"Strictly addressing the ease of access between fistula v. catheter, the fistula is easier for the outpatient nurse because the tech usually does it. If comparing a good fistula to a good cath, I would say the fistula is easier to access. If comparing a difficult fistula to a difficult cath, then it really just depends."
At my outpt unit, we have many pts with very poor fistulas (very small, poorly developed, very crooked, full of bends, lots of stenosis).
I find that caring for these pts is a lot more time consuming, difficult for both nurse and pt, and these pts get poor dialysis adequacy from their fistulas.
I much prefer working with catheters.
At my outpt clinic, nurses function as techs running a full load of pts, plus have nursing duties.
I also do inpt acutes, w/ q 15 min charting, which must be done on paper, then entered into Epic manually. Not too difficult when doing 1 : 1 care in ICU, but can get very hard to keep up w/ the charting when running 2 pts at a time in an acutes room, especially if pts are unstable.
As far as work load, difficulty of work, and autonomy, I much prefer acutes.
As for the hours, chronics is better.
Acutes hrs can be very long, and unpredictable.
Work load is very heavy, and labor intensive in chronics, but hours are generally routine.