Dialysis vs. Hospital Nursing

mandy13086 · Oct 13, 2014

I would also be interested to learn more about this.. :)

NurseRies, BSN, RN · Oct 13, 2014

Is it better? Hmm.. good question :). Every job role faces its own challenges, ups and downs, and stressors. I have not worked as a bedside nurse and have been a dialysis nurse for almost 5 years. Most co-workers say they would never go back to bedside after working in dialysis, because it is so much better. But that does not mean it's a great job. I always say you will either love dialysis or hate it. If you are unhappy as a bedside nurse, it would be worth taking that chance to try it out.

A typical day as an outpatient nurse would mean:

You are responsible for 10-12 patients in the morning, and 10-12 different patients in the afternoon. The techs will primarily be responsible for monitoring their treatment, starting, and completing dialysis. Each tech usually has 4 patients in the morning and 4 in the afternoon. State requirements vary. You will pass meds on some days, which takes several hours of your day. You will perform assessments on each patient and double check your tech's work to make sure there is a safe treatment and you will not crash your patients. You will do a lot of paperwork, such a monthly assessments, long term goals, medication reviews, foot checks, and education.

-The hardest part of outpatient is that you have so... much.. work. It is very fast-paced, and if your techs are inexperienced or immature, you job just got 5 times harder. If you have great techs and a wonderful manager, you will be very happy. It is great to get to know your patients on a long-term basis, see them improve, and joke around with them on good days. Other days, there will be blood all over the floor that you will be cleaning up, as you hear another patient vomiting. The phone may be ringing off the hook for you. You need to be able to multi-task like a maniac. I never sat down when I was the med nurse. I was always running around in circles checking on all the patients.

If you choose to be an inpatient, acute dialysis nurse:

-Days can be long, 12-18 hours. There are on call requirements. You have to be comfortable working without any backup. Machine problems? you're it. Can't stick the fistula? You're it. You can call someone, but they prob can't help you over the phone. The up sides are that you usually only do 1 patient at a time. Sometimes you have 2, stable patients that you run on dialysis simultaneously. You need to be a good nurse for this job, because you are dealing with complex problems and acute situations. Many treatments do not go smoothly, whether it is blood pressure problems, vomiting, diarrhea, pain, confusion, psychosis, access problems, or irregular heart rhythms. I like being independent and having an always changing, challenging environment.

I love my job and encourage people to try it out if you have any interest. But it is very hard, just in a different way then bedside. For some, dialysis is the "IT" job. This is it, the job they will retire in. Many feel that way. I have also seen plenty of people who work for 6 months to a year and then go running for the hills, saying it's the worst job they've ever had. I don't get that. I think it either fits your personality type or not. But I encourage you to try it out! If nothing else, you will learn a lot more about renal patients.

Guttercat, ASN, RN · Oct 19, 2014

It depends on the clinic. Some clinics hit that "sweet spot" where the work is hard, but one still (most days) leaves at the end of the day feeling like a success.

Other clinics--not so much.

It really depends on so many factors that would take a page or more to discuss in one post.

wanna b · Feb 3, 2015

Coming from the ER, HD is a piece of cake. Its a different kind of stress and pace. Like the previous posters wrote it depends on who you work with.

TNValley · Feb 4, 2015

Go for it! You might love it. I'd definitely ask about the clinic's "scores" (how they stack up to the local competition) before I accepted a job just anywhere, though. I see a disturbing better reimbursement to "better score" clinics developing in the US.

Anna S, RN · Feb 5, 2015

It is like comparing apples and oranges to compare HD nursing the the floor.

I have worked at some pretty good HD clinics, and I've worked at some that I would never step foot in again for any amount of money.

I've seen some experienced ICU/ER/L&D, etc nurses take to dialysis well, and I've other burst into tears saying they just couldn't do it.