Starting a new nurse career in Dialysis.I'm getting too frustrated a little too soon.tips?

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Hi i just started dialysis nursing. Ive been wanting it all this time but when i finally got it, it scares me to death. I dont know it im in the right career or im just in the wrong clinic.

Our patients are very unstable, very non compliant. Plus, i have so much paperwork i cant bear to do. Other than taking care of 12 pts that come all at once at the same time which is overwhelming but i got used to it now, we put in orders (HD, tx meds, labs) plus we answer the phone. Then pts start coding. We need to send them out. We call the transportation too for the pt. Its just nonstop. Is there any way these things could be improved?

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Specializes in General Surgery Assist.

What kind if staffing do you have ? Techs? LPN's?

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We're RNs and techs. RNs are responsible for everything on the floor plus we have extra assignments other than our careplans and med reviews like doing the staff schedule, anemia management, hepatitis b management, transplant labs, entering and dc pts

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Chronic dialysis clinic is high stress for nurses. In addition of starting and terminating you are also responsible for all the assessments and meds, charting and so on.

I am not sure why you have many emergencies - that makes me wonder. Sure, those patients are often fragile with a variety of illness but there should not be a code often and you should not be on first name basis with all the emergency responders in your area...

When pat gain too much weight and you have to HD them down to dry weight you have to pull more than you usually would do. Some patients do not do well with pulling harder - I guess you have critline monitors, which can guide you a bit. Pat who have a "bad" heart will not always tolerate too much fluid gain but also do not always tolerate too much pull - it can lead to chest pain and such. The patients who are non compliant and gain a lot between or fluctuate a lot in their electrolytes tend to do worse in general in terms of outcome.

But of course you do not have the time in chronic HD to play around a lot with pulling more or less - you are on a tight schedule.

It takes some time to get used to chronic HD but it is not for everybody and turnover can be high.

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I think it coz they're just too complicated and non compliant. Average of our pts gain 4-6kg in between tx. They're in and out of the hosp. We had 11 deaths for the past 2 months. They were either found dead at home or died at the hospital

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I think it coz they're just too complicated and non compliant. Average of our pts gain 4-6kg in between tx. They're in and out of the hosp. We had 11 deaths for the past 2 months. They were either found dead at home or died at the hospital

Of course that is a huge gain and overloads the hear which in turn will get sicker. Plus you just can't take off that much fluid so those folks end up in the ER with SOB and need extra HD in between if they are on a 3 times a week schedule.

If you like HD otherwise you can get a year or so of experience and see if acute dialysis would be for you. Some people do not like it because of potential for long work days and the frequent on calls but it is less crazy in terms of amount of patients...

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I do acutes. I did 8 weeks in the clinic for orientation and decided that wasn't an environment I could like or get used to. If you've got pts that are so unstable that they are coding then they should be sent to the ER prior to initiating tx. Scary stuff!

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I worked as Acute and Chronic Dialysis RN, then worked in clinical research in oncology/ immunology and now in psychiatry.

As for salary, I had best salary as Per diem RN in Acute Dialysis and I could do it only for 3 years , since it was stressful. I got best hospital experience and this knowledge helped me in every area.

I thought that dialysis patients are most "non compliant" and "difficult".

In some cases it is true, but the fact is that " all chronic clients non compliant" look what statistics show in hypertension, in diabetes, psychiatry . In Dialysis ,we as care providers see immediate result of "non on compliance".

After 9 years far from Dialysis environment, I will plan to go back, only if I will need money and my finance situation will be really bad.

Dialysis Nurses are the best!!!

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