Changing the operating structure in

In the ongoing series published in Nephrology News & Issues entitled "Running on Empty," compelling information relative to the severity of the nursing shortage and possible duration has been presented. As the end-stage renal disease (ESRD) population continues to increase, the shortage of nephrology nurses will become a mounting problem. This article offers a potential redesign in the operating structure of many renal dialysis and transplant centers that will redefine the role of the registered dialysis nurse. Possible strategies for the successful recruitment and retention of nephrology nurses are also addressed.