New grad dialysis with hopes of ICU

[TimS89]

Hello all,

I'm a new grad nurse that recently started with one of the big dialysis companies as a Hemodialysis RN, starting in the clinic setting. After months of applying to hospitals and critical care positions and hearing nothing back, I started to apply everywhere and anywhere for a nursing job. Luckily, I landed 2 interviews; my current one in dialysis and another at a psych hospital. Being that I want to eventually get into critical care, I figured taking the dialysis job was the better move, also because I can eventually get into the acute dialysis setting in hospitals. I'm in training now, and to my surprise I'm actually enjoying it. But what do you experienced CCRN's think? Have I doomed myself by not waiting for a hospital job? Will it be difficult to get into a hospital after 1 year in the dialysis setting? Does working in dialysis help at all with being a critical care nurse in an ICU setting? I also have a BSN, I'm hoping that helps a bit when the time comes to start applying to hospitals again. Any and all advice is welcome, thanks for the time.

[Cowboyardee]

You're better off at a dialysis clinic than you'd be unemployed. Will it help you learn what you need to for hospital and critical care nursing? A little.

If you really, really want to end up in critical care, just don't let up. Do your year in dialysis, but six months before that year is up see if you can find some recruiters at the hospitals you'd like to work in and contact them to let them know you're interested and will be applying. A few months before that year is up, start sending in applications. Take a med-surg position if no critical care positions are available. And then get in contact with the critical care unit director(s) and express your interest in moving to critical care when you've put in your time in med-surg. Don't relent.

One big barrier to getting into critical care is sometimes getting a whole lot of experience in other fields - hospitals feel they have to pay you scale for your years of RN experience, but if those years don't translate to critical care, then they feel they're getting a bad deal compared to someone with the same amount of experience in a more relevant area. One year of dialysis nursing shouldn't hurt anything much since you're still so early in your career. Just be wary of staying at less-relevant position for 5 or 10 years when your goal is ultimately to do something very different. Another thing that might help sometimes is agreeing to be paid (and trained) as a new grad when jumping from one field to another. It gets you a better orientation and makes you more likely to be hired, at the expense of a little money (and increasingly these days, a contract requiring a year or two of work). Thing is, once you have experience, you can either renegotiate your pay with your employer or apply to another facility which will then pay you for your total experience.

[TimS89]

Hey thanks a lot for the advice. That was honestly my plan in my mind when I first took this job. I know it won't be easy but nothing ever is, so it'll be worth it in the end. And honestly I'd have no problem being re-trained as a new grad, I think that would only help me ease into the transition. I was also thinking I'd get some certifications while I can through the AHA - ACLS/PALS. Anything can help I suppose when the time comes. Thanks again for the input.

[gromit1084]

I dont think it could hurt. I agree that its better than being unemployed. Don't give up and be relentless about getting to the ICU. Network constantly!

In the meantime, I would recommend you really work to not get lazy. And by lazy, I mean dont get comfortable to the point that you forget all the knowledge you've learned, and you become content with the scope of practice as it relates to dialysis only. ICU is VERY detail oriented, it is important to know your pathophysiology, interventions, medication, etc etc. It is an area of nursing that you constantly have to be learning and deepening your understanding (because it never is deep enough for the ICU's patient population). Keep reading and studying and learning while you wait for your year to be up. You'll thank yourself later.

A good book to read/study is "The ICU book" by Paul Marino

Good luck!