Acutes isn't for the weak, that's for sure! I've been in dialysis for over 8 years now. I've worked at Davita and FMC, as a floor RN, charge RN, clinic manager and now acute RN. I truly didn't think I'd enjoy it, but it's turned out great. Yep, the only thing you're sure of is what time you start work. Where you go, how long you'll stay there before you go to another hospital, what time you'll get off work, whether you'll get to eat lunch (usually standing up and in a hurry!) or not, working 16 hour shifts, working 16 hour shifts and THEN getting called back in the middle of the night...all the horror stories are true. But there's also the weeks of low census where you may only work 6 hours or maybe not at all, great during the summer out here (Unexpected days off = fishing) and the fact that you are compensated for those hours. I took a pretty big pay cut to leave my CM position and move "down" to acutes but I make way more money than I did in my years as manager, bonuses included! And if you really want to learn about hemodialysis, there's no better way than acutes. I've been in Western Michigan acutes for over 2 years and I still learn something new every day; something more to understand that helps me gain insight into disease processes or just improves my patient care. And if you got into dialysis to help or teach people, acutes is a great opportunity. I find it very rewarding to be able to sit with a new start and explain the process of dialysis to them and give them examples of how they can live with ESRD. I've heard that Davita pays more in this area, but the fact is that if they paid a significant amount more, FMC would follow suit to be comparable. That obviously isn't happening because FMC is the top dog out here and we've hired more than a few ex-Davita nurses. I consider acutes to be on top, financially, in the hemodialysis spectrum but if you don't like what you're doing, then no amount of money will be the right amount. You've only been doing this for a couple years, you can't have expected to be making top dollar already Have you guys rolled out the UCAP yet? That'll be a good way to increase your "worth" both financially and as a nurse. Anyway, hope you enjoy whatever you decide - good luck!