traumaRUs

As a nephrology APP, many of my pts are on Medicaid. Starting in January 2027, there will be up to a $35 charge for each dialysis treatment. When trump was in office the first time, he made a statement that he wanted 80% of all dialysis pts to be doing a form of home dialysis by 2025. Well....that didn't happen so this seems to be the next best thing from trump. Here's some info: The "One Big Beautiful Bill" Healthcare Cuts and What It Means for CKD, ESKD, Dialysis & Transplant Patients | National Kidney Foundation Big Beautiful Bill is Downright Ugly for K... - Kidney Dialysis Better make sure you stay on top of your HTN and DM2....

I am so very sorry you are going thru this! Shame on those bullies! I'm an APRN for a large nephrology practice. I see pts at both Fresenius and Davita dialysis units. In all the units I go to, I know there are nurses that have a background and/or restrictions. Can you go to a different dialysis company? Best wishes - the 17 months will pass. Please take care of yoursel

I was staff for many years and have wonderful memories of NTIs. Maybe PM one of the admins about AN being at NTI. Have a great time

I've worked for the same practice for 19 years. I don't really nitpick that much on the time. At least in my experience, its expected that you stick to the schedule. If 45 minutes is lunch, then if you leave early you return in 45 minutes. As to the meetings, it seems like you are already taking an extra 15 minutes for lunch so it doesn't seem out of the ordinary to ask you to attend meetings.

We have a local nursing home that has an entire wing of peds pts that are either vent dependent or require a lot of care. Many are wards of the state. Many have lived there since birth

Dialysis might be an option for you. Though its very specialized, it is friendly for nurses on probation

I don't work LTC but it seems weird to do bowel routine on night shift. Is that really in the pt's best interest? Won't it disturb his sleep?

I guess it just depends on how the board sees it. I would certainly make all of your social media private.

I'm not going but have gone to several in the past and they are awesome. So many opportunities to network, learn and grow. Have a great time.

Hi there - its pretty individual. In your scenario of the pt going to dialysis at 9am, I would ask what is their current BP? Is it normal in the 110-140 range, then I would hold their am bp meds because usually dialysis and volume removal is useful for controlling their BP. For chronic hemodialysis pts, many times, their BP will come down with fluid removal at dialysis. Does that make sense?

Apologize that I didn't see this sooner. I've been a nephrology APRN for 19 years. Likes: flexibility, stability, pay, hours, ability to establish long term relationships Dislikes: hours - some days are long if you have to travel a lot. For me that is the only downside. My job encompasses seeing dialysis patients weekly. There must be 4 total visits per month for each pt. One visit is usually done by MD and APRN does the other 3 visits. I work for a very large 31 physician, 14 APRN practice in central IL. I care for pts in three different dialysis units: 2 are 10 miles from my house and the third (the largest) is 77 miles from my house. Dialysis pts either dialyze MWF or TTS so I have to go to each unit twice/week. I can do two of the units in one day so that involves 4 days of my week. I also see CKD and other nephrology pts in office twice/month. I hope this helps

I'm a nephrology APRN, have worked with multiple dialysis nurses/tech over past 19 years. Here are some skills to capitalize on and that can transfer to a different specialty: 1. Your assessment skills. Many times, I receive calls from dialysis nurses about a certain pt. They may have a simple question or they may need more guidance. However, I always ask them what they would like for me to do? Does the pt simply need to have their EDW adjusted, do they need to have their bath changed or do they need to go to the ER via EMS? 2. Ability to handle emergency situations. Often the dialysis nurse is the initial provider in situations. So, you have to be proficient at BLS skills. 3. Interpersonal skills. You deal with patients, families, providers and must always do so in a calm, collected manner. Best wishes changing specialties

Short staffing, wages, amount of patients we are expected to see per day, paperwork

I am well over 60 and work as APRN. I went back to grad school at 48 years and been working 19 years as APRN and plan to work til I'm at least 70.

Gosh - I'm sorry you are having such a rough time with this. I would use YouTube videos for your specific machine. Unfortunately, I'm an APP so I don't actually set up the machines and don't have that knowledge.

Wanted to come back to this thread. I've now been an APRN for 18+ years and nope never been bullied - still quite mean too!

THanksgiving is my favorite holiday as it is when everyone in our family gets together. Christmas is reserved for church and just our immediate family in the morning and then we make the rounds to other family members Happy Holidays

I have several mentally ill patients as well though I work in a different role and environment. I change the subject when it comes down to perseverating on one topic. Boundaries, as Nurse Beth mentioned, are all important. You are not being rude or disrespectful if you have boundaries and stick to them. And yes, it is possible to be burnt out. Hopefully a change will be for the good. Best wishes.

What a nice, positive post. I'm 66 and still working hard. I'm an APP now so the stress is very different then when I worked bedside. And...while I'm one year closer to retirement, its still several years in the future. Happy New Year 2025!

How nice! I hope you are well on the road to recovery!

I would do it. I'm 66 and an APRN but plan to work until 70 full time and then switch to part time. Being an RN will offer you many more opportunities to "age while working." I do agree with Nurse Beth that it depends on your general health. I'm a healthy 66 now but who knows what tomorrow brings...Good luck in your decision

May not be a popular opinion but maybe just ignore everyone. No reason to have friends in nursing school - get thru it and move on. Some things to consider: 1. Nursing school is only a few years - you will have many more years of nursing practice. 2. Keep conversations very superficial - the weather, etc. 3. Look to others that are quiet and observant and model their behavior Best wishes - nursing school will be over before you know it. Take care

Need more details. I'm with above poster - how do you do a physical assessment especially skin assessment virtually?

I work in a specialty - nephrology so definitely would have been helpful to have had some knowledge of it before I started. However, my nursing background was level 1 Trauma ED so I emphasized: 1. My ability to think on my feet 2. Able to tell "sick" from "not sick" 3. Culturally competent as in the ER (and I'm sure critical care as well) was exposed to many different cultures and ethnicities 4. Multi-tasking 5. Experience with research (I worked in a teaching hospital where I worked with residents on some of their required research)

I agree with most of what you said. I've been a nurse for 30+ years, RN for 12 years and APN for 18 years. I will say that I have been both: the rude, no holds barred RN and the kinder, gentler nurse who does nurture new nurses. It has depended on many factors. When I worked in a level one trauma ER for 10 years we were constantly short handed and expected to cont to do more with less. We had scripts: "yes, I have the time" when it was obvious to everyone that we did NOT have the time or resources to do what was needed. The saving grace during this time was the people I worked with. The teamwork was the only thing that kept me coming back shift after shift. As an APN I feel that I'm not as stressed with regard to staffing but there are other expectations that can cause stress such as 1. dealing with prior authorizations for meds that are necessary to keep my patients healthy and out of the hospital. 2. Managed care programs that only manage the dollars for the insurance companies 3. Expectations from supervisors that are unreasonable. Well....I'm sure that is more info than you wanted.