The good ,the bad and....tell me

Hoosier_RN, MSN · Jul 6, 2021

It's a huge learning curve from other types of nursing. Also, look at your market. I'm in a few FB dialysis groups for dialysis nurses, and they say it's hard to get into in FL, and there's low turnover. That being said, get your name out there, make some contacts that can help you if this is true in your area.

kbrn2002, ADN, RN · Jul 7, 2021

As Hoosier said dialysis is a huge learning curve. That being said I found the orientation/training process while a little shall we say intense it was pretty thorough.

I've only been in dialysis about a year and a half and everybody told me it would take at least a year before I felt somewhat comfortable in the role. They weren't kidding.

The schedule in dialysis was for sure a big plus for me. We open early, we close fairly early. There's no afternoon's or nights, no mandatory overtime. No Sundays. I like that.

I found the pay quite competitive, I did ask for more than they initially offered and got my requested starting wage. I can't speak to the wages or job market in Florida however.

If it's something you think you might be interested in I say go for it. I made the change to dialysis nursing after working LTC for 25 years. It's been a good fit for me.

CN101, BSN, RN · Jul 7, 2021

I don't like it. Sure, there's a routine but it can be quite chaotic during turnover (when patients are coming on/off). Also, sometimes patients will pass out and you'll have to deal with that as well.

My hours are a mess. I usually work 3-4 days a week, sometimes I have to work 5 days a week because there is a shortage.

On some days, I'm there from 5am to 7pm or 10 - close (which can be 10-11pm). Sometimes I have to come in at 5am after working from 5am-7pm the previous day. This means I get zero time to relax after work and barely enough sleep. I'm sure not all dialysis clinics are like this, but I cannot wait to leave.

Eileen Meyers, RN · Jul 7, 2021

I love dialysis! It has it's issues, but that's anywhere in nursing. My schedule is reasonable. We are open 6 days a week, every Sunday and major holidays off. I start at 0430 and usually done at 1430-1500, depending on census. We only have 12 chairs so it's a small clinic. I would just ask a lot of questions. Management and staffing make a huge difference in your experience. Ask how many patients, how many shifts? How much staff is there and how many are new vs experienced?

kbrn2002, ADN, RN · Jul 7, 2021

5 hours ago, CN101 said:

I don't like it. Sure, there's a routine but it can be quite chaotic during turnover (when patients are coming on/off). Also, sometimes patients will pass out and you'll have to deal with that as well.

My hours are a mess. I usually work 3-4 days a week, sometimes I have to work 5 days a week because there is a shortage.

On some days, I'm there from 5am to 7pm or 10 - close (which can be 10-11pm). Sometimes I have to come in at 5am after working from 5am-7pm the previous day. This means I get zero time to relax after work and barely enough sleep. I'm sure not all dialysis clinics are like this, but I cannot wait to leave.

Wow, I am sorry. That is not a nice schedule at all. Definitely not all clinics are like that! All the clinics in our district use block scheduling. My particular schedule as well as the nurse that works opposite my days is 4 on, 1 off, 2 on then 7 off.

We are not required to pick up additional shifts if there is a shortage. Every clinic posts a list of open shifts for all clinics in the district and they are available to pick up usually with critical need pay as well as a bonus. Plus you earn additional money if you float to a clinic other than your home clinic as well as drive time and mileage. If a shift still remains unfilled then it is up to the clinic manager to either find somebody or cover the shift themselves.

We start at 0515 and are done between 3 and 4 pm. A rare day maybe as late as 430 pm or 5 pm. I am also in a small clinic with only 2 shifts so there is just the one chair turnover. It can get hectic during turnover but nothing unmanageable.

Hoosier_RN, MSN · Jul 8, 2021

2 hours ago, kbrn2002 said:

Wow, I am sorry. That is not a nice schedule at all. Definitely not all clinics are like that! All the clinics in our district use block scheduling. My particular schedule as well as the nurse that works opposite my days is 4 on, 1 off, 2 on then 7 off.

We are not required to pick up additional shifts if there is a shortage. Every clinic posts a list of open shifts for all clinics in the district and they are available to pick up usually with critical need pay as well as a bonus. Plus you earn additional money if you float to a clinic other than your home clinic as well as drive time and mileage. If a shift still remains unfilled then it is up to the clinic manager to either find somebody or cover the shift themselves.

We start at 0515 and are done between 3 and 4 pm. A rare day maybe as late as 430 pm or 5 pm. I am also in a small clinic with only 2 shifts so there is just the one chair turnover. It can get hectic during turnover but nothing unmanageable.

That's how the clinics in my area work as well. Good for the most part, an occasional bad day

SmilingBluEyes · Jul 8, 2021

Others covered your questions very well, so I won't repeat it all.

Smaller clinics are less hectic than larger ones. I have worked in one that has 7 chairs, 3 shifts and another that has 24 and also 3 shifts. I have worked in a clinic w/12 chairs and only 2 shifts. I have worked in all kinds of configurations over the years.

The bigger the clinic, often, the more hectic it is. Turnover is very hectic and you have to be on your toes. I recommend getting things done as they come up so as not to get behind. Getting behind will kill your time management and every minute counts in most places.

In smaller clinics, understand, you are the only nurse and there may be only 1 patient care technician with you. So even though small, it's up to YOU to make all the decisions in any situation, particularly emergencies---- and you have to be sharp.

The larger clinics generally have at least one other RN on that same time as you (or you overlap) and you can bounce questions/concerns off that RN.

I don't recommend being alone that first year or so if you can help it. Experience counts a lot in dialysis in helping you manage your patient load, supervising technicians and keeping up.

Like others said, it's a big learning curve, but not one that can't be overcome with effort and time.

Good luck and let us know if this is where you wind up!

CN101, BSN, RN · Jul 8, 2021

12 hours ago, kbrn2002 said:

Wow, I am sorry. That is not a nice schedule at all. Definitely not all clinics are like that! All the clinics in our district use block scheduling. My particular schedule as well as the nurse that works opposite my days is 4 on, 1 off, 2 on then 7 off.

We are not required to pick up additional shifts if there is a shortage. Every clinic posts a list of open shifts for all clinics in the district and they are available to pick up usually with critical need pay as well as a bonus. Plus you earn additional money if you float to a clinic other than your home clinic as well as drive time and mileage. If a shift still remains unfilled then it is up to the clinic manager to either find somebody or cover the shift themselves.

We start at 0515 and are done between 3 and 4 pm. A rare day maybe as late as 430 pm or 5 pm. I am also in a small clinic with only 2 shifts so there is just the one chair turnover. It can get hectic during turnover but nothing unmanageable.

It doesn’t work like that here. My facility administrator sets the schedule. Sometimes she’ll change it around depending on what’s going on, but that’s about it.

I haven’t floated to another clinic, but some of the techs I work with have. They don’t get paid extra. However, I believe they do reimburse you for drive time/mileage. If there’s no one to cover the shift, then the nurse is stuck by themselves or they’ll have someone come in earlier or leave later to cover for the missing person.

My clinic has 18 chairs and 3-4 shifts (3 TTS, 4 MWF). We start at 4:30am (with the techs coming in at 3:30) and we close at 10:30pm officially (or around 5-6pm on TTS)

kbrn2002, ADN, RN · Jul 8, 2021

11 hours ago, CN101 said:

It doesn’t work like that here. My facility administrator sets the schedule. Sometimes she’ll change it around depending on what’s going on, but that’s about it.

I haven’t floated to another clinic, but some of the techs I work with have. They don’t get paid extra. However, I believe they do reimburse you for drive time/mileage. If there’s no one to cover the shift, then the nurse is stuck by themselves or they’ll have someone come in earlier or leave later to cover for the missing person.

My clinic has 18 chairs and 3-4 shifts (3 TTS, 4 MWF). We start at 4:30am (with the techs coming in at 3:30) and we close at 10:30pm officially (or around 5-6pm on TTS)

Wow, that's a lot a shifts for an 18 chair clinic! Even the bigger clinics in our area run two shifts typically though they did expand one clinic to three shifts when we had some COVID positive patients. Are all the clinics in your system like that? If not put in for a transfer to one with a better schedule as soon as there is an opening. If they are all scheduled like that maybe look for a dialysis job with another employer if you like the dialysis setting but just don't care for the schedule

SmilingBluEyes · Jul 9, 2021

I worked in a 16 chair clinic that ran 4 shifts. We did not close until after midnight. Hated that.