ldyjstce

I have been in dialysis for 12 years and have done just about everything. I have been an in-center nurse; a PD nurse; helped with home hemo; currently an acute dialysis travel nurse. I will tell you what I was told when I started . . . you will either love it or you will hate it. It really does take a different kind of person to deal with all we do. Many nurses and techs have come into dialysis thinking that it is a cushy job and you just sit and monitor a patient. I can tell you that is NOT what dialysis is. If you are a clinic employee (in-center) your days start very early (some places at 3am) and some go overnight (nocturnal hemo). Acute dialysis is for us crazy people because it is either feast or famine. There are days that go on for 24 hours; there are days you are on call and are called in multiple times and then there are the days where you have 1 patient to run. If you are a staff employee, you just don't get your hours for the week when it is famine time. Also, no matter where you work, you will see the same people over and over . . . it is hard when you care more about the patient's life than they do. Also, I was told that I would not truly understand dialysis for 18+ months . . . and they were right! I have seen nurses go from MS to Acutes and it is a HUGE shock to them. Please, do yourself a favor and if you truly are interested in nephrology and dialysis, spend a year in a clinic. You will not regret the decision.

Worked for years in-center and PD. Just took my first Acutes job at the end of March. I was promised a rose garden and the first month was wonderful. Now, I am not seeing that rose garden. I did a 37 hour day (LOL) when 1 RN was on vacation and 1 RN was out of town while the 3rd RN had not been trained at our hospital. I also did a 17 hour (day) where I ended up in the ER of the hospital and no one could be found to cover my call. So I am wheeled down to the ER by the house supervisor and am still on call while getting IV meds for my massive migraine. In-center HD was a pain and the constant on call of PD wore me out . . . Acutes, however, is beast unto itself. At this point in time, I am seriously considering travel dialysis RN positions.

2 years as a hemo RN and have been a PD RN for 4 months. I get tired of ER, L&D, med-surg, etc., RNs thinking that either is EASY. I have been told that hemo is nothing since you just stick 2 needles in them and let them run for a few hours. BULL! These pt's literally put their lives in our hands daily . . . when you are pumping blood at 500mL/min and a needle "pops out", watch how fast they can bleed out. Amazing how a pt's bp can go from normotensive and 15" later they are in a hypotensive crisis. Sorry for the rant, but sometimes I get tired of people thinking renal nurses just deal with pee!!!

You are an RN at the assisted living facility? Your patient is inpatient for physical therapy/rehab? The rounding MD ordered lab work on this pt? What is the pt's background medical background? Did the MD provide a reason for requesting labs? Has the pt shown some type of decline medically? What is your facility's protocol on lab work? If you question the order, have you taken it to your superior? Many questions to answer in order to give you a well informed answer.

Had my B.S. in another field for many years before going into nursing. I started nursing school at 38 and became an RN at 40. I am 3 years into being an RN and know this is what I am meant to do. NOT CRAZY AT ALL!

PD solution is dextrose based . . . the stronger the dextrose strength, the more fluid pulled. Best explanation my preceptor told me: think of cutting up strawberries, put a little sugar on them and you get a little juice but put a lot of sugar on them and you get a lot of juice. Also, the DREADED peritonitis is demonstrated by getting a bag of PD fluid (called dianeal) and putting a shot of coffee creamer in it to give it the proper cloudy look. Hemoperitoneum (usually by women during menstruation and/or ovulation) can be demonstrated in steps by adding increasing amounts of red food coloring to the PD fluid. Evil fibrin that can block the flow of a PD catheter can look like white roundworms floating in their drainage bags. Drain bags with good clearance will look like urine in color. Hope this gives you a little help. You can look at Welcome to ISPD.org or Baxter U.S. - Homepage or Treatment Options - Home Peritoneal Dialysis - DaVita which is the company for whom I work. Good luck!!

