Satellite dialysis nursing: technology, caring and power.
This paper is a report of an exploration of nurses' perceptions of the quality of satellite dialysis care and how aspects of power that influenced quality nursing care. In Australia, the majority of people living with established kidney failure undertake haemodialysis in nurse-run satellite dialysis units. Haemodialysis nurses provide the majority of care, and their perceptions of what constitutes quality nursing care may influence their care of the person receiving haemodialysis. A critical ethnographic study was conducted where data were collected from one metropolitan satellite dialysis unit in Australia over a 12-month period throughout 2005. The methods included non-participant observation, interviews, document analysis, reflective field notes and participant feedback. Three theoretical constructs were identified: 'What is quality?', 'What is not quality?' and What influences quality?' Nurses considered technical knowledge, technical skills and personal respect as characteristics of quality. Long-term blood pressure management and arranging transport for people receiving dialysis treatment were not seen to be priorities for quality care. The person receiving dialysis treatment, management, nurse and environment were considered major factors determining quality dialysis nursing care. Aspects of power and oppression operated for nurses and people receiving dialysis treatment within the satellite dialysis context, and this environment was perceived by the nurses as very different from hospital dialysis units.