“Teamwork is needed”: care management of patients receiving haemodialysis through the eyes of their nurses - a qualitative study

Overcoming barriers to providing safe, effective, and holistic care to individuals undergoing haemodialysis is a professional responsibility of haemodialysis-trained nurses. This study aimed to investigate the challenges faced by nurses in hemodialysis patient care, the strategies they use to cope, and the areas they find difficult to manage. This qualitative study was conducted with nurses caring for hemodialysis patients. Data collection employed semi-structured, in-depth interviews and continued until thematic saturation was achieved. The reporting of the research followed the COREQ checklist. Data analysis was conducted using a content analysis approach. Three themes have emerged, namely “Difficulties encountered in care,” “Coping and caregiving” and “The need for teamwork.” The sub-themes that were determined in the “Difficulties encountered in care” theme were “non-compliance with fluid restriction, patient’s trust problem, lack of information, patients with anxiety, complications, vascular access problems, early termination request, getting up without resting and rushing.” The sub-themes under the “Coping and caregiving” theme were “nurse’s knowledge and experience, nurse taking precautions, psychological resilience of the nurse, trust instilled by the nurse, nurse’s communication skills, nurse’s professional behaviors and nurse’s patient education skill.” The sub-themes that were determined in the “The need for teamwork” theme were “adherence problems (treatment, diet, disease), the need for patient-specific dietitian support, and patient’s need for psychological support.” The findings highlight the critical role of haemodialysis-trained nurses in identifying and managing patient-related challenges through their professional competencies and clinical experience. However, addressing the broader needs of patients requires interdisciplinary collaboration, with nurses emphasizing the necessity of involving specialist support—particularly from dietitians and mental health professionals—in the development of holistic care plans.