The dialysis nurse has a unique role in the care of her patients. The uniqueness of her role is directly related to the special stress long-term hemodialysis mediates upon the patient. This stress often promotes significant psychological regression, with its attendant problems of immature behavior, dependency and even overt psychiatric symptoms. The nurse, because of her special relationship to the patient, is the first and often the only professional to deal with these problems. How well she can deal with this responsibility depends on several variables. The role she learned in her training will dictate her propensity to innovatively respond to the patient. A pleasant relationship with the medical staff will greatly sustain the personal comfort necessary for such demanding work. Participation in patient selection helps her understand the purpose and nature of her commitment.