Hospital floor versus dialysis versus home health - manageability

[whirlwind88]

Hello all, would love to hear your humble opinion on the following. I love being a nurse. Am employed on a hospital floor again, have a ton of energy (for being 50 years old) enjoy challenges yet....would love to hear others, briefly, speak of their feelings on these three areas of work. It's a general question, but I'm tired of not having lunch until I've been at work for 8 hours, and feeling like I get a ton done, yet a marble falls thru the cracks, and one of these days that marble could cost my license. In home health, toileting was a luxury, and not bringing home any cock roaches, haa ha! especially in the high crime area I worked in. Haven't done dialysis yet interview coming up.

Going to love my patients no matter where I work, will enjoy my coworkers as well.

In humble opinion, which one of these areas is more manageable?

Thanks for your thoughts.

[Anna S, RN]

I am also 50, and have worked in dialysis most of my nursing career.

I often do not get a lunch break until I've been at work for eight hrs in chronic dialysis. In acute dialysis, you also may not get one, even though the job is much slower paced, because there is no one else there to cover for you. You cannot leave the pt's bedside and often end up having to use the pt's bathroom to relieve yourself, unfortunately. If anything goes wrong, you only have yourself to rely on.

In chronic, outpt dialysis, it all depends on how the clinic is run/managed.

You can have the same number of pts and staff, and get all of your breaks, or none of them, depending on if a clinic is well organized or not. Chronics is very busy, and hard work. Most places will have you working 36-40 hrs a week.

In acutes, you will generally be 1:1 with pts, and the pace is slow, but most (the Big Two) companies will expect you to put in many long hours. 15-16 hrs shifts, maybe 70 hrs a week. They also require nurses to take call.

One of the things I like most about chronics is that you have the same pts over and over again. You get used to how they run, what they can tolerate on a tx, and so on. There is a lot of pt teaching and follow-up.You really get to know your pts, and follow their progress, or lack thereof, on a continuum.

Of course, there's a downside to this, as well- when you have pts who are real PIAs/rude/mean/non-compliant, you have to spend a lot of time with these unpleasant folks over and over again.

What I really didn't like about floor nursing is that you get new pts every day, different pt rooms, meds, docs, diagnoses, procedures, etc. There's no consistency. And of course, being worked to death on the floor.

Every few years, I get burned-out on dialysis, and do something else for a little while, but always end up going back to dialysis. It's just my thing. I just resigned from a home care job to go back to dialysis. To my surprise, I absolutely cannot stand home care. The driving around all day, constant phone calls, and the charting were awful, imo.

If you can, I'd definitely ask your prospective employer if you can shadow a dialysis nurse for a day.