Aim: A haemodialysis unit is an ideal setting for maximising client involvement but this requires a commitment to the process on the part of the nurse. The aim of the study was to discover the nurse’s experience of client involvement in an acute haemodialysis setting

Method: Semi structured interviews with five senior haemodialysis nurses were transcribed and analysed for themes.

Findings: Four themes were revealed: forming relationships, navigating the way, finding the balance, and riding the rapids. Nurses described the way they steer their clients through their dialysis experiences using various strategies dependant on the relationships they developed. They described the involvement continuum and the methods used to gradually release the clients from their initial dependence on nurses. Participants revealed many barriers to the client’s successful transition to independence.

Conclusion: The findings emphasize the importance of the nurse-client relationship, the extent to which the relationship is influenced by the dynamics of the situation and the influence of the philosophical outlook of the nurse.