ATTENTION: Workforce shortages as a barrier to optimal dialysis.

Providing optimal end-stage kidney disease (ESKD) management requires an adequately trained and sufficiently staffed workforce, including doctors, nurses, and patient care technicians (PCTs). The growing need for ESKD services for a surging population of dialysis-dependent patients has made obvious a workforce crisis affecting nephrology. For a multitude of reasons, the physician workforce supply available to provide dialysis care has failed to expand commensurate with patients need in recent years. Of most importance, fewer US trainees are choosing to enter nephrology, and fewer international medical graduates are available to fill training program rosters. Equally important but less frequently cited are occupational shortages of trained dialysis nurses and PCTs. This article brings attention to this complex workforce shortage and addresses the limited information available regarding how it might constitute a barrier to optimal dialysis care.

The Shortage of Expert Nephrology Nurses in Hemodialysis: A Literature Review.

The expert nephrology nurse is an integral part of quality care and essential for continuity of care in the renal community. A review of literature focused on the expert nephrology nurse, the need for these experts in the hemodialysis setting, and how the shortage of expert nephrology nurses may impact patient outcomes. The purpose was to synthesize the current literature to provide an understanding of the shortage of expert nephrology nurses. The review of 140 articles dated from 1984 through 2016 resulted in 65 that met the inclusion and exclusion criteria. The results of this literature review of shortage of expert nephrology nurses prompts concern for the renal community and its patients.