12sonrisa

Hey there! I will likely be moving to Victoria, BC or one if the university cities in Ontario next summer for my husband's PhD. I'm wondering what the job situation is like in those areas. I have been working as an RN for 1 year this September and have outpatient hemodialysis and inpatient adolescent mental health experience. Hoping for either a community health job working with low-income/homeless population or inpatient mental health/addictions. But of course I will work wherever there is a job!! It took me 5 months to get hired after I graduated last year in Calgary and that was in hemodialysis after doing my preceptorship there. I couldn't move at that point though due to my husband being in school. I'm hoping it won't be quite so bad since I have a year of experience now but would love any insight and advice you have to offer!! Thanks in advance!!

I hear you. I'm coming up to my one year anniversary of starting work as a nurse. I am luck though because I started out being hired into a regional renal program and then assigned to one of their units. My orientation was on the Unit I work at currently which is an AMAZING unit. I plan to look for a new position in the next year as dialysis is not my passion and I don't want to be pigeonholed into such a specialized area, but I can only hope I will find somewhere with such great staff and patient dynamics. Back to my point! after orientation, they assigned me to a different unit that has a reputation for being particularly mean to new staff, especially new grads. I deliberately kept an open mind going to the Unit and made the effort to be friendly with the staff which did help me have a better experience than some, but all it meant was that they picked on other new staff more than me. They were still mostly unsupportive and kept interactions with me to a minimum and we're not receptive at all to my questions. And I have since been told that I'm a really good nurse by patients and staff so I know that even though I probably asked dumb questions sometimes, it wasn't because of me, it's just not a good unit. There are many more reasons why but that is a post for a different day! Thankfully, I was able to get a position 5 months later on the Unit I orientated on and my life is so much better now. I learn more, enjoy most of my shifts and feel supported when things go south. I don't dread work and am honestly less stressed even though it's a much busier Unit. I agree with Ruby Vee that patient population doesn't really matter for your first few jobs. Do shadow shifts to get a feel for different units (before you apply or accept a position if you can but that's not always possible) and ask nurses you know about their work environment, then ask for introductions to their managers/apply for jobs if it sounds good. Good luck, keep us updated!!

Nursing school for me was brutal. I LOVE nursing and enjoyed the content we learned and actually working with patients. What makes it so hard is the amount of information you have to learn. Expect 800 pages of reading every week on top of seemingly pointless assignments. A lot of people complained about doing care plans but I actually liked them because they made sense and solidified the nursing process and theory for me in application to patient care. And you will start out doing poorly on tests because NCLEX style questions are completely different from any other test. So you will be re-learning how to answer test questions at the same time as learning a crap ton of theory and a couple days of clinical per week. My school also didn't set things up very well as I only had one year of med surge courses and clinical. We spent far too much time on public health & geriatrics and then had med surge very condensed. And only 1 week of peds/maternity and no critical care. Unless you chose those as specialties which I did not. We also had issues with a few of our instructors. It was worth it for me because I love nursing and school wasn't all bad. I do like school in general and miss going to classes. But only do it if you're sure you want to be a nurse. It's very hard work, minimal social life (and feeling guilty when you do actually interact with people for fun), crazy amounts of stress at times, and it's hard to find a job after school.

Personally, I would take the year, work full time, get the experience with kids that will look GREAT on a peds application, and get tuition reimbursement that will help keep you less in debt. I would assume thought that their tuition reimbursement would only apply for courses in the teaching field since it's a preschool. I would double check that before making a decision. I took a gap year to upgrade a couple grade 12 courses and worked part time. I was significantly more mature than my peers (even though I was only 19) and working helped me manage my time and work-school-life balance once I started nursing school. It sounds like you are very passionate about becoming a nurse. I am/was also and was SO ready to start nursing school there was no way I'd put it off. Ultimately it's up to you though! Make a pros and cons list and acknowledge your gut/feelings about the different options too. Come to a decision you're happy with and own it no matter the haters who will offer their opinions even when you don't want them! Best of luck!!

I work in community dialysis where non-compliance is a big issue. A couple weeks ago I had a patient with very clear signs of a cvc line infection. The doctor wanted her to go to emerge directly after dialysis and she flat out refused. All you can do is educate and document. This particular patient speaks an entirely different language so I was actually using a translator by phone. As long as you have educated them on why they need ER Care/medication/procedure and the consequences to their health if they don't do it, and then document heavily on the education provided and their informed non-consent, that's all you can really do. I also ask why they don't want to go in case a little extra education or support is needed. Their health care is up to them and how they view their quality of life with and without the treatment. We have a few homeless patients as well and with them I go a step further and ensure it is not a lack of transportation, funding to take time off work, etc. And always get social work involved if needed to help support them.

Also, nurse educators are an amazing resource! Your unit should have one and I recommend asking advice from him/her.

