ghilbert. point well taken. But a renal nurse and a CV nurse are two different skills and knowledge. As, in the comment before yours. If the Dialysis Nurse makes the pt. intravasculary dry then their actions are directly responsible for the pt's. pre-arrest condition. I am just saying that, once you have an LVAD and need dialysis a hospital setting with readily available knowledgeable support is the best setting for this pt. Not in a dialysis unit where the only support is another Dialysis RN and the local EMS. Taking roadtrips and traveling is the responsibility of the patient and is not involving another person's livelyhood in this decision. The dialysis RN is doing a job, period. Their life is going home and taking care of their families. It is not a calling, nursing is job, that only a few people can do and do well. It is no different than the master carpenter. Just because we may save a life or partake in the healing of another person. We should not place our egos on such a pedestal that we feel that we are better than the average person. A garbage man's job decreases mass infection among the populace by removing waste from our immediate enviroment, therefore, allowing all of us live a healthier life. Enjoy and nice hearing from you.