Sykepleiernes eksistensielle erfaringer i relasjon med den døende pasient og pasientens pårørende i hjemmesykepleien

Master's thesis in Health and social sciencesPurpose: The purpose of this study was to describe and interpret how nurses in home care cope with existential experiences in relation with the dying patient and the patient's relatives. The overarching aim is to contribute knowledge that can prevent stress and burnout among nurses and strengthen the palliative care to patients and their families in home care. Method: Qualitative method with a hermeneutical approach was applied. Sem-structured interviews with 6 nurses were conducted. The analysis was conducted based on the principles for hermeneutical sense interpretation. Findings: The analysis concluded in two main themes: 1) Nurse's vulnerability as a resource and risk in caring relationship and 2) The importance of communication and support. Conclution: The study shows that it can be difficult to find time and space to communicate with colleagues about existential issues in a hectic day. Despite the good colleague support nurses often experienced loneliness, powerlessness and isolation at work. There is a great need to put aside time for systematic reflection and guidance for nurses who work with the dying and their families in home care

Spenninger i flerkulturelle arbeidsfellesskap ved sykehjem. En etnografisk studie

Bakgrunn: Pleiepersonellets samhandling i sykehjem er viktig for kvaliteten på omsorgen for mennesker i livets sluttfase og for de ansattes egen velferd. I studien undersøker vi hvordan pleiepersonell i norske sykehjem opplever og forholder seg til det flerkulturelle arbeidsfellesskapet. Metode: Etnografisk feltarbeid og narrative intervjuer med nøkkelinformanter i sykehjem. Dataanalysen tok utgangspunkt i to situasjoner beskrevet i feltnotater som var representative for spenninger i arbeidsfellesskapet. Disse ble videre undersøkt gjennom en psykososial tilnærming med gruppebasert dybdehermeneutisk fortolkning. Resultat: Gjennom analyseprosessen identifiserte vi to nøkkelfunn: 1) Å se pleiere med innvandrerbakgrunn som et problem i en arbeidshverdag preget av travelhet og tidspress, og 2) Strategier for å unngå å bli stigmatisert som et (innvandrer)problem. Funnene viser hvordan diskriminering og rasisme utspiller seg på sykehjem, både gjennom indirekte og direkte ytringer. Konklusjon: I denne studien anvendte vi begrepene «indre rasist» og «mikroaggresjon» for å fortolke nøkkelfunnene og bedre forstå både minoritets- og majoritetsnorske pleieres uttalelser om ansatte med minoritetsbakgrunn så vel som våre egne holdninger som forskere i omgang med data fra feltarbeidet. De reelle uttrykkene for både implisitt og eksplisitt diskriminering og rasisme som belyses i denne studien, angår oss alle som medmennesker og medborgere i et mangfoldig samfunn.publishedVersio

"They stay with you": Nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who died

Aim: To explore and develop understanding of nursing home staff’s emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff (n=6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident’s death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with “special residents” in long-term care. To support holistic practice, awareness is needed of the emotional impact of relationships on health professionals. Suppressing feelings puts staff at risk of moral distress, compassion fatigue, and burnout, as well as higher turnover and absenteeism.Managers should facilitate discussions on professionals’ ideals of relationship- based practice, including processing of, and reflection on, emotional experiences in long-term care. Rituals to mark a resident’s death can provide further emotional containment.publishedVersio