Should I try HD?

Published

Specializes in Cardiovascular.

I have been looking at switching specialties from critical care to dialysis. What do you all find are the advantages/disadvantages? I am CRRT certified from critical care. I am interested in either clinic or acute care.

Up Vote Up Vote ×

I'm considering this move too. Did you decide to take the leap? What do you think so far?

Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.

I'm thinking of trying dialysis too. Most of my experience is outpatient clinic (wound care then community health/primary care). Did either of you switch to dialysis? If so, how do you like it?

Up Vote Up Vote ×

I havn't yet. I talked to a nurse in outpatient HD and they said hours are long and it's hard to get time off. You have the patient only 4 hours but if they are in a mean mood it can feel like longer.

Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
2 hours ago, vegasmomma said:

I havn't yet. I talked to a nurse in outpatient HD and they said hours are long and it's hard to get time off. You have the patient only 4 hours but if they are in a mean mood it can feel like longer.

Ok thank you for responding! I will be relocating to a small town at the end of the year. My choices are slim-home health, dialysis, and LTC. I don't have experience in any of these areas. Home health is my last choice. So i guess it's between LTC and dialysis. If I end u applying, I guess I can ask to shadow in a clinic!

1
Up Vote Up Vote ×
Specializes in Dialysis.
3 hours ago, vegasmomma said:

I havn't yet. I talked to a nurse in outpatient HD and they said hours are long and it's hard to get time off. You have the patient only 4 hours but if they are in a mean mood it can feel like longer.

It depends on the clinic. I started out in a small clinic and moved to a slightly larger sister facility across town. Never have trouble getting off. Long hours are split up into shifts in my region, so no one works the 16 hours that many lament about on here. Look into it and shadow ask many questions of the specific facility and company, as it does truly vary

1
Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
1 hour ago, Hoosier_RN said:

It depends on the clinic. I started out in a small clinic and moved to a slightly larger sister facility across town. Never have trouble getting off. Long hours are split up into shifts in my region, so no one works the 16 hours that many lament about on here. Look into it and shadow ask many questions of the specific facility and company, as it does truly vary

Thank you! I've been looking up "the big 2" online and they seem similar. Both have clinics in the area where I will be relocating. Does it take long for advancement in dialysis?

Up Vote Up Vote ×
Specializes in Dialysis.
On 7/24/2019 at 7:48 PM, Yellownurse15 said:

Does it take long for advancement in dialysis?

It depends on the region. In my region, it takes a bit, as there is heavy market saturation with nurses, so everyone hangs on to their jobs for dear life. Other areas of my state, not so much...

Up Vote Up Vote ×

Hello ladies!

So your thinking about dialysis? What a great decision. Prepare, as your perspective is about to change. Outpatient dialysis is nothing like what you have known in the Hospital, but in different but just as important ways.
My previous experience before dialysis was as an Ortho/Trauma RN and in acute rehab. I made the switch in 2014. I started out in Acute Dialysis, since I figured "I know Hospital stuff" Boy was I wrong! Along w/ poor training ( I had 11 preceptors- each w/ their own way) and only having 2-3 patients per day, For myself anyway, I didn't feel comfortable troubleshooting the machine and the patient as it was unlike Ortho nursing in every way. I asked to transition to a outpatient clinic. You will feel soooo out of the loop, maybe even bored when you first start, because you are used to running around and putting out EVERY fire that happens with your patients. Well now you get to breathe, well a little easier.

I am now the charge nurse at a dialysis center with up to 22 patients per shift. I have 5 dedicated certified technicians who cannulate the patients and monitor them throughout the treatment. I work with one other nurse, who gives all the patients' medications. If needed each nurse will cannulate a patient and the technician will monitor their vital signs. As charge nurse, I go to each patient, check their orders/ goal for fluid removal, current weight, and double-check the technician, that they programmed machine properly and set goal and dialysis bath as ordered. Auscultate lung sounds, check for problems since last treatment, check edema and chart assessments. Assess their fistula, refer to vascular surgeon for any problems. Labs drawn biweekly and monthly. Monitor patients and intervene should they become hypotensive, hypertensive, cramping, sycope ect. Never truly boring, always something happening.

