Chronic vs. Acute

mamabaer439 · Apr 12, 2011

I tried acutes for one month, after working chronic for 2 years. While I like doing acute dialysis, I could not tolerate the hours. Up to 16-18 hour days. Of course it all depends on the census. Some days there are way too many patients to finish the day at a decent hour, other days there are no patients at all so you get called off. Because of the variations, there is no guarantee of 40 hrs per week, or there are weeks you work 60+ hours. Then there is being on call. Needless to say, I said adios to full time Acute Dialysis. I do work per diem at Acutes to fill in hours that I can not get at the clinic (low census there too!) Now I have been called off of Acutes my last 4 scheduled shifts due to low census. Hit and miss. Some people flourish on all the craziness. You may be one of those. Good luck.

DeLana_RN, BSN, RN · Apr 14, 2011

Hi, I sent you a PM.

DeLana :)

Tish88 · Apr 26, 2011

I loved doing acutes, but the hours and call can be a challenge, especially if you have kids. I did acutes for over 15 years. I loved the very critically ill patients in the ICU's and trauma units - it was like a "rush" everyday!

The most hours I did in a day was 22 straight. I went home and slept for 2 hours and went back to the hospital for another 12 hour shift.

How many acute RN's are on the team? How many days of call are you expected to take in a week? Is there another back up call person, in case you get slammed with multiple acutes after hours?

The hours are unpredictable - with low census, you might not get 40 hours and then you might get 70 hrs in a week - that is when you have to learn how to manage your paycheck for those high and low times.

mswim · Apr 26, 2011

Thanks everyone for your info...I went for my shadowing today armed with lots of questions. There are currently 7 nurses on staff, they are hiring 2 more including me at 30 hrs or 3 days week. The also have a rule on hours straight worked. Your are only to work 16 hrs straight & after that another on-call person comes in for you. (That means there has to be at least an 8 hr break in between, not 2) They do their schedule in 6 wk blocks with taking one 3 weekday stretch of on-call, and one weekend each 6 week block. You do not work any of your days on call on the unit. You work every other saturday, & your weekend on call counts as a weekend but you are not there during the day. It sound like a pretty successful system...so I think I am going to take it. I also think working 30 hrs or 3 days will help with the burnout. What do you guys think?

Tish88 · Apr 27, 2011

"they do their schedule in 6 wk blocks with taking one 3 weekday stretch of on-call, and one weekend each 6 week block. you do not work any of your days on call on the unit. you work every other saturday, & your weekend on call counts as a weekend but you are not there during the day."

so, are you saying that you would work 3 days and not be on call those days, but you will be on call 3 other days that week? so, there is a possibility to work 6 days in a week???

what time does your call start? is it for 24 hours or starts after 5pm until 7 am?

how often does the call person get called out?

i don't think i am understanding the scheduled days and scheduled call days and weekend - sorry! :eek:

madwife2002, BSN, RN · Apr 27, 2011

Acutes just wasnt for me I was overworked and bored senseless.

Most of the ICU patients were unconcious and you sat in a room staring at the walls half the time! I worked in a union hospital so apart from doing the dialysis there was nothing else they let me do.

I had to sit on my hands and twiddle my thumbs.

I hated being on the road home and get a call to return as there was a new pt.

Ok if you dont have any other responsibilities and dont mind no pts to dialyze.

7 in your team means a lot of work is needed each week to maintain your hours

mswim · May 15, 2011

Sorry Tish88,

I will answer your scheduling question. You are correct the during the six week block in schedule, i have 2 weeks that I will be on call. One of the weeks on call it is for 3 days during the week, and one of the weeks I am on call over the weekend days. So for example I could be on call Mon-Wed during the evening, and then work Thur-sat during that week. I was told they used to do that you would work the same day as on-call which then people were there for a long time if they got called in. My other weeks I work my normal schedule.

chinga2372 · May 28, 2011

Hi! This post is very timely for me at the moment, I worked 2 years in the Chronic and just got hired in the acute, I am not really happy at the thought of the on call and traveling to four different hospitals but most of the nurses from the chronic that transferred to acute loved it there. Im just giving it a try for now and i promised to go back to chronic if I really didn't like it. I also took only 3 days a week in anticipation of the on call hours. Thanks a lot!