Striving to be heard and recognized: nurse solutions for improvement in the outpatient hemodialysis work environment.

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.