Has anyone returned to dialysis after many years?

[DeLana_RN, BSN, RN]

After 5 years in a clinic I did some PRN work in a hospital until 2008. My next job was in inpatient hospice (7 years), and after that I had wanted to leave the bedside to find an office job (such as RN navigator). Then came COVID19, and now no one is hiring for those kinds of positions.

The local hospital is, however, looking for a full-time inpatient/acute dialysis position in the same department I worked in 12 years ago. Although I have recent clinical experience, I have not done any dialysis in such a long time. I feel that the knowledge is still there, and might just need to be refreshed (IDK how much machines have changed, but probably not too much).

Am I naive to think that? Has anyone successfully returned to such a specialized area of nursing after so many years? Anything I need to know, any suggestions?

Thanks for any replies!

[Zeek, LPN]

The machines haven't changed that much in my opinion. I think you will be fine. You are right, your skills will need to be fine tuned, but you will start remembering once you start working. If they are kind to you, they'll give you a preceptor for a month or so to make sure you are doing OK before throwing you to the wolves. I would much rather have someone who has done dialysis in the past rather than trying to train a brand new nurse to do in-patient dialysis. Good Luck!

[Duncan6]

I started in dialysis in 1996 and stayed until 2007. Took a break to stay home with kids and tried a few other specialties before returning to outpatient HD 2018. The core of dialysis is the same. It's kind of like riding a bike. There are significant changes as far as policies- many are driven by CMS. Lots more charting and documentation. Lots more reports. Less staff. And depending on the company, things like Schedulewise programs that dictate your patient schedules. One big surprise for me was how we maintain BP- there is no more mannitol or hypertonic, etc, the only tools I have are NSS and adjusting the UFR. The best thing for me was doing the full orientation program. The company required it because I had been gone over 10 years, and at first I thought it was overkill, but generally it was very helpful and I felt confident on the floor. Best of luck to you!

[Ashley_SF, BSN]

If she's doing acute dialysis then she will have mannitol and albumin for BP maintenance. My docs do not use hypertonic solutions though..

[Duncan6]

@Ashley_SF,BSN That's true, I was thinking about my own experience in outpatient. Inpatient vs outpatient is very different when it comes to BP maintenance and fluid removal- more options for sure!