Nephrology

[Anoetos, BSN, RN]

Hi, new here, still in school, I'll graduate in '12 though. I work as a Nurse Tech (sometimes called a Nurse Extern in other facilities) on a nephrology floor in a large hospital. Our unit is small, 20 or so beds, and we get a lot of transplants and/or noncompliant home/outpatient dialysis patients who need "correction". Since we're a transplant floor, all our rooms are single occupant isolation rooms which means that we also get a lot of ID patients. We do really well with everything though, everyone is super careful, rigorous with PPE and so on. It's actually a great floor, low drama, high professionalism, etc.

We do CAPD at the bedside and it's been a great experience for me, my question is how nephrology nursing translates; that is, are there opportunities here? It appears to be MedSurg nursing with a renal emphasis, is this an area where I can carve out a niche? Can I expect this to be an opportunity to develop a skill set which I can take to other prospective employers (should I need to)? Does it offer any likelihood of moving into dialysis nursing?

Thanks for your time and kind consideration of questions from a noob.

[RN58186]

Not sure where you are located, but here the dialysis unit will often hire experienced nurses from the inapatient unit. I worked inpatients for 12 years before moving to Outpatient Transplant. I was told by a Nsg School instructor once that if you can work renal you can work anywhere, she was right! You get a lot of multi-system complications with renal pts so you really do learn a lot. I wouldn't trade my years on that floor for anything.

[Anoetos, BSN, RN]

We certainly do see a little bit of everything: major endocrinological problems, surgeries (transplants and amputations), and kidney failure itself comes with a crap load of sequelae. Seems like MedSurg on steroids. Hard but interesting and gratifying as well. Thanks for your response.

[RN58186]

Yeah, renal failure really is multi-system failure. I had an ortho doctor one day getting consent from a pt for a BKA. Since she wasn't a renal pt (we had gotten her just because we had a bed) I asked him if he was planning to transfer her to the ortho floor post op. He looked and me and asked why he would do that - we (renal) look after more amputations than ortho does so no, he wanted her back with us...... I was doing a stump drsg on a post op BKA one day and had a Master's physio student watching me who was doing a specialty in amputations. She asked me where I had learned to wrap a stump, because I was the first nurse she had ever seen do it properly. I like your description of Med/Surg on steroids, it really fits. In my time on the inpatient unit I looked after all the renal stuff (transplant, access creations, PD catheter insertions, amputations and such) but also post op hernia repairs, bowel resections, hysterectomy, ruptured ectopic pregnancy, CABG and stuff. Medical stuff - DKA, COPD, seizures, you name it. We admitted a young man one evening in status asthmaticus and DKA (not a renal pt). He came with orders for q1h blood glucose checks, q1h nebulizers, at least two IV's running..... As we were getting him settled the resident came up and she looked at us and said we were pretty calm for a bunch of surgical nurses - she thought we were the plastics unit that was on the other end of the floor. When we said no we're renal nurses, she said no wonder this doesn't scare you..... Although I love what I do in transplant, there are days I would like to go back to inpatients just for a shift or two... One thing I learned about renal though is you either love it or hate it, there isn't really much middle ground. And I love it....

[hes2371rn, ADN, BSN]

Fresh out of nursing school, I worked on a Renal Failure/Kidney Transplant unit. I was the BEST experience to have as a NEW GRAD. as others have said, its a multisystem disease process. You don't just have the renal/transplant patients either. You get the med/surg overflow, ortho, GERD, amputations as the above post states, surgical patients with wound vac therapy, the list goes on and on. You get a great learning experience, and from the sounds from your post, you work with some good people and that makes your work day great as well!! Good luck