New to Dialysis-feeling discouraged

NephroBSN, BSN, RN · Mar 31, 2006

Hi everyone,
I just recently started on a dialysis unit. I'm an RN with a couple years experience in Sub-acute, LTC, Psych, and Detox. I just finished up my class and just started with my preceptor. I feel so discouraged. I consider myself a good nurse and have excellent organizational skills. I can handle charge on a unit with 40 patients including a med pass/Tx/orders/rounds or handle charge/meds/orders/rounds on a 34 bed detox/rehab unit with ease..handle 2 patients in dialysis?..not even close::sigh::. I really like it too. I'm really unsure if I should quit. I have had 3 weeks of class(3 days/wk) and clinical(2days/wk). I can handle the basics and can set up machines and put one person on and take one off..and repeat for one patient but I guess I should be able to handle more at this point. I had two(and have 3 weeks to get comfortable with 3) with my preceptor today and couldn't get them both off and the machines stripped and set-up and new people on in a timely manner. I was getting so overwhelmed and forgetting steps. I drill and drill on the steps to every procedure with my sig other several times a night too. I left there shaking today. You have to go so fast, I'm scared I'm going to do something wrong and really hurt someone. I'm supposed to go back monday to start 3 weeks with my preceptor (4 days a week), I don't even know if I should. I'm sick to my stomache over it. I never even felt like this as a new grad. I love the speciality. I can tell if I could learn the job this is the speciality I would retire from. I can't tell if I'm just inept and unable to work in this area or if most people feel this way and have so much trouble. Has anyone else felt like this?
Sue

PM me and we can chat. I'd hate to see you give up ....

psalm, RN · Apr 1, 2006

...hope you are feeling better about this. Since you have good skills from your previous positions, give yourself some more time for all the pieces to fall into place. You are still learning new skills and balancing acts. I know I HATE the feeling of being new and slow. I love learning new skills but it takes me a bit longer than others (it seems to me). Maybe my learning style. I would like to go dialysis but because of my learning style i hesitate. I don't want to slow things down. So I know how you feel, but you sound like you are more organized than i am. Let us know how you do.

diabo, RN · Apr 2, 2006

There are some days we can't seem to see the forest for the trees, and other days, we can't seem to see the trees for the forest. If I get too hung up on the details, I work like a snail. If I concentrate on getting the job done quickly, I may miss a small, but very important detail. Working in a dialysis clinic, like many other areas, may tend feel like a balancing act. Right now you need to get comfortable with the basic routine and trust that others will come to your rescue if you holler. (and holler you must. Blood can clot quickly) Everyone wants you to succeed cause guess what, next week you'll be bailing some of the others out when they get frassled as we all on those crazy days. Watch and talk to the other nurses, and find out their methods and routines. Sounds like you care about your work and your patients. Accompanied with a big smile and a little sense of humor, you should do great.

Steve

thomstew · Apr 4, 2006

It's no joke that it takes a year to feel confident with your dialysis skills. I was sick to my stomach everyday for the first 6 months. I was so scared I would hurt someone. I had been an acute RN for 16 years on Med/Surg when I came to dialysis. There is no way to compare it to anything I had ever done! 3 years later I can't think of doing anything else. I love it. Stick with it The patients and your co workers need you. Don't stress yourself out. It takes longer than you think but once everything starts to click you will be happy you stayed. PS your co workers have been there too, ask them for some emotional support I bet they will step up to the plate for you. Good Luck

Natkat, BSN, MSN, RN · Apr 8, 2006

Hi.

I'm not a nurse (yet) but I work as a PCT. Dialysis is very difficult to learn. There is nothing wrong with you not being able to do this yet. I've been doing this 7 months and about a month ago I was able to take care of all 4 patients myself and successfully complete a turnaround. Today was the second time.

It takes time, my dear. You won't learn this quickly. EVERYONE who does this job tells me it takes 6 months to a year to be comfortable doing this. Everyone around you has been where you are. They understand that you are having a hard time and they will help you when you need them to. As someone else said, the day will come when they will need your help too.

