Coleebee

^^ that

It varies by company and region as to how many nurses are there in the clinic. In my area with a certain large main provider 20 or less patients you have 1 RN, the other large provider has 2 RN's with 20. In general I think Acutes is less stressful working conditions than Chronics, however not knowing when you are going home, multiple add and being on call are stressors too. There are pluses and minuses too both.

^^ that

Oh to the OP, in my Chronics clinic, I was the only RN for 17 patients, and often had to take a 4 patient assignment on top of that (as I said bad clinic). It is apple and oranges trying to compare Acutes and Chronics. Westiluv described it beautifully.

When I worked Chronics I had a bad clinic :-( , bad management, bad techs and so on, but I do long for the more stable hours. I hate the On Call, I hate not sleeping well those nights and afraid of missing a phone call. I will probably make my way back to Chronics one day...I can't keep this up forever...I'm already exhausted. I won't go back to work for one of the big companies, I'd give the other one a try. I enjoy Dialysis, I think it is way better than floor nursing. I have my bad days when I want to leave completely, but the grass isn't always greener on the other side. When I think about how miserable I was working the floor (ICU) it puts things back into perspective for me. Until I get 5 add ons :-) such is the life of an Acute Dialysis nurse

Yeah, but to be a DON you most often have to have LTC experience. I can't lose my shirt to wait for that experience :-(

I have worked in Chronics and currently work in Acutes. In my opinion they are 2 completely different animals. In Acutes you are the Dialysis Nurse, you don't have people around to help you with Dialysis. You are it. I found my years of PCU/ICU/Cath Lab very helpful with my transition to Acutes. However, I have mad respect for Med/Surg Nurses, they are some of the hardest working Nurses in the hospital. They deal with all sorts of patients, and while you may not see a lot of "cardiac", you see about everything else. With that being said I did Chronics first. I miss Chronics, I miss my stable patients, I miss having relationships with them. The Acute setting is fast paced, and kinda a fly by the seat of your pants experience. You may have a 6 hour day or a 16 hour day, you do not know.

I was really bummed. There is no way that I can take that kind of pay cut, I wouldn't be able to pay my bills. I expected a maybe a dollar less, but not $4. (My hospital doesn't pay a lot and I live in a city that regardless of what people think, has a high cost of living) On the bright side, I do work in Nephrology, so we do have a lot of Geriatric patients there, I will eventually leave the hospital, and do outpatient Nephrology again, but for the time I will stay where I am at. I do hope that I can find something, but I cannot accept an almost 10,000 dollar pay cut. Thank you for all of your advice, I admire every single one of you who works in LTC.

Interview went really well! However the pay is significantly lower than I was expecting. I live in a "low pay state" but what they offered me was new graduate RN pay. I know money isn't everything, and I really love gerontology, however I cannot quit my Nephrology job for a $4 dollar pay cut. :-(

I have an interview at a non for profit Continuous Care Retirement home on Monday for a RN in the Skilled Nursing area (they are affiliated with the Presbyterain Church). To make a very long story short, I have been in Acute Care since I became a RN, however Gerontology is my passion. I have always wanted to do Gerontology, it is the reason I became Nurse to begin with (worked as a RA/ Med Tech in Assisted Living while going to Nursing School). I took the Acute route first (because everyone seemed to think that was the better idea). I have worked in Cardiac/ICU and Nephrology and after efectively burning myself out in the hospital (hospital nursing is not for me), I still long and yearn for my geriatric patients. I certainly have a passion and desire to work with them. I am very excited for this oppurtunity, and hope that the interview goes well. I would appreciate any advice for the interview. Questions to ask, salary expectations and so on. Any advice is welcomed. Thank You in advance!

I burned out quick at DaVita Chronics. I hated it, loved my patients...hated everything else. You are not alone. Management was a joke, and more and more expectations were piled on me. I had little or no help and my manager (also an RN) was a waste of space. I gladly got out after 10 months...it was a living hell.

I have been doing Dialysis now for 2 years, it is time for a change of scenery. It does not matter if it is for outpatient or acutes. I am ready to run screaming! I love my patients, but the "suits" aka process people are making it impossible to take care of my patients.

Hello all first time posting in the specialty. I've been healthcare for a long time, it all started years ago as a firefighter paramedic. I've been RN for three years. I actually got my RN after working an assisted living facility as a Med Tech and falling in love with gerontology. Gerontology is why I went back to nursing school, I was ready to leave the medical profession altogether. Since graduating I have worked either cardiology or nephrology, I still have a desire to work gerontology itself. After all it is what made me fall back in love with Nursing. My specific question is to find out some information on the church run retirement homes. In my area there are two church run retirement homes, they both have an ALF and a SNF attached to them, for their residents only. They both have great ratings with the Medicare.gov site. What is your experience with these places if any? Thank you so much for your response.

