thinking about switching from OB to dialysis...

Specialties Ob/Gyn


hi! I need some advice/opinions. I am a labor and delivery nurse (at our FBC we are told to refer to ourselves as "specialist"...we do post-partum when there are no laboring patients, and also work in the nursery. We just opened our new unit about 2 years ago and combined the three areas. It hasn't been easy and most of our most experienced nurses have left. To give you an example of our high turnover...none of the nurses that I oriented with are still working is left. We are staffed with mostly new nurses, right out of nursing school....don't get me wrong...I like new nurses. But, I've been a labor nurse for two years...and they consider me to be one of the "experienced" nurses...scary. I do have cardiac background but I absolutely love labor and delivery. I'm at the point now where I do feel comfortable and that allows me to enjoy my job even more. Here is my problem...our management is horrible. We were all forced to do 12-hour shifts (or quit) and we do 6 a pay period (6 12's in two weeks). This happened last month. On one of our days off we have to be on call for a 12 hour shift. I work it's wearing me down. I asked to be moved to day shift and the director told me that she needed me to train the new nurses coming to our shift and wouldn't let me go. Instead, I found out yesterday, that she is keeping one of the new grads on days until one of our nursery specialists feels comfortable enought to labor patients. Mind you this nursery specialist is the best baby nurse on the planet, HATES laboring I can imagine it's going to take a while. I'm 37, have a 10 -year-old, and it's not easy switching days/nights all the time...i've worked night shift for five years now...(2 years at this unit) and I don't know how much longer I'm willing to sacrifice my health. There are no other hospitals in our area with L and D job in a small southern city. I have an interview to work for a dialysis company (Gambro) Thursday.....I don't want to leave a job I love...but I'm just plain sick of being treated like absolute crap by this managemnt team. Does anyone out there have any advice for me.

Travel nursing is not an option at this time in my life...Christine

There is always a lot to the story you cannot put in writing, but I can see where management would have a problem letting you work days when they need a strong nurse at night. Can you suggest a staff meeting to discuss hours, etc. so that the manager hears it from everyone? If not, I guess your best option is to leave. Maybe you can return to L&D when your daughter is older. Good luck.

You have to stand up for yourself however you can.

Sometimes that means doing pros and cons and cutting your losses. Do whatever is most important for your own family's needs. You cannot let others set your life routines and expect to be content. You are in control.

By the way, there are worse situations out there. You just have to decide what you are willing to tolerate....what you want out of your job/life.


12 Posts

Thanks to you for replying to my message. There is more to the story..but I tried to make it as concise as I could to give the general picture. I agree that there are a lot worse places to work and that's what makes this decision so hard. I don't want to jump out of the frying pan and into the fire. I just have to decide what is right for me. I really want the perspective of other nurses. I realize that nursing is hard work, no matter where you go...But, we do have to stand up for ourselves and the nursing shortage just gives us a lot more options. My husband, who is also a nurse (CVICU) loves his job and is in grad school on his way to becoming a nurse practitioner and alway tells me that we as nurses have to keep in mind that we get paid and treated based on what we feel our own selfworth is....


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Oh, wow, I could have written your post....

I have been considering a switch to dialysis, myself. I, too, get sick of nights, weekends, Holidays at work....and I am not getting any younger. Neither are my kids. You have to do what is right for you.

If you are seirous about making this switch, I would suggest a couple things. Post in the Dialysis Forum, some pointed questions to the experts there about what it is like to do acute and chronic renal nursing. Then, search out residencies in your area and find out what they require of you to get the training you need. As for myself, it was not do-able at the time. The residency would have required 5 days a week, 8-6 or so, and I just don't use babysitters or daycare for my kids. So, that will have to wait a while for me.....

I wish you luck in your choices and your career. Look around, ask a lot of questions and if it seems good, GO FOR IT, I say. Best wishes to you!


534 Posts

Specializes in private duty/home health, med/surg.

Two years, and you're one of the experienced nurses? That doesn't reflect favorably on the management in your facility.

It sounds like you really love L&D. Do you have an interest in dialysis? Are you going to be replacing the stress of a poorly managed but much loved L&D job with the stress of going to a dialysis job that you don't have your heart into?

I know you mentioned that there aren't other hospitals in your area with L&D openings. I suggest putting in your resume there anyways for any upcoming positions. Try networking to see which of the other hospitals have happier nurses.

I feel for you--good luck in whatever you decide!


