MedSurg to Dialysis Transition

[Nurse Beth, MSN]

Dear Thinking About Change,

Dialysis can  be the change you are looking for and as an experienced MedSurg nurse you qualify for an entry level dialysis position.  Initially there's a steep learning curve, learning to prime, setup and teardown machines, but they will provide you with all the training. 

Once you learn the protocols, it can be fairly routine and repetitive. You have to be organized and have critical thinking skills, but you will be "juggling" far less in Dialysis than you do in MedSurg. Overall, it's less chaotic.

As a dialysis nurse, you can get to know your patients well and foster relationships with them. Patient education is an important part of your role.

You can work in an outpatient setting or in acute care. In chronic dialysis, you will have weekends and holidays off, which is really nice after working weekends and holidays in acute care. You can be required to work long hours and  different shifts, however, as dialysis nurses are in short supply in many areas. Once you are  independent in practice, you may be on call.

You aren't able to earn a certification ahead of time. To be eligible for the Nephrology Nursing & Dialysis Nursing(CNN/CDN) certification, you must have completed 2,000 hours in nephrology nursing. Consider joining  the American Nephrology Nurses Association to attend local chapter meetings and receive the Nephrology Nursing Journal.

Good luck and all the best in your new venture-

Nurse Beth

[J.B.Chan, BSN]

Depending on where you decide to work is the crucial factor. If you can find a position at a smaller unit- that would be your best bet. The larger units are much more hectic (not that, the smaller ones don't have their moments). The hours can be very long, sometimes in excess of 12 hours, just being honest here. Additionally, like the rest of healthcare, chronic dialysis facilities right now are having issues with staffing shortages. However, after working for many years in the hospital setting- I prefer chronic dialysis any day over the rat race in the hospitals. The company I work for has a generous tuition reimbursement plan- they paid for approximately 90% of my BSN and are also paying a huge chunk of my MSN (FNP program). Also, there is much room for advancement in chronic dialysis- you can move up the chain relatively easily if that is something of interest. As with the rest of healthcare- there are pros and cons to working in chronic dialysis but overall- I love my job. Most importantly, forming bonds with the patients and knowing that you have positively impacted their lives is very rewarding. Dialysis is an entirely different world- but if you want a change, I say go for it. Good luck to you!

[Hoosier_RN, MSN]

I work in chronics, we work Saturdays and holidays except Thanksgiving, Christmas and New Year, so it will vary by location/clinic. I urge you to try it, I love it and maybe you will too!

[NRSKarenRN, BSN, RN]

Peruse AN's  Dialysis-renal-urology  forum for this specialty advice. Take  Dialysis Schedules into consideration as some start 5:30AM, or end late at night -- often 10-12hr shifts.  Best wishes in transitioning to a satisfying nursing position.

[CN101, BSN, RN]

It's funny because I did the opposite transition. 

I had a negative experience at my chronic clinic. We opened from 4:30am - 11:30pm MWF. TTS was a little better, usually 4:30am-6pm (the latest). The work is "easy" but the hours aren't. Many nurses I spoke to left because they hated the early or long hours. Not all clinics are the same though. Try it and see if you like it. 

[traumaRUs, MSN, APRN]

I'm a nephrology APRN who sees pts in several chronic units. Each company has their own personality. Personally, I'm glad I'm employed by a large nephrology practice. I don't care to be called a "team-mate" (I'm not on a sports team) or have to acknowledge that I live in a "village". (From FMC and Davita). 

It is very technical and the skill-set that is transferrable is the assessment skills, the compassion, the long-term relationships you can build. 

Best wishes

[Jennifer Laidlaw]

I work in Canada as a Dialysis nurse. It is a bit different up here. We are primarily hospital based. Our chronic patients come to hospital based clinics. There are a few community centres but they are usually the exception than the rule. We start at 730 and finish at 2345. Usually work 8 hr shifts. Unit is open Monday to Saturday. This only changes for christmas day and new years day when we will work the Sunday so staff and patients can have the holiday off. 

We get the benefit of residents and fellows from the university coming through to learn and keep us on our toes. Wonderful Nephrologists that really do care about their patients. And patients that do not have to worry about the cost of the treatment they are receiving.  It isn't a perfect system, but it works. Because we are hospital based, I also get the experience of acute dialysis/on call as well. 

I hope you try nephrology out. It is a different breed. You won't be bored. There is always something happening to keep the unit active. Most nurses see the dialysis nurse when we are dialyzing at the bedside and one on one. They think dang you guys have a great job, super easy. And yes when you see me at bedside one on one it does Look nice and easy. I will agree with you. But in our main unit, when you start juggling 2-3 patients (primary care) or 13 patients (with 4 techs, team care), it becomes much more complicated. 

My only suggestion to you is to give it time when you start. It took me nearly a year to feel comfortable in the unit. Each season brings its own challenge for the patient and this affects their stability. 

 

[K. Everly, BSN, RN]

I would be curious about this too.

I’ve thought about dialysis because I think it might work well for my personality - high anxiety & prefer to do one thing at a time, some OCD traits, very organized at work and always finding new/better processes to improve my flow, absolutely love to educate pts and families and build connections, also enjoy becoming highly skilled in a few areas rather than a Jack of all trades master of none. 

My friend tried it at Davita outpatient and said it was boring, which I doubt I would say but she and I are different. She said there was a lot to learn when you first started but they totally train you to competency and not to fret if you don’t feel like you have any idea what it takes early on. What I didn’t love when I looked at applying was that it was 10-12 hour days, 4 days a week, with on-call. I feel like if you’re working those hours 4 days a week it would be hard to maintain good work-life balance trying to squeeze on-call in there too.