Sorry this is so long. But what I found, now that I am comfortable not "Fixing everything", lol, anymore. Is I love these patients. I see them 3 days a week. I know all their stories. I know how they live, I've seen good and bad. I have gotten in arguments w/ patients, and they were mad at me. But we are a little family and we work it out. We love each other, all the staff is there for the patients and the patients' know we are the reason they are alive. We have lost some, and we remember them fondly. Other's have gotten new kidneys! I honestly don't miss having one patient for maybe 2 days, and never knowing how it turned out. Hope this helps. Love being a nurse.

Oh and our clinic is closed on Sunday so there is that. I work 8 hour shifts, 2 Saturdays. 1:15-9P, usually out by 10

2
Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
On 7/29/2019 at 5:30 PM, Hoosier_RN said:

It depends on the region. In my region, it takes a bit, as there is heavy market saturation with nurses, so everyone hangs on to their jobs for dear life. Other areas of my state, not so much...

I'm in NC. I see a lot of job openings for dialysis, both Davita and Fresenius. I'm getting my MSN in Leadership and Management. If I decide to try dialysis, hopefully there would be advancement opportunities within the company. Thanks for your response!

1
Up Vote Up Vote ×
Specializes in Dialysis.

Good luck to you. I love dialysis!

Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
8 hours ago, Healerforlife said:

Hello ladies!

So your thinking about dialysis? What a great decision. Prepare, as your perspective is about to change. Outpatient dialysis is nothing like what you have known in the Hospital, but in different but just as important ways.
My previous experience before dialysis was as an Ortho/Trauma RN and in acute rehab. I made the switch in 2014. I started out in Acute Dialysis, since I figured "I know Hospital stuff" Boy was I wrong! Along w/ poor training ( I had 11 preceptors- each w/ their own way) and only having 2-3 patients per day, For myself anyway, I didn't feel comfortable troubleshooting the machine and the patient as it was unlike Ortho nursing in every way. I asked to transition to a outpatient clinic. You will feel soooo out of the loop, maybe even bored when you first start, because you are used to running around and putting out EVERY fire that happens with your patients. Well now you get to breathe, well a little easier.

I am now the charge nurse at a dialysis center with up to 22 patients per shift. I have 5 dedicated certified technicians who cannulate the patients and monitor them throughout the treatment. I work with one other nurse, who gives all the patients' medications. If needed each nurse will cannulate a patient and the technician will monitor their vital signs. As charge nurse, I go to each patient, check their orders/ goal for fluid removal, current weight, and double-check the technician, that they programmed machine properly and set goal and dialysis bath as ordered. Auscultate lung sounds, check for problems since last treatment, check edema and chart assessments. Assess their fistula, refer to vascular surgeon for any problems. Labs drawn biweekly and monthly. Monitor patients and intervene should they become hypotensive, hypertensive, cramping, sycope ect. Never truly boring, always something happening.

Sorry this is so long. But what I found, now that I am comfortable not "Fixing everything", lol, anymore. Is I love these patients. I see them 3 days a week. I know all their stories. I know how they live, I've seen good and bad. I have gotten in arguments w/ patients, and they were mad at me. But we are a little family and we work it out. We love each other, all the staff is there for the patients and the patients' know we are the reason they are alive. We have lost some, and we remember them fondly. Other's have gotten new kidneys! I honestly don't miss having one patient for maybe 2 days, and never knowing how it turned out. Hope this helps. Love being a nurse.

Oh and our clinic is closed on Sunday so there is that. I work 8 hour shifts, 2 Saturdays. 1:15-9P, usually out by 10

Thank you so much for your detailed reply! I will be relocating in a few months and I see so many dialysis positions available in outpatient clinics. I'm really considering trying it out. I worked at an outpatient wound center for a year and we saw the same patients every week. You really get to know the patients and their families. The work schedule for dialysis is also appealing to me. Right now, I work in a primary care clinic 5 days a week and I would like to go back to 3 or 4 days per week. I know dialysis calls for early mornings and I'm ok with that. I hope the dialysis training is as good as the companies advertise on their websites!

1
Up Vote Up Vote ×
+ Join the Discussion