I wholeheartedly disagree with the statement that new grads shouldn't become Dialysis RNs. I stumbled into dialysis nursing as a new grad and, as everyonein dialysis has experienced at one time or another, there have been days when I ask WHAT AM I DOING?! I would say the caveat should be that if the new grad is very young, fresh and doesn't have a lot of "life" under his/her belt, it will be difficult. These patients are very sick but usually don't look that way externally. These are the most non-compliant and "grumpy" patients one will have the pleasure of working with. In my 2 years, I have been cursed at, yelled at, called every type of name, been hit, pushed and threatened by patients. BUT the job is fulfilling. As an experienced dialysis RN, my team welcomes new grads -- we can train them BEFORE they get the bad habits instilled. If you are interested in the field, find a facility that will allow you to "shadow" a nurse and make sure you are there for turnover! Turnover is where a lot of people have the hardest times!

DITTO! I am 8 months in and am wanting something else.

At my clinic (30 chairs) all nurses are required to be BLS and ACLS certified. All PCTs are required to be BLS certified. A code sheet is made out weekly (sometimes daily) as to who does what in the case of a code. Since I started 8 months ago we have had 1 full code and 1 partial (respiratory arrest for appx 15 sec / cardio was fine). We all acted as a team should. Some of the younger staff were "frozen" but everything was done in a precise and proper manner.

I work in a 30 unit center with most chairs filled at each shift (we run 2 shifts per day/6 days per week). There is a definite "power struggle". The techs think the nurses do nothing but sit and chat; I, being an RN, can never get all the work done that we HAVE to get done. Assessments, med checks, foot checks, progress notes, etc. on 90 pts. along with putting pts. on, taking them off and turning stations over -- it is tremendously frustrating. Nurses and techs each have 4 stations and the nurses are responsible, of course, for putting on all the catheters (even if they are not our assigned pts) and pushing all the systemic heparin boluses. We are always behind the 8-ball. Needless to say, this being my first RN job out of school, and being 5 months into the job, I constantly wonder -- "what have I done?!?!"

not sure as to the answer for your question, but i own a card iii steth. i received it my last year in nursing school as a birthday present. suffice it to say that i love :heartbeat:heartbeat it. my thought was that i was going to go into cardio -- needless to say, i didn't. lol i work in dialysis where it is imperative that we auscultate lung and heart sounds and i find that i pick up much more on my assessments with my stethoscope! in fact, other nurses come and borrow mine (or borrow me) to listen to questionable sounds. love the card iii! only thing i would change would be to give it another inch or two on the length. good luck!

hi, guys! i am 2 months into my hd rn job and have yet to have anyone give me the lowdown on the portion of the bundling that will hit on 1/1. i have a legal background as well as a teaching background, so reading the super-inflated medicolegalese (nice new word, huh?!) language isn't something that scares me. i just can't get anyone go shoot me to the right spot where i can read about the hd patient bundling and the requirements/guidelines/etc. that will be impacting us. i think i could help some of our staff members out if i could read it, digest it and bring it down to a more understandable level. if someone could shoot me a site, the fr number or something/everything/anything useful, i would be most appreciative!

Oh, I just now saw this -- my heart is broken. I, too, just graduated from nursing school and could always count on Daytonite to set me straight on any questions I had. She was such a wonderful teacher I do hope she knows how much we all care(d) for her. Thank you, Joyce for everything.

It depends on who you have as a teacher. I thought they were both easy. Most people think Moral is easier. Just a hint, get everything out of the way before you go into the program. That is what I did and I am counting down the days until graduation (May 15!!). A lot of people put things off until the summer before 4th Semester and what a HUGE mistake it was. 4th Semester is absolute hell and you don't want to have to do anything during or before other than prepare.

I will be graduating in less than a month and I hate to inform you, but the field here is extremely tight. Most of the hospitals do their major recruiting in March/April and secondary recruiting in Octoberish. The market here is so competitive and the outlook for jobs is slim. We have so many nursing schools around the area (8 that I can think of right off the top of my head) so it is very difficult to find work. If I were you, I would get my feelers out this summer.