Sykepleiere i hjemmebaserte tjenester – hvorfor fortsetter de i sin stilling?
DOI:
https://doi.org/10.7557/14.4975Emneord (Nøkkelord):
helsetjenester i hjemmet, meningsfull sammenheng, salutogenetisk prosess, sykepleier, nurses, phenomenological hermeneutic method, remaining in current position, salutogenetic process, sense of coherence, Fenomenologisk hermeneutisk metode, fortsette i sin stillingSammendrag
Sykepleiere som arbeider i helsetjenester i hjemmet har krav om høy kvalitet på sykepleieutøvelsen. Samtidig har Norge en sykepleiermangel og primærhelsetjenesten utfordringer med å rekruttere og beholde sykepleiere. Studien beskriver og fortolker hva som var viktig for å fortsette i sin stilling som sykepleier i helsetjenester i hjemmet. En kvalitativ design ble benyttet. Deltakerne var seks sykepleiere i alderen 26 til 60 år ansatt i helsetjenester i hjemmet i en distriktskommune. Data ble samlet inn gjennom individuelle intervju. Transkriberte intervju ble analysert ved hjelp av fenomenologisk-hermeneutisk metode. Resultatene er formulert som fire tema: Å være ønsket velkommen hos pasienter; å ha samhold med kollegaer og leder; å ha variasjon i arbeidshverdagen; å ferdes i naturskjønne omgivelser. Studien konkluderer med at det som synes å være viktig for at sykepleiere fortsetter i sin stilling, er å ha en opplevelse av å lykkes. Studien løfter fram at dette synes å være mulig for sykepleierne i helsetjenester i hjemmet. Det er mulig når sykepleierne inngår i en sammenheng som er meningsfull, begripelig og håndterbar. Fordi sykepleiere har en sentral rolle i helsetjenester i hjemmet, trengs det mer forskning på hvorfor sykepleiere fortsetter i sin stilling.
Abstract
High-quality nursing care is a goal and requirement in health services. The Norwegian primary health care is challenged by a shortage of nurses, difficulties with recruiting and retaining nurses. This study aims to describe and interpret important aspects allowing nurses working in home healthcare to remain in their current position. A qualitative research design was used. The setting was one district municipality’s home healthcare. Six nurses aged between 26 and 60 years were recruited through strategic sampling to individual interviews. Data were analyzed using a phenomenological hermeneutic method. Four themes emerged from the analysis: Being welcome at the patients’ home; experiencing community with colleagues and leader; experiencing work task variety; traveling in scenic surroundings. Thus, the significance of having a sense of coherence, comprehensibility, and manageability cannot be too strongly emphasized. The study indicates that remaining in home healthcare practice seems to revolve around achieving a sense of success as a nurse.
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Referanser
Aiken, L.H., Sloane, D.M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Sermeus,W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet, 9931, 1824-1830. https://doi.org/10.1016/S0140-6736(13)62631-8
Allen, D. (2014). The invisible work of nurses: Hospitals, organization and healthcare. London: Routledge.
Andresen, I.H., Hansen, T., & Grov, E. (2017). Norwegian nurses’ quality of life, satisfaction with job, and their intention to change job - a study based on the LOGG data. Nordic Journal of Nursing Research, 37(2), 90-99. https://doi.org/10.1177/2057158516676429
Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Sociological Science Medicine, 36(6), 725-733. https://doi.org/10.1016/0277-9536(93)90033-Z
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health promotion international, 11(1), 11-18.
Antonovsky, A. (2012). Helsens mysterium - den salutogene modellen. Oslo: Gyldendal Akademisk.
