Consider acute dialysis


I wanted out of bedside nursing and I jumped into acute dialysis nursing in the hospital. It has been so much less stressful and more rewarding. I just want to share my experience for others who enjoy working 3 12hr shifts in the hospital but hate bedside nursing.  

Pros- 3 12 hr shifts in the hospital, working on all units like oncology, med/surg, ICU, ED, ICU step down, cath lab observation. Being on a variety of units with patients of all levels of acuity has provided many learning opportunities.  The primary RN still has full responsibility of the patient while I just focus on dialysis, making adjustments on the machine and monitoring vital signs and LOC. I float between 3 different hospitals and do dialysis bedside, one patient at a time. (Some hospitals transfer patients to a treatment room for dialysis.) The patients and their families are usually happy and grateful for you being there. Providing diabetes, hypertension, dialysis and ESRD education has been reinforced into my own education as well. I've become proficient at fistula and graft cannulation, central line catheter maintenance, sterile dressing changes and TPA administration.  I have also developed an eye for signs of fluid overload and third spacing in these patients as well. You aren't breaking your back lifting, turning and cleaning up code browns. You aren't giving 100 medications. 

There are a few cons. A major one is the unpredictability of your hours. Sometimes the hospital census is low which effects the number of dialysis cases. When it's slow you aren't working. On call shifts are required in addition to the 3 12hr scheduled shifts. This can be awesome OT hours if you want more money or it can be a nuisance if you don't want that many hours. Delays like occluded lines or low BP can add extra hours to your shift as well. But this work is pretty easy, physically and mentally) so extra hours aren't necessarily going to drain you like it would in other jobs. 

Overall this is a great alternative to working as the primary nurse on the floor and I highly recommend it! 







13 Posts

I started 8 month ago from bedside to acute dialysis I love the autonomy. It is stressful if a catheter is not working or a machine breaks down but it is a very specific work and you become an expert over time 

Hoosier_RN, MSN

3,656 Posts

Specializes in dialysis. Has 30 years experience.

I may try acutes someday, but I like my job in the clinic. Dialysis, IMHO, is an excellent specialty, but I've found that people either love it or hate it