Certified Nephrology Nurse

happybunny1970 · Mar 22, 2008

There are two certifications for Nephrology Nursing -- one for RN-ADN and one for RN-BSN. This is the website for the credentialing organization:

http://www.nncc-exam.org/

This is the website for ANNA -- the national society for Nephrology Nursing -- it can probably answer many of your questions:

http://www.annanurse.org/

I work for Fresenius Medical, and I believe they do provide some sort of compensation for the certification, but I'm not eligible to sit for it yet... two of the nurses I work with have the certification.

Pay depends largely on where you live and your specific job responsibilities. I was out of nursing for a couple of years before I found this company last year, so I don't know how they compare to other positions in nursing -- but I have nothing to complain about. Fresenius offers an AMAZING benefits package, and many of the perks my coworkers were not aware of until I did the research and pointed it out to them. There is a Flexible Benefits program, choice of two major carriers for health insurance, with three levels of coverage on each (also dental and vision), discount programs with automobile makers (I was able to buy two new Ford vehicles last November at less than dealer cost), they match up to 3% of your pay when you contribute to their 403b retirement plan (after the first year), and tons of other discounts with health clubs, LASIK surgery, and on and on. My unit utilizes a 7-on, 7-off schedule, which I LOVE: Our weeks run from Thursday to Wednesday, so we work Thurs/Fri/Sat, have Sunday off (except for the one nurse taking call, which means once every 2-3 months), then Mon/Tues/Wed. Then we have 7 straight days off, which is great because you can plan so many things (like dr visits or vacations) that you would otherwise have to take vacation time for. Then twice a year you can sell back your vacation time for cash.

My unit is inside a major hospital, and our benefits are WAY better than those of the staff that actually works for the hospital. That's how we get many of our nurses -- they jump ship from the hospital to join us!

One thing about Dialysis -- you either love it or hate it. There's a good six-month learning curve before you really start to gain confidence and it is extremely technical. You are taught everything you need to know, and the training period (with classes) is 1-2 months long. I have found it to be much more satisfying than previous positions I had in OR or ICU. Acute (inpatient) is quite different than outpatient.

Hope this helps.

maila · Mar 23, 2008

Thank you for your response happybunny. You have given me a great insight on nephrology nursing . However, I am also reading some posts here on past DAVITA dialysis nurses and almost all feedbacks are on the NEGATIVE side... so guess the FRESENIUS FACILITY is better than the DAVITA although when i look at dialysis directories, i observed that DAVITA is visible in every state. ...,,,

CocoaGirl · Mar 23, 2008

Don't be too quick to think that Fresenius is a great company to work for. Yes they have decent benefits, but the cost to employees for coverage is extremely high. They do not give you any extra salary for being CNN certified, I was told this is "personal satisfaction" to be CNN certified & not required for the position so no additional salary. I actually let mine expire this year, I was tired of all the expense to maintain the certification, which is not reimbursed for. In our area of the country, FMC actually is the lowest paying dialysis provider. We have people going to Davita for better salary & FMC's pay does not even compare to the area hospital rates. We have been waiting on our "salary survey" for over a year now, I'm not holding my breath that there will be any changes. Sorry to be so negative, but just being honest.

happybunny1970 · Mar 23, 2008

I'm sure CocoaGirl is right... so much about how well you are treated, both personally and paywise, has to do with the individual site you are working in. Nurses who work in the outpatient facilities have a whole other set of circumstances than we have in inpatient, and Fresenius also runs the Dialysis department at the hospital across the street, but their whole aura is different (much of that has to do with the politics of that hospital). But I must say that this is not unique to Dialysis Nursing. Payrates and job satisfaction levels vary from one employer to another, from one location to another, heck -- even one shift to another.

The best thing you can do is scroll through the specialty groups on this site and see what sort of field appeals to you. Pick two or three, then communicate with nurses in that field or go on some interviews and ask a LOT of questions. You'll never know FOR SURE what a job situation is until you're actually in the job, but at least you can make an educated guess. You've got to find the position that appeals to you and gives you the most satisfaction.

As I said, I was out of Nursing altogether for a couple years, so I don't know how well my pay compares to others, but I honestly don't care -- it's more than I made when I left the field, and all money aside, I have the best group of people to work with and truly enjoy what I do. And having that job satisfaction, actually enjoying getting up and going to work, is more important to me than the money.

wordsmith · Mar 25, 2008

It really does depend on where you're located. I'm in a city of about 60,000 near the west coast in a privately-owned freestanding facility. The docs also own a few smaller facilities. The atmosphere is great. Because there aren't as many employees as there are at a large corporation, the benefits aren't as good, but you make tradeoffs. I came from a large health system and a hospital I liked very much, but there was no promotion opportunity and no place to go. The benefits were great and I liked my coworkers but I was severely underemployed.

This employer was willing to train me in dialysis nursing and I don't think I'd ever leave where I am now. I've been there a couple years and I think the pay is fair for where I live and what I know. I also realize that Medicare doesn't reimburse for crap and what keeps the facility running is the doctors' office visits and the patients who are fortunate enough to have private insurance (not too many of those!).

Only a couple of our nurses have their CNN. A couple more were talking about taking the CDN exam but haven't done so yet. Some of the techs were planning on taking the exam for the techs. I don't think there is a specific pay increase for being certified but I'm sure it's considered in the annual review because it shows the employee is motivated to increase nephrology knowledge and this company gives employees a lot of credit for that.

