New Nurse and I dont think dialysis is for me HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

ExpatHopeful, LPN, LVN · Oct 31, 2011

I was thinking it too GrnTea. I just didn't say it. Props.

vanburbian · Oct 31, 2011

I was thinking it too GrnTea. I just didn't say it. Props.

Me too....thanks for pointing out my same thoughts and first impression.

sutelibunn · Nov 1, 2011

Heh... Internet forum? Not a job application.

roser13, ASN, RN · Nov 1, 2011

i am sorry to be saying this and apologize in advance because i know the perennially-aggrieved will slam me for it, but here goes nothin'.
the original post was so stuffed with usage and spelling errors that, had a written application for employment crossed my desk looking like it, i would have tossed it in the circular file without a second glance. it fairly screams, "i don't care what they think about me so i don't care how i present myself." this is not what you will need to do if you wish to get a better job.
op, if you do want a better job, and especially if you want to succeed in a bsn program, please, please, please get some help with your written work product. you say you don't do much in your job now, but surely you must do some patient assessment, teaching, and emotional support in a dialysis unit. if your charting on these critical topics looks like your post, it wouldn't surprise me if they didn't want to keep you on.
this is not a personal attack, it's a plea for the profession. just sayin', and trying as hard as i can to be helpful. really, honest and true. we need nurses; please do what you can to be one, and that includes clear and accurate written communication.
::sigh:: ok, now just hit me.

i struggle so much with this issue. on the one hand, op is an rn who has managed to land a position in a very tough economy.

on the other hand, i wonder how she managed to do that with (apparently) such poor written communication skills? it is hard to eloquently express those concerns without being branded as one who "eats their young." i applaud grntea for going where others have failed to go.

carolmaccas66, BSN, RN · Nov 1, 2011

I'm always amazed at the amount of new grads on here who think that 2 months in a job is enough to guage how that job is.

Sweetie, you should try to stick this job out. In Oz you would NOT get a dialysis job after graduating - no way in a cold hell. You need a grad dip and/or 1-2 years experience from memory. And we are all BSNs over here, which doesn't automatically mean u will get a job upon graduation.

Stop and think hard re your job. What is it that you don't actually like? R u comparing it to jobs you've never done - the grass is greener syndrome? Are you not learning enough? R u using critical thinking skills? Can u try to see everyday as a challenge, rather than a bore? You MUST be learning some valuable skills surely? Are you disorganised or just bored?

If I were you, I'd stick it out for a year. Also go see the older nurses or NUM and ask for some learning goals u can accomplish - surely you just can't push meds all day? Sounds like ur not working hard enough, really. This is a great learning opportunity - you should be doing extra research on dialysis/renal patients. I enjoyed my clinical on the cardiac/renal ward & helped with some dialysis - it was very enlightening.

I can't believe ur just 'bored'. I know new grads here who would kill for ur job.

If u hate it so much, quit & go get ur BSN, as u won't be happy otherwise.

I just wish some younger people on here could be a bit more grateful for what they have. I had to work all thru my clinicals & move to another state, away from family & friends to get experience, and people on here whine that they have a job near them, but 'its' not the EXACT job I want'. Real life lesson is that u probably won't get the job u want for a long time, and you'll need a lot of experience behind you. Life just doesn't work that way. And the grass isn't always greener on the other side.

Try to stick it out I reckon and learn all you can.

elthia · Nov 1, 2011

I am sorry if I can not word this as eloquently as it needs to be worded.

Dialysis is a cream of the top job where I work. There is a waiting list for dialysis and cath lab jobs at my facility. They are both stressful, highly sought after, technical jobs, that require tremendous amounts of skill, training, tact, empathy, assessment skills, and commitment. I know of facilities that will hire travel nurses for dialysis vs a new grad.

If you have such a great dislike for renal patients, you might want to quit nursing. Renal patients are everywhere. They are in medsurg, they have heart attacks, they have openheart surgery, they are diabetic, oncology, even pediatric patients have ARF. Having a strong foundation in dialysis could be a golden ticket anywhere.

