The Australian and New Zealand nephrology nursing workforce: clinical pressure and organisational culture.

There has been increasing prevalence in the community of chronic kidney disease and an increased demand for nephrology trained nursing staff. We explored how nephrology trained nurses are impacted by daily caseload pressure, organisational support and workplace education. A co-designed 57-item questionnaire developed by the research team and clinical nephrology nurses hosted on Qualtrics™ was distributed to nephrology nurses in Australia and New Zealand. The 370 respondents described a strong professional identity as a nephrology nurse. 70% described pressure to work overtime and only 2% were adequately staffed. 40% felt at times that their patients clinical care was 'unsafe' and one-third described the erosion of work-based educational opportunities. However, team collegiality was high, a strength of the nursing profession. The nephrology nursing workforce will face important challenges over the next decade and there must be an organisational response to prevent continued staff shortages.