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Municipal Night Nurses’ Experience of the Meaning of Caring
Mälardalen University, School of Health, Care and Social Welfare.ORCID iD: 0000-0002-9821-9945
Mälardalen University, School of Health, Care and Social Welfare.ORCID iD: 0000-0002-3307-6779
Mälardalen University, School of Health, Care and Social Welfare.
2009 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 5, p. 599-612Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding tovocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.

Place, publisher, year, edition, pages
2009. Vol. 16, no 5, p. 599-612
Keywords [en]
gerontologisk vårdvetenskap
National Category
Nursing
Identifiers
URN: urn:nbn:se:mdh:diva-7917DOI: 10.1177/0969733009106652ISI: 000268845300009PubMedID: 19671646Scopus ID: 2-s2.0-70249126570OAI: oai:DiVA.org:mdh-7917DiVA, id: diva2:292753
Available from: 2010-02-09 Created: 2010-02-09 Last updated: 2017-12-12Bibliographically 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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