First Nursing Job Dialysis Am I Stuck Forever

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Specializes in ED / CTICU.

I am A new graduate who graduated in May of 2018. I was licensed by June 15, 2018 and I was offered a job to start in July 16th, 2018 at an outpatient dialysis center. It was my only job offer at the time so I decided to take it because I was not getting any hospital offers at the time. This job was also non contract so I thought I can take the job while working on my BSN and applying for different jobs and going on other interviews. I felt that any experience beats having no experience. I could start building a resume. The problem is that a lot of people, and even some Nursing Professors warned me and told me not to take a dialysis job because if I did then I would be doomed that no hospitals will ever want to hire me in the future. I feel that it is better to get any type of RN experience rather than sit around for months waiting for my Ideal job. I decided to give dialysis a chance and I needed to start working. I did not want to blow through savings waiting for my dream job. My other problem is that I am not into dialysis at all. I realize that I have not been working there for a very long time but believe me when I tell you that I have seen enough where I know that this specialty is not for me. While I am still learning and getting experience, I find hemodialysis to be very repetitive and I feel like I am not using a lot of med surg skills learned in school. I am not ready for something this specialized this early on in my career. I strongly prefer to see more of a variety of patients in a hospital/acute setting. Also starting at 5AM and not getting out until 9 o'clock at night is killing me. I realize that most Nursing jobs are long hours But the 16+ hour shifts are starting to getting in the way with my BSN studies.

Is this just a myth that once someone works in dialysis that they are stuck in it for their entire career? I don't believe that this myth is true because when I started working at my dialysis center, a nurse that had been working there for close to a year and had been offered a hospital position and resigned. I feel there is hope that I will get in a hospital in time but then again, her hospital offer was kidney related. She was offered a medsurg position for pre and post op on a kidney transplant unit. As grateful as I am to have a job and be working as an RN, I still feel terrified that I am going to restrict my career options. I know that things could be worse and I could have no job as many people that I graduated with back in May are still not working. Truthfully it is the same people without jobs who have never worked as an RN who I went to school with who are putting these ideas into my head. These are the people who would rather let months go by without a job or experience. They feel that it is better for them to work on their BSN's and then after that apply for their ideal job. They complain about being licensed and unemployed yet they are super picky about where they want to work. Hopefully those in this speciality or who previously worked in this specialty can give me better advice.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I am A new graduate who graduated in May of 2018. I was licensed by June 15, 2018 and I was offered a job to start in July 16th, 2018 at an outpatient dialysis center. It was my only job offer at the time so I decided to take it because I was not getting any hospital offers at the time. This job was also non contract so I thought I can take the job while working on my BSN and applying for different jobs and going on other interviews. I felt that any experience beats having no experience. I could start building a resume. The problem is that a lot of people, and even some Nursing Professors warned me and told me not to take a dialysis job because if I did then I would be doomed that no hospitals will ever want to hire me in the future. I feel that it is better to get any type of RN experience rather than sit around for months waiting for my Ideal job. I decided to give dialysis a chance and I needed to start working. I did not want to blow through savings waiting for my dream job. My other problem is that I am not into dialysis at all. I realize that I have not been working there for a very long time but believe me when I tell you that I have seen enough where I know that this specialty is not for me. While I am still learning and getting experience, I find hemodialysis to be very repetitive and I feel like I am not using a lot of med surg skills learned in school. I am not ready for something this specialized this early on in my career. I strongly prefer to see more of a variety of patients in a hospital/acute setting. Also starting at 5AM and not getting out until 9 o'clock at night is killing me. I realize that most Nursing jobs are long hours But the 16+ hour shifts are starting to getting in the way with my BSN studies.

Is this just a myth that once someone works in dialysis that they are stuck in it for their entire career? I don't believe that this myth is true because when I started working at my dialysis center, a nurse that had been working there for close to a year and had been offered a hospital position and resigned. I feel there is hope that I will get in a hospital in time but then again, her hospital offer was kidney related. She was offered a medsurg position for pre and post op on a kidney transplant unit. As grateful as I am to have a job and be working as an RN, I still feel terrified that I am going to restrict my career options. I know that things could be worse and I could have no job as many people that I graduated with back in May are still not working. Truthfully it is the same people without jobs who have never worked as an RN who I went to school with who are putting these ideas into my head. These are the people who would rather let months go by without a job or experience. They feel that it is better for them to work on their BSN's and then after that apply for their ideal job. They complain about being licensed and unemployed yet they are super picky about where they want to work. Hopefully those in this speciality or who previously worked in this specialty can give me better advice.

I agree that any experience is good experience. You can learn a lot in outpatient dialysis; things that will help you throughout your career. Only if you're willing to actually learn, though.

it sounds as though the ideal job for you would have been Med/Surg . . . something I've been advocating for years as the perfect first job. I don't think spending a year or more in the dialysis clinic is going to make you ineligible for hire into a Med/Surg or Renal unit. Every little bit of experience is experience you can use. You are learning -- or can be learning -- about medications and their various indications, side effects, doses, toxic effects and potential interactions with other drugs or other conditions. You're learning about lab values -- what's a normal potassium, what potassium is considered an emergency? What bath do you use for a patient with a K+ of 7 vs. a K+ of 2? Hopefully you're learning all about kidney function, and how the kidney works.

