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Thanks everyone! Glad I am not alone, I am transferring units in a few weeks so if it doesn't get better will probably cut to part time and find a per diem in something new and fun!!

Anyone starting to burn out in dialysis, I work in home dialysis and getting so tired of davita's management, and all the reports they require, and all their expectations. Anyone else experiencing this??

Hi everyone, I currently have been working in home dialysis for 3 years, before that I worked in med-surg I felt it was so stressful, never knowing what to expect with codes and falls and crazy pt's. I think I am getting bored and burnt out from home dialysis, tired of being on-call, tired of pt's always calling and texting. Tired of money hungry mgr's and the push to increase census. I also work mon-Friday, not having time to do anything. I miss 12 hour shifts, more like I miss 4 days off. I feel like going back to med-surg might be calling my name, I feel like I will be better at med surg this time because there is so much autonomy in home dialysis so I make judgement calls all the time. What should I do? Do nurses actually go back to med-surg???

I work for davita as a peritoneal dialysis nurse, it's ok, I liked it more when I first started, pt's are constantly texting me and calling me, also I am on call every other week, money is ok but my phone is constantly by my side, and I am always checking my phone. I miss 12 hour shifts at times, getting tired of working mon-fri, I also cover multiple clinics due to low census. Mgmt is always pushing for more pt's to train and tons of paperwork.

I have been doing home dialysis for 3 years and I am getting really tired of it, too many managers, on call all the time, I never get away from my job left early today and must have gotten 5 text messages from managers, I am thinking about rehab nursing, just want something when I leave for the day I am done no one will be calling me!!

Due to changes in medicare, dialysis companies are pushing home dialysis, it's cheaper since pt's are performing therapy at home and you don't need the staff like in hemo. It's a very nice area to work in but I don't like pushing pt's into it, it's their choice.

Hi Everyone, I have been working in home dialysis for 2 years, I really enjoy it, I like the pt's and teaching. But to anyone who has worked in the speciality...does it feel like sales sometimes? I feel like my managers expect me to sell the therapy...like I need a certain number of pt's so I need to get on the hemo floor and sell PD like a car. I don't think I like this aspect at all, it's the pt's decision, I shouldn't need to apply pressure so they do home dialysis. Not happy right now!! Thanks, had to vent!!

Sometimes you need a lot patiences for your patients! I have been in home therapies for 2 years and I love what I do but you all patients at some point need reminders and retraining. Each month when they come in I do education w/ them so their skills stay fresh and I can gauge how much has been forgotten or if they are getting lazy w/ hand washing or disinfecting the transfer set. Home nurses might not be running from pt to pt in the hospital on the HD floor but we do a lot of teaching and encouraging some times that can become tiring if someone isn't listening! Good luck!

Well hopefully you did we'll on your interview but personal experience should count for a lot especially taking care of family. Davita is very family oriented so I am sure they will take your experience into account. Good luck!

I love working in home therapies. It gives pt's choices and puts them in control. It is the best career move I have ever made, and comes w/ much job security because it is expanding pretty quickly. I don't think there are many jobs out there because many programs are small and sometimes use the HD staff to cover, not that they are similar jobs at all.

I work in home dialysis and love it, love the relationships I have created w/ pt, knowing when something is going on with your pt since you know them so well. I am not a big fan of on-call, but everything else I really like. I like training new pt's and convincing them they can do this at home, and when they can, it feels very fulfilling that I taught them. I never thought dialysis would be my niche but I really like it and plan to do this for a while. Good luck w/ your new career move! Glad I made the move to dialysis!

I think experience is a lot more important then a BSN. I wouldn't worry at all since you have so much experience. I am currently working as a home dialysis nurse (peritoneal dialysis) for Davita. They are expanding all over due to increasing need for dialysis. I really like my job, I teach new dialysis patient how to dialyze at home and follow their labs every month, I mean I do more then that but you get the idea! Good Luck!

Nights are a hard shift, if you can consistently sleep on the same schedule you will probably feel better. When I worked nights, I would come home and sleep for 4 hours, then wake up because I was hungry for lunch, then I would be exhausted the rest of the day and usually wanted to go back to bed by 8pm. You also want to eat small healthy meals and snacks, drink plenty of water, avoid lots of caffiene and sugar, it will make you crazy. I wish my body liked working nights because I love the staff and the quiet of the unit and more time w/ patients plus when everyone is going to work you are coming home, which is nice, but my body hated staying up all night, I would love to try it again but I would need to stay on a daytime sleep schedule. Good luck!

I have been a nurse for 5 years and my stresses levels have increased a lot since I have graduated. I suffered from panic attacks the first 2 years of nursing, to this day I actually see a therapist for this problem, even though I have not had a panic attack in a few years. You post makes me realize I am not alone, nursing is the hardest job I have ever had. At my first job, I used to be jealous of the cleaning staff, they did not have to worry about killing someone or someone falling out of bed. I am still on anxiety meds, I have been through a few jobs but I think I have found my niche in home dialysis, nice hours and good relationships w/ chronic patients. My weight has gone up and down, and I was definitely guilty of emotional eating after long 12 hours shifts in the hospital. Anyway, good luck w/ your decisions but it does get easier and there are so many choices in nursing. Remember to get enough sun while working nights, I ended up w/ a vitamin D deficiency while on nights, which can trigger depression among other issues.

