small clinic but I was usually working 11 to 12 hours at the bigger clinic I transferred from so it's not based on a 40 hour week. 

[SmilingBluEyes]

On 6/2/2021 at 10:28 AM, kbrn2002 said:

I switched to dialysis nursing  a little over a year ago after 25 years in a SNF. I left a job I truly thought I would retire from so the idea of such a drastic change was a little traumatic for me but I took a leap and am glad I did. 

I don't work for Davita so I can't offer insight there, I work for the other big company in dialysis.  I was impressed with their extensive training, in my experience they do support new nurses and new to dialysis nurses. I never felt pushed to proceed at a faster pace than I was comfortable with. By the time I was able to practice without supervision I felt reasonably comfortable doing so. 

I still have plenty of times I run into questions I just don't know the answer to  and help is always available. If my manager isn't around that day I know I can always reach out to another clinic so an answer is always just a phone call away. I've found it to be an overall pretty supportive work environment.

I've worked in two clinics after transferring to one closer to my home. Both clinics I have experience in have good teamwork and equally if not more important good clinic managers.  I realize that may not be the case everywhere, maybe I've been lucky in that regard. 

A big pro for me in deciding on dialysis when I made a career move is the schedule. The clinic opens in the morning and closes at end of day. No more mandated overtime when the next shift calls in!  My clinic is strictly days though, I do know there are clinics out there in bigger cities that operate 24 hours, even a few that are nights only.

Also no Sunday's as we are closed with the rare exception of adjusting schedules for Holidays, at this point the only Holiday's we close for are Christmas and New Years so the schedule will adjust then. Thanksgiving is an optional closure, the clinic I worked for was open Thanksgiving last year but the clinic I am at now has always closed that day. Though the staff I am always scheduled with is willing to work that day so we may talk our manager into running that day. Too soon to make that decision yet. 

I don't know if it's the case everywhere but our district does do block scheduling which I love. So easy to plan around a set schedule! We do a week on week off rotation.  My particular schedule is 4 days on, 1 off then 2 on followed by a full week off.  This also means taking a week off gets me 3 weeks off so extended travel is real possibility again! 

The typical day is between 10  and 11 hours in my current small clinic but I was usually working 11 to 12 hours at the bigger clinic I transferred from so it's not based on a 40 hour week. 

This post says it all. This has been my experience in dialysis nursing. It's not less stressful or easier but for outpatient dialysis (not in the hospital), there is NO call or overnight work. The hospital is different. You are working either a whole lot or not enough. It depends on census in the unit. There is call too. Your days are unpredictable. You may be done, say,  at 11pm but then they admit a patient who needs urgent dialysis and well, you just got 4-5 hours added on.......or you are done only 6 hours after starting because you only have one tx that day. But you will be on call in case they admit a patient needing tx. Some people I know LOVE hospital/acute dialysis, so if all this sounds OK, you can go for that.

As far as outpatient/clinical dialysis:  The one thing you will have to get  used to is if you work mornings/day shift your day is gonna start SUPER early. In some clinics, this may be as early as 4-430 am (for nurses, techs start as early as 230 or 3 am). Evenings usually work until 11 or midnight. Most shifts amount to about 10 hours in larger clinics.

In SOME smaller clinics, people tend to work doubles (yes more than 16  hours) so avoid those that do this unless you like that idea. The upside is you only work a couple days a week and get credit for full time. It's up to you! Just know if you are in a small clinic (generally <12-14 chairs) you are the ONLY RN in the building once your  orientation is over. So you want to train in a larger clinic for a while.

Few clinics do nocturnal dialysis, but they are out there. If nights is not for you, I would avoid those.

There ARE other companies besides the "big two" (Fresenius and Davita). Look around. I hear good things about some of them from those I know work for them.

[GginaGG]

I'm transferring from inpatient ICU to inpatient dialysis unit - can anyone recommend any training material?  My training will be hands on preceptorship only - I have some time to study before transfer.  Thanks!

[SmilingBluEyes]

 Try going to the American Nephrology Nurses Association website for information and links to materials for education:

 

https://www.annanurse.org/

 

GOOD LUCK.

[GginaGG]

Thanks so much - I did just that and found some good books!

[integrativenurse]

I've worked for DaVita. I have to say the truth is it can go both ways depending on the clinic. Coming from the northeast moving to the south, as far teamwork, work-life balance, salary, etc, the worst up there where I came from the best that they can offer down here. I feel that we were tighter up, have more fun than my experience down here. Now, I've never worked for FMC so I can't speak for their environment and culture. I just think that our DaVita culture in the northeast area is better than my short-lived DaVita experience in the south.

In my experience Incenter dialysis clinic, techs come in about an hour earlier (0430 or 5)to mix bicarb and set up the machines. Then we come in to get other stuff ready -- help out to finish setting up machines, draw heparin, check orders, make coffee, BS with techs and nurses. A typical day in my clinic runs from 0600 to 2000 (I say my clinic because others can run longer they have a different set of teams coming in later). Positives (again speaking for my northeast experience): camaraderie, getting fed all the time, no calls. Cons: pay, work hours too early for me.

Now, hybrid chronic-acute federal job: Pros: great benefits and advancements, overstaffed but not being rotated to another unit and we shut our mouths and stay on the down-low (yeah, sometimes we feel guilty especially during this pandemic). Cons: calls, still too early for me.

Anyway, overall you'll find diluted reviews for any company but DaVita treated me well but God continues to bless me and led me to better things. I hope I answered some of your questions.

[LostMyPen,RN, BSN]

I've been in outpatient HD for 9 years with the other big name company. The training was exceptional, there is plenty of room to grow, I have lots of support resources and great teamwork. The stress is minimal with no mandated overtime and plenty of PTO. The hours are tough though, 4am-4pm but I haven't missed any of the kids soccer games and can cook dinner every night so it's worth it to me. Really I think outpatient HD is a hidden gem that many nurses don't know about. Good luck with your new position. I hope you love it!