difficulty in getting dialysis nurse job

westieluv · Mar 30, 2014

Do you have any other experience besides being an IV nurse? I work for Fresenius, and I know that they like for you to have some floor experience, especially critical care.

thomas76 · Mar 30, 2014

I worked in medical surgical unit for 5 years prior to working in IV. I thought of outpatient dialysis not acute. Are the requirements the same?

schnookimz · Mar 30, 2014

Hmmm maybe your area is saturated? It's typically not a field I would say is hard to get in to.

Try to expand your search area a bit. Often one manager covers a large area and if that manager doesn't like your résumé for whatever reason then you might just be passed over. Expanding your search area may allow another manager to view your résumé.

westieluv · Mar 31, 2014

I think acutes would be easier to get into. I know it is in my area because there is a huge turnover, due to the erratic hours and on call requirement. It is like a revolving door around here; they get someone fully trained and then the long days and on call starts and they're gone, time to hire someone else and start over again...

thomas76 · Mar 31, 2014

I have heard that once they see your resume, it takes months for them to call you for an interview..that is if they are interested.. is that true?? A friend of mine got called for an interview after 8 months of applying. She had given up hope.

thomas76 · Mar 31, 2014

Really?? I thought acute required experience in critical care areas. But chronic dialysis it is preferred but not really required.

schnookimz · Mar 31, 2014

Really?? I thought acute required experience in critical care areas. But chronic dialysis it is preferred but not really required.

I started out in acutes with no experience and I am fine. Actually the way it was explained to me is that it can be easier to start in acutes bc if you need help then at least there's other people around, though maybe not dialysis staff, whereas in chronics you might be the only RN there.

westieluv · Mar 31, 2014

I started out in acutes with no experience and I am fine. Actually the way it was explained to me is that it can be easier to start in acutes bc if you need help then at least there's other people around, though maybe not dialysis staff, whereas in chronics you might be the only RN there.

I also started out in acutes with no dialysis experience. I found the opposite to be true; in acutes, there may be other people around, as in the floor nurses at the hospital where you are working, etc., but it's rare to find one who knows the first thing about dialysis, so there are many times when you are literally the only person in the building who knows anything about dialysis at all, which can be very intimidating when you are brand new to dialysis and fresh off of orientation and on your own. At least in chronics, even if you happen to be the only RN in the building, you have dialysis techs who know dialysis inside and out to help you if you have a question or encounter a problem. It's quite rare to be the only RN in a chronic unit anyway, because unless it's a very small clinic, there should be another RN sharing the patient load with you, and every clinic has a manager that knows dialysis and is more than likely an RN.

westieluv · Mar 31, 2014

I have heard that once they see your resume, it takes months for them to call you for an interview..that is if they are interested.. is that true?? A friend of mine got called for an interview after 8 months of applying. She had given up hope.

That wasn't my experience. I originally applied for a home dialysis RN position with Fresenius and they called me within 24 hours. I didn't end up taking that position because it was going to involve really long hours and after hours on call, plus I had already found another job that I wanted more.

Strangely, last year when I needed to find something full-time with benefits, Fresenius just happened to call me and ask me to interview for a position in acutes, which was when I started working for them. I say strangely because I had never even applied for the acutes position, it wasn't even on my radar. All I can figure is that they kept my resume from when I applied for the home dialysis RN position back in 2011.

schnookimz · Mar 31, 2014

I also started out in acutes with no dialysis experience. I found the opposite to be true; in acutes there may be other people around, as in the floor nurses at the hospital where you are working, etc., but it's rare to find one who knows the first thing about dialysis, so there are many times when you are literally the only person in the building who knows anything about dialysis at all, which can be very intimidating when you are brand new to dialysis and fresh off of orientation and on your own. At least in chronics, even if you happen to be the only RN in the building, you have dialysis techs who know dialysis inside and out to help you if you have a question or encounter a problem. It's quite rare to be the only RN in a chronic unit anyway, because unless it's a very small clinic, there should be another RN sharing the patient load with you, and every clinic has a manager that knows dialysis and is more than likely an RN.[/quote']
You're right, the floor nurses know nothing about dialysis. But I had a long orientation that taught me a lot and my teammates are only a phone call away.
When I say that there is other staff to help you, I mean that if something starts going bad with the patient, it is not your job to manage their other medical care at all. You are only there to do the dialysis procedure. If things go south, stop tx and get out of the way.
In the clinic, you're the nurse, don't people look to you for all the answers? Although I am guessing people go south last frequently in the clinic since they are primarily stable?

westieluv · Mar 31, 2014

You're right, the floor nurses know nothing about dialysis. But I had a long orientation that taught me a lot and my teammates are only a phone call away.
When I say that there is other staff to help you, I mean that if something starts going bad with the patient, it is not your job to manage their other medical care at all. You are only there to do the dialysis procedure. If things go south, stop tx and get out of the way.
In the clinic, you're the nurse, don't people look to you for all the answers? Although I am guessing people go south last frequently in the clinic since they are primarily stable?

Well, my experience in acutes was that if the patient started to crash, sure, you take them off and the hospital staff takes over, but then everyone, including the doctors sometimes, question whether it was the dialysis that caused the decline and then they start to question if the patient should have had dialysis, if the treatment was too intense for them, if you took them off soon enough, etc., etc., which I thought was annoying. Oh, and one of our nephrologists would not allow us to adjust a treatment AT ALL, much less take a patient off, even if they were crashing, without calling him for orders first, which was ridiculous and not realistic at all. I'm talking about if the patient's BP dropped suddenly, we couldn't even give them 200 ml of NS back before we asked him or he accused us of trying to play doctor and would threaten our nursing licenses. Who needs that?

In the chronic unit if a patient starts to crash (e.g. BP reads 70/30, feeling dizzy), you adjust their treatment by returning fluid, decreasing the UF goal, or whatever. That will usually do the trick, but if it doesn't, or if they have a more serious symptom like chest pain, we call 911, they are there in less than five minutes, and the patient is whisked off to the ER, so we really don't have to deal with a crashing patient for long either. And yes, they crash much less often because they are more stable, so, like I said, adjusting the treatment will almost always fix the problem.