Preconditions for district nurses’ telephone counselling during call-time in municipal home care: An observational study

Abstract

Telephone counselling is a growing and complex task for district nurses in municipal home care, especially during evenings and at weekends. Work at call-time is often handled via telephone from cars, without access to records or other information about patients. There is a lack of research in this subject. The aim of this study was to explore preconditions for district nurses' telephone counselling at call-time. An observational study with an inductive approach was conducted. A structural protocol was used with a following open question. Seven district nurses who worked in home care in two municipalities in Sweden participated. Data were analysed using content analysis. Five categories were identified: 'availability', 'professionalism', 'communicability, 'secure approach', and 'technical approach'. Accessibility appears to be given priority over security. Ethical reflection is required on telephone management policy for district nurses' telephone counselling while driving and other interventions that require undivided attention.

Registered nurses’ challenges and suggestions for improvement of their leadership close to older adults in municipal home healthcare

“…Moreover, RNs perceive that care staff’s lack of competence is a challenge for their leadership. In Sweden, it has been described as necessary for RNs to delegate work tasks in nursing care to care staff to make home healthcare work [ 13 , 30 ]; education is often included in the delegation [ 13 ]. A comparison between 2005 and 2015 shows that medical tasks performed by care staff, such as giving injections, had increased [ 62 ].…”

“…RNs’ leadership includes ensuring customized and sufficient care by planning, supervising and following up the older adult’s care [ 16 ]. RNs coordinate the care for older adults [ 6 , 14 , 29 ] and are expected to guide care staff and solve problems [ 30 ]. RNs as leaders close to older adults, are described as being multi-artists [ 6 ], which entails trust and control, continuous learning, competence through knowledge and ability, nursing responsibility on an organizational level, application of skills, awareness of the individual’s needs and wholeness, mutual support, mutual relationships, collaborating on organizational and interpersonal levels, and exposure to challenges.…”

Registered nurses’ experiences of information technology use in home health care - from a sustainable development perspective

“…From an environmental dimension, unnecessary travel is reduced. This is confirmed by Jonasson, Holgersson, Nytomt and Josefsson [25], who believe that communication IT (such as mobile phones/smartphones) is an essential tool for the RN in HHC, providing the opportunity for counselling and teaching, as well as for getting in touch with patients, relatives, colleagues and other healthcare professionals. Other findings show that RNs see IT and communication IT as a means of increasing accessibility.…”

“…RNs working in elderly care experience stress when they feel alone in complex work situations and are frustrated by the expectation that they should know everything and should be everywhere at the same time [3]. As Jonasson, Holgersson, Nytomt and Josefsson [25] emphasise, IT and IT solutions need to be adapted to the complex work of RNs in home care. IT that is adapted to the needs of the HHC system helps ensure a safer working environment.…”

“…Tingle [ 24 ] describes care in healthcare systems as a risky business, where a lack of communication, insufficient training and knowledge, as well as the health culture, can be underlying causes of inadequate patient safety. The findings of a study by Jonasson et.al [ 25 ] also revealed that technology could both be a facilitating work tool and a frustrating hindrance for RNs. Perhaps RNs’ knowledge of IT provides an understanding of how it might be changed for the good of future nursing, in the context of sustainable development [ 26 ]?…”