Chronic Dialysis VS Acute Dialysis


Hi everyone. I need advice on those people working on acute dialysis. I have been working on chronic dialysis for 4 years now. I have rare medical condition where I am needing surgery every other year and had hx of craniotomies in the past. Lately, I ve been really getting sick and tired of working in the dialysis clinic. The turnover of staff is unbelievable. We always work short staffed, pt being put on late and on top of that you have to be updated with your monthly paperworks and more stuff added to RN responsibilities. Sometimes I am the only nurse on the floor and still have my own patient assignment to put on , plus do patients assessment and meds. I work in Fresenius. We just recently hired 3 new nurses but seems like they will not gonna stay with the kind of workplace we have. The last 2 RN staff we hired only stayed for 6 months and left for better job. The nurse manager seems not to care with the staffing issues, some coworkers just do whatever they want and can get away with it. I am considering transferring to acute dialysis. My question is how is acute dialysis compare to chronic dialysis. Which is more physically demanding and less stressful? Im thinking that acute at least you dont have to deal with monthly paperworks, burntout coworkers, unsupportive manager. Please enlighten me with the pros and cons of acute dialysis. I really need to find another job that is less stressful and less physically demanding. Thank you.


476 Posts

Specializes in Peds Critical Care, Dialysis, General.

I just left acute dialysis nursing after nine months. Both sides of the coin are stressful, but in different ways. You are expected to take call in Acutes. There is still paperwork to keep up with. It is very physically demanding if you are doing mobile treatments. The same problems you have noted at your current job will be waiting for you on arrival to the Acute setting, along with even more headaches. 20-24hr days are not uncommon. Then, there is a drop in your census and you're getting hardly any hours. The turnover rate in my unit was atrocious. It is assembly line nursing. If you are looking for less stress and less physically demanding, forget Acutes.


19 Posts

Has 4 years experience.

Thanks for your reply. It really helps me alot with my decision. I guess its not worth it to transfer and sacrifice the schedule i have in chronic dialysis which is the only good thing about it. At least after i go home i dont have to deal with phone calls. I will try to deal with the chaos in the clinic for now until i find something else that is good for my health and less stressful. May i ask what area of nursing do you work now? Thanks again


476 Posts

Specializes in Peds Critical Care, Dialysis, General.

I went back to a previous position with a twist. I'm one of the two night charge nurses in a small community hospital. We have general medical/surgery beds, an inpatient rehab unit and detox. The community (which is the entire county) is small and close knit. It is a unique environment and I appreciate more this time around. Love the pace on nights!

Kyrshamarks, BSN, RN

4 Articles; 626 Posts

Lol...reading about dropping census. I wish. I am in acutes and routinely have to work 16 hour days and can work Mon thru Saturday if I wanted to. Heck, I worked 22.5 hours just yesterday getting patients done at 3 different hospitals. All overtime.


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 26 years experience.

Acutes may be more stressful. There is definitely heavy lifting involved, and pushing machines around and you only have so many techs; you may be asked to do some of their work on top of your own.

You may never know how long or short your day may be. For example, you could be humming along on an 8 or 10 hour shift, just about to walk out the door after your last tx----and whoops---- 2 patients are just admitted to the hospital that need urgent dialysis. Congratulations, your day just now became hours longer. Or other days, you may be called off d/t low census.

And being on call is a part of it all. Me, I don't like being on call or having my 10 hour day turn into 14 or 18 hours or more. But that's me. That is why chronics was always where I worked and stayed. Acutes never interested me. I did the whole 12-16 hour shift plus call/weekend thing for 14 years in acute care hospital nursing. I am over it.

Specializes in Renal Dialysis. Has 10 years experience.

Acutes can be a headache but it's not all bad. My primary job is a large program run independently by the hospital. It's a huge facility so our unit is built like a chronic unit with 20+ spaces for beds, plus ICU runs. All other modalities are covered by techs in a different sector of the department. We have census ups and downs but there are always people wanting to go home so you can get your hours. Today, most of the staff went home early. I stayed for the time and a half. Tomorrow, however, is slammed already with many patients on the "maybe list". We rarely work more then 13 hours. They recently changed the guidelines about doctors adding late patients and such. Call isn't bad, I just go home and go to bed. In a year in a half here, I've been called in only one night. Honestly, this job is the least stressful job I've had in years.

My PRN gig with one of the big two, however, is a nightmare. Every negative that has been mentioned and more. I'd have to be facing the unemployment line to be a regular employee there. So I guess it really does depend on the facility and how they run things. I say shadow a place if you're interested.


1 Post

I am leaving acute dialysis for several reasons....1 the management isn't always "go team Davita"...2 I'm about to take call and that is causing me undue stress! Nobody is excited about call though 3. The scheduling sucks...6 hours one day....16 the next...then there are no patients so you get called off (3 days in two weeks)! 4. The "teamwork" in chronics is non-existent! You are 90% of the time alone! I am new to the world of dialysis and I should have a "teammate" to call if I have trouble...they NEVER answer the phone! One day, there will be an emergency and I will be SKREWED! 5. The chronic center I visited this week has 14 chairs...and let me tell you about teamwork! This place is amazing! The PCT's make this center run like a well oiled machine! The manager is top-notch! Yes, I will work harder but I have a schedule! The staff is amazing. I can't say that for all chronic centers bc some have 30 chairs and are like being in hell on fire! It's all in the individual center! Good luck!