Experiences of Professional Nurses in Specialized Practice Context Hemodialysis Care: A Qualitative Study

Abstract

Introduction: Hemodialysis is a complex and high-risk renal replacement therapy that requires continuous monitoring, accurate clinical decision-making, and strict adherence to safety standards. Although private hospitals generally employ an adequate number of qualified nurses for these units, the demanding nature of the work, characterized by a high volume of indirect nursing care and quality management activities, may influence nurses’practice experiences and their perceived professional value.

Research objectives: To explore the experiences of professional nurses caring for patients undergoing hemodialysis within a specialized practice context.

Research methodology: This qualitative study employed an interpretive phenomenological design. Participants were 10 professional nurses from a hemodialysis center in a private hospital, selected via purposive sampling. Data were collected through non-participant observation and in-depth interviews. Interview data were analyzed using thematic analysis, while observation data were used to support and enrich the discussion of findings.

Results: Five main themes emerged: 1) core values in nursing practice, 2) patient-centered care based on human dignity, 3) the nursing practice process within a specialized context, 4) essential competencies of hemodialysis nurses, and 5) care goals for patient well-being. Observations revealed that nurses spent more time on indirect nursing activities and care quality management than on delivering direct patient care.

Conclusions: The experiences of hemodialysis nurses reflect a blend of integrated clinical expertise, human values, and relational care practice, underpinned by a substantial indirect workload that remains essential for ensuring patient safety.

Implications: Healthcare work systems should be improved to formally recognize indirect nursing activities as critical mechanisms for maintaining patient safety and ensuring high-quality care for patients undergoing hemodialysis.