New Grad Dialysis or ICU?

BAKidneyBean · Jun 23, 2013

Choose an area of nursing in which you have an interest. You will find out quickly whether you've made the correct decision. I started out as a new nurse in the ICU. I loved it while I was a student, but I did not care for it once I received my license. I now work in hemodialysis and LOVE it in both the chronic and acute care settings. I use the skills I learned in the ICU and apply them every day in dialysis. You will find that as a RN there is much more to learn about nephrology and the care of patients living with renal disease. It's very complex. You will never stop learning as a nurse period even if you stay in one particular field for the rest of your career. Don't worry about not getting the opportunity to learn because nursing is always changing! Good luck with the career path you choose!

Erikadawn RN · Jun 23, 2013

I have been in dialysis for about 18 months, I was a new R.N after being an Lpn. I work with a few nurses who were dialysis techs prior. They are the most knowledgeable dialysis nurses I have ever worked for. They have taught me so much and are the best sticks in the clinic. If you truly love dialysis, then stick with it. If you want a change then go to the ICU.

NokturnalMike · Jun 23, 2013

Thank you both for your feedback. I do appreciate you both sharing your insight and experiences. I enjoy Dialysis, even though I know there is room to learn more about it everyday. I am very comfortable with the workload and requirements. My only concern is will I be respected as an RN if all I know is dialysis? A few Dialysis-Only RNs I know, panic if they are told to insert an IV or assess a JP drain. Things that they never work with so it becomes so foreign they panic, especially when the patients develops A-Fib or some type of concerning emergency. I see nurses like this and think, Gosh I don't ever want to feel unprepared or underdeveloped. I guess that's my true concern. Will I stunt my growth if I stay where I am comfortable and never branch out? Or is it possible to be cross trained somehow?

nutella, MSN, RN · Jun 24, 2013

I used to be an ICU use, went there as a new grade and worked in different fields before going into acute dialysis. I have to say that I benefit greatly from all my nursing experience. When I go to an ICU I am able to converse and work on the same level as the ICU nurses which helps a lot. When I work in a hospital tandem with telemetry and patients having chest tubes, drains and so on I am glad that I learned all about it. There is simply no anxiety about how to handle or care for it and it gives a deeper understanding of the patient's situation. Knowing what it means the patient is on 'pressors' when I do HD or CVVH helps to run dialysis.

There is a learning curve for technicians who become a RN. First of all there are RN tasks you will have to do in dialysis, which require RN skills. You have more responsibility, it is not just the technical aspect. If you are "all dialysis" and you know you will never work somewhere else as a RN it is not a problem to be a new grade in HD after being a tech for that amount of years. You can learn and adjust but you RN knowledge and skills will be not as broad. If you want to do something else, ICU is great. Once you are comfortable in ICU you could go part time and do per diem in dialysis for example. Just think about it carefully - you have to like what you do.

TEXASWAG, MSN, RN · Jun 24, 2013

I currently work as both an acute dialysis nurse and an ICU nurse. Knowing both specialties have served me well. When I work in the ICU, the other nurses come to me about issues with CRRT. When I go to the ICU as a dialysis nurse, I'm more than familiar with vasoactive drips, monitors and ventilators. You can gain invaluable experience as an ICU nurse. If you don't like working as an ICU nurse after a year, then you can always apply somewhere as a dialysis nurse for sure. Your experience as an ICU nurse would be an asset.

NokturnalMike · Jun 24, 2013

Thank you all for your help it is so helpful hearing from all of your personal experiences. The ICU sounds like a great opportunity, I just may have to start where I am comfortable and have connections. But I really like the per diem in Dialysis and Full time position in the ICU, eventually that will be my goal. Thanks for that suggestion!

One last question for me; If I work in Dialysis as a new grad and after a year or so decide to transfer to the ICU, will the orientation adjust based on how well I am doing? I fear I would be so new to those skills it would take me a lot longer to adapt.. Basically I was told you only get "New Grad Orientation once, so you should pick a good field to get it in, not something you already know." Since I already know a lot on Dialysis my manager said there won't be a lot to learn, just the charting aspect. That is the thing that worries me, I learned a lot just doing school clinicals because they were skills I have never encountered before. So should I do "new grad orientation" in ICU because its more in depth as a new nurse rather than a transferred nurse? Or is that just a rumor

TEXASWAG, MSN, RN · Jun 24, 2013

Well, this has been my experience. As a new grad in ICU, my orientation was excellent. My orientation consisted of working in the unit with a preceptor and attending classes at the hospital over several weeks. I didn't know everything and my preceptor didn't expect me to.

I've seen some nurses transfer from a tele floor or a medical floor, and others nurses did expect them to know atleast the basics like performing patient assessments, inserting iv's, some medications, inserting NG tubes, enemas, etc.

So, if you transfer from dialysis to ICU you will be just like a new grad in a certain aspect as far as your skills. Really, I guess what I'm trying to say is why not just go for the ICU position. Dialysis will be there when you're ready to go back.

NokturnalMike · Jun 25, 2013

Well the ICU position was filled but I was offered a job in PCU Tele. What do you guys think about that vs Dialysis? Should I take that over the acute dialysis? What are the responsibilities of the nurse in Tele?

NurseRies, BSN, RN · Jun 26, 2013

Well the ICU position was filled but I was offered a job in PCU Tele. What do you guys think about that vs Dialysis? Should I take that over the acute dialysis? What are the responsibilities of the nurse in Tele?

I wouldn't do it in a million years, but that's just me. I used to think floor nursing was the way to go, but now, I just want to be happy at work. As an acute dialysis nurse, I see what the floor and telemetry nurses go through, and I want no part. And if that doesn't make me a "real nurse", then oh well. You can always try it out and dialysis will still be here. Good luck!

DialysisRN12 · Jun 26, 2013

Ditto to everything NurseRies said!!

TEXASWAG, MSN, RN · Jun 27, 2013

Hmm, tele vs acute dialysis. Running ragged the entire 12 hour shift with 4-5 patients or doing a 3-4 hour dialysis treatment with less stress. Acute dialysis!!