just keep swimming · Nov 1, 2011

I know this has already been said a few different ways, but I still feel obligated to respond. I have been in chronic hemodialysis for 7 years now (2 as a pct while I went to school and 5 as an RN). Every day presents a new challenge, not because that's just how dialysis is, but because I look for them. Each patient you treat has many co-morbidities that you are also treating. Your assessment skills need to be excellent as you do not have doctors or NP's rounding every day. You are their eyes and ears and if you miss something, you are doing your patient a great disservice. If you aren't using critical thinking that is because it is your choice not to. Yes you are pushing the same medications each day and every treatment is initiated and discontinued the same way, but this is not what you are really there for. What is going on with your patients? What trends do you see in their labs? When you are doing your anemia management, are you just changing orders according to what the protocol says, or are you looking at the whole picture? I guarantee that after 2 months on the job, you do not know everything there is to know about HD, and if you think you do, you are extremely dangerous to those patients. Give it some more time and put some effort into it, round with the docs and ask questions, speak to a more senior nurse and spend some time picking her brain....you will find out that you're selling yourself short on all you could be learning from this experience. Good luck!

talaxandra · Nov 1, 2011

I work with grads who feel the same was about our end-stage renal population - the patients are boring, it's all about the pills, there's nothing to know and they're not learning anything.

So to the OP: if you understand

1/ how multiple different processes are involved in the development and continuation of renal failure,

2/ how these in turn affect the six functions of the kidney,

3/ how to recognise whether the failure is continuing to progress or is stable,

4/ how the impairment of each of these functions affects every other organ in the body,

5/ how biochemical changes create apparently unrelated chains of events in non-renal systems,

6/ how comorbidities like diabetes and hypertension cross-react with the renal failure,

7/ how each of the many medications work,

8/ the effects they have,

9/ the side-effects they have,

10/ the rationale for their prescription,

11/ how they work with and against dietary restrictions,

12/ how those restrictions affect the patient (both in compliance and the creation of chronic malnutrition, and in non-compliance and greater long- and snort-term adverse effects), and on top of that

13/ appreciate all the biopsychosocial affects of dialysis, well done.

Now that you've scratched the surface of renal nursing, you're ready to start getting a handle on it.

If you don't know all that then you're confusing tasks with acuity and missing out on the most valuable learning opportunity your career may ever offer you.

xtxrn, ASN, RN · Nov 1, 2011

Ask the nurses where you work how much 'warning' they usually gets before someone codes in the dialysis chair :)

xtxrn, ASN, RN · Nov 1, 2011

I struggle so much with this issue. On the one hand, OP is an RN who has managed to land a position in a very tough economy.
On the other hand, I wonder how she managed to do that with (apparently) such poor written communication skills? It is hard to eloquently express those concerns without being branded as one who "eats their young." I applaud GrnTea for going where others have failed to go.

And, another example of how interviews without interpersonal contact (as in "I need to interview a nurse" threads) reflects the overall "not getting it". It's not just the OP...it's a generation.

KWIM? IDK- b4 u post, look at ur part in something. :up:

madwife2002, BSN, RN · Nov 1, 2011

Ask the nurses where you work how much 'warning' they usually gets before someone codes in the dialysis chair :)

Zero to 60 in 5 seconds LOL

Seriously they can be talking with you and then they are gone!

We had an ICU RN with many years experience come to work at our unit, came for an easier life!

Was shocked at how much there was to learn and how fast paced it gets.

I think Renal nursing is one of those specialities where you love or hate it, there really isn't any imbetween.

The OP probably falls into the latter catagory and needs to move on to where she feels happier

Note to OP you are a new grad, most new grads struggle in their first year no matter where they work.

xtxrn, ASN, RN · Nov 1, 2011

Zero to 60 in 5 seconds LOL
Seriously they can be talking with you and then they are gone!
We had an ICU RN with many years experience come to work at our unit, came for an easier life!
Was shocked at how much there was to learn and how fast paced it gets.
I think Renal nursing is one of those specialities where you love or hate it, there really isn't any imbetween.
The OP probably falls into the latter catagory and needs to move on to where she feels happier
Note to OP you are a new grad, most new grads struggle in their first year no matter where they work.

Yep. My grandma coded twice during dialysis, and that was when she was still at home, going as an outpatient. She'd get admitted, stabilized, then home for another round. Nine months of that- with nurses who were very attentive.

One day (when she'd come from home, and wasn't "bad" enough to be in the hospital) she didn't make it....I was 15- and got the call at school; my dad and mom were out of town, and I was told to go to his office (high school principal) to call my grandpa before going home--- dumb plan- but they were in shock.....So they told me she was dead...multiple myeloma was behind it (another thing to learn about for the OP), with heart, kidney, and liver issues).

ANYWAY- it doesn't take but a second for a dialysis patient to go south, then gone. It's more than just the tasks- it's the gut feeling and ability to apply knowledge- and that takes a lot more than a couple of months to get solid on- a LOT more. :up: