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Supportive leadership in Swedish community night nursing
Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-9821-9945
Mälardalen University, School of Health, Care and Social Welfare. Ersta Sköndal University, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden.
Mälardalen University, School of Health, Care and Social Welfare. (CAREH)ORCID iD: 0000-0002-3307-6779
2010 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 7, p. 822-831Article in journal (Refereed) Published
Abstract [en]

Aim  The aim of the present study was to examine the support night nurses’ give to staff in community night nursing.

Background  Studies have shown that support given to staff is one of night registered nurses’ (RNs’) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.

Methods  All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations.

Results  The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.

Conclusions  Out of ‘concern for the staff’ the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs’ awareness that by giving support to staff this affects the staffs’ caring for older people.

Implications for nursing management  The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

The aim of the present study was to examine the support night nurses give to staff in community night nursing. Studies have shown that support given to staff is one of night registered nurses (RNs) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.

All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of concern for the staff  the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs awareness that by giving support to staff this affects the staffs caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

Place, publisher, year, edition, pages
Blackwell Publishing , 2010. Vol. 18, no 7, p. 822-831
Keywords [en]
care of older people, night nursing, nursing leadership, observations, support
National Category
Nursing
Identifiers
URN: urn:nbn:se:mdh:diva-10589DOI: 10.1111/j.1365-2834.2010.01155.xISI: 000283239100007PubMedID: 20946218Scopus ID: 2-s2.0-77958505520OAI: oai:DiVA.org:mdh-10589DiVA, id: diva2:359335
Available from: 2010-10-27 Created: 2010-10-27 Last updated: 2020-11-12Bibliographically approved
In thesis
1. Närhet på distans: Nattsjuksköterskors vårdande i kommunal äldreomsorg
Open this publication in new window or tab >>Närhet på distans: Nattsjuksköterskors vårdande i kommunal äldreomsorg
2009 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Registered nurses’ [RNs] experiences of caring in nursing, working  conditions for caring and reflection in municipal night care was explored to create expanded knowledge and understanding of care for older people. As a consequence of the Ädelreform and development in hospital health care a displacement from clinical health care to municipal care of older people has taken place. Night RNs’ work in the complex municipal care of older people implies single handed work in a consultative function. The RNs are distanced from the care receivers; it is care staff who mainly perform bed side caring. Municipal RNs’ care for older people during nights means trusting their own knowledge and reflective ability, in having nursing responsibility for large groups of old care recipients.   

 

This thesis takes point of departure in a qualitative research approach, with four empirical studies. These have been accomplished in a medium sized municipality in the middle parts of Sweden. The aims of the part studies were: to elucidate municipal night nurses’ experiences of the meaning of caring in nursing (I), to explore Swedish municipal night nurses’ experiences of their working conditions for caring in nursing (II), to examine the caring for care staff offered by municipal night nurses, in the setting of old care recipients people enrolled in the municipal social care system (III) and to describe nurses’ conception of reflection in their working situation (IV). Data were collected with interviews (I, II, IV), diary notes (II) and participative observations (III). The data were analyzed with phenomenological hermeneutics (I), thematic content analysis (II, III) and phenomenography (IV).

 

The results reveal that night RNs caring in nursing means the paradoxes: being close at a distance, being responsible without control and being independently dependent. Caring in nursing means a caring stance in prioritizing and taking responsibility for care recipients and care of care staff (I). Night RNs’ caring is dependent on the organization and care staff, and is complex by the fact that the RNs are not care staff leaders. The RNs’ autonomy prerequisite the ability to handle their work, which mainly means mediated caring communicated by telephone (II). The night RNs’ care of care staff means an informal nursing leadership. With their medical competence and authority the RNs occupy a superior caring leader function in nursing (III). Reflection is conceptualized as an instrument to handle the working situation and requires capacity of presence, flexibility and courage. To reflect is experienced to use knowledge, ethics and also personal values, in considering, estimating and assessing caring situations and actions (IV).

 

The conclusion of the studies (I-V) is that the night RNs’ caring is dependent on the prerequisites described in the dimensions of the organization, self-understanding and vocational and professional relations. The RNs must be able to reflect and handle the situation of caring at a distance, without loosing the vocational fundamental condition of caring, though the consultant function implies that they seldom encounter the care recipients. Increased quality, development and creating possibilities for dignity in care for older people means the RNs must participate more in bed side caring. The RNs should also be caring leaders and be given the opportunity for adequate specialist training in gerontology nursing.

Place, publisher, year, edition, pages
Karolinska Institutet, 2009
Series
Doktorsavhandlingar, NVS Karolinska Institutet
Keywords
Night nurses, caring, nursing, night nursing, phenomenological hermeneutics, thematic content analysis, phenomenography
National Category
Nursing
Research subject
vårdvetenskap
Identifiers
urn:nbn:se:mdh:diva-15098 (URN)978-91-7409-579-1 (ISBN)
Public defence
2009-11-20, Hörsal 1 röd,, Alfred Nobels Allé 23,, Huddinge, 13:49 (Swedish)
Opponent
Supervisors
Note
Medicine doktorsexamenAvailable from: 2012-08-20 Created: 2012-08-07 Last updated: 2015-02-04Bibliographically approved

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Gustafsson, ChristineAsp, Margareta

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