Experience dialysis nurses....PLEASE HELP!

kasmus · Jun 15, 2012

I have been a dialysis nurse for almost a year. I work in the acute settings, dialysis patients in the hospital. I am typing this from the ICU now. Dialysis can be boring sometimes and exciting others, had a code blue today. Davita is a really good company to work for and they treat their employees well. I have never worked in a chronic clinic but thoses nurses work their ass off (I'm told!) They are often responsible for 12 mostly stable patients, are responsible for all meds, assessments, etc. There are PCT's (nursing assitants) that put and take the pt off dialysis, you as the RN are in charge. I enjoy doing dialysis in the hospital, I am an acute dialysis nurse. Like I said, I have no personal experience to offer you from the chronic clinic standpoint. If you're sick of dispensing meds all day, diapers, colostomy bags, dialysis nurses do not usually deal with those things but notice, I wrote USUALLY. It has happened where a pad needed changing, a colostomy bag opened/emptied and PRNs are given but it is not the norm for my position. I hope this was helpful, write back if you need more. P.S I work with several nurses that have been doing dialysis for 25 years and love it!

Fink · Jun 16, 2012

Thanks, Kasmus! I would probably really enjoy the acute dialysis based in the hospital because that is what I am used to. Code blues....bring them on! Only the chronic area is open now. I am glad to hear you enjoy it!

MJB2010 · Jun 18, 2012

I worked in chronic dialysis. I loved the patients, you really get to know them. You work your tail off. I initially was hired for three 10 hour shifts but quit when Ii got tired of doing three 16 hour shifts. They just kept adding patients and not replacing staff that left. I really enjoyed the work, but felt they were working us to death. My advice would be to ask to shadow and see how big the clinic is. Then see how many RNs are there. Make sure you are not alone like I was. If you get a shot to work in acute setting, jump at that. I really wish I had given acutes a shot, but I got so burned out I went to med surg. I miss dialysis. I miss knowing my patients and seeing them day after day. Now I just toss meds at them and run away in the hospital. Feel free to ask any questions I will help in any way I can. If staffed properly, dialysis is a great field and the training is excellent.

klaRN01 · Jun 18, 2012

MJB2010,

Im glad to read your perspective on the chronic dialysis setting. Currently I work in acute care and was considering chronic dialysis because I thought the work would be a little less stressful but from reading your post it doesnt seem that way. Another reason I was considering was because I hate hospital hours Im sick of flipping between day and nights and working weekends and holidays. I know the chronic

setting does involve Saturdays and holidays arent totally eliminated I just thought it would give me a bit more of a structured schedule and more family time.

MJB2010 · Jun 18, 2012

We had at least 3 nurses come from acutes to work in my clinic, none stayed more than a month. If you can find a small clinic with 10 or less chairs, it would be really nice. Some clinics only run 2 shifts of patients, so you would not get the long days. It was nice to have Sundays off. We started early, too. I got their at 5 for the patients to start at 6. if I go back, I'll be looking for a small clinic with 2 shifts.

klaRN01 · Jun 18, 2012

Kasmus

For acute dialysis how long are the hours in the hospital setting does it involve alot of weekends and holidays and offshifts? It sounds like its a lighter load than the outpatient dialysis setting. I am currently a floor nurse on a cardiac imcu/med surg unit, i've been there for 2 years, and im BURNED OUT already. Im sick of the workload, the staffing, all those things you named in your post, having a schedule thats all over the place and etc. I thought about trying dialysis but had always leaned toward the clinic setting because in the acute setting I was worried about being there alone if something were to go wrong with a patient or if there was a situation where i needed help. However after reading your post it doesnt sound like it would be as hard as i thought. Did your training prepare you well for the position and once on your own how long did it take you to feel comfortable?

klaRN01 · Jun 18, 2012

I have been a dialysis nurse for almost a year. I work in the acute settings, dialysis patients in the hospital. I am typing this from the ICU now. Dialysis can be boring sometimes and exciting others, had a code blue today. Davita is a really good company to work for and they treat their employees well. I have never worked in a chronic clinic but thoses nurses work their ass off (I'm told!) They are often responsible for 12 mostly stable patients, are responsible for all meds, assessments, etc. There are PCT's (nursing assitants) that put and take the pt off dialysis, you as the RN are in charge. I enjoy doing dialysis in the hospital, I am an acute dialysis nurse. Like I said, I have no personal experience to offer you from the chronic clinic standpoint. If you're sick of dispensing meds all day, diapers, colostomy bags, dialysis nurses do not usually deal with those things but notice, I wrote USUALLY. It has happened where a pad needed changing, a colostomy bag opened/emptied and PRNs are given but it is not the norm for my position. I hope this was helpful, write back if you need more. P.S I work with several nurses that have been doing dialysis for 25 years and love it!

