Take job in dialysis or OR?

[Nurse Magnolia, BSN, RN]

Yes...very different specialties. I have the opportunity to work at either and I can't decide between the two!

I am a new nurse (9 months). I left my psych job a few weeks ago due to COVID and the fact that the patients live in a community-style unit and we were still taking new admits and not making anyone wear masks or even (at the time I left) limiting visitors. I could see that when this hit the unit, it would hit hard. My husband is immune-compromised so I felt like the risk on this unit was high.

I began looking for new jobs that would start in 1-2 months and I landed two offers. My goals were to get back into a more medical nursing career. I love psych, but it's not what I want to do long term.

The first offer is in a local dialysis clinic that has plenty of PPE. Hours are 4 10's a week. 2 Saturdays a month. Lots of opportunity for advancement and growth. Pay is good.

The second offer was for an OR nurse in a large hospital system. M-F with rotational call. Pay is lower than Dialysis.

OR interests me from a technical standpoint and the idea that I would get to see a lot of really interesting cases. I'm a pretty analytical and detail-oriented person. Dialysis interests me because I like the location of the clinic (shorter commute than the hospital) and better options for growth without going back for an advanced degree.

Concerns for Dialysis is that I'll be bored and the start times are EARLY. Concerns for OR are that I won't really get to talk to patients much and that I will have to stand for very long periods of time.

I know these specialities are worlds apart. I like them both and I have concerns for both.

So it will come down to this -

Which position do you think has the least amount of COVID risk? I know OR has risk for intubating and extubating. Other risks you can see? Dialysis risks?

My husband being immune-compromised is top of my list for accommodations I need to make for my career.

I know this is all over the place. I feel all over the place. I truly cannot decide! I have zero experience in either and I can't shadow because of COVID - which makes this decision a blind shot in the dark.

(Cross-posted to OR nursing forum)

[zoeintx]

I would go where the work is...dialysis! I have been a nurse for 26 years, 16 in dialysis. If you look for job opportunities you will see lots of dialysis positions with sign on bonuses.

I work in a chronic outpatient clinic and can honestly say our supply of PPE is adequate. We have been asked to limit our mask and gown changes throughout

the day but that is about all that has been asked.

The problem has been with patient's stealing supplies. We used to have masks, gloves and hand sanitizer EVERYWHERE but now they are strategically placed for staff.

In the past month I know of only one patient who has tested positive and I took care of her. She had no symptoms until she suddenly spiked a fever. She was hospitalized, recovered and been discharged home?. I was scared but I'm okay?.

My company has been very proactive in protecting staff and for that I am grateful and happy to go to work.

[Nurse Magnolia, BSN, RN]

39 minutes ago, zoeintx said:

I would go where the work is...dialysis! I have been a nurse for 26 years, 16 in dialysis. If you look for job opportunities you will see lots of dialysis positions with sign on bonuses.

I work in a chronic outpatient clinic and can honestly say our supply of PPE is adequate. We have been asked to limit our mask and gown changes throughout

the day but that is about all that has been asked.

The problem has been with patient's stealing supplies. We used to have masks, gloves and hand sanitizer EVERYWHERE but now they are strategically placed for staff.

In the past month I know of only one patient who has tested positive and I took care of her. She had no symptoms until she suddenly spiked a fever. She was hospitalized, recovered and been discharged home?. I was scared but I'm okay?.

My company has been very proactive in protecting staff and for that I am grateful and happy to go to work.

Thank you so much for this! This is my observation as well. Plus this job is with one of the big two so I know that there is a clinic in the town we plan to move to in a few years. I'm definitely leaning towards dialysis. Are you with one of the big two?

[SnipRN]

I'm not sure why you think you'll be bored in dialysis, as opposed to OR. I suppose the cases would be interesting to watch. I did enjoy my OR rotations in nursing school because I thought the surgeries themselves were fascinating. But as far as nursing duties go.. there was a lot of standing around. That, or running for supplies. At least, that is what I observed.

Plus... I'm not sure where you live, but a lot of places have cancelled or postponed elective surgeries for the foreseeable future. I have a few friends that work in the OR who have been on low census for the last couple weeks. You will literally NEVER have this problem in dialysis.

I do tend to be a bit biased though, because I love my job in dialysis. ?

[SnipRN]

Sorry, should have mentioned that my clinic is also well covered as far as PPE goes. Plenty of gloves, masks, gowns, full face shields. Right now we are using surgical masks, but we do have a supply of N95s should a patient screen positive for COVID. Dialysis patients are a high risk group, so we have been taking a lot of precautions. Visitors aren't allowed in my clinic right now. Everyone (including staff) is screened every day upon entering the building, and everyone has to wear a mask. We have not had any positives yet, but it has also only recently shown up in my area. Still, I feel that my facility has the right policies in place to minimize risk to patients and staff.

[kbrn2002, ADN, RN]

I started a new job with dialysis recently. Still in training as a matter of fact. If you are analytical and detail oriented this is the job for you! I've been a nurse for a long time and had no clue how much I didn't know about this area of nursing. I'm learning new things daily and frankly at this point it's a little overwhelming how much there still is for me to learn. It's exciting though tackling a new challenge!

PPE is a standard part of the job every day, sure it's a little ramped up now but it's my understanding even in times before and I am sure after Covid-19 infection control is something that is just not taken lightly in this specialty. There doesn't seem to be any concern about running out of PPE in my organization at all. There are plenty of gowns, gloves and masks. Heck, I must go through a half a box of gloves myself daily. We all have our own face shields that are easily cleaned but if they are broken we do have adequate supplies to just grab a new one.

I do work for one of the big companies and another poster is absolutely right about the portability of this job. There are clinics everywhere so a transfer if you need to move at some point will likely not be a problem. This employer also seems to be very supportive of the staff.

Plus dialysis is a life saving procedure that for the foreseeable future will not see any decline in demand so if you find you like the specialty job security is high. Even during disaster's your services will be needed. Heck, especially during disaster's even. Dialysis provider's go to great lengths to ensure their patients get the care they need despite the circumstances. With this current disaster my company seems to be pretty on top of things with planning and implementing.

[Nurse Magnolia, BSN, RN]

On 4/12/2020 at 12:13 AM, SnipRN said:

I'm not sure why you think you'll be bored in dialysis, as opposed to OR. I suppose the cases would be interesting to watch. I did enjoy my OR rotations in nursing school because I thought the surgeries themselves were fascinating. But as far as nursing duties go.. there was a lot of standing around. That, or running for supplies. At least, that is what I observed.

Plus... I'm not sure where you live, but a lot of places have cancelled or postponed elective surgeries for the foreseeable future. I have a few friends that work in the OR who have been on low census for the last couple weeks. You will literally NEVER have this problem in dialysis.

I do tend to be a bit biased though, because I love my job in dialysis. ?

I guess I was worried it would be too routine, but the more I've read about it, I am finding that is not the case and I would have a lot of opportunities to challenge myself and learn new things. Thanks for the feedback!

[Nurse Magnolia, BSN, RN]

FYI I accepted the dialysis position! I start May 11. I'm looking forward to learning about this new specialty!

[zoeintx]

Good luck to you!

[Nurse Van]

Dialysis nursing in a clinic is very rewarding with a tremendous amount of non-stop hustling. As far as protecting employees from Covid, I work for one of the big 2 and we have been provided with adequate ppe. I would also like to add that my clinic and a few others have been chosen to treat Covid + patients as the need arises. I only mention this because it could become a reality in any clinic at any time. Though, I feel this environment is well controlled as opposed to in a hospital setting because we have a tremendous amount of autonomy when it comes to who is coming and going from the clinic. As rewarding as it is to really know these patients as well as I do, it is becoming very difficult to lose so many to this virus in such a short period of time.

[Hoosier_RN, MSN]

CONGRATS! I love dialysis, and I promise you, there will be plenty to learn to keep you from being bored

[kbrn2002, ADN, RN]

On 4/13/2020 at 2:35 PM, Nurse Magnolia said:

FYI I accepted the dialysis position! I start May 11. I'm looking forward to learning about this new specialty!

Congratulations! I think you'll end up loving it but prepared to be a little overwhelmed in the beginning. I had no idea how much I didn't know about kidney care until I started this job. I am about half way through a 12 week orientation and it's just now starting to come together a little bit.