Shadowing in HD. New(ish) Grad.

[EiEiO_55120]

Good morning.

I graduated in May and started my first RN position in early July. I accepted the first position that was offered to me that wasn't LTC because I felt that I'd have an easier time getting into a hospital and, frankly, LTC doesn't appeal to me.

Currently, I am working on a TCU that primarily serves patients with socio-economic struggles such as homelessness, addiction and mental health disorders who also have need for skilled nursing care- such as complicated wounds, IV abx etc... It is a small facility with all of the struggles that seem to go along with being a small facility (little structure, little oversight, terrible staffing, utter chaos-everyone has their hands in everything, awful benefits).

Recently, I had an interview with a large dialysis company for a hospital-based acute dialysis position. I was surprised to even get an interview, as I have been applying for several positions every week since I graduated with very little response.

The interview went well, I think. It was a long interview, where we discussed the process of HD, the hospital environment, specializing, my clinical experience, my likes and dislikes related to nursing, new grad woes and nursing woes in general.

During the interview, I asked if shadowing would be an option. I am so new to nursing that I don't even know what my interests are. Also, I really want wherever I go from my current position to be a place that I am happy and stay for a while. At the end of the interview, we scheduled a date for me to shadow which is next week.

My thoughts on the acute HD position are:

1)I will get a wide variety of patients and hopefully discover my area of interest.

2)I will feel more supported as a new nurse, as the training is full-time for 12 weeks (vs. 10 shifts- sink or swim, at my current position).

3)The environment will feel more professional and controlled, with the focus being on pt outcomes and best practice rather than just getting through the shift.

My questions for experienced renal/HD nurses are:

-Is my train of thought regarding the benefits of the acute HD realistic?

-What do you perceive as the 'positives' and 'negatives' to this type of nursing?

-Besides HD/PD/renal info, is there anything that I should brush up on before my shadowing shift?

Thanks!

[jlautier]

I too worked at a LTC facility immediately following graduation from school, even with my BSN i found it difficult to land a job in a hospital. I found the LTC place to be unorganized, unsafe, and not a place for a new grad.

Luckily, i received a call from one of my friends who worked for a large dialysis company, said i should check it out. Since then I have left my LTC place and been working outpatient dialysis for almost 3 years. I love it. CKD comes with so many comorbids... and the nurse needs to be in tune with each patients medical history in order to provide safe treatment. You'll get it.

The training i received was 3 months long, i felt ready to work the floor once i was completed. I now take charge, precept, and love every day I am at work.

your shadow experience really will be a peer interview, not about skills but about personality. Its a close knit family, at least at my center, and you need to jive with the people working there or else it can affect the unit's flow. Just be yourself, good luck!

--Currently enrolled at an APRN program, want to specialize into a nephrology APRN. My company pays 4,400 year... reimbursement. cant be beat!

[EiEiO_55120]

Thank you so much for getting back to me!

Your response gives me hope. I have been starting to think that I may just hate nursing in general... Maybe in a more organized, professional environment I will find that I actually enjoy using this degree that I worked so hard for. :)

[jlautier]

No matter where you start working, give it time. I've had doubts too. It gets better. Push through!

[Twinmom06, ASN, APN]

Inpt HD requires a 6 month orientation before you are allowed to be the only nurse doing dialysis in the hospital (or able to be on call) - its CMS guidelines. You should get 8-12 weeks in class/OP clinic and then the remaining 3 months in the hospital (that's where I'm at now - I come off orientation 1/13) - so far I'm enjoying my job - although I could have done without the 16 hour shift today.

its feast or famine though - some days there's barely enough work to do to get a 6 hour shift in, and today we had 12 patients total - hence the 16 hour shift.

Good luck!