1,378 Posts

LDRP is great....when you get everyone crosstrained. We went through that transition you describe about 17 years ago and it is wonderful. However, it sounds as if you have lousy management and I can certainly understand your concern: especially in L&D with a lot of new people. You are certainly between a rock and a hard place! I guess it bolis down to how much you want to stick it out. Dialysis will be no piece of cake.


12 Posts

LDRP is great....when you get everyone crosstrained. We went through that transition you describe about 17 years ago and it is wonderful. However, it sounds as if you have lousy management and I can certainly understand your concern: especially in L&D with a lot of new people. You are certainly between a rock and a hard place! I guess it bolis down to how much you want to stick it out. Dialysis will be no piece of cake.

I know you are right about dialysis not being a piece of cake...but it would be a day job and right now I just don't know how much longer I can subject my body to night shift...I don't think L and D is a piece of cake either....we have our slow times but we have times when it's busting loose and our birth center is so huge and spread out it makes it difficult to monitor patients. Nothing makes me angrier then when I'm assigned two laboring patients and I go out to the main nursing station and none of the monitors are up because all of the post-partum nurses are charting on the computers. That's kind of improved now because of my fits when I see it happen. To be safe, you have to find another labor nurse (good luck sometimes) and ask her to please watch your strips while you go to the supply room to set up a table or do whatever. Most of the time we don't get a break to even go eat because we can't leave our patients (nothing new to most LandD nurses, I know) - but not eating for 12 hours isn't fun...I've lost 10 pounds...but that's a plus for me...:) But it still makes me mad when I see all the other specialities go get dinner and laugh and joke at one of the nurse's stations while the labor nurses are running our behinds off! Then when we do get a break and noone is in labor...we get couplets. As soon as a labor patient comes in....we give report on our couplets and it's back to labor. I'm just blowing off some steam... What I do love is my patients. I know that this is the most important day of their life and I want it to be the very best and safest experience possible....


1,007 Posts

Specializes in A myriad of specialties.

Hey ChristineInteresting thread---I can tell you love L&D...but am curious to know how your intervew went with Gambro? It's a good company--I worked for them years ago. Like another poster stated.."dialysis will be no piece of cake"--very true but it is a very reqarding and very challenging field. As far a it being just a "day job" however--possibly not---there are shifts in chronic dialysis that are the eve. shifts--but at least they aren't nights! Good luck with your decision!

Hellllllo Nurse, BSN, RN

3 Articles; 3,563 Posts


Well, I just quit a dialysis job because I'm worn down and tired of being treated like crap.

Let's all trade jobs- :rotfl:

Seriously, one hard thing about dialysis is getting used to the techs having quite a bit of autonomy and authority, yet the nurses are resposible for their actions.

On the other hand, chronic dialysis does have good hours- no nights and no Sundays.

Most units are closed on Christmas Day, as well.

If your local dialysis clinic has a peritoneal program, I would check into that. I have really enjoyed being a peritineal dialysis pt educator and case mgr (I floated between hemo charge and PD).

Peritoneal is growing, as studies are showing ESRD pts do better on PD, and the reimbursment is better than with hemo.

I have come to the conclusion that when it comes to nursing jobs, I have developed a two-year limit; I can't stand to stay at a job for more than two years.

I do enjoy dialysis- it's just the weird politics and screwed up mgmt that got to me.

Good luck, Christine!


12 Posts

I had my job interview yesterday with Gambro and it sounds like something I would really like! I would be working in acute dialysis and I'm looking forward to the challenge! Actually, the pay is better than the hospital...the benefits are better...and the opputunity for advancement is better. I'm keeping my fingers crossed that everything goes well and my plans fall into place. I plan on doing a lot of studying..there's so much to learn! It will be a huge challenge and I'm looking forward to it!


281 Posts

Gosh, I could have written your post as well. I have been a labor nurse for nearly sixteen years and I am still on nights. Unfortunately, that is how it is now a days and the experienced people are the one who are made to sacrifice. A union involovement can help with the situation of the newer person being on days unless she is still on orientation...

Many of my friends have gone into dialysis and seem to like it, but most of them are back because they miss delivery so much..

I wish you all the best.. Stand up for yourself. As the most experienced labor person ( and man, two years is just scratching the barrel), you have some pull that you might not even be aware of. I was in a similar position last summer and made a proposal that things needed to change or at least go my way a bit more or I was leaving. They couldn't afford to lose another experienced person and eventually I got my way...I wish you only the best...

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