moving from chronics to acutes with little experience

jb2u, ASN, RN · Jun 13, 2011

I think you will be fine. They should really give you more than two weeks though!!! We give our experienced nurses at least 6-8 weeks. I did not find dialysis hard to learn, but you do need to learn the policies for that particular facility!! That alone can take more than two weeks.

Papaofeleanor · Jun 15, 2011

Agreed, you'll be fine. alas, proceed with caution and insist on as much training/orientation that you feel you need to be set up for success. having said that, most of us never feel ready to 'fly the coop' and be fully fledged...not matter what the new endeavor.

i spent 6mos doing dialysis in the outpt setting before transferring to acutes where i've been for about 3yrs. i say proceed with caution as the biggest contrast to me between chronic and acutes is that you have to be competent in the whole gammut. chronics you can get away with having shortcomings as likely there will be a tech or fellow-nurse that can pick up the slack if you encounter something unfamiliar. on acutes, it's all you...setting up machine, doing a little plumbing in the process to hook up to water, pt-assessment, cannulating avf/avg's that you may not be familiar with (for the ESRD pt's who are in-house), technical aspects of the machine and trouble-shooting, etc. etc.

Additionally, being flexible is the name of the game doing acutes. there have been many days i've come in expecting a light load, thinking i'd get home at a reasonable hour...only to stay for 12hrs or so instead. not to mention the need to be on-call. which is definately a draw-back and very limiting. there can be those occasions where you work a full 12hr day, leave the hospital only to be called back in an hour or so to do an additional emergent tx. you can easily find yourself stumbling home at 4a in the morning after being at the hospital 18 out of 20hrs or so. on that note, good to cultivate a true team mentality with your fellow acute nurses, who will have to take the lion's share of the following day's load after such an epic/marathon shift! although, at least where i work, such a marathon in the exception and not the norm. anyway, all the best!

MJB2010 · Jun 16, 2011

I am new to dialysis (1 year now) and have found myself having to rely on the techs for information. I feel my orientation was NOT adequate - especially learing the machine (alarms, recircing pts, troubleshooting). The problem is that many of the techs are not as willing to help a new RN learn. As sad as this sounds, some techs seem to get a chuckle seeing the nurses struggle trying to trouble shoot machines, access problems, etc.... I have heard that many of these techs ave a "chip on their shoulder" for being paid less? I am looking to transfer to acutes but question if I have enough knowledge base to be on my own? The techs where I work do most of the recircing when pt's have to get to the bathroom..........I am comfortable putting pt's on and taking off, but still not 100% sure with maching alarms, recircing etc....... Is it feasible to transfer to acutes with being unsure yet in the chronic setting??? I am so willing to learn - I just need a reliable source to give me the information that I need to do my job. I have been offered a position in acutes, but since I have one year experience in dialysis, they are only giving me only a 2 week orientation. Any advice is appreciated!!:heartbeat

I have found some of the techs to be exactly as you describe. Thankfully there are also some kind ones that are willing to help! I am new to dialysis as well and I can tell you that which techs are on for the day make such a difference in how my day goes. Why are they so mean? lol. Only a couple of them are like that in my clinic so I guess I am fortunate.