So I've been a dialysis nurse for two weeks. I am a second career nurse who spent the first year of licensure as a psych nurse and then decided to make the switch to dialysis for many reasons. I am training at a Davita clinic in the Pittsburgh region right now. My training is 9 weeks in orientation and then three more weeks of independent practice with oversight until I'm on my own completely with my own assignment.
I honestly had no idea what to expect. I couldn't even shadow for the job before accepting it because of Covid. I can say I am very pleasantly surprised at how much I am enjoying it so far. Here are my thoughts:
The Good:
I was worried to begin about being trained by a PCT. In the hospital, the PCT's have far fewer responsibilities and I just couldn't see the value. NOW, I do. The PCT training me is amazing. PCT's in dialysis do so much more and have so many more responsibilities than hospital PCT's and her knowledge is vast. I understand this may vary depending on who's training you - but my preceptor is awesome at her job and she's been there 10 years. The RN preceptor has been there 9 years as well. Everyone I've met has been with Davita for a very long time, giving me a positive image of the company.
I learned to set up the machines this week and I am up to doing 3 machines in an hour and helping at turnover getting machines set up. Apparently, this is pretty fast for a brand new person. So I feel like I'm making progress. The flow of the unit is starting to make sense to me as well and I like the pace. Super busy getting everyone on the machines, then time to get caught up and talk to patients, and then it's time to take patients off and put new people on and you are super busy again. The ebb and flow is something I like.
I was concerned about PCT's pulling meds for patients, but then I realized once on the unit that it's pretty limited and very little room for error. The nurse verifies that the PCT pulled the right about of heparin before it's given. All other meds are given by the nurse. This fact seemed missed in a lot of the posts I'd read prior to starting.
I really enjoy talking to the patients and I'm excited to learn about cannulation next. Right now I am independent up to the point of putting the patient on the machine, including charting.
The Bad:
There isn't much bad. Getting up at 3am is tougher than I thought. But I work 4am -2pm right now and I like getting home in the afternoon.
The class portion is interesting to me, but tough because PCT's and nurses are trained together for the first 12 weeks. The PCT's that I'm working with are amazing because they've been there a long time and succeeded within the company. My training class is another story. Not everyone makes it. And I can tell that some won't. Coming in late, one was sleeping during class, talking back, rudeness, unprofessional. It's tough because the entry-level for the PCT is nothing. No experience needed. All training on the job. So you have people coming straight from working retail or fast food and coming into a professional environment and some just don't know how to behave. There are 8 people in my class. Three nurses, the rest PCT's and of my PCT classmates I can see two making it as they are professional and eager to learn. Lack of previous education does not make one unsuccessful as a PCT, but some of the people literally have no desire to be there except that it makes more money than other entry-level jobs. I feel like the PCT turnover has to be extremely high.
I wish nurses were trained separately but I understand why they are not. We are all learning the same things from the ground up. It's just hard being in class with others who don't care, can't keep up with what page we are on, know literally NOTHING about medical terminology and talk back to the amazing instructor we have.
The only other bad is the chairside charting system. It is SO OUTDATED and not very user friendly. They are supposed to be getting a new system which will integrate all of their systems and I think that will help a lot. Right now there are several different systems and they don't talk to each other.
Other than the class frustration, I've found my first two weeks at Davita to be really good. I'm loving the company culture and the people I've met. I can see myself here for a long time. I hope. I am pleasantly surprised at dialysis nursing. I am still on task mode but am starting to piece together why certain things are done and how that affects the patients. The rationales will come. But for now, I'm happy!
Now in the middle of 6 weeks. I am still really liking it. I don't hate it so I must be one of those people who love it. I'm enjoying getting to know my patients a lot and I started cannulating at the start of this week and had no trouble. Of course, they gave me pretty easy fistula's and grafts at this point. My biggest challenge right now is turn over. I guess because some people come late and others show up early, sometimes we have two take offs and a put on within 10 minutes of each other. There is no way I can do that alone - even off of orientation. They say it's not typical to be scheduled like that and when it is, people jump in to help - which is accurate. I can handle a two pod assignment currently from start to finish. But I haven't figured out how to add that third in quite yet - but that's OK....I'm not supposed to know how to do that yet.
I haven't learned much "nursing" stuff, but I am doing assessments and meds. PCT's pull heparin for the second and third shifts. RN's pull for the first shift. I've learned a little about the nursing charting in their systems, but not a ton yet.
I've explored many of the opportunities for advancement and I am excited to know that in a year or two I can progress in my career.
So far, so good! I'm not sure why people think dialysis isn't 'real' nursing or that you'd be bored....It most certainly is, and I don't have time to be bored. I'm very, very busy all day!
