I manage ICHD units and moon light in hospitals. Hit me up if you want more info. It’s definitely not easy but it is way better than the hospital. If you like advanced patho and managing complex patients it isn’t for you.

Edit for more: most dialysis companies have upward mobility for all RNs. No APRN needed. In most cases you don’t even need an MSN. Put a few years into the floor, manage good outcomes and you could transition to support services, education, tech development without a degree. Been doing it for 5 years.