I enjoy having Sundays and one other day off. We're not scheduled like Fresenius--I was interested to read about that schedule. I work like that, but I work every week! Guess we don't have enough nurses:nuke:

It's a good place to work for the most part. Not perfect--what place is?--but one of the better ones I've seen, for sure. There's a point where contentment means more than money, as long as I can pay my rent, buy my gas and groceries, and have scrubs to wear to work. And my kitties have their cat food, the little snots.:redbeathe

maila · Mar 25, 2008

Thank you WORDSMITH for sharing your experience with privately-owned freestanding facility. I am currently weighing my options weather to apply in Davita, Fresenius or a non-profit dialysis facility. I am currently working in the Med-Surg area and i'd like to shift into another area of nursing which i am considering nephrology nursing. I am interested though with Davita's NOCTURNAL DIALYSIS...coz as the other nurses posted regarding 1st shift, 2nd and 3rd shift, the stress is overwhelming aside from the techs and other co-workers that you need to bear with. Can any NOCTURNAL NEPHROLOGY NURSE out there share your experience on this shift. Thank you.

CocoaGirl · Mar 25, 2008

Wordsmith you are so right about having contenment more that $$$. I too worked for a privately owned dialysis facility for over 10 years, it had its ups & downs, but I really loved it. We were all about the best quality care & compassion for our patients & co-workers. 99% of the employees got along & worked well together. THEN, we were acquired by Fresenius & it has been h*ll ever since. Now everyone is on edge & bickering due to short staffing. Most of the longterm employees left & were replaced with inexperienced techs. Patient care went down the tubes & now we are constantly hounded about using to many supplies (they count the inches of tape you can use, no joke). I believe that every company should be able to make a profit, BUT not at the patients expense. It is a shame that direct patient care staff & nurses are way underpaid while the managers collect big fat bonuses & the CEO's make millions of dollars in salary each year.

wordsmith · Mar 29, 2008

Good gravy, counting inches of tape??? Our FA does want us to watch supplies and med usage, but not to the detriment of the patients. If we drop something on the floor, like gloves or a roll of tape, it has to go in the trash. Exception: a bottle of Epo gets scrubbed really well with Vionex and alcohol. Why? Cost.

We give the patients with accesses a "goodie bag" to keep in their vehicles in case they break open on the way home. It has 1-2 Chux, a small (partially used up) roll of plastic tape (easier to tear than silk, even if we tape them with silk), and a few 4 x 4s and 2 x 2s. We tell them that we can only give them one bag like that because we don't get reimbursed for bandaging), just to forestall requests for home supplies and so on.

I understand some facilities do not allow pts to eat/drink while on tx. That makes sense to me for obvious reasons. However, while we don't encourage it, we allow it. I'm not going to sit there and tell a diabetic who needs to eat at noon and who's dialyzing from 10 a.m. to 2 p.m. that no, they can't eat while on tx. Better to eat than me having to treat hypoglycemia, eh? Never mind the patient having a CBS of 40 and being out of it :nuke: We offer coffee and tea; they have to bring their own snacks. Medicare doesn't have a diagnosis code for "hungry."

We do have stress--I won't lie to you. Our ratios seem to be about the same as elsewhere: 24 chairs, 2 RNs, 1 PCT to 4 pts. If no one's having a problem we have enough time to do orders and misc. paperwork. If someone's crashing, we barely have time to do meds and assessments. Three days a week we have umpteen catheters and in our state RNs have to take pts off catheters. So we have that, too. But, most everyone plays pretty well in the sandbox, not much pail bashing over others' heads.

I really hope our docs continue to own the facility and don't look into selling it to a big corporation. I've never gotten the impression that they would. I think they're happy being in charge and steering their own ship.

There is a nocturnal dialysis facility I've heard about in Portland, Oregon, but I don't know who runs it. I might be able to find out the name of it if you're interested. I've heard good things about nocturnal dialysis, but personally, after working too many noc shifts in hospital, I'm not interested in doing more nights.

If you have any other questions, go ahead and post 'em. Someone will have an answer, somewhere. Good luck.

lncforme · Aug 12, 2010

I am a legal nurse consultant and I am looking for a certified nephrology nurse to review a case and serve as a testifying expert in a case in AL. This occured at a DiVita facility, so this individual cannot have worked for this company. Looking for someone in the South.

lncforme

mad071 · Aug 19, 2010

Contact me. Will send my resume.

Lacie, BSN, RN · Aug 21, 2010

:yeah:

I am a legal nurse consultant and I am looking for a certified nephrology nurse to review a case and serve as a testifying expert in a case in AL. This occured at a DiVita facility, so this individual cannot have worked for this company. Looking for someone in the South.
lncforme

I do this myself but previously worked for Davita in 2006 for a year so counts me out on this one. But I will say if anyone here employed by Fresienius or others - GO FOR IT! I make some pretty decent $ for this and love doing it. Been getting quite more cases this year than usual against Davita rather than for them (4 just this year). I make a whole lot more then I ever made in the hospital or any other area by the hour. The only time it may be a problem if you worked for Davita is if the case is "defending" Davita. If a case "against Davita" it doesnt matter. Also in cases unless a CNN is specifically named/involved in the complaint you dont need another CNN as any Dialysis RN with enough experience can do so. I'm not a CNN but reveiw and serve as a testifying expert.