Kasmus

For acute dialysis how long are the hours in the hospital setting does it involve alot of weekends and holidays and offshifts? It sounds like its a lighter load than the outpatient dialysis setting. I am currently a floor nurse on a cardiac imcu/med surg unit, i've been there for 2 years, and im BURNED OUT already. Im sick of the workload, the staffing, all those things you named in your post, having a schedule thats all over the place and etc. I thought about trying dialysis but had always leaned toward the clinic setting because in the acute setting I was worried about being there alone if something were to go wrong with a patient or if there was a situation where i needed help. However after reading your post it doesnt sound like it would be as hard as i thought. Did your training prepare you well for the position and once on your own how long did it take you to feel comfortable?

Quiltmaker · Jun 20, 2012

Hi all! I've been a dialysis nurse for 2 years, on top of 10 years ICU and 20 years homecare. Fresenius and Davita are both solid companies...but please keep in mind they are also both "for profits", the name of the game is the same everywhere-do more with less. If you're looking to dialysis to take a break...well, it's not going to work out so well. It's hard work, long hours with crazy times followed by "yep, we're still busy"! I've worked acutes, chronics, adults, peds...for profit and not for profit, big and small units-I work as a traveler, so I get a lot of variety! Bottom line- if you like needles, blood, chronically ill and/or acute patients you can enjoy the work. IMO the safest way in is through a chronic clinic for a year...trust me, you'll need the experience with relatively stable patients before you break loose on ICU patients, this is VERY different nursing and will change your perspective on the use of "fluid resusitation" forever! Good luck!

Tish88 · Jun 21, 2012

I went from working ICU straight into acute hemodialysis. That was 25+ years ago. I had 3 weeks of orientation to learn hemodialysis and pheresis and I was on my own. With an ICU background, I don't feel you need to do chronic dialysis first.

I would highly recommend acute hemodialysis to any ICU nurses, since you are comfortable around these sick patients and can react to any situation in a timely manner.

As for acute hemodialysis hours - well, they are not stable hours especially if you are on call. You can be at work all day long 10-12-14 hrs, go home and get call back out to the hospital. The longest day that I worked was over 22 hours straight. As an acute, you are there to make sure all patients receive their needed treatments.

Acutes generally work a 7 day work week, we don't get off Sunday, unless you are not on call and the total hours each day can vary from 6 hours to 20+ hours. There usually is not a set time frame for acutes.

I did acutes for over 18 years before I switched to a chronic unit. The 60-70 hr weeks was killing me and I was not getting any younger!!! Sometimes I miss the adrenaline rush though.

Each acute program will differ, it depends on what type of hospital you will provide treatments at. I covered many level I trauma hospitals, so we were always busy. A smaller community hospital would probably not be that busy.

kasmus · Jun 28, 2012

klaRN01,

I do four 10 hour shifts a week with some on call time. It's a hospital so there are w/e's and holidays. For my hospital, we have stable shifts like 07 to 1730 or I work 1000 to 2030. I do travel to other hospitals in the the city that Davita is affiliated so the work is pretty steady. Every hospital is different in staffing, I am alone in the hospital (on my unit) with pts but we are working on changing that to at least 2 staff on or at least a resource nurse to help.

I had three months of training and Davita is really accepting of the learning curve and I wasn't left alone for six months. I am sure if I wasn't comfortable, they would've worked with me to get there.

I hope this helps...

doro8144 · Jun 29, 2012

Kasmus,

I am an acute dialysis nurse also, I am employed with the hospital, though. Not Davita or Fresenius. We can do 1:1 , or 2:3, sometimes 2:4, currently. However, Davita is making offers to our hospital claiming they can provide cheaper services. How many patients do they leave you alone with? Being alone with multiple patients does not seem safe, especially with hospitalized patients. Please tell me what your ratios are like. Thanks