Thank you for each update!! I'm loving this thread. I'm still trying to convince myself to go for dialysis.
I do have worries because on other threads I read that techs can be vindictive and make it hard on nurses in training. I've read in some states it's illegal for techs to give heparin but they still do it and the nurse is liable. I've read that nurses find themselves being the only nurse in the facility at times.
What is your typical schedule? Is it physically demanding? I've always been afraid of dialysis because everyone said the hours are rough and they're ALWAYS super busy.
What is your typical schedule? Is it physically demanding? I've always been afraid of dialysis because everyone said the hours are rough and they're ALWAYS super busy.
It varies by clinic, even in the same company and town. You would have to interview and hopefully shadow. Go for it!
Thank you for each update!! I'm loving this thread. I'm still trying to convince myself to go for dialysis.
I do have worries because on other threads I read that techs can be vindictive and make it hard on nurses in training. I've read in some states it's illegal for techs to give heparin but they still do it and the nurse is liable. I've read that nurses find themselves being the only nurse in the facility at times.
I have not run into mean techs at all. But I can tell you that if you are nurse who thinks that being trained by a tech might be beneath you, then the job isn't for you and I think some of the "mean tech" comments come from people who feel just that way. As a nurse, you will be trained by a tech. I'm being trained by an amazing tech as well as a nurse for the nursing parts. But the bulk is by the tech. You have to go in humble because no matter how long you've been a nurse, you likely haven't experienced dialysis so you are starting from scratch in that area of nursing. I'm trying to soak it all in.
I'm sure things vary by region and clinic. But so far, I've had no problems. In the smaller clinics, you may be the only nurse in the facility, but you also have the techs, who really do most of the patient care anyway unless you end up having a pod yourself - which in the smaller clinics is possible.
What is your typical schedule? Is it physically demanding? I've always been afraid of dialysis because everyone said the hours are rough and they're ALWAYS super busy.
It is busy - but that makes the day go fast and the 'busy' comes in spurts. Morning put ons, turnover, ends of shifts etc... I am able to take a half-hour break and a half-hour lunch throughout the 10-hour shift. The break is paid, the lunch is off the clock.
The hours that people think of as rough, I don't mind. I work 4 10's a week and I start anytime between 4 and 5:30 depending on the day, but I'm done between 2:30 and 4:00pm so that's nice. Getting up at 3am can be rough some days but I like getting home by 3 and seeing my family. It's way better to me than 7-7:30 or 11-11:30 which is what I worked in the hospital.
When you are looking up dialysis and see people talking about 15 hour shifts, those are the acute dialysis positions. Nurses that work acutes are on call and can end up working crazy long hours. It's feast or famine.
The clinic I am training at is 3 days a week so the nurses and techs work 3 12's but occasionally have to work 13's if the day has gotten behind. I work 3 days there and have class the fourth day.. THe clinic I am going to is a 4 day a week clinic with 3 shifts, so I'll work 4 10's whon I'm off orientation.
I wasn't able to job shadow at all because of COVID, so it was a leap of faith. I watched a ton of in-center dialysis Youtube videos for some idea.
So I've been a dialysis nurse for two weeks. I am a second career nurse who spent the first year of licensure as a psych nurse and then decided to make the switch to dialysis for many reasons. I am training at a Davita clinic in the Pittsburgh region right now. My training is 9 weeks in orientation and then three more weeks of independent practice with oversight until I'm on my own completely with my own assignment.
I honestly had no idea what to expect. I couldn't even shadow for the job before accepting it because of Covid. I can say I am very pleasantly surprised at how much I am enjoying it so far. Here are my thoughts:
The Good:
I was worried to begin about being trained by a PCT. In the hospital, the PCT's have far fewer responsibilities and I just couldn't see the value. NOW, I do. The PCT training me is amazing. PCT's in dialysis do so much more and have so many more responsibilities than hospital PCT's and her knowledge is vast. I understand this may vary depending on who's training you - but my preceptor is awesome at her job and she's been there 10 years. The RN preceptor has been there 9 years as well. Everyone I've met has been with Davita for a very long time, giving me a positive image of the company.
I learned to set up the machines this week and I am up to doing 3 machines in an hour and helping at turnover getting machines set up. Apparently, this is pretty fast for a brand new person. So I feel like I'm making progress. The flow of the unit is starting to make sense to me as well and I like the pace. Super busy getting everyone on the machines, then time to get caught up and talk to patients, and then it's time to take patients off and put new people on and you are super busy again. The ebb and flow is something I like.
