Because this is true, it is critically clear that the nursing leadership manager's role is one of a vital nature and that support for nurses in their role is the primary component that must necessarily be integral to leadership in nursing in dialysis units if the turnover of nurses is reduced to the lowest possible level. The nursing leadership manager's role is one that must proactively deal with burnout of these dialysis unit nurses instead of attempting to address these as they occur. Prevention is 'key' toward this end. As the demands grow for quality and competent nursing staff so does the need grow for competency in leadership nursing manager roles. Because the dialysis unit nurse is very closely involved in their patient's care and because these patients are required to report for treatment several days a week for several hours a day the nurse's mental, physical and emotional state and effectiveness quite clearly has impacts on the outcomes of dialysis patients. Bibliography

Aiken, L.H., & Patrician, P. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49, 146-153.

Aiken, L.H., & Sloane, D.M. (1997). Effects of organization innovation in AIDS care on burnout among urban hospital nurses. Work Occupation, 42, 453-477.

Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction [Electronic version]. JAMA, 288, 1987-1993.

Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R.A., Clarke, H., Giovanetti, P., Hunt, J., Rafferty, a.M., & Shamian, J. (2001). Nurses' reports on hospital care in five countries [Electronic version]. Health Affairs, 20, 43-53.

Aiken, L.H., Havens, D., & Sloane, D. (2000). The magnet nursing services recognition program: A comparison of two groups of magnet hospitals. American Journal of Nursing 100, 26-36.

Aiken, L.H., Sloane, D., & Lake, E. (1996). Satisfactions with inpatient AIDS care: A national comparison of dedicated and scatter-bed units. Medical Care, 35, 948-962.

Aiken, L.H., Sloane, D.M., & Klocinski, J.L. (1997). Hospital nurses' risk of occupational exposure to blood: Prospective, retrospective, and institutional reports. American Journal...

(1994). Lower Medicare mortality among a set of hospitals know for good nursing care. Medical Care, 32, 771-787.
Bednar, B., Steinman, T.I., & Street, J. (2002). Changing the operating structure in renal nursing. Nephrology News and Issues, 16, 25-28.

Brett, J.L., & Tonges, M.C. (1990). Restructured patient tare delivery: Evaluation of the ProAct model. Nursing Economic$, 8, 36-44.

Buerhaus, P.I., Needleman, J., Mattke, S., & Stewart, M. (2002). Strengthening hospital nursing [Electronic version]. Health Affairs, 27, 123-132.

Buerhaus, P.I., Staiger, D.O., & Auerbach, D.I. (2000). Implications of an aging registered nurse workforce. JAMA, 283, 2948-2954.

Davis, P.A. (1992). Unit-based shared governance: Nurturing the vision. Journal of Nursing Administration, 22, 46-50.

Lake, E.T. (2002). Development of the practice environment scale of the nursing work index. Research in Nursing & Health, 25, 176-188.

Levine, L. (2001). A shortage of registered nurses: Is it on the horizon or already here? (RL30974). Washington, DC: Congressional Research Service.

Mapes, D.L., Bodfish, L.J., Pisoni, R.L., Rayner, H.C., Young, E.W., & Held, P.J. (2001). Predictors of staffing practices in hemodialysis (HD) facilities: Dialysis Outcomes and Practice Patterns Study (DOPPS).Journal of the American Society of Nephrology Abstracts, 12, 337A.

McClure, M.L., Poulin, M.A., Sovie, M.D, & Wandelt, M.A. (1983). Magnet hospitals: Attraction and retention of professional nurses. Kansas City, MO: American Academy of Nurses.

Scott, J.G., Sochalski, J., & Aiken, L. (1999). Review of magnet hospital research: Findings and implications fur professional nursing practice. Journal of Nursing Administration, 29, 9-19.

Steib, Karen (2008) Careers in Nephrology Nursing. Minority Nurse. 2008. http://www.minoritynurse.com/features/nurse_emp/10-25-05d.html

Thomas-Hawkins; Denno, Mary; Currier, Helen; and Wick, Gail (2003) Staff Nurses' Perceptions of the Work Environment in Freestanding Hemodialysis Facilities. Nephrology Nursing Journal August 2003.

The Role of the Nurse Manager in the Clinical Outcome of Dialysis Patients