Nephrology Nursing Journal September-October 2021 Vol. 48, No. 5 447 Nephrology nurses provide complex technological care to large numbers of patients who have a substantial clinical burden (Li et al., 2018). This care can also involve provid- ing long-term support to motivate and comfort patients and their families in the face of declining health and mor- tality due to the progressive nature of chronic kidney dis- ease (CKD) (Bednar & Latham, 2014; Hayes & Bonner, 2010; Meguid El Nahas & Bello, 2005; Neild, 2017; Thompson et al., 2015). The close relationships nephrology nurses have with their patients, combined with the pres- sures of a demanding workload, can often result in emo- tional and physical work-related stress (Ashker et al., 2012; Flynn et at., 2009; Hayes & Bonner, 2010; Kapucu et al., 2009). This stress can have an adverse effect on the well- being of nephrology nurses (Ashker et al., 2012). Factors that influence the lack of well-being of nephrology nurses include poor interpersonal relationships with colleagues, the inability to deliver quality patient care, and long shifts (Ashker et al., 2012; Hayes & Bonner, 2010). Planful prob- lem solving, seeking social support, self-control, positive reappraisal, and positive interpersonal relationships with colleagues are associated with increased well-being and decreased job stress levels (Ashker et al., 2012; Hayes & Bonner, 2010). However, Hayes and Bonner (2010), in a review of the literature, also found that interpersonal rela- tionships with physicians were identified as having both a positive and negative influence on job stress and burnout. Employers experience major challenges in recruiting, training, and retaining nephrology nurses (Gaietto & Brooks, 2019; Gardner et al., 2007; Mehrotra et al., 2011; Wolfe, 2014). Gardner and colleagues (2007) found evi- dence of high attrition among this essential workforce. In a study by Ulrich and Kear (2018), 40% of the nephrology nurse respondents reported that they planned to leave their current positions in the next three years, with most plan- ning to retire or take another position in clinical/patient care nursing. The attrition rate for nephrology nurses is anticipated to continue rising as factors that contribute to work-related stress persist (Gaietto & Brooks, 2019; Mehrotra et al., 2011). This is particularly concerning given Copyright 2021 American Nephrology Nurses Association. Montoya, V., Donnini, K., Gauthier-Loiselle, M., Sanon, M., Cloutier, M., Maitland, J., Guérin, A., Dutka, P., Pryor, L., Thomas-Hawkins, C., Voegel, A., Hoffman, M., Savin, S., Kurzman, A., & Kear, T. (2021). Mental health and health- related quality of life among nephrology nurses: A survey- based cross-sectional study. Nephrology Nursing Journal, 48(5), 447-461. https://doi.org/10.37526/1526-744X.2021. 48.5.447 Nephrology nurses face health and wellness challenges due to significant work-related stressors. This survey, con- ducted online between July 24 and August 17, 2020, assessed the psychological well-being of nephrology nurs- es in the United States during the COVID-19 pandemic (n = 393). Respondents reported feeling burned out from work (62%), symptoms of anxiety (47% with Generalized Anxiety Disorder-7 [GAD-7] scores ≥ 5), and major depressive episodes (16% with Patient Health Questionnaire-2 [PHQ- 2] scores ≥ 3). Fifty-six percent (56%) of survey respon- dents reported caring for COVID-19 patients, and 62% were somewhat or very worried about COVID-19. Factors, including high workload, age, race, and the COVID-19 pan- demic, may partially explain the high proportion of nephrol- ogy nurses who reported symptoms of burnout, anxiety, and depression. Key Words: Nephrology nurses, mental health outcomes, health-related quality of life, mental health survey. Mental Health and Health-Related Quality of Life Among Nephrology Nurses: A Survey-Based Cross- Sectional Study Vicki Montoya, PhD, APRN, FNP-BC, Katie Donnini, BA, Marjolaine Gauthier-Loiselle, PhD, Myrlene Sanon, MPH, Martin Cloutier, MSc, Jessica Maitland, MScPH, Annie Guérin, MSc, Paula Dutka, MSN, RN, CNN, Lillian Pryor, MSN, RN, CNN, Charlotte Thomas-Hawkins, PhD, RN, FAAN, Arthur Voegel, MA, Mark Hoffmann, PhD, Samuel Savin, BA, Alissa Kurzman, MPH, and Tamara Kear, PhD, RN, CNN, FAAN Nephrology NursiNg JourNal the time it takes to train nephrology nurses and the increased need for skilled nephrology nurses to address the growing clinical burden of chronic kidney disease (CKD) and its associated morbidities (e.g., diabetes, hypertension) (Gaietto & Brooks, 2019; Sharif et al., 2016). The current pandemic due to the novel coronavirus dis- ease of 2019 (COVID-19) has amplified the health and wellness challenges faced by nurses (Lai et al., 2020; Neto et al., 2020). In a survey of frontline health care providers Note: Author biographical statements appear on next page.