Good post! Thanks! My doctor says to improve yourself, you have to "marry" yourself, meaning you take care of yourself and make the commitment to improve what you want to improve whether it's weight loss, exercise, anxiety...I think of that when I am trying to motivate myself.

Good luck w/ school! I think what makes a good nurse is having common sense and good judgement. You also have to be able to trust your own instincts, and you have to be a good listener, if a pt tells you something is wrong it probably is.... A good sense of humor helps also since we deal w/ life and death and serious situations, you need to be able to diffuse anxiety! Also being able to stay calm under pressure helps too, but that comes w/ time it won't be the first 6 months or even 1st year as a nurse. :)

For a renal floor, I would definitely review electrolyte values. A lot renal pt's are also diabetic, so review diabetes, as well as htn meds. Common renal meds include: epogen/procrit, venofer, phosphate binder (to be taken w/ meals, not before or after), vitamin D analogs. You may also see a lot of wounds so antibiotics will be given often and wound care will be done frequently. I spent 3 years on a renal floor and learned so much!!! I am now in home dialysis and love it! Good luck!

The feeling of being chewed up and kicked around will get better when your confidence grows and you have some more experience. I think some nurses are happy but the hospital is a tough area to work in, you have shift work combined w/ working holidays and weekends. It's also a lot of responsibility which can be scary to nurses at times. Maybe the nurses you work w/ haven't found their niche. But I can tell you as a nurse I am not always super cheery but I do my best to appear happy and get thru my shift. Best of luck!

Give yourself some slack! Being a new nurse is so hard!! 4 months in as a new nurse on a cardiac floor I broke down and had a panic attack in the middle of my shift. It was very embarassing but I just couldn't keep up, I was way behind and just felt so overwhelmed. You have to take good care of yourself, eat right, exercise, spend some time doing things you like to do. Forgive yourself and give yourself some time to settle in. I used to get attitude from the oncoming shift too, I think it's a game and since you don't feel super-confident they are intimidating. As for going into the rooms in the middle of the night and parents giving you a hard time, that is just something you will have to ignore, you are there to care for your patient, if the parents can't see that they are in the wrong. I have been in nursing for 5 years and trust me it does get easier. Hang in there, take care!

Hi Everyone, Just looking for some insight, I currently work in home dialysis M-F 8-430pm w/ on-call every few weeks. I enjoy my job but sometimes I really miss the night shift on my med-surg floor and dealing w/ more complex issues. I liked night shift, my body hated it, but I enjoyed working w/ a group of nurses and techs. I definitely didn't like day shift on the med-surg floor, gave me panic attacks! A little advice needed, I am probably moving in 6 months and I am torn if I should pursue returning to the hospital or stick w/ home dialysis. There are pro's and con's to both, I get tired of working 5 days a week but I do enjoy having weekends off. Just not sure what to do, I feel like I have a really good job but then I also feel like the hospital was challenging... Thanks for any input!

Do what feels right to you, it sounds like you already know what you want to do. It might be a good idea to stay per diem at the hospital because it's good money and you can keep up your skills. I left med-surg after a few years for home dialysis and love my decision but I did keep my m/s position per diem for the extra money and keeping up my skills. Good luck!

The first year as a new nurse is really difficult. My suggestions would be: Try to stay organized at work (prioritize in the order of importance, pain meds for patient A is more important to get before filling patient B's water jug) Keeping pt's safe is always your first priority, if your patients are safe everything else will get done at some point Don't be too hard on yourself, you will make mistakes or make a doctor or your manager mad at some point in time but it's ok, you are learning Slow down, you can't do everything at once, you are not going to know every bit of information all the time Take a good report from your previous nurse, taking good notes and writing down key information will keep you up to speed, make sure your notes are organized, use a highlighter to help out Remember, you are only one person, you can only do one thing at a time Good luck! You will survive your first year, it just takes some time Oh yeah, and make friends w/ your nursing assistants, they can make or break your day, they will be your right hand and help them whenever you can because they will return the favor x 10!!!

If you are interested in those areas you might want to pick the hospital you really want to work in and apply for a med-surg position then after maybe one year you can transfer to one of those areas when a position opens up. It's easier to get into a specialty area like that once you are already working in the facility, you have more networks open to you. Recruiters are more likely to hire into med-surg when you don't have hospital experience. Good luck!

I just posted a response to this above, sorry!

This was a few years ago and it was a paper MAR, they had the Lantus and regular insulin listed right in a row and I got mixed up, no policy that I know of but I left that hospital. The hospital that I worked at more recently does have high alert meds highlighted and some of those meds needed 2 nurses to sign off so it could be give.