What skills do Dialysis nurses use?

[JillRNColorado]

Since I am a new grad and considering a job in the field...I wondered if anyone might tell me what skills are commonly used in Dialyisis (Chronic setting). For example, it is obvious assessments are done routinely but how about starting IV's, SUB Q's, foleys etc.... Please share what skills you use on a day to day basis because I am afraid I will lose mine if I don't frequently use them in this envirnment. Please anyone??

Thanks in advance.

Jill

[jnette, ASN, EMT-I]

Obviously, your assessment skills are paramount. As are critical thinking skills as realted to fluids and electrolytes. Certainly cannulating skills, the occasional subQ injections, Tuberculine PPD, some outpatient clinincs still hang blood. CHF knowlege is a biggie since your dealing with great potential for fluid overload, then of course the drops in bloodpressures.

Skills pertaining to central lines, dressing changes, blood draws.... those are just some for starters. I'm sure others will add to the list. :)

[DeLana_RN, BSN, RN]

Hi,

pp has summarized the clinical skills in the outpatient/clinic setting it very well. In acutes/hospital dialysis, we may do much more, including Foleys, NGTs (those of us who dare, LOL), and other "hospital" nursing procedures.

I would just like to add that for various reasons (see several previous posts on the subject) most experienced dialysis nurses do not recommend that new grads enter the specialty. The reasons are many, including a lack of adequate orientation for someone with no previous clinical experience, and the autonomy a dialysis RN can have (which means, you may not have any other nurse(s) to consult with when a pt complication arises). It can be done, and some companies will hire new grads, but you will be at a great disadvantage if you don't have some general nursing experience - (at least) one year of med/surg or critical care would be best.

Best of luck to you!

DeLana

[beautifulyoyo]

I do have to agree with Delana, I was a dialysis technican for about 10 years before I became a nurse. I got out of the field just to receive other skills. I now work in dialysis again and have found that those nurses who have only done dialysis are very afraid of working with the critical patients. They panic, and call me when something happens. I do recommend getting skills on a med surg floor or a critical care unit before going into dialysis.

[anurseadvocate]

One of the problems is that the federal regulations only require minimal amount of time in dialysis before one is put in charge of a unit. This can be dangerous and if a new nurse to dialysis is in a unit, his/her provider might want to upgrade her/his position. This can be dangeous as you have stated above. Experienced dialysis nurses will tell you it takes years to evenj learn to problem solve and problem shoot such as machine problems, or even with medical conditions. It would behoove any RN working in this setting to realize that the techs do most of the treatments (fistulas) but the RN still is responsible to the care that is given and for supervision of the unit. It is we, the RNs, who have a license that we must protect. I would clearly state do not take on more than you can carry because when push comes to shove, well, u know the rest..too many nurses are put into positions in the dialysis unit of which their skills are not up to par.dangerous, dangerous and dangerous.

[workingmomRN]

I agree with the previous posts 100%. Dialysis is not the place for a new grad. You need good assessment skills & the ability to supervise the techs. They can make or break your day, & depending on the size of the clinic, you may be the only RN in the building. Scary sometimes even for us who have been doing this for a long time.

[ldyjstce]

I wholeheartedly disagree with the statement that new grads shouldn't become Dialysis RNs. I stumbled into dialysis nursing as a new grad and, as everyonein dialysis has experienced at one time or another, there have been days when I ask WHAT AM I DOING?! I would say the caveat should be that if the new grad is very young, fresh and doesn't have a lot of "life" under his/her belt, it will be difficult. These patients are very sick but usually don't look that way externally. These are the most non-compliant and "grumpy" patients one will have the pleasure of working with. In my 2 years, I have been cursed at, yelled at, called every type of name, been hit, pushed and threatened by patients. BUT the job is fulfilling. As an experienced dialysis RN, my team welcomes new grads -- we can train them BEFORE they get the bad habits instilled. If you are interested in the field, find a facility that will allow you to "shadow" a nurse and make sure you are there for turnover! Turnover is where a lot of people have the hardest times!