Background The prevalence of kidney disease continues to increase, as does the acuity of kidney care. Patients with kidney failure are older, sicker and less mobile. Health systems are under more pressure to manage growing care needs and capacity constraints. This is likely to have an impact on nursing workforce experiences.

Aims The aim of this research was to examine nephrology nursing in South Australia to understand the impact of increasing acuity and organisational factors that may support and sustain the workforce.

Methods An exploratory semi-structured qualitative approach, facilitating eight focus groups with 36 nephrology nurses across six public metropolitan renal units was applied. Data were thematically analysed.

Findings Three central themes relating to nursing culture, patient acuity and organisational factors that impact the nursing workforce were identified. Sub-themes identified were pride and passion, teamwork and collegiality, increasing patient acuity and the lack of clinical rationalisation in kidney care, the value of a ‘flat’ hierarchy, and vulnerability during the COVID‑19 pandemic. Consequently, we identified a disconnect between institutional expectations and what the participants considered pragmatic reality. Participants reported sustained workplace pressure, a ‘triage’ approach to care, and a sense of work left undone.

Conclusion Nephrology nurses experience a gap between ‘supply and demand’ on their time, resources and workload. These findings highlight the need for further exploration of the root causes and the development of new systems to provide quality, safe and rewarding care for patients and to reduce the risk of workforce moral distress and burnout.

Background Pain is a common but complex problem to manage for people with chronic kidney disease (CKD). Poorly managed pain contributes to poor quality of life and increases carer stress. We wished to investigate the prevalence and severity of pain and describe analgesic use in people with CKD.

Method A cross-sectional analysis of patients attending two nephrology outpatient clinics completed a 16-item self-reported questionnaire. Nine questions related to demographic and clinical details; four questions explored the presence and severity of pain and medication taking behaviour; three questions evaluated health literacy skills.

Results The survey was completed by 143 participants (a response rate of 17%). Most participants (n=98; 84%) reported pain, with the severity described as moderate (32%) or severe (22%). Despite the high self-reported prevalence of pain, almost half (48%) took no regular analgesia. Paracetamol-based products were most commonly used (53%), followed by opioids (22 %) and paracetamol/codeine combinations (13%). Of those with moderate or severe pain, 11.9% took no regular pain relief. Health literacy was not associated with the presence of pain, pain severity, use of pain relief, or type of pain medications used.

Conclusion This study provides useful information beyond documenting the prevalence of pain in people with CKD. The study highlights that a proportion of people with CKD and moderate to severe pain are not managing their pain effectively. This finding was unexpected, and future research exploring this discrepancy may inform interventions to improve quality of life.

Objective The spread of the coronavirus disease (COVID‑19) pandemic has created an opportunity to re-evaluate and refine existing models of healthcare delivery for patients receiving dialysis at home. This study aims to explore the experiences of home dialysis nurses during the pandemic.

Methods This was an observational study via survey. Participants were recruited through the home dialysis nursing networks in Australia and the province of Ontario, Canada.

Results A total of 45 nurses responded to the survey, 53% (n=24) from Australia and 47% (n=21) from Ontario, Canada. The nurses identified that most units had moved to ‘virtual’ patient visits, only seeing those patients with urgent issues in person. They also reported problems with delivery of supplies for patients, implementation of social distancing during training, difficulties for patients with navigation of telehealth platforms for ‘virtual’ clinic visits, and staffing shortages with staff needing to stay home with any suspected COVID‑19 symptoms or contact. The nurses perceived that being flexible in their roles and working hours were helpful during the pandemic, while being ready to adapt at short notice was also important.

Conclusion During the COVID‑19 pandemic, patients receiving home dialysis have benefited from fewer healthcare facility visits and a greater ability to adhere to social distancing measures, thus limiting exposure to COVID‑19 infection. Yet, patients may face challenges relating to delay or back order of dialysis supplies and social isolation, and may struggle with telehealth platforms. Our learning experience from this pandemic will help us identify the challenges encountered and measures taken to address them.

Background Point-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by renal nurses in Australia. Its purpose is to assess arteriovenous fistulas (AVFs) prior to cannulation and to guide cannulation itself. It has been shown that renal nurses can be trained to acquire the advanced skills to use this method competently; however, it is not known if they communicate their observations to other healthcare professionals such as vascular access nurses, interventional radiologists or vascular access surgeons in tertiary hospitals.

Aim This scoping review sought to determine if it has previously been reported that renal nurses who use POCUS communicate specific patient findings.

Method The scoping review was performed using nursing and medical databases comprising MEDLINE, Embase, Web of Science and CINAHL Plus with Full Text.

Results

There is a paucity of knowledge about renal nurses communicating observations made using POCUS devices with other healthcare professionals. A PRISMA checklist has been used to validate the results of this scoping review.

Conclusions Despite evidence that renal nurses are increasingly using POCUS, it is unknown if they share their observations with other clinicians to advance care of their patients. An observational study is warranted to examine the communication processes in this respect. This information could prove to be useful in the context of advancing vascular access care for this patient group and could inform clinical practice.