Meanings Over Time of Working as a Nurse in Elderly Care

Abstract

Abstract:Background: Although registered nurses (RNs) play a central role in the care of older persons, their work in elderly care has historically been described as "low status" in nursing. This is especially problematic due to the global issue of RN turnover, but there is still little evidence of how to change this trend. Better understanding is needed of the reasons why RNs work in elderly care, as well as knowledge of whether these reasons have changed over time. Aim:The aim was to explore the meaning of working in elderly care, over time, from the perspective of RNs.Method: We interviewed thirteen RNs working in nursing homes, six of them in 2000 and the remaining seven in 2012, and analysed the resulting data using Interpretive Description. Results:The results show similarities and differences over time in the RNs' reasoning about the meaning of their work with older persons, from a focus on obstacles to a view of opportunities.Conclusion: An RN's intention to continue working in elderly care might be based on their beliefs; their view of older people, and their experiences of being able to influence the care. Managing this knowledge could be an essential factor in reversing the historical trend of RN work in elderly care being seen as low status, and the increasing turnover in such nurses. Our results could stimulate reflection on daily care and beliefs about caring for older persons.

Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

“…In this study, we learned from NAs’ experiences and knowledge of how a meaningful daily life can be developed for older persons in a nursing home. For a well-functioning team [ 6 , 12 , 13 ] it is crucial to learn from NAs and use that knowledge in the care of older persons, that is to sense and find the right way of being, and read the older person to judge how the person is feeling. It is crucial to adapt to the older person and share their daily life.…”

“…Blomberg et al .’s [6] study showed that the team can design this care and they can initiate changes in the care. A well-functioning team is crucial to good quality of care [13] because the better they work as a team the better everyone feels, including the older persons [7].…”

“…study [ 7 ] revealed that NAs described the care they provide as more than a job: they are driven by a desire to do the right thing . It is the “right” attitude that is required to work with older persons in nursing homes [ 6 , 7 ] that determines the content and quality of the care [ 7 , 10 ]. Further-more, it has also been shown that nursing staff use their involvement, friendliness and sensitivity in nursing homes to create positive situations, where the older person is treated as an individual [ 11 ].…”

“…Alongside NAs there is also the need for an interdisciplinary team of care providers who attend to the older persons’ psychosocial, emotional, spiritual, physical, and clinical care needs [ 12 ]. Blomberg et al .’s [ 6 ] study showed that the team can design this care and they can initiate changes in the care. A well-functioning team is crucial to good quality of care [ 13 ] because the better they work as a team the better everyone feels, including the older persons [ 7 ].…”

Technologies in older people’s care

“…This interaction seemed to be important source of meaning in caregivers' work, since caregivers expressed a lack of being appreciated by their employers, the care receivers' next-of-kin and society. The caregivers' wish of being present and having disturbance-free interactions can be understood in relation to the concept of attentiveness 5 and has likewise been described in a study 36 where RNs in care for older people valued caring time instead of administrative tasks. Caregivers in our study wanted to see the person behind the illness and be attentive towards not only the person's medical conditions but also their personal preferences and shifting needs.…”