@OP, The best advice I can give you is to do your research. There are few unions here and no mandatory staffing ratios (hospitals set them). I have worked in a hospital on a PCU that I have taken 6 patients regularly (on days) moved to another hospital and had 4 regularly on a step down sometimes 5 (which is normal) I currently work in a Acute Dialysis setting so our ratio is suppose to be 2:1, recently they have been pushing us to 3:1 (in the dialysis unit) it remains 1:1 in the ICU/bedside dialysis situations. Just yesterday I was on ICU dialyzing a patient and the ICU RN had 4 patients, yep 4...2 ICU pts on vents and 2 Medical patients. In the Mother/Baby unit 5:1 is occurring frequently, and Med/Surg is 7 on days. That is crazy. I'm not saying this only happens in Florida, it happens other places too. Florida can be a lovely place. My friend who lives in Boca will never leave she loves her job, even with the lower pay (she is from NJ originally) she is happy. I've always said that if I was a fan of beaches, palm trees and 90+ degrees 10 months of the year than Florida would be the place for me. However, I miss seasons, leaves changing, hills and mountains, so it is time to move on for me. The further south you go in FL the higher the pay, however the cost of living is high compared to pay, throughout the state. Certain parts (especially Southeast FL) rival parts of the Northeast in cost of living. Housing is expensive, electricity is expensive, food is expensive and so on. I know that occurs elsewhere too. I of all people understand wanting to leave where you live and try something new. I have lived in 3 different states, all have pluses and minuses. I will answer your pay question as best as I can. Pay in general is going to be lower to mid $20's to start. You do get shift diff, but that varies by hospital and is usually a percentage of your base pay. I know someone who has 8 years experience in ICU that just started working in Miami as an ICU charge nurse for $28.20 an hour, she moved from the Orlando area so that is a big pay increase for her, but she had to negotiate that. (and I would love that pay too). As I said before, best of luck in your move to Florida.

Base pay for an RN with no hospital experience in my neck of the woods is $20-23 an hour. A friend of mine works in Boca Raton and she started out at $24.

No Publix, and Walmart is only slightly cheaper. It is ridiculous. Best of luck on your move. I just wanted you to know so you aren't in shock with the pay difference, compared to the high cost of living.

Living in Florida is very different from visiting. I have been here for 13 years and cannot wait to leave. You will make considerably less money and although the cost of living is lower than NYC it is not as low as people think. Especially since the pay is less. The cost of food is astronomical here. i paid $9.50 for Peanut Butter the other day. I live a little north of where you plan on moving, so I cannot speak for the hospitals. I can tell you that I know several RN's with 8 years experience making new grad in other states wages.

It all depends on the unit. I worked Chronics and had a crap manager and crap techs. I was burnt out after 6 months, cried at work. It was horrible. I work for a hospital based acute dialysis unit now and I love it. I wouldn't go back to Davita.

Oh my...now wear...darn iPhone spell check

A good quality pair of running shoes

I bought Dansko's, I hated them. I started to have Plantar fasciitis like pain and my pinky toes were blistered all to hell. I switched back to tennis shoes and the problems disappeared. I think 12+ hours shifts hurt your feet regardless. I'd say save the money and buy a good pair of running shoes. I know where my Dansko's to the barn to muck out stalls.

I am about to make the switch form Chronics to Acutes. It will be a hospital based unit, not one of the big providers. I will be working with RN's (no PCT's), 3 12's a week and 1 night on call a week. I am looking forward to getting back into the acute/critical care side of it. Chronics, while great for the experience and training (helped me relaize that I LOVED Dialysis as a specialty), I definitely miss the autonomy.

I make more at DaVita, than I did at the hospital. $2 more an hour. Florida however is a low pay state for everything. It is really bad in Central Florida too. I have heard that it varies from state to state. All I can tell you is that I am making what a graduate nurse makes in another state. I am making more than my former coworkers at the hospital.

DaVita (in Florida) pays the same rate for training that they do for Nurses. For example: I was hired at a certain rate of pay. It was not less during the training process. It did not go up after training.

I work In Center Hemo ( Chronics). I am scheduled 4 10 hour shifts. I get really close to it. I rotate with another RN. We get at least 36. RN's are in for the long haul. Since there are only 6 days of Dialysis a week we (the RN's) will rotate the week that one of us goes home early on that 4th day, so one week I get 36, the following I get 40.