I'am a new graduate ARNP and have recently starting working as a Nephrology ARNP. I round on patients who are getting dialysis and I also see patients in clinic. During my interview I told the providers that I didn't have Nephrology experience and they agreed to train me for one month. However, when I started I got one day of orientation at the dialysis center and no orientation at the clinic before I was seeing patients alone. It was kinda like a sink or swim...The other providers are there to answer questions when i need to but it just doesn't seem right to throw a new graduate in such a situation...Over the last month I've just been teacing myself about dialysis and the care of patients with CKD...So its going ok it would just be nice to be in a more supportive environment. Any other Nephrology ARNPs out there who can offer advice on how to make the most out of this horrible situation....Any specific text books that you would recommend. I am specifically looking for a dialysis handbook that is simple and a quick read.
As an experienced dialysis RN, I have worked w/ a number of NPs- some with no nephrology experience or orientation. If you build relationships with the charge nurses at the clinics where you round, this will help a lot. They know the pts very well, and can tell you how the pts are tolerating tx, and what the pts need.
When you round, if you look at the blood pressure screen on the dialysis machine, you can follow the pt's MAP trending, and see if pts who are hypertensive on tx are having a renin response, or if it's something else. The BP and MAP trending on that screen can also tell you if a pt's HTN is because of fluid overload, or if it's because they may need a change to their BP meds.
Thanks so much for all of the responses, they were all very helpful.
Aymara I have the text you recommended and will review that some more (I'am about 3/4ths of the way through it).
CrzyNP (love the name btw), thanks for the text book recommendation as well. Valerie-Salva you are so right about what you said. I have learned so much by working with the experienced dialysis nurses. They have been more than helpful and are always willing to answer any questions.
Thanks again everyone . I am definitely feeling a little more confident in my new role as an Nephrology ARNP...
Thanks for checking in on me. It is getting a bit easier, I am learning more each day and my textbooks are my new best friend. Last week the MD I work for apologized for not giving me a good orientation and said that she was happy to have me but was just so behind in her clinic that it's hard for her to take the extra time to teach me things they way she wants to. It felt good to be validated and to know that she realized what was going on BUT at the same time...it still does not help me much...I am just taking it one day at a time and asking questions when I need to. Hopefully, next week will be better.....who knows
On a more positive note, I love the patient population that I am working with. They all keep telling me how happy they are to see me every week, because they rarely seen the MD and when they did she was so rushed....so it feels good to hear that over and over again:D. The dialysis nurses are great as well. We are both learning a lot from eachother!!!!!!!
I'm so glad things are going better. This population can be tough but I'm glad you are enjoying yourself a little more. Take care and if we can help, let us know.
. I am definitely feeling a little more confident in my new role as an Nephrology ARNP...
Valerie Salva, BSN, RN
1,793 Posts
As an experienced dialysis RN, I have worked w/ a number of NPs- some with no nephrology experience or orientation. If you build relationships with the charge nurses at the clinics where you round, this will help a lot. They know the pts very well, and can tell you how the pts are tolerating tx, and what the pts need.
When you round, if you look at the blood pressure screen on the dialysis machine, you can follow the pt's MAP trending, and see if pts who are hypertensive on tx are having a renin response, or if it's something else. The BP and MAP trending on that screen can also tell you if a pt's HTN is because of fluid overload, or if it's because they may need a change to their BP meds.