New Grad Does Not Want to be Stuck in a Residency Program

[Nurse Beth, MSN]

Dear Nurse Beth,

I am 36, I will graduate from nursing school in December 201. I will most likely do my NCLEX test in January. I do not want to get into a residency program, but it looks like that will be my only option. Is there any way you can advise me on how to avoid this? I do not want to be a bedside nurse and that is what I will be most likely doing if I get into a residency program. I do not want to be stuck in a place for two years that I know I will not enjoy what I am doing. I will love to work in a dialysis clinic or unit. Residency programs underpay nurses and I want to avoid this as much as I can.

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Dear Doesn't Want Bedside,

Congrats on being close to graduation. It's unusual to frame a nurse residency position as your only unwanted option, because it's usually considered quite the opposite- a coveted opportunity. Depending on where you live, it can be competitive to land a position in a nurse residency program.

Residency programs typically pay entry level wages in line with market standards. The real value is that they offer needed support for new grads. Your true education starts after graduation. It is possible to land a job in dialysis, as many dialysis positions stipulate "experience preferred" (meaning they take nurses with no experience). When you consider hourly wage, look at the whole package- benefits, tuition reimbursement.

More important, look down the road when you may want to do something other than dialysis. It's important not to lock yourself into a narrow specialty. In other words, make sure you are thinking long-term and not just short-term.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[ruby_jane, BSN, RN]

Had a residency program been open when I graduated from nursing school (second career nurse at age 40), I would have jumped at the chance. You think you know what you want but you don't really know what you want in nursing, and the residency program will hopefully onboard you safely and provide you with the critical skills that you did not learn in nursing school. Good luck.

[beekee]

If you want to avoid the bedside, the best thing you can do is a nurse residency. Look at job postings for jobs you'd like. A lot of the non-bedside jobs require 1-2 years of acute care experience, or at least prefer it. Dialysis included, as for a clinic you can't be the only RN there until you have 1 year of experience.

[Hoosier_RN, MSN]

go for the dialysis specialty if you want, but if you don't get into that, go for the residency. You have nothing to lose but time and experience. Good luck!

[Zeek, LPN]

I have been in the dialysis field for over 30 years and I can tell you that we welcome new grads. It is sometimes better to have some med/surg experience, but we want to teach you from the ground up. Go to a local unit and ask if you can shadow an RN for part of a day. This will enable you to see if the fast pace and the work keep you interested. There are great units out of all the large providers, but I have found that the non-profit units suit my personality best - they seem to be most focused on the patient. In my 30 years, I have done all facets of dialysis including the technical side (repairing machines, taking care of water treatment etc.). I have travelled, done peritoneal dialysis, acute dialysis in hospitals and even home hemodialysis. For me, it is fascinating work - we may see the same patients over again, but you form close bonds with them, and are very alert to changes in physical or mental functioning. Best of luck to you!

[booter512]

A lot of the dialysis companies here (Virginia) are not owned by hospitals. Some have contracts with the hospitals, and come in and do bedside dialysis at the hospital, but they are separate companies. They have their own free-standing dialysis buildings too. I'm sure that you can find a dialysis company not owned by a hospital near you, which could get you out of a residency program. The hospital I worked at didn't even have a residency program. Funny how different areas in the US treat their nurses so differently.