Experienced Dialysis Nurse wanting to eventually get a new specialty

RN6689 · Jun 29, 2017

I spent 7 years in icu and then switched to acute dialysis with no experience. I trained in a clinic for 8 weeks and then acutes for 3 weeks. I'm only a year in and I'm thinking about leaving. My schedule is horrible. Days are always at least 14 hours, plus call, and the occasional "half" day that is added on with short notice. I only get my schedule about a week in advance. I feel like I have zero energy to devote to a life outside of work. Plus, dialysis is not as interesting.

It sounds like you are pretty motivated and like learning new things, so you would probably enjoy icu. Everywhere I've worked is self scheduling and is three 12s. Typically they want 2 weekends a month. I used to set my schedule a month to 6 weeks in advance. You can actually make plans, which is nice. It is more physically and emotionally demanding, but much more satisfying and stimulating than dialysis. The biggest challenges are increased stress level, fast pace, and dealing with combative patients and difficult family members.

Although, most of my icu experience has been in level one trauma centers. Many of the smaller hospitals where I've done dialysis in icu seem to be much calmer.

RN6689 · Jun 29, 2017

I worked in icu for 7 years before switching to acutes. I had no prior experience. I'm a year in and thinking about leaving. The schedule is aweful. I usually work three 14 hr days, plus call, plus the occasional "half" day that's thrown in. I get my schedule about a week in adavance. I have not been able to take a single PTO day this year. I have zero energy to devote to life outside of work. Sure the stress level is lower and I get paid a bit more, but I'm not sure it's worth it. I'm losing my critical nursing skills and experiencing burn out at a much faster rate.

Icu requires three 12s. Most places I've worked you pick your days. Weekend requirements are usually 2 per month. I typically would know my schedule 4-6 weeks in advance. It is much more satisfying and stimulating, but be prepared to deal with a faster pace, combative patients, and difficult family members.

RN6689 · Jun 29, 2017

Sorry, Im new to this site and thought my initial post didn't submit. Not sure how to delete one.

llg, PhD, RN · Jun 30, 2017

You might want to do an "in between" job to help make your transition easier. For example -- take a job on a med/surg floor that handles a lot of renal patients. They would be the type of unit most likely to hire you -- and your expertise in renal pathophysiology would be an asset. Such a job might help you get into the rhythm and routines of the inpatient care of patients with some other types of diagnoses.

After you have made that transition and established a good reputation for yourself and a good general med/surg nurse ... the transition to ICU might be easier to make. You would be more attractive as a job applicant and you would have already adapted to the routines, paperwork, and schedule of that world.

CFrancine, BSN, RN · Jul 4, 2017

I had a couple nurses in my acutes department get hired in ICU with no problem. You have a good background.

I'm curious about the fact you have your CDN and CNN.... I thought the CNN covered the CDN plus more. Is there a reason to have both? I just got my CDN since I only do IHD but I can technically take the CNN as well. I figured if I got my CNN, they would cancel the CDN. No?

NurseRies, BSN, RN · Aug 4, 2017

Thanks for the comments!

I got my CDN when I worked outpatient, then got the CNN when my acutes manager asked me to. I didn't plan to get both, but apparently since I was doing a little educating and precepting, they preferred the CNN. For the record the CNN is more suited for acutes and CDN outpatient for sure. I am up to renew next year and not sure if I will keep them both.

It also seems like it may be about who you know to get a job. There's a couple of ICUs I think I could get into with the right nurses recommending me, but the question is would I be ready? I mean they do hire new grads in some of the smaller ICUs , so that is a possibility maybe, with the right training.

CFrancine, BSN, RN · Aug 5, 2017

Your background is excellent so I would not worry about qualifying for a job. I was a new grad nurse working in ICU. I personally believed I struggled but management was sad to see me go when I went to dialysis. If it is a place with a strong training program, which it should be if they're open to hiring nurses without ICU background, then that's a plus.

You're right, it really does come down to who you know. I've only been a nurse for 4 years but I usually have multiple jobs at a time. That really has been the driving force behind my nursing career. I have switched jobs several times but all in the direction of growth. The main thing is to get your name to the hiring manager so they will actually call HR and request your application. HR can't always see how indirect experience can make you a strong candidate for a position. But any nurse manager would find you to be a gold mine. So talk to any of your friends that might work in ICU. They can not only ask the manager if they are any upcoming positions, but also just give a brief synopsis of your qualifications and ask the manager if they would ever consider hiring such a candidate. More than likely they are hiring because ICUs tend to have high turnover. I work at a really large company and many people do the ICU as a stepping stone to grad school.

If you work in a lot of ICUs as an acute nurse and maybe have seen the manager a few times, you can approach them yourself. They may not know you're in the market but when they find out, they might encourage you to apply. Once, I had a side job as a hand hygiene monitor in a hospital. People assumed I was just a nursing student because that's who usually does that position. When the ICU manager found out I was in ICU nurse, even though still a new grad, she approached me and said if I ever needed a job to give her a call. She knew nothing of my nursing skills but I had a good relationship with the hospital liaison and I think she like the fact that I was just doing something to help improve patient care and stepping outside of the box. She made good on that months later when I heard a few of my coworkers where actually applying to that unit. I sent her an email one day and her response was literally asking how fast could I get there for an interview.