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Care priorities: Registered nurses’ clinical daily work in municipal elderly care settings
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-1174-2523
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, 388-395 p.Article in journal (Refereed) Published
Abstract [en]

Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. Inaccording to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure isperceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web-based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and wereattributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in southwestern Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation. © 2012 Nordic College of Caring Science.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2012. Vol. 27, no 2, 388-395 p.
Keyword [en]
delegation, elderly, home care, intervention, municipal care, priorities, Registered Nurse, support
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-19324DOI: 10.1111/j.1471-6712.2012.01051.xISI: 000318815700023PubMedID: 23003218Scopus ID: 2-s2.0-84877795395OAI: oai:DiVA.org:hh-19324DiVA: diva2:546330
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2017-04-13Bibliographically approved
In thesis
1. The bright side of life: support in municipal elderly home care
Open this publication in new window or tab >>The bright side of life: support in municipal elderly home care
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Registered nurses in municipal elderly home care have in some occasionsdifficulties in identifying the patients’ needs and prioritize intervention inaccordance with the patients’ preferences, which is to obtain social and emotional support. The overall aim was to explore and describe which supportive interventions registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: A retrospective descriptive study (I ) were conducted and followed up by a qualitative approach with Grounded Theory as a method (II IV ). Sample to study; I , registered nurses (62) performed interventions to 6138 patients between 80- 109 years. II , 12 registered nurses, who performed 36 home visits to patients between 80- 102 years. III , 16 registered nurses. IV , 18 patients between 80- 96 years. Data was collected by; I , between 2004- 2008, during the months of April and October using a web- based form which was filled in by registered nurses. II , through nonparticipant observations when the registered nurse made a home visit. III and IV , using informal conversational interviews. Results: Combined, the four studies show that emotional support is important to a group of older patients because it helps them to experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward in a dignify way. Patients lost or reduced ability to process their emotions makes so that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mission is to identify their needs and guide them into a state of serenity. Registered nurses on the other hand, makes priorities based on patients preferences. Registered nurses strengths was their profession that contributed to the patient's emotions became available to them. Weaknesses was registered nurses workload and lack of knowledge about the identification of emotions. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. 70 p.
Series
Örebro Studies in Care Sciences 45, ISSN 1652-1153 ; 45
Keyword
Emotion, elderly home care, intervention, priorities, support, registered nurse, older patients, serenity
National Category
Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:hh:diva-25804 (URN)978-91-7668-940-0 (ISBN)
Public defence
2013-06-14, Hörsal 2 Prismahuset, HSP2, Örebro universitet, Fakultetsgatan 1, Örebro, 14:10 (English)
Opponent
Available from: 2014-06-27 Created: 2014-06-23 Last updated: 2015-02-18Bibliographically approved

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