I'm suspicious of anyone with less than a couple of years experience telling me that they're bored with ANY job, or that they know for a fact that "this specialty isn't for me." Frankly, you don't really know enough yet to know what specialties will keep you interested and why. That's something you figure out over time.

Stay in your current job for a year. During that year, think about what you like and what you don't like about your current job. Then, when you're ready to move on, you'll have a far better idea of what to move on TO.

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

IMO it is a lot easier to explain landing in a job that is less than ideal than to explain months of inactivity after obtaining your license. One possible side benefit - during my (fortunately) short tenure in a job that I absolutely hated, a chance conversation led to a connection that was essential in obtaining my next job. You never know when opportunity may knock.

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Specializes in Nephrology, Cardiology, ER, ICU.

Outpt HD nursing takes really a year to learn the job because of the tech aspect. I came into nephrology as a new grad APRN with many years of critical care/ED experience. I had never worked as a dialysis RN.

My take (after 12 years as an APRN):

I personally would not iike to be an RN in an HDU for the following reasons (several of which you cited):

Repetitive

Same patients with horrendous chronic needs

Very ill patients some of whom have learned to "game" the system

However as APRN in nephrology I have more roles other than just seeing HD patients. I also like the autonomy. The practice I work for is super awesome and we have very little turnover with regards to APRNs.

My take: get your orientation done, gain some experience, then capitalize on it to gain a hospital job. When I was interviewing for this position I highlighted my ability to think on my feet, handle emergencies on my own (sudden cardiac death during dialysis is REAL), ability to deal very well with all types of patients from the younger ones for whom dialysis is a huge infringement on their lives to the adults trying to work and have a family life, to the elderly who never thought retirement would include HD.

Best wishes on your decision.

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if you're looking for a more hospital med/surge experience, you can always move to acute (hospital based)dialysis Yes you have your frequent flyers, but you do get to meet different people, and get to do a lot of educating

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Specializes in Dialysis.

I know more than a few nurses that work in a variety of hospital settings. They got their start in dialysis. Also, acute care nursing isn't the perfect fit for everyone. Keep applying to other jobs, but try to stick it out and show a pattern of job stability and willingness to learn.

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Specializes in dialysis.

I am fresh out of Nursing school and I love dialysis! However 80 per cent of my LPN experience is dialysis. I may stay in Nephrology land forever...maybe not ICHD but but in some aspect of it. I also say stay for 1 year and get nursing experience, if you do end up leaving you will utilize your experience as an ICHD nurse somewhere in your career （╹◡╹）

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Nurses have left chronic HD to go into transplants and ICU. HD is a love it or hate it thing. I think it depends on a lot of different factors.

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Specializes in Informatics, Critical Care, Case Management.

If it's any console I started my nursing career in psych. When I interviewed, the director asked me if I really wanted the job because most new grads who apply for psych are only just wanting to get their foot in the door. Then asked if I can promise to be there for a year before I tried to transfer. I worked there for 1 year and 8 months, then med surg, then case management, and now I'm in dialysis.

Let me just say that if you don't like it, give it some time as one poster said (I never leave a job until I've done it for a year), learn all you can about the pathophysiology of your patients, then if you still don't like it, apply for a hospital position. If you can, apply for acute care HD, get to know different nurses and managers (networking), then apply for something that interests you. You are not even close to the "pipeline", being a new grad, and there are plenty of hospitals that are looking to hire new grads because you guys are better for the budget. So, for now, work on building your knowledge, resume, and network.

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I think there's a misconception about dialysis. I worked as a PCT in a chronic clinic and when I interviewed at a hospital for CICU, they sort of scoffed and tried to put me off. I had to let them know that much more than dialysis goes on in these centers. Some of those patients have many varied illnesses, so you will learn a lot. Patients code while in treatment. We have had so many emergency situations. You WILL use your nursing skills even though it's a "specialty". You just have to highlight that on your resume/cover letters and in your interviews. I was surprised that the nurse manager from nephrology was in on my panel interview for CICU and he was clueless about what went on in the clinics. They were surprised by the many skills I'd used, even as a PCT, and I got the job.

I work in an Acute hospital setting now, and the senior nurses look to me for help because as a PCT in the clinic, I did everything and experienced a lot. I work with patients all over the hospital in different units with various illnesses and conditions, so I'm being exposed to everything from transplant to peds to icu to psych. I even work with the inmates in our "hospital jail". Dialysis isn't a one trick specialty. You just have to seek new experiences and let people know that you're well-rounded.

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You're not stuck in anything unless you decide you are.

All experience counts.

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Specializes in Nephrology, Cardiology, ER, ICU.

Just to add on. Some things you WILL learn/experience in outpt HDUs:

Assessment skills

Time management

Chronic disease management

How to call a provider and provide a succinct report over the phone to a provider so they understand your needs

How to deal with emergency situations - pts DO code in HDUs

Palliative care of the dialysis pt

Best wishes

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