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

"Jeg klarer ikke finne noen ord". Å arbeide tett på døden

Denne boken er utgitt Open Access og er omfattet av åndsverklovens bestemmelser og Creative Commons-lisens CC BY-NC 4.0. Publikasjonen kan aksesseres på: https://s3-eu-west-1.amazonaws.com/spartacus.no/production/attachments/Alt%20som%20lever%20m%C3%A5%20d%C3%B8_Open%20Access.pdfDøden angår oss. Våre dødsforestillinger sier noe om hvem vi er, hvordan vi oppfatter oss selv, og hva som er viktig for oss. Tanatologi er vitenskapen og læren om døden. Den utgjør et voksende tverrfaglig felt internasjonalt. Alt som lever, må dø bidrar til å sette tanatologien på kartet i Norge. Boka springer ut fra et nytt nordisk nettverk av forskere som arbeider med døden fra ulike perspektiver og ulike fag: idéhistorie, filosofi, helsefag, kulturstudier, litteraturvitenskap, psykososiale studier, sosiologi og teologi. Er døden vårt siste tabu, eller snakker vi tvert imot mer om den enn før?I vår tid er døden blitt et medisinsk anliggende som først og fremst håndteres av helsepersonell. Hvordan skal vi forholde oss til døden som enkeltindivider og samfunn?Utgitt med støtte fra Fritt Ord, Avdeling for tverrfaglig helsevitenskap ved Det medisinske fakultet (UiO), Det helsevitenskapelige fakultet (UiS), Nettverk for kjønnsforskning (UiS), samt forskergruppene Profesjonelle relasjoner i velferdsyrker (UiS) og Samfunn, helse, makt (UiO).publishedVersio

How do migrant nursing home staff relate to religion in their work with patients who are approaching death?

Abstract Aim: To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and theory: Individual in-depth interviews were conducted with 16 migrant healthcare workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a “thick description” of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of significance. Findings: Religion held various meanings for the migrant healthcare workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants related to religion at work was therefore based on individual preferences and internalized practices. Conclusion and implication for practice: Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being.publishedVersio

"Jeg klarer ikke finne noen ord". Å arbeide tett på døden

Døden angår oss. Våre dødsforestillinger sier noe om hvem vi er, hvordan vi oppfatter oss selv, og hva som er viktig for oss. Tanatologi er vitenskapen og læren om døden. Den utgjør et voksende tverrfaglig felt internasjonalt. Alt som lever, må dø bidrar til å sette tanatologien på kartet i Norge. Boka springer ut fra et nytt nordisk nettverk av forskere som arbeider med døden fra ulike perspektiver og ulike fag: idéhistorie, filosofi, helsefag, kulturstudier, litteraturvitenskap, psykososiale studier, sosiologi og teologi. Er døden vårt siste tabu, eller snakker vi tvert imot mer om den enn før?I vår tid er døden blitt et medisinsk anliggende som først og fremst håndteres av helsepersonell. Hvordan skal vi forholde oss til døden som enkeltindivider og samfunn

Who thinks about death? A psychoanalytically informed interpretive study of communication about death among nursing home staff

The purpose of the present study was to gain insight into how death is a theme of communication and reflection among staff at a multicultural nursing home. Sixteen interviews with healthcare providers from five nursing homes in Norway were conducted and interpreted through a depth-hermeneutic approach. Our analysis across the dataset yielded an emergent finding related to a prominent lack of communication about death between the healthcare personnel and the patients, as well as among the staff community. We present a psychoanalytically informed interpretation of the absence of talk about death in the nursing homes. Our results indicate the operation of a social defence that helps health care providers maintain distance from anxiety associated with death. Reflection that foregrounds healthcare personnel’s own experiences, feelings and thoughts related to death is needed to encourage staff to open up to, and digest, the various impressions death can generate.publishedVersio

The function of ritualized acts of memory making after death in the neonatal intensive care unit

(1) Background: Some infants die shortly after birth, leaving both parents and nurses in grief. In the specific setting where the data were collected, the bereaved parents receive a scrapbook made by the nursing staff in the NICU, and a box made by a local parent support group. Making a scrapbook and a box when an infant dies in the NICU can be regarded as ritualized acts. The aim of this study is to explore the functions of these ritualized acts of making a scrapbook and memory box when an infant dies in the NICU. (2) Methods: Focus group interviews were performed with experienced nurses in the NICU, and with members of a parent support group. Reflexive thematic analysis was used to interpret the data. (3) Three main themes were constructed: “Making memories”, “showing evidence of the infant’s life and of the parenthood”, and “controlling chaos”. (4) Conclusions: Through the ritualized acts of making scrapbooks and boxes, nurses and members of the parent support group collect and create memories and ascribe the infant with personhood, and the parents with the status of parenthood. In addition, the ritualizing functions to construct meaning, repair loss, relieve sorrow, and offer a sense of closure for the makers of these items.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

How do migrant nursing home staff relate to religion in their work with patients who are approaching death?

Abstract Aim: To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and theory: Individual in-depth interviews were conducted with 16 migrant healthcare workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a “thick description” of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of significance. Findings: Religion held various meanings for the migrant healthcare workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants related to religion at work was therefore based on individual preferences and internalized practices. Conclusion and implication for practice: Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being