how does a new grad get into this?

westieluv · Jun 4, 2014

Yes. Get some experience outside of dialysis first before trying to get into it as a new grad. Patients with renal failure usually have a host of other health issues as well, so the more experience you have working with cardiac patients, brittle diabetics, and noncompliant patients, to name a few, the better you will be in dialysis. Renal failure is obviously their most pressing concern in the dialysis setting, but there are so many other comorbidities that come into play and affect the adequacy of their dialysis treatments, so a couple of years on a Med/Surg/Tele unit would be a huge help to a new grad who wants to get into dialysis.

As a chronic dialysis RN, I deal on a regular basis with CHF, hypertension, hypotension, uncontrolled diabetes, bleeding, skin ulcers, liver failure, anger, depression, and noncompliance. If I wouldn't have had some kind of background in a more general field of nursing and dealing with these kinds of comorbidities when I started working in dialysis, I think it would have been much more overwhelming, and it isn't easy even now. Dialysis patients are a very complex patient population, because chronic renal failure affects every system in the body and every area of someone's life.

I work for one of the Big Two dialysis companies and, at least in my area, they generally won't hire new grads. If and when they do, the new grad must work under another RN for a full year.

MizChelleRN · Jun 4, 2014

I agree! Our company is currently trying to market job searches to new grads and I just can't agree with it. Of course there are exceptions to all generalities but I think dialysis nurses need more real world experience, critical thinking and the ability to identify and treat issues quickly and that kind of experience comes from working in a hospital setting. Even techs that become nurses seem to lack some piece of the puzzle although they usually make pretty good dialysis nurses. Agreed a very complex population with multisystem involvement.

schnookimz · Jun 4, 2014

I started as a new grad. I had 3 years of tech experience and 1 year as an lpn and I promise I had no problem as a new grad. I learned it all and feel like I have a very good handle on it.

It's very overwhelming at first, but every new grad job is.

westieluv · Jun 5, 2014

I started as a new grad. I had 3 years of tech experience and 1 year as an lpn and I promise I had no problem as a new grad. I learned it all and feel like I have a very good handle on it.
It's very overwhelming at first, but every new grad job is.

It makes a night and day difference, though, that you had spent over three years working in dialysis, essentially running several treatments a day and observing dialysis nurses doing their jobs and seeing how they handled difficult situations. There is no comparison between that and being a brand new grad who has never worked in dialysis at all.

NurseRies, BSN, RN · Jun 5, 2014

I started as a new grad in outpatient dialysis because it was the only job offer I had. I also had no medical experience, other then clinicals. I had been a server/bartender for 7 years. It was overwhelming the first couple of months, but I had 6 months of orientation and then worked under a charge nurse until I hit my 1 year, then I became charge nurse. I felt comfortable with things at that time, but it took a while to feel proficient. I also don't think I understood the bigger picture until I started doing acutes. You'll have moments were things suddenly all come together and make sense. The bigger picture with these patients is what is hard to teach. They have so many problems, conditions, symptoms, complications, and questions.

My clinic hired some other new grads after me, I watched a couple of them flourish, and more then a couple of them completely fail or quit. But I know several new grad outpatient dialysis nurses that have done very well and are now working at hospitals or in charge. I do not think you NEED med-surg experience to be good at your job or get in, but of course it helps. It all depends on how quickly you learn, your attitude, and the ability to think fast and make decisions. This field is good for some, and very bad for others. Good luck!

schnookimz · Jun 6, 2014

It makes a night and day difference, though, that you had spent over three years working in dialysis, essentially running several treatments a day and observing dialysis nurses doing their jobs and seeing how they handled difficult situations. There is no comparison between that and being a brand new grad who has never worked in dialysis at all.

Miscommunication!!!

I was a new grad with NO dialysis experience.

When I said I worked as a "tech" for three years I meant a patient care tech on the floor in the hospital, not a dialysis tech :)

I promise I never ran (or even saw) a dialysis tx before in my life until I started as an RN in acutes!

SmilingBluEyes · Jun 6, 2014

No matter where you work, the learning curve is steep. My clinic has hired new grads with a good measure of success. It will be hard, but so is any area of nursing, such as med-surg or SNF. Learning your role as a new grad in any unit takes time. Look for a unit that offers an excellent orientation, such as Fresenius (where I work). They allow new graduates plenty of time one-on-one with a preceptor then none of them are "on their own" completely for at least 1 year after they graduated. Plenty of time to learn "the trade" and do well. I encourage you to apply. Good luck.