In September I'll have been working as a nurse for 1 year (hemodialysis and inpatient adolescent psych). From experience, in the beginning, most days will be hard and you will feel stupid and like a burden. HOWEVER, the only way to be a better nurse and move out of the "new" phase is to embrace every obstacle as the previous posters have said. I still spend time outside of work reading textbooks and articles related to what I see at work. It's important to take care of your physical and mental health as well. It's true that you can't take care of others unless you take care of yourself first. Schedule your study time and schedule specific activities to nourish your mind, body, and soul. I highly recommend seeing a counsellor because this is one of the most stressful transitions you will ever make. But if you embrace the hard and learn to swim through it, you WILL make it!

Both are amazing!!! I started in community hemo after graduating as it was my only job offer and it was a great place to start! I agree with all the benefits AngelKissed mentioned and would also add that as a new grad, it was nice to be in a somewhat less stressful environment than acute care because i could focus on learning those assessment, etc skills without having the added stressors acute care brings. I feel significantly more prepared now to do acute care than I did when I graduated. I also work casual on an adolescent mental health inpatient unit and love it! That said and while I think every nurse should have some level of mental health experience/practice, dialysis will be better medical preparation for icu. I too hope to try icu one day and I think having the experience of needing top notch assessment skills and experience working with patients AND machines will be helpful. Best of luck!!

I am in a similar boat as well! It took me five months and having my final preceptorship in dialysis to finally get a my first nursing job in dialysis. There are things I like about it but it can be very repetitive and I'll be starting casually in adolescent mental health next month for some variety. I love psych but also want to get some medical experience soon... I've only been in dialysis for 4 months so definitely feel like it's too soon to move to med surge but I'm a little bit antsy to get that experience under my belt! I agree there is definitely a perception of us as new nurses in dialysis. A lot of the more experienced nurses keep saying to just leave and go to med surge but I don't want to be a job hopper! I can't PM yet but would love to hear how your transition goes! Good luck!! :-)

I'm not sure! Here, you are assigned to one unit as your home unit and then after 3 months or so you can start picking up casual on other units. You just have to ask the admin coordinator to schedule you for an orientation shift on that unit. It's so hard to get a line that it's really nice to be able to pick up on extra units! Yeah, dialysis was my final focus. I asked for outpatient clinic but was not expecting dialysis! It was a good placement though. I don't want to do dialysis long term but there are aspects of it I really like and I'm also just happy to have a nursing job at all!

Don't worry about feeling ignorant! Dialysis seems like a well-kept secret! I had no idea about any of it until I did a practicum in community dialysis in school!

Haha yeah when I started in HD I read the posts here and was basically terrified from what I'd read! Have you heard of home hemo? It's fantastic! One of the best options for patients who can manage it! From what I've seen, there is only one dialysis unit in each location. There are two hospital units (one has nocturnal and both do inpatient and outpatient). The one with nocturnal also has an outreach program where after you have plenty of experience, you can be on call for the other two hospitals since they don't have dialysis units at all. Those outreach patients would be ED or ICU patients. Then there are two outpatient units in urgent care buildings and two outpatient units in malls. It is very strange going to work in scrubs in a mall! I assume Edmonton is similar but we are Southern Alberta Renal Program and I know there are some differences from the Northern Alberta Renal Program.

I missed part of your question in my original post! Yes, I got 4 weeks of full-time classroom and practical on-the-unit training followed by a 2 week preceptorship and a short exam based on the theory. From what I have seen, you don't usually get charge-trained until you've been working on the unit for about a year. Feel free to ask more questions! :)

Welcome to dialysis! I've been in community dialysis for four months now (first job post-grad). From what I've read on here, it's pretty different from the states! At least in Alberta. It's similar to other units in that there is a charge nurse with a mix of RNs, LPNs, and NAs on the floor. In my experience, there are usually 4 pods with 5 patients. Each pod has an RN and an LPN. Some units leave it at that and it's very team-oriented in caring for those patients. Some units go a step further and split the pod in two where one nurse has two patients and the other has three and then after that run they switch spots to keep the workload somewhat even. Even in that system, the other nurse is still your buddy but you are basically on your own unless you go ask for help. On my units (I work PRN/casual on four of them), there are three runs per day (AM, PM, HS). AM start times are 0715, 0730, and 0745. PM start times are 1245, 1300, and 1315. HS start times are 1815, 1830 and 1845. Depending on the Unit, our shifts either run 0700-1515 and 1500-2315 or 0645-1500 and 1445-2300. Only one unit in my area has nocturnal and it's similar to inpatient/acute dialysis in that they won't let you do it until you are proficient with community/outpatient. The NAs get there around 6 (I think!) and they prepare the machines. Once the nurses get there, we double check that we have the right supplies, assess our patient, check for medications and labs, program the machine parameters based on the dialysis prescription, put on the patient (needles or CVC) and then do it all again with the next patient. Throughout the run we are right near by and monitoring them at least every half hour as well as doing medications and dressing changes, etc. And we take them off the machines at the end and make sure they are ok to leave. The NAs really know the machines better than the other staff so I ask them questions often when there are alarms! They also get blankets, keep supplies stocked on the Unit, put patients on and off the bikes and get the machines cleaned and ready in between patients to name a few things.

Fantastic article! Definitely printing this one out! I've been wondering about DBPs too as I've seem many DBPs in the 30s-50s but no one ever seems concerned.