Bjarnadottir, A. (2011). Work engagement among nurses in relationally demanding jobs in the hospital sector. Vård i Norden, 31(3), 30-34. https://doi.org/10.1177/010740831103100307
Bjerknes, M.S. & Bjørk, I.T. (2012). Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting. Nursing Research and Practice, 1-7. https://doi:10.1155/2012/690348
Brewer, C.S., Kovner, C.T., Djukic, M., Fatehi, F. Greene, W. Chacko, T.P. & Yang, Y. (2016). Impact of transformational leadership on nurse work outcomes. Journal of Advanced Nursing, 72(11), 2879–2893. https://doi.org/10.1111/jan.13055
Brook, J., Aitken, L., Webb, R., MacLaren, J. & Salmon, D. (2019). Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review. International Journal of Nursing Studies, 91, 47-59. https://doi.org/10.1016/j.ijnurstu.2018.11.003
Cohen, J., & Stuenkel, D. (2009). Providing a healthy work environment for nurses. The influence on retention. Journal of Nursing Care Quality, 24(4), 308–315. https://doi.org/10.1097/NCQ.0b013e3181a4699a
Cowden, T.L., & Cummings, G.G. (2012). Nursing theory and concept development: a theoretical model of clinical nurses’ intentions to stay in their current positions. Journal of Advance Nursing, 68(7), 1646–1657. https://doi.org/10.1111/j.1365-2648.2011.05927.x
Ellenbecker, C.H. (2004). A theoretical model of job retention for home health care nurses. Journal of Advanced Nursing, 47(3), 303–310. https://doi.org/10.1111/j.1365-2648.2004.03094.x
Ellenbecker, C.H., Porell, F.W., Samia, L., Byleckie, J.J. & Milburn, M. (2008). Predictors of home healthcare nurse retention. Journal of Nursing Scholarship, 40(2), 151-160. https://doi.org/10.1111/j.1547-5069.2008.00220.x
Ellenbecker, C.H., & Cushman, M. (2012). Home healthcare nurse retention and patient outcome model: discussion and model development. Journal of Advanced Nursing, 68(8), 1881–1893. https://doi.org/10.1111/j.1365-2648.2011.05889.x
Faris, S.A.S, Stigsdotter, U.K., Lottrupb, L. & Nilsson, K. (2012). Employees’ use, preferences, and restorative benefits of green outdoor environments at hospitals. Alam Cipta 5(2), 77-92. https://frsb.upm.edu.my/dokumen/FKRSE1_27-305-1-PB.pdf
Forbech Vinje, H. (2007). Thriving despite adversity: Job engagement and self-care among community nurses. (Doktoravhandling) Bergen: Universitetet i Bergen.
Furunes, T, Kaltveit, A. & Akerjordet, K. (2018). Health promoting leadership: A qualitative study from experienced nurses’ perspective. Journal of Clinical Nursing, 27(23-24), 4290-4301. https://doi.org/10.1111/jocn.14621
Gautun, H., Øien, H. & Bratt, C. (2016). Underbemanning er selvforsterkende. NOVA rapport 6/2016. Hentet fra: https://docplayer.me/27939869-Underbemanning-er-selvforsterkende.html
Halvorsrud, L., Kuburovic, J. & Andenæs, R. (2017). Jobbtilfredshet og livskvalitet blant norske hjemmesykepleiere. Nordisk tidsskrift for helseforskning, 13(1), 1-15. https://doi.org/10.7557/14.4119
Halvorsrud, L., Pahr, I. & Kvarme, L.G. 2014. Hjemmesykepleieren i møte med den nedstemte pasienten. Sykepleien Forskning, (3), 244-250. https://doi.org/ 10.4220/sykepleienf. 2014.0133
Helsedirektoratet. (2020). Kompetanseløftet 2020. Hentet fra: https://www.helsedirektoratet.no/om-oss/forsoksordninger-og-prosjekter/kompetanseloft-2020
Helse- og omsorgsdepartementet. (2009). Meld.St. 47. (2008-2009) Samhandlingsreformen. Hentet fra https://www.regjeringen.no/contentassets/d4f0e16ad32e4bbd8d8ab5c21445a5dc/no/pdfs/stm200820090047000dddpdfs.pdf.
Helse- og omsorgsdepartementet. (2015). Meld.St. 26 (2014-2015). Fremtidens primærhelsetjeneste – nærhet og helhet. Hentet fra: https://www.regjeringen.no/no/dokumenter/meld.-st.-26-2014-2015/id2409890/sec1
Helse- og omsorgsdepartementet. (2018). Meld.St.15 (2017–2018). Leve hele livet — En kvalitetsreform for eldre. https://www.ressursportal.no/meld-st-15-2017-2018-leve-hele-livet-en-kvalitetsreform-eldre. Hentet fra: https://www.regjeringen.no/no/dokumenter/meld.-st.-15-20172018/id2599850/
Higgins, G., Spencer, R.L. & Kane, R. (2010). A systematic review of the experiences and perceptions of the newly qualified nurse in the United Kingdom. Nurse Education Today, 30(6), 499- 508. https://doi.org/10.1016/j.nedt.2009.10.017
Hjemås, G., Zhiyang, J., Kornstad, T. & Stølen, N.M. (2019). Arbeidsmarkedet for helsepersonell fram mot 2035. Hentet fra: https://www.ssb.no/arbeid-og-lonn/artikler-og-publikasjoner/_attachment/385822?_ts=16c855ce368
Jackson, D., Clare, J. & Mannix, J. (2002). Who would want to be a nurse? Violence in the workplace − a factor in recruitment and retention. Journal of Nursing Management, 10(1), 13-20. https://doi.org/10.1046/j.0966-0429.2001.00262.x
Kirchhoff, J. (2011). Yrkesrelatert stress i hjemmebaserte tjenester. Sykepleien Forskning, (2)6, 144-150. https://doi.org/10.4220/sykepleienf.2011.0100
Kristoffersen, M. (2013). Strekke seg mot tinder, stå i kneiker: Om å fortsette i sykepleien. En studie av livsforståelsens betydning for sykepleieres utøvelse av sykepleie. (Doktoravhandling) Stavanger: Universitet i Stavanger.
