New to dialysis, need advice

MizChelleRN · Jul 4, 2014

Be humble. Listen and learn. Your techs and what they know will make or break you. Treat them with respect. Ask lots of questions. Don't just push buttons on machines or silence alarms if you don't know what they mean or how to properly assess the situation. Never get too complacent or less alert, conditions in dialysis can change on a dime. Develop good habits per policy/procedure bc bad habits are hard to shake and will bite you in the ass every time. Stay current with the practice. Be easy on yourself, you will be lost confused and overwhelmed for awhile. Keep plugging away.

I assume you'll be with one of "big 2" companies? Your first few weeks will be learning in a classroom. Study like you're back in school. Don't play the "I'm the nurse and you're the tech" card. Yes you'll have to override decisions but always question, ask what the thinking was and COLLABORATE. especially at first the regular staff knows these patients better than you do until you get your groove going.

Know know know that water room inside and out. It's one of the hardest things to learn but you are absolutely responsible for every aspect of it. Know how to check the water logs bc chances are you won't be the one doing the checks but you have to be aware of what happens in there.

Use your resources. Find out who and what they are and use them. Ask lots of questions.

Don't let the patients see you sweat. Be calm don't scare the patient or give them any reason to doubt you.

These are a unique people. Diverse. Scared. Sometimes spoiled and entitled, frustrating but always try to consider where they come from and how hard it would be to be in their place.

Built up toxins in tge brain and body can affect their ability to learn, comprehend and understand. Give knowledge to them in small doses or how you assess they can accept it. If yougive them more than they can handle, you'll beat your own head against a wall.

Don't be afraid to be aggressive where you need to be. Under-dialyzing patients is as much a disservice as running them too hard. Your spidey senses will eventually tell you what to do. Patients usually know what they can handle but their word is not the final word. Someone will tell you they can't take off X amount of fluid. Their needs change and sometimes you have to try for more to make them better. Conversely know when to say no. Dialysis ain't Jenny Craig. If you don't have 5 kg on, you can't take it off.

Am I rambling? Welcome to dialysis. You'll love it or hate it but we need good people working here. Hope you stay.

ParrotHead_RN · Jul 8, 2014

Thank you very much for your advice! I really appreciate it. I am working for one of the "big 2" companies. I will take this advice with me.

Thanks again!

jodhime · Jul 9, 2014

Wow! That was great advice! Thank you. I also start Dialysis next week as a new grad. I am scared to death! :) I have a question that feels very shallow, but can you recommend a good scrub color for dialysis nurses? My clinic does not have a set color scheme and I was thinking of buying black scrubs just for ease of washing the same color. But I read somewhere that bleach splatters are a possibility (inevitability?) during dialysis work. Any advice before I drop a load of $ on scrubs? Thanks so much!

Anna S, RN · Jul 17, 2014

You will get bleach/water mix on your scrubs. Black is not good for dialysis because you can't see if you get blood on your clothes if they are black.

seppuku · Jul 23, 2014

as one of the other posters said, your techs will make or break you. If they dont know what they're doing or are just plain lazy, then you will suffer. My usual crew of techs is fortunately very good and even when I do 16 hour shifts, it seems only like 8. Don't be scared, just learn as much as you can. You will be seeing the same patients every other day and be doing the same exact job everyday. You will get good at it naturally with experience. If not, then I would quit.

whirlwind88 · Aug 21, 2014

Was looking around for information about what to expect and some tips for hanging in there so I can be of service in a dialysis clinic as an RN, have always worked the hospital telemetry floor. Am in interviews, unsure of pay at this time, but hope to get the job. Thanks MizChelleRN for your note!

jdethman · Sep 1, 2014

Be humble. Listen and learn. Your techs and what they know will make or break you. Treat them with respect. Ask lots of questions. Don't just push buttons on machines or silence alarms if you don't know what they mean or how to properly assess the situation. Never get too complacent or less alert, conditions in dialysis can change on a dime. Develop good habits per policy/procedure bc bad habits are hard to shake and will bite you in the ass every time. Stay current with the practice. Be easy on yourself, you will be lost confused and overwhelmed for awhile. Keep plugging away.
I assume you'll be with one of "big 2" companies? Your first few weeks will be learning in a classroom. Study like you're back in school. Don't play the "I'm the nurse and you're the tech" card. Yes you'll have to override decisions but always question, ask what the thinking was and COLLABORATE. especially at first the regular staff knows these patients better than you do until you get your groove going.
Know know know that water room inside and out. It's one of the hardest things to learn but you are absolutely responsible for every aspect of it. Know how to check the water logs bc chances are you won't be the one doing the checks but you have to be aware of what happens in there.
Use your resources. Find out who and what they are and use them. Ask lots of questions.
Don't let the patients see you sweat. Be calm don't scare the patient or give them any reason to doubt you.
These are a unique people. Diverse. Scared. Sometimes spoiled and entitled, frustrating but always try to consider where they come from and how hard it would be to be in their place.
Built up toxins in tge brain and body can affect their ability to learn, comprehend and understand. Give knowledge to them in small doses or how you assess they can accept it. If yougive them more than they can handle, you'll beat your own head against a wall.
Don't be afraid to be aggressive where you need to be. Under-dialyzing patients is as much a disservice as running them too hard. Your spidey senses will eventually tell you what to do. Patients usually know what they can handle but their word is not the final word. Someone will tell you they can't take off X amount of fluid. Their needs change and sometimes you have to try for more to make them better. Conversely know when to say no. Dialysis ain't Jenny Craig. If you don't have 5 kg on, you can't take it off.
Am I rambling? Welcome to dialysis. You'll love it or hate it but we need good people working here. Hope you stay.

This is solid advice. The only thing I would add is review acid base balance, basic electrolytes, and BP meds, if you are rusty.