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Advanced practice nurses in nephrology: collaborative solutions to manpower shortages.

As the shortages of both nephrologists and experienced staff nurses increase, innovative solutions will be necessary. The most common CPM will continue to be the nephrology APN hired by and working in collaborative practice with nephrologists to provide care across all settings (hospital, office and dialysis unit). Creative arrangements between dialysis corporations, nephrologists, and APNs may also provide for a team approach for treating renal disease patients within the dialysis unit. The team would include the nephrologist, APN, dialysis staff, dietitian, and social worker. Each team member would fulfill roles appropriate to their training, experience, and demonstrated level of competence with the common goal of improved patient outcomes. This would provide the best use of limited resources.