What do you think of paying for four months of training versus on the job training.

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Hopefully there are los angeles nurses who are familiar with Joanne Pittards very expensive but reputable 4 month training at Glendale college.

If you have paid for your own training elsewhere to enter the field of dialysis versus getting on the job training, I would like to hear whether you thought it was worth it.

I have had bad experiences with preceptors in the three different areas of nursing I have tried. I also made the mistake of not getting a job in nursing when I was fresh out of school. I got my first job one year later. I need a good foundation in Dialysis because I do not have med. surg or ICU experience. I have 6 months of experience in hemodialysis and I received 2 weeks of lecture and 12weeks of training with a preceptor by a big dialysis company. However this was 1.5 years ago and I had a preceptor who was impatient and who just did not want to train me. Then the new manager who came in was a total witch and very unprofessional. She was fired 2 months after I left. This center has been through many managers.

I learned the machines through the dialysis technicians who were more willing to train me. I was able to perform the routine more slowly than others but I did not feel confident and I could not trouble shoot most of the time. I never missed a day though despite the hostile environment i worked in. I really want to get back in but the thought of going back to encounter all the criticism and lack of support has kept me away for a while. I have an easy job now making a decent amount but it is not going to help advance my career in nursing. Eventually I would like to do acute dialysis. Do you think these schools charging $5000 can really give someone entering the field a more solid foundation than they could get through the big corporations training nurses? Please let me know what you think and share your experiences. Do you think the training on the job is only suitable for nurses who already have a solid foundation in other areas of nursing such as med surg or ICU, or those really smart nurses who can thrive under pressure? I did very well in school but I cant seem to thrive under pressure on the job :o . I have friends who I helped with studying in school who say they had great preceptors and now they are established and doing well. What do you honestly think?

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i don't know how it works in other units, but at davita they have learned the hard way(high turn-over in staff), to really take the time to educate the staff about dialysis, there is constant eduation--some of it mandatory and some elective. i think that you need to do some homework and find out about the staff turnover, most people quit because dialysis staff seems to eat thier young. the machines???? i know it can be very stressful not being able to trouble shoot--all the while the patient is freaking out and you are starting to get even more stressed, but learning the machine really takes time---sometimes i look back and think that was really the toughest part. i felt very safe in my nursing practice but those machines!!!!!!! they still can drive me crazy and i am still learning about them!! so give yourself a break about that, ok? i would never, never, never spend my hard earned $$$ on a class that you mentioned for dialysis, mostly due to the fact that if you get into a good unit they should teach all that anyway---and they will whether or not you have taken the class. i asked my facility manager about this and she laughed!!!!! if you really want to get into dialysis, you need to really check out the unit, ask alot of questions and ask to spend some time on the floor, ask who the preceptor is, how long have they held that position, how long the FA has been there. i know at our unit our FA asks serious job applicants to spend an hour on the hemo floor, talking to staff, seeing what we really do and hang out for us before they decide to take the job, she also listens to our feedback about what we think of the person! good luck, i hope this helps----tired dialysis nurse.

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Thanks for your advice I agree that finding a good unit is the key but I am so jaded after all my bad experiences that I find it hard to believe that I will find that. I have considered sending out my resume to see what kind of responses I get.

You mentioned you felt confident in your nursing skills and I honestly have to say that I dont after being 1 year off, right out of school and then taking 1.5 years off this last time. In all fairness I have to say that even if I found a well intentioned preceptor I am afraid that my nursing skills and knowledge are rusty. I never worked in med surg so I have even thought of taking a refresher course at a local community college. I think chronic dialysis is more routine than other nursing areas but I think someone like me would have a more difficult time learning on the job partly due to insecurity then a nurse coming in from med surg and feeling confident about his/her knowledge and skills as a nurse.

