Nursing the machine: An ethnography of a hospital haemodialysis unit

Public Knowledge Project
Publication Type:
Journal Article
Journal of Nephrology & Renal Transplantation, 2009, 2 (3), pp. 28 - 41
Issue Date:
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This paper reports the process and findings of an ethnography conducted in a hospital haemodialysis unit. The aims of the study were to acquire a comprehensive understanding of how nursing care was conducted in a hospital haemodialysis unit and to identify structural and cultural enablers or barriers to the provision of patient centred care. Five themes were identified. Doing more with less, who gets a machine?, technological creep, "dialysis centred care and the bottom line. These themes were seen to impinge on the nurses ability to provide patient centred care. The study confirmed that the nursing culture in the hospital haemodialysis unit did not enable nurses the opportunity to recognise the patients suffering and discomfort and failed to provide any interventions to ameliorate it. The focus for nurses needed to shift from care associated with the dialysis procedure to a more holistic patient centred model.
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