Pivot Spotlight: Acute Dialysis Nurse
Meet Dominique
Hey there,
This month's spotlight features my nursing school classmate Dominique, who discovered her professional calling in acute dialysis nursing and never looked back. While many nurses navigate multiple specialties throughout their careers, Dominique's journey stands out for its remarkable consistency and satisfaction. Having worked exclusively in dialysis since graduation, she shares her unique path in our interview – from how she initially discovered this specialty to what a typical day looks like in acute dialysis. Dominique also offers valuable advice for nurses considering dialysis as a career path. Her story reminds us that sometimes the first specialty we choose can become our professional home, offering both stability and fulfillment without the need to pivot.
Meet Dominque
What is your current nursing role, and what does a typical day look like for you?
My current role is an acute dialysis nurse. As an acute hemodialysis nurse, my assigned work location varies day to day. The night before my scheduled shift, I am told my assigned hospital. This role requires travel. Once I arrive at the hospital, I will have a list of patients who need dialysis for the day. By assessing the patients’ labs and conditions, I will prioritize whom I should dialyze first. Most acute dialysis programs have a charge nurse who handles this task. If the patients are more stable (not in the ICU or on isolation), you will care for two dialysis patients at a time, with treatment times ranging from 3 to 4 hours. If the patients are in the ICU or on isolation, you will care for them 1:1, bringing both a hemodialysis machine and a reverse osmosis machine to the bedside.
Once the patient is connected to the dialysis machine, you will monitor the patient’s blood pressure every 15 minutes, ensuring the patient’s blood pressure remains stable throughout treatment while removing fluid from the patient’s vascular system, making adjustments as needed, and contacting the nephrologist when problems arise.
As an acute dialysis nurse, I typically work two shifts a day, which involves two bedside treatments or two shifts in the dialysis suite, where I care for two dialysis patients at a time. The day is typically 10 to 12 hours long, depending on the patient load. Some days, when the patient load is low, you may work a 6-hour day. On the other hand, if the patient load is high, you may work a 15-hour day. On-call duties are also required; some acute dialysis programs require two days of on-call duty a week, while others only require it once every six weeks.
What is one thing you love about your current role? What is one thing you dislike about your current role? (3-5 sentences.)
I love the flexibility of being an Acute dialysis nurse. Some programs will allow you to come into work, say, at 11 am when you typically work 7 am-7 pm. So if you have a doctor appointment that morning, you can go without using your PTO. The one thing I dislike is that you don’t know when your shift will end, as the patient load can change at any time.
Have you heard of " soft nursing"? Would you consider your nursing roles a soft nursing role?
I believe that being an acute dialysis registered nurse is considered a soft nursing role. I feel that I have a good work-life balance. I work independently and at my own pace, which gives me peace of mind, and my patient load isn’t overwhelming.
Looking back at your bedside nursing experience, what skills from that time have proven most valuable in your current position?
I have never worked as a bedside nurse. I worked for three years as a chronic dialysis nurse, which gave me confidence in machine troubleshooting and in quickly responding to adverse effects that can occur during dialysis, including hypotensive episodes, cramping, seizures, and, unfortunately, cardiac arrest.
What sparked your interest in this particular path, and how did you navigate the transition from traditional nursing?
I am an RN graduate with an associate’s degree. In New Jersey, the hospital system wouldn’t allow nurses with an associate’s degree to work unless they were enrolled in a bachelor’s program. I wanted to work right away, and I knew the nursing home setting wasn’t for me. I was looking for jobs and came across DaVita; they were willing to train, and no experience was required. I applied, interviewed, and got the job working in outpatient chronic dialysis.
What has surprised you the most about working in this role compared to your initial expectations when you made the switch?
When I transitioned from being a chronic dialysis nurse to working in acute care, what surprised me the most were the unpredictable hours we were expected to work each day. In the outpatient dialysis clinic, there is a scheduled time for all patients, so you have a set schedule.
Would you recommend this role to other nurses, and why?
I would recommend being an acute dialysis nurse. While all nursing fields have their pros and cons, I believe the stress level associated with this role is manageable.
For nurses interested in a similar path, what certifications, skills, or experiences would you recommend they pursue?
To become an acute dialysis nurse, you will need at least 6 months of experience in an outpatient dialysis clinic. Some hospitals offer cross-training programs that transition nurses from the ICU to acute dialysis nursing. Additionally, some programs will train nurses from other departments, but this depends on the hospital.
What advice would you give to nurses who are feeling drawn to explore non-traditional roles but are hesitant to make a change?
I believe it will cause no harm to learn a new nursing area outside of traditional bedside nursing, especially if you are feeling burnt out from your current role. I see acute dialysis nursing as a softer nursing specialty, where you can take the time to educate your patients and care for them thoroughly, as you will be spending 3-4 hours with them. Take a leap of faith; you never know what type of nursing you will fall in love with.
If you made it this far, I appreciate your support. I hope you found this interview insightful. If you have any questions for Dominique or would like to learn more about dialysis nursing, please comment below.
If you are ready to pivot in your nursing career, here is how I can help:
Book a 1:1 Pivot Planning Session.
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