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OK BABY NURSE, AND I DO MEAN THAI AS A TERM OF ENDEARMENT, YOU NEED TO GET YOUR MO-JO GOING!!!!!!! WHEN I WAS HIRED AT THE UNIT I CURRENTLY WORK IN, MY FA WOULD NOT EVEN INTERVIEW ANY NURSE WITH OUT LEAST 10 YEARS OF NURSING BEHIND HER/HIM. BECAUSE OF THE NURSING SHORTAGE, THEY NOW RECRUIT NEW NURSES, I HAVE MIXED FEELING ABOUT THIS. THERE ARE SOOOOOOOO MANY REASONS ONE ENDS UP ON DIALYSIS---FROM THE ONES THAT EVERYBOBY KNOWS LIKE HTN AND IDDM, BUT THERE ARE OTHER REASONS TOO, LUPUS, POLYCYSTIC DISEASE, KIDNEY CA, SUICIDE ATTEMPS, STAPH INFECTIONS, OD'S, TRAUMA (mvas,burns), THE CAUSE OF ONE'S KIDNEY FAILURE HAS A DIRECT EFFECT ON HIS/HER DIALYSIS AND THIS DETERMINES THE EFFECT ON THE REST OF HIS BODY SYSTEMS.....SO WHAT I AM TRYING TO SAY IS THAT YOU NEED A STRONG BACKGOUND IN NURSING AND VERY GOOD ASSESSMENT SKILLS TO REALLY BE A GOOD DIALYSIS NURSE. THEY ONLY WAY TO GET THE ABOVE AND GET YOUR CONFIDIENCE UP IS TO WORK AS A NURSE...GET A JOB ANYWHERE, WELL,OK, NOT JUST ANYWHERE BUT MAYBE ON A TRANSPANT FLOOR, ER, ICU, JUST START WORKING AS A NURSE, YOU SOUND LIKE YOU JUST NEED TO BUILD UP YOUR SKILLS????? I HAVE WORKED ER, ICU AND MED/SURG AND I DO NOT THINK I COULD BE AN EFFECTIVE HEMO NURSE WITHOUT THIS BACKGROUND. I AM SURE THAT THERE ARE NURSES WHO CAN AND HAVE, BUT I THINK IT WOULD BE VERY, VERY DIFFICULT. GET A JOB, GET YOUR GO GOING, WE NEED BRIGHT, YOUNG NURSES LIKE YOURSELF---US OLDER ONES(46), ARE GETTING TIRED. DON'T GET DISCOURAGED, DON'T BE AFRAID TO BE THE NURSE!!!! YOU KNOW MORE THAN YOU THINK . SINCE IT SOUNDS LIKE YOU CAN TAKE YOUR TIME TO FIND THE RIGHT JOB?---WHERE ARE ANY OF YOUR FORMER CLASSMATES WORKING? ARE ANY OF THEM HAPPY WHERE THEY ARE AND IF SO START TO NETWORK WITH THEM. MY FIRST TWO YEARS OUT OF SCHOOL I WAS SICK AT MY STOMACH BEFORE WORK , AND I WORKED WITH THE MOST WONDERFUL GROUP OF NURSES IN THE WORLD, THEY TOLD ME AT LEAST ONCE A WEEK, "RUN FROM A NURSE WHO DOES NOT ASK QUESTIONS, THEY ARE THE ONES WHO KILL PEOPLE" KEEP LOOKING, I KNOW YOU WILL FIND A FIT, SOMETIMES IT TAKES SEVERAL TRYS---KEEP US POSTED. TDN:icon_hug:

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:chuckle I DON'T KNOW WHERE ALL THESE NURSE WORK THAT SAY DIALYSIS IS ROUTINE, THE ONLY THING I THINK IS ROUTINE IS THE FACT THAT EVERYONE IS ON DIALYSIS----I HAVE HAD VERY FEW "ROUTINE DAYS" AT WORK.....WHAT DO Y'LL MEAN?? I AM CONFUSED AND I HAVE BEEN A HEMO NURSE FOR OVER SIX YEARS!!!:confused:, TDN

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:chuckle I DON'T KNOW WHERE ALL THESE NURSE WORK THAT SAY DIALYSIS IS ROUTINE, THE ONLY THING I THINK IS ROUTINE IS THE FACT THAT EVERYONE IS ON DIALYSIS----I HAVE HAD VERY FEW "ROUTINE DAYS" AT WORK.....WHAT DO Y'LL MEAN?? I AM CONFUSED AND I HAVE BEEN A HEMO NURSE FOR OVER SIX YEARS!!!:confused:, TDN

That statement about it being routine was from someone who does not have alot of experience and only worked in a chronic unit for 6 months. It highlights my very basic experience but luckily the director was always available and the ER was in the same building. I honestly felt uneasy alot of the time but would call the doctors often to be safe. The ER experiences I had were increasing respiratory distress before the patient was actually hooked up to the dialysis machine and the doctor ordered that she be sent to the ER and receive acute dialysis, chest pain often resolved with nitroglycerin, low bp easily resolved with saline, hypoglycemia, and a TIA.

I agree with tired nurses statements above but I have friends who have done NICU and med surg and those sound alot more hectic and stressful than dialysis.

Since I dont see myself working in those fast paced environments I thought that school might give me someowhat of a better understanding and skill since the instructor really breaks it down in the books she has written and I will get a chance to work slowly with actual patients with someone who is actually willing and not time crunched to share their knowledge. I know it is nowwhere near as good as having years of experience in med surg or ICU but I would consider those areas just as challenging if not more than dialysis. I also enjoyed alot of the dialysis patients. Before I move on to acute dialysis I thought about working as a traveling chronic dialysis nurse once I have 1-2 years of experience in one chronic dialysis center.

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Thank you for taking the time to consider my dilemma. You are right, I have to get going and work hard to gain experience and I know more schooling is just a start that I was hoping would get me going on in a better direction.

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