Has anyone started out in Dialysis as new grad and then gone on to get Med-surg exper

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If you have experienced dialysis as a relatively inexperienced nurse and then went on to get med surg experience can you please discuss your experience. After getting med surg experience did you feel it made a big difference in your dialysis nursing. I am debating whether to reenter acute care nursing in a hospital med surg unit new grad program or reentering hemodialysis which I have 8 months experience five years ago. I also did a few months of maternity nursery but I did not like it. I am wondering how essential med surg. experience would be. I eventually would like to do acutes and maybe home hemodialysis. They appeal to me because I can avoid alot of the politics that go on when you are stuck on a unit for years with the same people.

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I hate to sound like an old nurse, but in fact I am. LOL I believe you need a good foundation in nursing. I believe you get only the very basics in nursing school. I know many think they can skip an essential step in becoming a compentent nurse. Most can't. Do one year of med/surg. I believe you will be glad you did. JMHO.

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Can you please elaborate on why the med surg experience is the only way to get a good foundation. I know you will be doing alot of procedures and busy work. Is it alot less horrible in med- surg with the new ratios of 4 patients per nurse?

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I didn't say it was the only way. It does give you a broad base. You'll see many diseases, maybe only once, but you'll understand them if you see them again. You will learn to priortize your work load. You'll learn how to make your day doable. Not every one has a ratio of 4 to 1. Practice makes perfect.

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Specializes in jack of all trades.

I was told ratio of 4:1 in dialysis also LOL. I ended up the only RN in the building most of time with no one to fall to for advice which entailed me being responsible for 12. My techs carried 6 pts each and I did all the assessments, meds, etc. Depending on where you are many places see counting as the bodies working to pt ratio and not what your task ultimately are. ! RN and 2 pcts therefore 12 pts gives a 4:1 ratio ( I know but many places do exactly this). I had 25 years ICU experience and still found things in chronic dialysis to be difficult at times as there was no one to call on in an emergency but myself. I couldnt imagine if I had gone directly into this type enviroment as a new grad and not end up being overwhelmed. Just my 2 cents.

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I have to agree with Lacie (again ;)). It was daunting enough for me to go into chronic/outpatient dialysis with over a year experience on a very busy med/tele/stepdown floor with a 1:8 (!) nurse/pt ratio (yes, this was in the dark ages of '98-'99 and absolutely insane).

The main problem in dialysis for new grads is not so much the ratio but the lack of preceptors/mentors. Yes, you will be taught all about dialysis, but the training varies little for UAPs (PCTs, techs) and nurses. Basically, you will need to already have a good, solid foundation in nursing. More likely than not, you will not get this in dialysis.

Some of the things you should know: Lots and lots of normal and abnormal assessment findings (breath/lung sounds, etc). Signs and symptoms of complications of dialysis (OK, this is mostly learned on the job); diabetes; neuro (stroke); cardiac; G.I. bleeds. How comfortable are you running a code with staff who may rarely do this and rely on you to lead? How comfortable are you being the only RN in the building and having to deal with any clinical problems that may occur?

I have to agree with pp, it is best to get a year or so in med/surg first. Also, this may be the only way you could ever get into acute care in the future. And even then, it's not easy (speaking from experience as I'm trying to do just this right now; and I even worked in the same hospital's acute dialysis unit!)

Best of luck to you,

DeLana

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Specializes in Case Mgmt, Anesthesia, ICU, ER, Dialysis.

I had PCT and LPN experience in dialysis before I was expected to run my own floor, plus a little diabetes floor and ER.

Do the med-surg. You won't be sorry.

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Specializes in Tele, Dialysis, Med-Surg, ICU,GI.

This is what I'm actually doing now, I started out in dialysis as a new LPN, I worked 3 years in a chronic dialysis unit, doing pretty much everything (we did not have dialysis techs, the LPNs were it). When I became a RN, I decided to make the leap into Med-Surg nursing, I did this for a few reasons. I wanted to grow professionally as a nurse. I want to go back to school possibly to become an NP, I believe I needed a broader background then just the one specialty. I felt if I wanted to go back into dialysis, my experience would not hurt me but make me a better health care provider.

I have also worked with nurses who have started in dialysis and stayed in dialysis, they are great nurses. However, with or w/o med-surg experience, you do need to work in chronic facility for a year, before making the leap into home-hemo or acute.

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