So I'm an RN in Texas (that's as specific as I'll get for anonymity reasons). I did ICU nursing for four years and I've been doing Acute Dialysis nursing for two years now. Acute Dialysis is doing dialysis treatments for patients admitted to facilities such as hospitals, rehabs, and nursing homes, rather than doing dialysis treatments at an outpatient dialysis center. I knew I didn't want to work in an outpatient dialysis center because I've had friends and coworkers who have done that and they've expressed that the workload is extraordinary and it's extremely stressful due to the fast pace and workload. Acute Dialysis jobs have for the longest time belonged only to contract dialysis companies such as Fresenius, Davita, and various other smaller contract companies. These contract companies charged exorbitant prices to the facilities they serviced but the facilities got the benefit of not having to buy or maintain their own equipment and not have to hire, train, and retain their own dialysis staff. Well a new machine came on the market relatively recently that costs about $4,000 dollars per machine rather than the $20,000-$80,000 for other models. Because of this lots of hospitals are now buying their own machines, hiring their own staff, and taking their whole dialysis programs in house rather than contracting them out to these other companies. It's saving the hospitals TONS of money. Do you think patient's are going to see any benefit from that? Of course not, but that's a different post all together. What this post is about is the job I've found that I intend to stay at and milk for all it is worth.
Let it be known, I went into the medical field and nursing because I wanted to help people, so my anti-work sentiment is NEVER to the patient's detriment. I always aim my anti-work sentiments towards the employers. My patients always receive my absolute best care because I do have a heart and I do care for them. I treat them like I would treat my own family and I would expect that from any other healthcare professionals. Be angry at the system but don't take it out on the people who need help.
Now that that is out of the way, since hospitals have started taking their dialysis programs in house I have worked for three different employers. One I was a dialysis staff RN at a single hospital in a major hospital system in a very densely populated city in Texas. The pay was mid tier and the benefits were crappy. The workload was heavy, but manageable. I only stayed there 7 months. The second, I was a staff RN in a float pool covering 5 hospitals. We had a home facility where we worked most of the time, but we did have to float to other facilities pretty regularly. The pay was good and the benefits were really good, especially the insurance, but the workload was EXTRAORDINARY. I mean crazy hours. I stayed for about 9 months because the money was good and the overtime and callback pay made the checks pretty great but it was at an absolute burnout pace and the management was awful. Now, we get to my current job and the best anti-work job I think the medical field has to offer:
When I left the float pool job I took a job at a rural hospital that was taking it's dialysis program in house. They hired me and one other nurse (a friend of mine, we applied together and got the jobs together so that has been great too. We work very well together.) to help them set up the program before their contract ended with the previous company. We helped write and review policies and procedures, we helped determine what construction and plumbing upgrades or remodels the dialysis room needed, we helped determine where and how to create our own storage room for supplies, and we helped create the program of how we would participate with the nephrologists to carry out orders and treat patients. Ultimately, the pretty much let us build our own program with a little bit of administrative oversight. We were stoked about that but once we went live is when I realized the true gold of this job: it is an INCREDIBLY low volume facility. Meaning we might do 15 treatments a month. So half of the days we work we don't have any treatments. What does that mean for us? We do routine machine maintenance, which takes maybe 20-30 minutes cumulatively in a day, and we might have one treatment a day which is like 4-5 hours of work (not hard work, mind you). Our shifts are 12 hours. On the days when we don't have a treatment, I sit and play on my phone for like 11 hours. I schedule doctor's appointments, dentist appointments, call friends, play mobile games, read books, walk laps around the hospital for exercise, and take 90+ minute lunches. You might think, wouldn't administration try to find something for us to do so we're not just riding the clock? They ask for a little help here and there in dire situations. I think in the three months I've been at this job I've been asked to go help out somewhere else three times and it's never been for longer than a couple of hours, and it's never been hard work. If we're going to help out they always give us the easy stuff to do. And the reason administration doesn't mind if we're just sitting riding the clock is because paying us is VASTLY cheaper than it was costing them to pay the company they were contracting with. Even with us doing nothing half of the days we come to work, the hospital is STILL saving money. And that brings me to pay and benefits: The hourly pay is great, the most I've made in my career. I'm at $41/hour and at this job I'm doing almost NOTHING for that wage. It's amazing. Secondly, the benefits: the insurance is pretty good and the various other benefits are about average but the tuition reimbursement combined with the partnership they have with an online university makes it so you can get a Masters degree and even a Doctorate degree for no money out of pocket. It's insane. So all that explanation for this summary:
TL;DR: The job I have now is 12 hours shifts and half the days I might do 4-6 hours of work in a shift and the other half I do about 30 minutes of work. The pay is great, the benefits are great, and I get to do basically whatever I want while on the clock. I'm going to use the benefits to get free graduate degrees all while doing little to no actual work. I get to take good care of my patients while doing very little actual work and sucking a great salary out of a major national hospital system.
American healthcare is a scam. I'll take great care of you if you need my care, but I will take advantage of my employer in every way possible because that's what they do to the American people.