I was concerned about PCT's pulling meds for patients, but then I realized once on the unit that it's pretty limited and very little room for error. The nurse verifies that the PCT pulled the right about of heparin before it's given. All other meds are given by the nurse. This fact seemed missed in a lot of the posts I'd read prior to starting.
I really enjoy talking to the patients and I'm excited to learn about cannulation next. Right now I am independent up to the point of putting the patient on the machine, including charting.
The Bad:
There isn't much bad. Getting up at 3am is tougher than I thought. But I work 4am -2pm right now and I like getting home in the afternoon.
The class portion is interesting to me, but tough because PCT's and nurses are trained together for the first 12 weeks. The PCT's that I'm working with are amazing because they've been there a long time and succeeded within the company. My training class is another story. Not everyone makes it. And I can tell that some won't. Coming in late, one was sleeping during class, talking back, rudeness, unprofessional. It's tough because the entry-level for the PCT is nothing. No experience needed. All training on the job. So you have people coming straight from working retail or fast food and coming into a professional environment and some just don't know how to behave. There are 8 people in my class. Three nurses, the rest PCT's and of my PCT classmates I can see two making it as they are professional and eager to learn. Lack of previous education does not make one unsuccessful as a PCT, but some of the people literally have no desire to be there except that it makes more money than other entry-level jobs. I feel like the PCT turnover has to be extremely high.
I wish nurses were trained separately but I understand why they are not. We are all learning the same things from the ground up. It's just hard being in class with others who don't care, can't keep up with what page we are on, know literally NOTHING about medical terminology and talk back to the amazing instructor we have.
The only other bad is the chairside charting system. It is SO OUTDATED and not very user friendly. They are supposed to be getting a new system which will integrate all of their systems and I think that will help a lot. Right now there are several different systems and they don't talk to each other.
Other than the class frustration, I've found my first two weeks at Davita to be really good. I'm loving the company culture and the people I've met. I can see myself here for a long time. I hope. I am pleasantly surprised at dialysis nursing. I am still on task mode but am starting to piece together why certain things are done and how that affects the patients. The rationales will come. But for now, I'm happy!
I've been working in dialysis for 14 years; 12 years of that was with DaVita. I spent my last 3 years in DVA as a facility administrator. If I hadn't moved down south for NJ, I've would've stayed with the "Village." My experience with DVA in NJ is completely different from last 6 months in the south. Same company, different way of running things. Had much more fun (one of the core values) up north. Could've been just the area I was from (NJ/NY). NJ pioneered the STAR program. I ran/taught the program in my region. All trainees have no dialysis experience regardless if they've been nurse/techs/MAs for years so we worked with them. And my people (trainees and/or staff) got fed very well! Yes, under my program, some trainees attempted to abuse our laxity. I pulled them to the side and handled their asses accordingly. Let's just say we separated the grain from the chaff; the good ones made it and now excelling at their jobs.
Wherever a nurse or tech go, they'll go under PCTs' wings. Nurses in training should not be apprehensive just because they're being precepted by techs. They know their stuff. They won't or shouldn't undermine your clinical experience/knowledge as a licensed practitioner.
As far as charting before my current job (dialysis), I've only worked for DCI and DaVita so I cannot speak for FMC or other dialysis providers out there. We were doing paper doc in DCI. Chairside Snappy and Falcon programs are much user-friendlier than the program we're using at my government job, in my opinion.
I wish you luck in the Village and I hope you enjoy being part of the team I much as I did!
I’m doing home health right now and thinking of switching to dialysis. I have done time in ER, med/surg oncology, outpatient IR and now home health. I love HH but hate having to be on call and I’m always thinking about work- there’s no clocking out. I’ve been interested in dialysis for a while but scared to take that jump. Do you have to work 4 days in a row or is it every other day? I know different clinics have different schedules.
Your posts have been very informative so thank you for sharing!
Do you have to work 4 days in a row or is it every other day? I know different clinics have different schedules.
Again, every clinic varies because of census. My advice, apply. Interview, and ask these questions then. If it's not what you want, you can turn it down when offered
I’m doing home health right now and thinking of switching to dialysis. I have done time in ER, med/surg oncology, outpatient IR and now home health. I love HH but hate having to be on call and I’m always thinking about work- there’s no clocking out. I’ve been interested in dialysis for a while but scared to take that jump. Do you have to work 4 days in a row or is it every other day? I know different clinics have different schedules.
Your posts have been very informative so thank you for sharing!
Sorry I’m just now seeing the whole second page of comments LOL disregard!
Hoosier_RN, MSN
3,968 Posts
So glad that its going well for you. Enjoy!