Why do nurses work chronic dialysis if the companies/hours are so bad?

fragino · Jul 10, 2016

That's because, like most others, those who like their jobs don't usually seek a forum to complain. I worked in cardiac telemetry for four years and have now worked in chronic outpatient dialysis for the last four for one of the big two in various settings. I still like my present job a lot better than my old one thank you. I really liked and still miss cardiac telemetry but I don't miss spending most of my time doing toilet work, lifting 300lb patients in and out of bedside commodes because they are on diuretics or kayexalate and I really really don't miss feeling like my patients and I are in danger because we are always short-handed in an acute situation. Yes, there are negatives to working chronic dialysis and for some people that outweighs its disadvantages. As always, the people you work for or with will 99% determine if you will like your job or not.

westieluv · Jul 10, 2016

I have never heard anyone who works in chronic dialysis say that the hours are bad, the hours are one of the reasons why people stay in chronic dialysis (no Sundays, no major holidays, get to go home when the clinic closes in the evening so never any after hours on call or night shift work).

I have also worked chronics for both of the Big Two and I can honestly say that they have had just about the best training, benefits, pay, and other perks, of any company I have worked for over my 26 year nursing career.

My experience has been that chronic dialysis nurses tend to stick at their jobs because of the above and because they get to be experts at what they do and develop relationships with their patients, and in the clinics where I have worked none of the nurses had been there less than two years and several had been there for 5+ years.

Are you sure you're not thinking of acute dialysis nurses complaining about their hours and working conditions? Both of the Big Two tend to beat up their acute nurses in a lot of areas for some reason, and the hours can be excruciating and ridiculous, to say the least. I have not experienced an acute program that does not have a huge turnover rate and unreasonably long hours except for one in my area where Frenesius does the acutes in a large, local hospital and the nurses have set shifts instead of having to work all day and then be on call the same night, and they never need nurses because their nurses are happy.

I am truly surprised that you have had the experience of chronic dialysis nurses complaining and job hopping more than nurses in other areas, because where I live, it's the acute inpatient nurses and especially the LTC nurses who hate their jobs and go from job to job hoping to find one that fits.

Marshall1 · Jul 10, 2016

Thanks westieluv..I've been toying with the idea of moving into dialysis for years but to be honest, all the negative posts on here and other places had me re-think things..it sounds like nurses are working 12-16 hour shifts all the time. Where I live there are the large 2 plus a few smaller, private clinics but those hire only experienced dialysis nurses - same w/the hospital & working in a hospital setting is what I am trying to get out of. My biggest concern is not the training, fast pace, difficult patients..my biggest concern is working 4 days a week 12 + hours - I understand some days would be late just like anywhere else but reading the posts on here/elsewhere it sounds like this is the norm for chronics too..I have no problem working/working hard but I will never be one where my job is my life - I want balance to the point a person can have it working in healthcare - if that makes sense..

westieluv · Jul 10, 2016

The pace in a chronic unit is fast during turn, when you are getting one shift of patients off of their treatments and the next shift on, but between turns it is much more laid back. You document blood pressures, along with your techs, every 30 minutes and address any issues with hypotension, cramping, etc. and you pass meds, which involves giving IV push doses of Epogen, Hectorol, and Venofer and any PRN meds such as Benadryl or Tylenol that the patients request.

I work in a Davita chronic unit and full-time is considered anything over 30 hours. I work three days a week only, and they don't mind if we can get our work done in 30 hours/week, in fact it helps their bottom line, so some days I only work 5 am to around 3:30 pm. I never work Sundays because the clinic is closed, and we are also closed on major holidays like Christmas and Thanksgiving and Easter, just because it is always on a Sunday. We are still open for minor holidays like Memorial Day and the 4th of July, but those aren't a huge deal to me anyway and we still only have to work every other one. My schedule is: M-W-F, W-F-Sat. repeatedly. This means that every other weekend I get a four day weekend, which I am in now. It is awesome! I have worked a lot of nursing jobs that were all weekend, every other weekend, and much longer hours than I am working now.

Twinmom06, ASN, APN · Jul 11, 2016

I work acutes, and despite the weeks where I work 50-60 hours (which has been going on since January), I truly enjoy my job. I only have one or two patients I'm responsible for at a time. They aren't allowed out of bed, and the aforementioned meds are the only ones I give. Patient needs pain meds? Call the primary nurse. Have to use the bathroom? Bedpan or urinal or they wait. I don't have to toilet 5-7 patients, make sure they aren't sundowning and falling out of bed, I don't have to spend an hour or 2 charting etc etc...

Marshall1 · Jul 11, 2016

The chronic clinics here for 4 10's..I have no idea how the schedule would be set but like yours I know there are no Sundays/call/nights..I was contacted by one of them last week about a position..which was interesting because I had been thinking about it again..I'm just really concerned about 12-14 hour shifts all the time...I know for a variety of reasons I would not be able to do that on a continuous basis & wouldn't want to waste their time or mine. The recruiter told me they open at 5 a.m. & are usually out between 3-4 p.m. barring any issues.

westieluv · Jul 11, 2016

My experience has been that the techs that work in your clinic make or break how long the day is most of the time. We have some expert techs who are able to immediately address missed treatments earlier in the day due to hospitalizations, traveling, etc., and move third shift patients into earlier slots, which many of them prefer anyway. They still have to run it by the nurse, but if the patient is happier with an earlier time and it will not affect the techs' ability to perform turn in an efficient manner, it works out just fine. This results in fewer patients left at the end of the day and even if we still have to wait for the last patient to come off at 7:30 or whatever, we have more free time to chart and do other tasks that we couldn't get to during the busier part of the day.

We also always have two nurses scheduled everyday, an opener and a closer, so the opening nurse knows they will not have to stay to close and the closing nurse doesn't have to come in until 10 am. 12 hour days are not common in our clinic.