Wanting to explore dialysis nursing

Hi there! Im an acute travel dialysis nurse. In the world of dialysis we have two things, one is acute (inpatient-hospitals) and the other is chronic (outpatient-clinics). Chronic is extremely fast paced and high pt vol. Acute is often 1:1 if not 2:1. Best thing about acute dilaysis is you have them for 3-4hrs and after that they are not your problem anymore. Acute has VERY long hrs, no clock out time. You can work 16hrs a day ( I worked a lot of 20hrs) and theres on call for emergency dialysis in the ER. The work isn't hard, a lot of sitting around while waiting for dialysis to be done. Can be boring unless the pt is unstable. I say start out in Chronic to get used to working with machines and cannulating pts (fistula and grafts). Unfortunately, most ppl that do Chronic ended up leaving dialysis because its too busy and fast paced. For example, I used to work at Davita chronic center, I have 16 pts, 3 rounds, total of 48 pts a day.....I had to give them meds, checked everyone's machines, troubleshootings, scheduling, care plan, play phone tag with the ones that didn't show up, medication recons, giving out vaccines, edication, A LOT of labs and lab reviews, calling taxi and get them home. If nobody picks them up, you are staying with them at the clinic and you have to figure out how to get them home (I hated this part the most). If a dialysis tech calls in, you take on ALL of their responsibilities and pt load while still having to do your own work. If you survive that, join acute dialysis. Most acute programs will not take new dialysis RN without experiences but now im starting to see they bypassing that. I do not recommend Davita AT ALL. They will work u like a dog and the pay is bad. US Renal and Fresenius are better. I have worked with all 3. Fresenius is my favorite! If you ended up doing Acute dialysis with Fresenius, they will give you a cellphone to chart! Yes we charted on cellphones! Just click all the boxes away and small phrases! I love it! It works like a normal phone so I used it as a workphone and don't give out my personal number. In Acute you have a lot of automony and you will call the nephrologists a lot. You get to make a lot of decisions. I love dialysis, because its one of the nursing specialties that I can see my work is saving someones's life especially those STAT critical dialysis in the ER. Nobody in the ER can help that pt but only you can! Acute dialysis you work solo, it's you and your machines so its kinda scary at first knowing that you don't have a lot of resources around to ask for help. 

Well said. 

As far as certification, one requires one year of experience while another is asking for 2,000 or 3,000 hours.