Where can I go from here?

[newrse]

Hi all. I was wondering if someone could give me some advice 'cause the anxiety I have is almost debilitating right now.

I got my Associate in 2013, graduated with my Bachelor in 2015. I had a miserable LTC experience for a few months, and then got a job as a chronic dialysis nurse. Truthfully, I like it a lot- I can imagine myself doing it for a long time. However, I have so many external pressures for moving on to a hospital, and ideally, that's what I'd like to do.

I see an opening for an acute dialysis nurse in a hospital...But everyone says you need to have MedSurg experience to advance anywhere. Truth be told, I've never enjoyed that rotation. I'm completely out of floor practice at this point (no clinical for my BSN program), and I'd rather not have to go back to that.

So my questions are:

1. For anyone with the specialty: Can a chronic nurse move on to be an acute nurse? What can you tell me about the differences? Is it a good career path? Any advice for moving up?

2. What are the options for me? Honestly, in my soul, I don't feel like I have it in me to do MedSurg..And if I have to go down this route, how can I prepare for it? I do like desk work/research and traveling. Can I even do anything with those?

External forces are just telling me "It's best to be in a hospital." My hope is riding on that acute position..

I guess I'm just looking for some validation here, as someone who became a nurse very young in life and I'm just making my way through a system that doesn't seem to be working for me.

[HouTx, BSN, MSN, EdD]

You should go ahead and apply for that acute dialysis position. I have had the pleasure of working with a lot of acute dialysis nurses - all very expert; some were LVNs. In my experience, acute dialysis nurses were only responsible for managing dialysis for inpatients - either chronic dialysis patients while they are hospitalized or patients who have experienced ARF. They aren't expected to manage all aspects of patient care. They also provided consults - to advise nursing staff on any dialysis-related issues, such as which meds to hold, how to manage IV fluids during dialysis, etc.

The patient will still have other nursing staff delivering care while they are on dialysis. I'm sure there would be a learning curve involved with the ARF patients, but you'd be working very closely with the Nephrologists who are always overseeing inpatient dialysis efforts.

Go for it.