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Registered and Specialist Nurses' Perspectives on Organisational Changes in Swedish Municipal Home Care: A
Elzana Odzakovic1, Agneta Kullberg2, Therése Bielsten3
1Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
Aim:
To explore and characterise organisational changes related to clinical competencies, responsibilities, and roles from the perspectives of registered and specialist nurses in municipal home care settings.
Design:
A qualitative exploratory study was conducted.
Methods:
Inductive thematic analysis was used to analyse field notes from shadowing 18 participants (12 registered nurses and six specialist nurses) from the beginning of their working day until the end of their shift.
Results:
The analysis revealed four main themes: the black box in the health care system; workarounds in the workplace; a profession on the brink of change; and the transfer of tasks towards the neighbourhood with linked subthemes.
Conclusion:
This study indicates that registered and specialist nurses in municipal home care need to be more visible in the health care system, collaborating with others and as part of broader society, to meet the needs of the increasing number of older people living at home.
Patient Or Public Contribution:
The results can be used when developing home care in communities by acknowledging the accountability that registered and specialist nurses exercise, despite limited resources and support, as well as recognising the importance of advanced practice nurses in coordinating home care. This study also highlights potential suggestions for developing municipal home care by acknowledging the accountability of registered and specialist nurses.
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