Kristoffersen, M. & Friberg, F. (2015). The nursing discipline and self-realization. Nursing Ethics, 22(6), 723-733. https://doi.org/10.1177/0969733014543967
Kristoffersen, M. & Friberg, F. (2016). Transformasjonsledelse og økte effektivitetskrav i sykepleien. Nordic Journal of Nursing Research, 36(1), 13-19. https://doi.org/10.1177/010740831559516317.
Kristoffersen, M. & Friberg, F. (2017). Relationship-based nursing care and destructive demands. Nursing Ethics, 24(6), 663–674. https://doi.org/10.1177/0969733015623097
Kristoffersen, M. & Friberg, F. (2018). Remaining in the nursing profession: The relevance of strong evaluations. Nursing Ethics, 25(7), 928-938. https://doi.org/10.1177/0969733016684545
Kristoffersen, M. (2019a). Nurses’ remaining in everyday nursing practice – a comprehensive model. Sage Open Nursing, 5,1-9. https://doi.org/10.1177/2377960819866343
Kristoffersen, M. (2019b). Problematizing Boundaries of Care Responsibility in Caring Relationships. Sage Open Nursing, 5, 1-9. https://doi.org/10.1177/237796081880869212
Kramer, M. (1974). Reality shock; why nurses leave nursing. Saint Louis: C.V. Mosby Co.
Kvale, S., & Brinkmann, S. (2012). Det kvalitative forskningsintervju. Oslo: Gyldendal akademiske.
Leknes, S., Løkken, S.A., Syse, A., & Tønnesen, M. (2018). Befolkningsframskrivingene 2018. Modeller, forutsetninger og resultater. Hentet fra: https://www.ssb.no/befolkning/artikler-og publikasjoner/_attachment/354129?_ts=1643ab45088Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park: Sage.
Lindseth, A. & Norberg, A. (2004). A phenomenological hermeneutical method for researching lived experience. Scandinavian Journal of Caring Sciences, 18(2), 145–153. https://doi.org/10.1111/j.1471-6712.2004.00258.x
Mørk, E., Beyrer, S., Haugstveit, V.F., Sundby, B. & Karlsen, H.T. (2018). Kommunale helse- og omsorgstjenester 2017. https://www.ssb.no/helse/artikler-og-publikasjoner/_attachment/358290?_ts=165a44eac40
Polit, D.F. & Beck, C.T. (2018). Essentials of Nursing Research. Philadelphia: Wolters Kluwer.
Silverman, D. (2006). Interpreting qualitative data. London: Sage Publications.
Skjøstad, O., Beyrer, S., Hansen, J. & Hjemås, G. (2019). Sykepleieres arbeidssted og nyutdannede sykepleieres tilknytning til arbeidslivet. Hentet fra:
Skjøstad, O., Hjemås, G. & Beyrer, S. (2017). 1 av 5 nyutdanna sykepleiere jobber ikke i helsetjenesten. Hentet fra: https://www.ssb.no/helse/artikler-og-publikasjoner/1-av-5-nyutdanna-sykepleiere-jobber-ikke-i-helsetjenesten.
Taylor, C. (1999). Philosophy and the human sciences. Philosophical papers 1. Cambridge: University Press.
Texmon, I. (2013). Dagens og morgendagens eldre – en demografisk beskrivelse. I: Ramm, J. (Red.), Eldres bruk av helse og omsorgstjenester (s.27-38). Hentet fra: https://www.ssb.no/helse/artikler-ogpublikasjoner/_attachment/125965?_ts=13f8b5b6898
Tourangeau, A., Cranley, L., Laschinger, H.K.S., & Pachis, J. (2010). Relationship among leadership practice, work environments, staff communication and outcomes in long-term care. Journal of Nursing Management, 18(8), 1060 – 1072. https://doi.org/10.1111/j.1365-2834.2010.01125.x
Verdens helseorganisasjon. (2014). A universal truth: No health without a workforce. https://www.who.int/workforcealliance/knowledge/resources/GHWA-a_universal_truth_report.pdf.
Verdens helseorganisasjon. (2019). Call to action: Addressing the 18 million health worker shortfall. Hentet fra: https://www.who.int/hrh/news/2019/call-to-Action-Campaign-FirstRoundSubmissions.pdf?ua=1
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