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Goal To provide an overview of the satisfaction of nephrology nurses in the hemodialysis workplace setting and its impact on retention. Objectives 1. Discuss reasons for nephrology nurse turnover and [...], One group of nurses not frequently studied but who have felt the burden of shortages of registered nurses (RNs) is that of nephrology nurses. Nurses' valuable insights must be solicited for the accurate assessment of current work environment issues and for their specific solutions. The purposes of this study were to explore nurse satisfaction and dissatisfaction with the work environment in outpatient hemodialysis facilities, to solicit nurses' insights on potential solutions, and to develop national strategies for improvement. Focus group qualitative methodology was utilized with focus groups and individual interviews, including a total of 101 RN participants from 45 outpatient hemodialysis facilities. The overall category of this study was Striving to be Heard and Recognized, with the following four supportive categories: Maintaining Competency, Resolving Staffing and Resources, Strengthening Organizational Leadership, and Rebuilding Relationships. Nephrology nurse participants have identified strategies within each category for the improvement of their work environment. The voices of nephrology nurses must be heard and acted upon in a timely manner to improve workplace environment.

Goal To provide an overview of the cultural differences of Native Americans, the impact of those differences on health care to Native Americans with chronic kidney disease, and the value [...], Racial bias, stigma, stereotyping, and health disparities are pervasive in health care across America. The purposes of this research study were to assess if there was a significant difference in cultural knowledge and awareness in college health science students before and after receiving education about Native Americans receiving hemodialysis. Pre- and post-surveys were administered to assess cultural attitudes, beliefs, and knowledge. The intervention included a one-hoar presentation on the findings of a research study. The qualitative component included students' writing a critical reflection paper related to a case study of a young Native American with chronic kidney disease. There was a statistically significant difference in the pre- and post-test, suggesting that students can learn cultural awareness from Native Americans receiving dialysis and can apply culturally aware interventions following an education session based on clinical research, The themes of this study were a) approaching the patient with an open mind; b) developing trust; c) assessing beliefs, culture, and knowledge; d) educating and re-educating with patient and family; e) convincing the patient to have dialysis; and f) creating a sacred space. Nephrology nurses can partner with local colleges to present findings from research and help facilitate culturally relevant care.

The purpose of this classic grounded theory study was to explore what spirituality means to individuals who are American Indians receiving hemodialysis. Twelve women and 9 men ages 24 to 62, volunteered for this study. Informed consent was obtained, and in-depth interviews, field notes, and theoretical memos were completed. The metaphor 'Prayer Warriors' described the core category of this study. Praying played a major role in the following categories: (a) suffering, (b) honoring spirit, (e) healing old wounds, and (d) connecting with community. Praying involved hard work, suffering, sweating, hunger, and passion, and was a powerful way to cope with the stress of hemodialysis. Goal To begin to build a body of evidence on the perception of spirituality by patients undergoing hemodialysis. Objectives 1. Enumerate the components of a study on perception of spirituality in American Indians on hemodialysis. 2. Describe spirituality as depicted by participation in survey of American Indians. 3. Relate examples from the results of the study on the importance of spirituality to American Indians on hemodialysis., Spirituality is an integral component in the lives of people with end stage renal failure. As nephrology nurses, we have been called to harness the restorative powers of spirituality, caring [...]

The purpose of this study was to discover what spirituality means to hemodialysis patients and how it influences their lives. Grounded theory qualitative research method was used to discover meaning, provide understanding, and create a beginning substantive theory of spirituality. Four men and 7 women, 36 to 78 years of age, receiving outpatient hemodialysis in the northwestern United States, volunteered to participate in this study. Demographic data were collected and indepth interviews were completed. The Glaserian method of grounded theory was used for data collection and analysis. The central core category of this study was finding a balance, which occurred in the following four phases: (a) confronting mortality, (b) reframing, (c) adjusting to dialysis, and (d) facing the challenge. Categories of spirituality were faith, presence, and receiving and giving back. Participants described spirituality as a life-giving force from within, full of awe, wonder, and solitude, that inspires one to strive for balance in life. Participants validated the description of spirituality, categories, and phases to assure that it captured their person experiences. A focus group of hemodialysis staff validated the results for clarity, understanding, and application to clinical practice. The results of this study provide a theoretical framework to guide nursing practice as well as an understanding of what spirituality means to hemodialysis patients and how it influences their lives., Insight into the spiritual realm of patient care will transform nursing in this millennium. Harnessing the restorative powers of spirituality and caring for the body-mind-spirit of nurses and patients alike [...]

Commentary Dr. Walton has addressed an important topic in her research. To my knowledge, this is the first study on spirituality in people receiving hemodialysis therapy. The findings of the [...]