For a very, very long time I felt sick to my stomach every day. I worked in a constant flop sweat. I thought I was going to have a nervous breakdown constantly but I stuck with it. I remember whining "I just want to have one good day; just ONE!" and eventually I did. Then a while later I had another one, then another. Pretty soon the good days got closer and closer together. Gradually I had more good days than bad until I go to where I only have a bad day now and then. The difference today is that when I do have a bad day, it doesn't make me fall apart. I can pick myself up and move on, knowing that I'm having "one of those days" and tomorrow - or even next shift - will be beter.

Please don't give up. When the day comes that you are able to do this job comfortably, it will give you a sense of accomplishment like nothing you've ever done. Hang in there!

chart209 · Apr 13, 2006

Hie

Having in dialysis for sometime now. I qualifed and went straight to dialysis.Manager was reluctant to take me but need new blood. What you feeling is normal. I can manage 32 patients now with the help of co workers but the first days i would press a buttom and look around for someone and open my eys I have big eyes i did not realise butnow i know. you will be fine it takes time and you won't live trust me.

a

RednkRN · Apr 14, 2006

AH, I remember my first days in dialysis as a pct. I got sick to my stomach every morning before going in. ANd boy did i make some silly mistakes trying to be speedy verses accurate. I imagine before you could run that 40 pt unit you spoke of efficiantly you were overwhelmed there too. you just got better and felt confident and forgot the bad. Dialysis is the most rewarding position i ever held. I worked on a med/surg unit when i got offered this job indialysis i have now. my skills were rusty but i have the basics. i have been back in dialysis as an rn for 6 months now and i still havent built up my speed to where it used to be, but my pts now "me" and they are fine with waiting a few more entertaining minutes to see me fumble and joke about life. thats what makes it worth while is sharing moments like that with people you wil come to think of as family. Give yourself time and soak up every slow moment because in 6month to 1 yr you will be moving so fast sometime the fun things will pass you by. Hang in there and good luck.

writeone · Apr 14, 2006

Hi,

We've all felt that way. It is very overwhelming. My nurse manager always stresses to our new employees, take your time and do it right, the speed will come. That IS the main thing...take your time and do it right. I can certainly feel your stress. I remember when I went into dialysis six years ago this month. Like you, I had worked med/surg and could handle anything. It was a madhouse. Then, I moved to SC (from NC) and decided to try something new. I felt confident in nursing, felt like I could learn anything...whew. Like you, I almost quit. DON'T! I felt like I didn't pull my load, I felt like my co-workers were frustrated with me, I felt inept. It's a busy place, the pace is fast...but, you too will be right there with them. It took me nearly a year to feel comfortable and by then, you've fallen in love with the field.

I work part time now and look to continue that along with a move into the legal nurse consulting field.

You hang in there and PM me anytime.

DT

WyndDrivenRain, BSN, RN · Apr 15, 2006

Thank you everyone for your support. It isn't getting much better. I just can't handle a 3 person assignment fast enough. I am drowning at turnaround and my preceptor has to keep bailing me out. I leave there everyday in tears and I only have this coming week(4 shifts) to pull it together because then I'm on my own. I am in knots constantly. I can't relax even over the weekend because all I can think about is that I have to go back there next week. It just downright sucks. I never imagined this was something I just would not be able to do. Thanks again.

Sue

writeone · Apr 16, 2006

Would it be possible to speak with your nurse manager to discuss your feelings? Tell her that you may need some additional time with your preceptor?

Ask yourself... Is this what I want to do? Do I like it enough to try to make it work?

I wish you well. When you do the very best you can do, it's all that can be asked of you.

DT in SC

chart209 · Apr 18, 2006

Hie,

It will get better trust me. It takes so much time for staff in dialysis units to accept a new person I have been on my unit for 3 years and still i have problems but I just go do what i have to do and go home. I tell myself that i have not come here to make friends but work. Do what you can if you have problems call someone else not your perceptor because some people feel very important if their teach you that's what she is probably doing trying to put you down everyday. Don't quit your work because of someone live when you have got something under your belt. You are a threat that's why she is doing that to you. I can tell you we have the same type of people on my unit i know how you feeling but not to worry it will come to pass.

Good luck