ICU RN thinking about doing Acute Dialysis

Chas23RN · Sep 19, 2012

The only thing I can say is I have worked in HD for 2 years and I am going PRN because I have never in my life felt less like a nurse. It is very repetitive. You set up machine, test it, Assess Pt, obtain VS, set goal for fluid removal, get access and hook pt up. The charting is boring and you give very little meds. Acutes can be crazy because you dont always work a set schedule at a certain hospital but if it is through a hospital and not a company like FMC or Davita then it may be different. The first 6 months wasnt that bad for me because it was all new but it started to get so boring and burn out sets in quick .

Chas23RN · Sep 19, 2012

Just wanted to add most places acute and in center dialysis have crazy hours I have to be at work at 5am and my friend who done acutes for a long time quit because the hours were all over the place, you do dialysis when a pt needs it and that could mean 5 am in the morning...it sucks. Hopefully you will find something that works for you

Guttercat, ASN, RN · Sep 19, 2012

Many acute dialysis RN's come from a ER/ICU background. It's just a naturally good fit.

Personally I loved acutes even though there were times I would have thrown myself out the window had they not been made of shatterproof, tempered glass.

It's a very autonomous position and oftentimes you have great docs to work with. You also get to work with just about every department in the hospital.

Call stinks, though, but one call day a week isn't too bad. It's the 10PM call-in for so and so who decided to eat a giant potato that get under your skin.

Sometimes it is very slow, and sometimes the pace is like a Nascar circuit. Sometimes the job was just downright fun.

Yes, you can become "too specialized". I did. Could you remain on a per diem basis with the ICU and work once a month?

Edit to add: it sounds like the above comments before my post pertained to outpatient dialysis, which is a whole 'nuther animal. I did acutes for ten years and enjoyed it, whereas outpatients made me want to poke my eyes out.

RN625 · Sep 23, 2012

Guttercat has it right. Your thinking is right on & I applaud you for recognizing the skills that acute RNs have and use. We are most often criticized for "sitting around" at the bedside. I too moved from ICU and was prepared when the patient went south. I also hate working OP hemo clinics which are repetitious, etc. Acutes is very physically demanding and after many years I had to leave it behind. I now do Home therapies, teaching & managing Peritoneal & Home hemo patients. This too is very rewarding, more phone managing & clinic work with seeing patients 2 x month, etc.

I think you should give the acute team manager a call! Good luck! Let us hear from you. As we say, you'll either love it or hate it!

Chisca, RN · Sep 24, 2012

Guttercat pretty well covered it. I predict you will be bored but when you go back to ICU you will be the best CRRT nurse around.

amyla008 · Sep 26, 2012

Thanks for the answers everyone!

Guttercat: what were the frustrations and what were the fun parts?

RN625: Can you speak a little to the physical demands? I know you have to push the machines around the hospital and lift the gallons of dialisade - are the other physical demands? (just curious because one of the reasons I am tired of the ICU is I am tired of lifting 200- 300lb pts).

I just talked to the manager and am going to get a resume to him. They aren't hiring right now but he thinks that could change soon.

Chisca, RN · Oct 3, 2012

At my hospital it would help if you had a plumbers license. Part of the dialysis machinery is a reverse osmosis machine and the there are different water connections depending on which part of the building you are in. If you are not mechanicaly inclined it can be difficult. If ever there is a water leak anywhere people immediately blame the dialysis nurse.

Guttercat, ASN, RN · Oct 3, 2012

At my hospital it would help if you had a plumbers license. Part of the dialysis machinery is a reverse osmosis machine and the there are different water connections depending on which part of the building you are in. If you are not mechanicaly inclined it can be difficult. If ever there is a water leak anywhere people immediately blame the dialysis nurse.

That made me laugh. How true!

Oh the floods I've created.

One time I put a machine in rinse and left the room to go on break. During that time, the outlet hose came out of the wall. Thirty minutes later it was raining on an OB patient... two floors down. Oooops...

Amyla, your question regarding "dislikes" and "fun parts" would take an entire page to outline.

I will say that people who don't want to do acute hemo are usually those not comfortable in an autonomous role, or have little patience for "difficult" personalities as dialysis patients frequently have. There is a perception that all the dialysis nurse does is "sit there" and while this is occasionally true, it is not the norm.

I worked with one (excellent) nurse who went back to surg/ortho because the stress of the autonomy was too much for her. She thought floor nursing was way easier. I personally find floor nursing much more difficult and physically demanding.

People that do like it almost never go back to their ICU/ER/Medsurg roots. In acutes, you are still exposed to all those areas, and still get to learn and contribute, but the opportunities to problem solve lean more to the side of the medical model, rather than the nursing model.

I loved it. In acutes, you do become specialized, but hardly out of touch. You see it all.