You have to be pretty independent to do acutes as you are called out to do ICU patients. The ICU nurse will still be responsible for patient care but it can be daunting to walk into the ICU setting with no critical care experience. The problem with dialysis, as a nurse, is the lack of any balance between your personal life and the requirements of the job. I frequently have to do 12-16 hour shifts and no one understands that you don't know exactly when you will be home. Clinics at least offer some balance. Acutes offer long hours and lots of call. Pay may be low but you will make up for it by all the overtime. Whether you want it or not.