LostMyPen,RN

I'm located in NC, low cost of living rural area. Been with the company for 12 years as an RN and currently at $50/hr. Started at $24 as a new grad. Cap RN4. Not sure what the max is.

I've been doing 3 twelves in outpatient hemodialysis for 10 years. I like that the hours and patients are predictable. No nights, no Sundays and no call requirements. 4am-4pm was difficult to adjust to, but I've been able to be at every afternoon school event and home in time to cook dinner so it's worth the sacrificed sleep.

I've been in outpatient HD for 9 years with the other big name company. The training was exceptional, there is plenty of room to grow, I have lots of support resources and great teamwork. The stress is minimal with no mandated overtime and plenty of PTO. The hours are tough though, 4am-4pm but I haven't missed any of the kids soccer games and can cook dinner every night so it's worth it to me. Really I think outpatient HD is a hidden gem that many nurses don't know about. Good luck with your new position. I hope you love it!

I have had the Nexplanon for 3 years. After the initial adjustment phase, I only have maybe one period a year. Like all other meds it has its side effects but never forgetting a pill, no monthly trips to the pharmacy and few to no periods are totally worth it.

I've been doing outpatient dialysis for 6 years now and I love it. I do 3 12s, rarely 4 days if covering for someone on vacation. The hours are crazy, 4am-430pm but never 16 hour shifts. It's an adjustment learning to go to bed early to get up at 3am but otherwise completely doable. Im usually able to still take the kids to practice and cook dinner everyday. The work is VERY repetitive. Every patient almost has the same needs but they're complicated with multiple comorbidities. You learn to multitask and wear many hats (social worker, dietician, infection control, etc). I reccomend the field to many of my nursing friends that are stressed out in acute bedside nursing. As long as you find a clinic that is well managed and treat their staff as a resource and not a warm body filling a role, there is a lot to be appreciated and room to grow in outpatient hemodialysis.

I graduated from this program in 2013. As I remember, it was highly competitive. There were 200-250 applicants that tested and only the top 10% were offered a seat. Go ahead and reach out to any BSN friends you have in acute care settings to see if anyone is willing to precept you. We were responsible for securing our own clinical site and preceptor. Those clinical connections will be good for after graduation as well. Central NC is saturated with nurses and I had a difficult time finding a job despite my years of LPN experience. Wish you the best of luck!

Hey guys, I'm toying with the idea of moving from outpatient hemo to home therapies (HD or PD). I am very happy with my current position - great pay, 3 (12's), no Sundays, awesome clinic and team.....im just bored and ready for something new. I've been doing the exact same routine from 4am-4pm for nearly 6 years. Any advice, personal experience, tips or words of wisdom??? Thanks!

I've done this before. Was actually not as complicated as I had feared. I got the glow paint, a dark shoe box, and black light and talked to them about germs and hand washing. put the paint on and show them how much glow paint is left after they washed their hands. I did 5 groups of 4 kids at a time. Surprisingly the teachers had the poorest hand washing technique.

I'm starting my last class at American Public University this week. All classes are 8 weeks. Its taken me 2 years because I had some prereqs like STAT and HIST to finish up. In total I think Ill have just under $10k and with employer reimbursement and financial aid, its even less out of pocket. Its accredited and completely online as well. I highly recommend.

Attempting to change the wound vac on a large young lady's sacral decub. She warned me before I started that it was a "heavy flow" day. I assured her it was no big deal and got to work trying to keep her balanced on her side with one hand and removing the old sponge with the other. She said "thar she blows" and before I could react the shear force of her flatulence blasted my face with menstrual blood, no shield, mask or goggles on. Remaining professional in that moment and restraining my gag reflex was a challenge. I quietly got her to a safe position and excused myself to gag and dry heave as I showered in the emlpoyee bathroom sink. Worst day of my career

I'm in NC in an outpatient hemodialysis setting. Here we have unlicensed personnel administer IVP heparin boluses with on the job training. Of course the RN must check the dose and is held responsible.

Dialysis RN here. I've been in outpatient HD for 5 years, 3 of which as charge nurse. As foreign a practice as this may seem, and contradictory to what we learn in nursing school, this truly is the most efficient way of giving meds. Keep in mind: -This is an outpatient clinic setting where patients are stable and medications change very little -There are no narcotics of any kind. We give IV vitamin D, epogen, and Venofer. Occasionally an antibiotic. -"clean" and "dirty" are a big deal in this setting. You must prepare the medication in a clean area away from patients. Then, after donning full PPE (sheild,mask,gown,gloves) you administer and document at the chairside. You must remove and store all PPE before returning to where the meds are kept. If you tried to repeat that procedure for all patients on that shift, you would run out of time before their treatment ends and its now a missed dose. There can be 20-40 patients dialyzing simultaneously. -In our clinic we have a clean and a dirty nurse. The clean nurse is usually charge that day. She stays in the clean area preparing meds with preprinted labels. The dirty nurse double checks the dose against the order and administers so that there is no cross contamination between the clean med prep area and dirty chairside station. -The only potential side effect of an incorrect med being given is a minor change in lab results. None of these medications are fast acting. The first time a med is given we monitor for allergic reaction. -You work with the same nurse day in and day out. These meds aren't being drawn by a stranger. In this setting you know and trust your team mates. Outpatient HD is very much a team care model with many different caregivers at once (RN,CCHT,PCT) -In this state (NC) LPNs can administer IV push medications. Our unlicensed dialysis technicians push IV heparin that has been drawn up or checked by the nurse. The state auditors and Joint Comission regularly inspect and approve this procedure of medication administration Just my $0.02

I'm not sure which test you're referring to. The entrance test isn't bad, unlike TEAS this test was strictly nursing questions much like NCLEX. The tests through the course were taken at home during a certain time period (test opens on Monday you have until Wednesday to take it, one hour time limit) and these were done with a camera attached by usb to your computer. The camera has a 360 view of you and your room to be sure you aren't cheating with say an open book.

I graduated from DCCC LPN-RN in 2013. I found the coursework reasonable and appropriate. I did 1-2 12 hour clinical per week and probably dedicated 1-2 hours per non clinical day on the coursework. The hardest part was finding your own preceptor and clinical location. Hopefully they have worked the kinks out of that process and have established connections with local hospitals and nurses willing to precept. Other than that I highly recommend the program to LPNs looking to get their RN while still working.