RESUMO
OBJECTIVE: To identify the challenges, dilemmas and satisfactions presented by nursing professionals in hemodialysis services during the care of renal patients. METHOD: Institutional ethnography was used, and 18 semi-structured interviews were conducted with nine members of the nursing staff. Conventional content analysis was performed. RESULTS: For the nursing staff, care presents challenges such as the complex physical and emotional condition of patients, the management of technology for care, and coping with the suffering and death of patients with whom they have established a close relationship. The dilemmas are related to providing care for patients who refuse to receive it, and the personal and family costs involved in treatment in contrast to the limited quality of life of some patients. The main satisfactions are collaborative work, the sufficiency of resources and the confidence and recognition for performing independent work. CONCLUSION: The findings of the study are associated with the presence of professional burnout and interference in the ability to build satisfactory interpersonal relationships, lower job satisfaction and quality of care.