Torn between Dialysis and med/surg for my 1st RN job

Nurses New Nurse



(Sorry its so terribly long but I desperately need another nurse's advice)

I'm a newly licensed RN and its hiring season over here in Tx. I so far have had a few interviews but 1 job in particular has officially offered me a position at their dialysis center through Fresenius. I know that dialysis is a specialty so I'm somewhat reluctant about taking the position as I am a new RN with no other medical experience other than nursing school. I was offered $26/hr which is on the lower end but will suffice in my book. The benefits are good, 5 wks vacation, set schedule M, W, F, 5:30a-5:30p or maybe longer, and 10 wks class training with 1 day a week at the facility shadowing a tech to learn the machines. Sounds great right???

Well, I have my doubts about this job due to the fact that it is a specialty. They have been known to hire nurse grads, however, I question the amount of nursing knowledge, foundation, and support I'd be receiving there. Since I do not have any other nursing experience (ex. med/surg or any other basic nursing care), I wonder (even after training) if I will be able to identify when a patient is too overloaded, under loaded, or about to crash?? Am I going to be subjected to responsibilities that I don't feel adequately qualified to perform?? Will I be left to oversee too much that I don't feel comfortable with due my inexperience? I've heard of new RN's loosing their licenses because of dialysis. Either they made a wrong move and the patient crashed and died or they didn't have the intuition that a veteran nurse would have to identify when a patient was going downhill, and in turn, the patient crashed and died. I also question the company's moral. There is no clinical manger so they are using the area manager to complete my hiring process and because she is overseeing 5 other centers, she's overworked, impossible to reach over the phone, and is promising to do things that she still hasn't done yet. I've also met the nurse manager at the facility I'd be working at and she several times forgot my name, thought I was an LVN even after I told her that I was an RN and didn't even ask me questions or look at my resume during our interview (which she rescheduled with me twice and showed up 30 mins late to), she just told me I was hired.

It truly seems that they are just wanting an able body to fill an empty position and is not really interested in my knowledge, skill, experience, or comfort level.

I did however receive a call back from a hospital that I applied at that has been my 1st choice hospital to work at since before I finished nursing school. I've had 2 clinical rotations at this hospital so I'm familiar with their core values and the culture there. The position is for a med/surg unit and I have an idea that the shift will be 7p-7a which is not my favorite shift, but I feel like it would be best for me to start off on. Especially so I can drop my daughter off at pre-school in the am and see her a little bit before I go into work. The interview is Monday and I'm excited but scared at the same time. I have a feeling that they will not offer me more than what the dialysis center is offering me because a friend I graduated with just started there at $25.50/hr, and that is evidently the starting rate for new grad nurses at this hospital. I would be worked like a dog and expected to work doubles..which I am definitely not interested in and have no energy for. Sorry, but I suffer from severe anemia and I'm terribly out of shape so I cant possibly work 14 and a half hour double shifts 3-4 times a week. A minimum of three 12 hour shifts spaced apart is all I would be able to stand, trust me. This position would be the best choice for my future nursing career as I would learn so much and be exposed to a vast range of nursing skill and knowledge that all nurses definitely need no matter what field or specialty the end up in. The dialysis center would limit me to only dialysis nursing knowledge and ,therefore, I'd only be hire-able in that field of work.

I am just torn between these two very great, but very different positions that have both their pros and cons. I definitely need more Nursing insight on which job a new nurse should take, so, I'm asking anyone to please come forth and give me any advice as It would be EXTREMELY appreciated.

I know I will ultimately be making this decision on my own but I feel that there is so much I still don't know about the nursing profession.

Many Thanks,


that is a tough choice... but if I go back to my new grad times and choose MS or dialysis, I will choose dialysis as they tend to be less on the feet, relatively easier going than MS *note: from what I have seen, don't go raging on this because I said this; strictly my experience*, and it's a specialty. Of course the biggest thing you will have to ask is if it's relatively smooth for dialysis nurses to get a job in specialty areas like ER, ICU, OR, etc because I would hate to get stuck doing dialysis. MS is a tough place for new grads that will BURN YOU OUT if you absolutely hate it. I mean all other departments suck as new grad too but I would at least enjoy something if I liked doing it (for me that was ER which I didn't get on my first job.. :() Non of the relatively new nurses and even most of experienced ones absolutely hate MS, so I say as long as employers have no stipulation against dialysis nurses when you want to move departments, I say do dialysis.

There is no right or wrong answer to this. I did 6 months of med surg and hated every second of it before I switched to dialysis. If you start in a dialysis clinic you will be on your feet all day long non stop so I don't think that it's any less physically demanding then med surg. I like dialysis because I'm doing less dirty work and waitressing. Once you have a solid 6 months in a chronic dialysis setting you can move to acute dialysis. Once you move to acute dialysis you will be doing dialysis treatments on most of the units in the hospital. Your acute dialysis experiences will be respected and you could likely work on any one of those units that you treated dialysis patients on. I don't regret my little bit of med surg experience, but I don't regret disappearing from the med surg scene so fast either. I can make a lot more money as an acute dialysis nurse and not feel like a slave, servant, maid all day.

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