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Keywords

Chronic, Acute, Renal Failure, hemodialysis, staffing shortages, burnout

Disciplines

Nursing

Description

To meet the care demands of patients with Chronic and Acute Renal Failure, the need for hemodialysis RNs continues to increase. Concerns about stressful work environment, long hours and staffing shortages often result in burnout and attrition (Enriquez et al 2025). Enhancement of shared governance and its potential for increasing work engagement may be helpful in addressing some of the more negative aspects of the Hemodialysis RN work experience.

Recruitment of experienced nurses who do not have hemodialysis experience is one way to increase staffing. However, orientation can be lengthy. While the current Royal Oak unit orientation/competency checklist serves as documentation of completed computer modules and learned skills/concepts, our preceptors have stated that they need better tools. They shared that some of their past experiences at other sites with a training binder, including detailed daily/weekly lesson plans, objectives and content would help. In addition, although the unit doesn’t have enough turnover to allow for group new hire classes, preceptors requested some time to be away from the unit, in a quiet area, to review topics such as dialysis machine operation, vascular access management, and patient assessment/management of specific care to hemodialysis treatments

CMS Conditions for Coverage state training must include key dialysis principles and procedures (initiation, monitoring and termination of treatment), documentation, vascular access care, possible complications such as hypotension, muscle cramps, headache, fever & chills, hemolysis, exsanguination and air embolism. Water treatment and dialysate preparation is also crucial as is infection control and patient safety (Payton, et al 2025).

PICO Question: Will hemodialysis unit preceptors use of an orientation toolbox to train inexperienced hemodialysis RNs result in improved recruitment/retention and competency?

Publication Date

5-2025

Comments

Nurses Week at Corewell Health William Beaumont University Hospital, Royal Oak, MI, May 6-12, 2025.

Hammering it Out: developing a toolbox to orient inexperienced hemodialysis new hires

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