Nordic homecare nursing from the perspective of homecare nurses—a meta-ethnography

Abstract

The pressure on homecare nursing in the Nordic countries has increased in recent years because of a reorganisation of healthcare systems that has put a focus on very early discharge from hospital as well as demographic changes. This article details an analysis of the findings of 13 published qualitative research reports about Nordic homecare nurses' experiences of their work. Using a process of meta-ethnography, the authors identify five themes within the primary research: home care as a professional practice on foreign ground; home care as a massive time constraint; home care as fair rationing; home care as relationships with relatives as fellow players or opponents; and home care as latent paternalism. These have two main implications for practice: homecare nurses should continuously be taught how to cooperate with partners who are emotionally involved; and also homecare nurses may benefit from training that focuses on the challenges of carrying out professional work in private settings

Home‐care nurses’ distinctive work: A discourse analysis of what takes precedence in changing healthcare services

“…Working in the patient's own home impacts the working conditions and nurses must adapt their work accordingly. This is a special feature of the work that is often highlighted in studies of home-care nursing (Martinsen et al, 2018;Öresland et al, 2008). Also, the work takes place not only in one home but in many different homes, and thus includes many varied contexts.…”

“…The context of working in a patient's home poses challenges relating to the provision of care and working conditions. Several studies have highlighted the professional and ethical challenges encountered by performing nursing in a home context (Martinsen, Mortensen, & Norlyk, 2018; Öresland, Määttä, Norberg, Jörgensen, & Lützén, 2008) in addition to the logistics of traveling from home to home (Holm & Angelsen, 2014; Skinner, Yantzi, & Rosenberg, 2009). Home‐care nurses face many expectations and demands, and a massive time restraint is highlighted by many as characteristic of their work (Bendix Andersen, Beedholm, Kolbæk, & Frederiksen, 2018; Fjørtoft, Oksholm, Førland, Delmar, & Alvsvåg, 2020; Pusa, Hägglund, Nilsson, & Sundin, 2015; Turjamaa, Hartikainen, & Pietilä, 2013).…”

“…The context of working in a patient's home poses challenges relating to the provision of care and working conditions. Several studies have highlighted the professional and ethical challenges encountered by performing nursing in a home context (Martinsen, Mortensen, & Norlyk, 2018;Öresland, Määttä, Norberg, Jörgensen, & Lützén, 2008) in addition to the logistics of traveling from home to home (Holm & Angelsen, 2014;Skinner, Yantzi, & Rosenberg, 2009).…”

Struggles with infrastructures of information concerning hospital-to-home transitions

“…A cross the globe, policy demands have called for a move of care delivery from secondary to primary care due to demographic changes and an increase in the number of older people with multiple comorbidities (Violan et al, 2014;Martinsen et al, 2018). Accordingly, health systems undergo reorganisation, with a specific focus on short in-patient stay, specialised treatment and very early discharge.…”

“…Accordingly, health systems undergo reorganisation, with a specific focus on short in-patient stay, specialised treatment and very early discharge. However, several studies stress that homecare nurses are facing many challenges due to the increased demand of supporting patients with more complex medical conditions and health needs (Martinsen et al, 2018;Phelan et al, 2018).…”