Relocation for Hemodialysis Nursing

[GaleFlorence]

Hi my fellow RNs!

I may have the opportunity to relocate to New Mexico for a HD position. I would be new to the area as well as HD. I am aware that HD Nursing is very busy and long hours but is it any different than working on med surg inpatient hospital unit? I would be running all day and nights (when I worked nights) and the documentation was challenging with patient load. My favorite part is working with patients and families however what I disliked is the time stress. Have any suggestions/tips? Thanks!

[Ashley_SF, BSN]

Hi GaleFlorence!

I don't have any experience working on a medsurg unit, but I have worked as an outpatient hemodialysis nurse for the past 4 years. I worked in 3 different very busy units and was on my feet all shift and worked over my 12 hours every day. The nice thing about outpatient dialysis is you give only a few meds, IV antibiotics and maybe IDPN, depending on your unit. What I found challenging was being responsible for 12 patients, occasionally 15, if a nurse called out/ we were orienting new staff. On a good day my techs were on top of vitals, reported downward or upward trends in blood pressure promptly, and my patients were relatively stable. On a more challenging day I would have multiple patients crumping, oblivious techs, and doctors in the unit constantly trying to give me verbal orders in the middle of assessments/ CVC put ons, etc.

All that being said, there are smaller units with relatively stable populations and low staff turnover which would most likely make for a much different experience. As a dialysis nurse in a large, urban city I had a lot of challenging patients with few resources and ultimately decided I just couldn't hang anymore. But, I really enjoyed the relationships I was able to build with my patients. When I did have time I absolutely loved being able to sit down with them and work with them on their health goals and how we could optimize their quality of life.

My advice: talk to dialysis nurses in your area, if possible shadow at a clinic to get a feel for the environment. You'll be working with patient care technicians and having responsible, motivated and diligent support staff will have a large impact on your day. There are some threads on AN that outline a day in the life of a dialysis nurse that can be illuminating as well.

Best of luck!

[GaleFlorence]

Thank you for your response. I am going for a site visit in September and have been trying to ask as many people as I can for their experiences in HD.

[Lanarae]

Hey! I have worked in Med-Surg before and I have been working in HD for the past 4 years as a Charge RN and Clinical Coordinator. I have to say that Med-Surg is something I would never return to but HD I am passionate about. Being able to make a rapport with your patients and really be involved in their long term plan of care is rewarding. Patient's come to dialysis three times a week on average so you really get to know them unlike the hospital which is a revolving door. There aren't many medication variations. The most common being Epogen, Venofer, and Hectorol with some IDPN and antibiotics in some cases. I work with some strong techs and nurses and we know our patient's really well and it's just a great feeling to go into a workplace where you really feel like you are making a difference.

My hours are long however because I am the lead nurse so I open and close and can't leave until the last patient is picked up, but working only MWF I can deal! Documentation isn't as strenuous as Med-Surg either. Definitely shadow a nurse in a clinic but I am so happy I left Med-Surg.