8 Mellomlederes vurdering av kompetansebehov i sykepleie etter samhandlingsreformen

Abstract

NØKKELORD sykepleierkompetanse | avansert klinisk kompetanse | kommunehelsetjeneste | spesialisthelsetjeneste | teamarbeid ABSTRACT The purpose of this study was to gain knowledge about the needs for competence in nursing in Norway after the introduction of the Coordination Reform in 2012. To gain knowledge in this field is important for those with responsibility for planning and implementing competence in the health services system. The study has a hermeneutical and phenomenological design. During spring 2013, three focus group interviews were conducted with nurses holding midlevel manager positions in the primary health services and the specialist health services on a local government level. The need for nurses with advanced clinical skills and competencies was especially highlighted. A formalized advanced clinical nurse position should be included among the measures to be considered when discussing how to deliver quality in future health services in a cost-effective way.

Challenges in municipality healthcare services—The nurse leaders' perspective

“…More competence was not necessarily needed for strengthening the services according to the informants, but instead changing how the available competence was organized. Earlier studies confirm this and state that lateral task moves between professions may make the municipal healthcare services more effective and increase the availability of these (Tyrholm, Kvangarsnes, & Bergem, ).…”

“…This way related healthcare services would be coordinated better. There is a need for re‐thinking and paving the way for new roles and increased cooperation in order to reach everyone dependent on help (Tyrholm et al, ). Organization between the municipal departments was one future solution which was presented in this study.…”

Økt spesialisering og differensieringi sykehjem

“…Denne utviklingen fører til mer spesialiserte kunnskapsbehov og mer avansert sykepleie enn tidligere (Bing-Jonsson et al, 2016;Bing-Jonsson, Bjørk, Hofoss, Kirkevold & Foss, 2015;Tyrholm, Kvangarsnes & Bergem, 2016). Én konsekvens kan bli at brukere med komplekse og flere ulike sykdomstilstander blir plassert i en struktur som i økende grad ser og behandler én diagnose eller ett behov hos beboerne.…”

Not just “sweet old ladies” – Challenges in voluntary work in the municipal long-term care services

“…Recent studies show that service recipients in nursing homes and home care are increasingly frail older people characterised by multi-morbidities, cognitive failure and polypharmacy (Helvik, Engedal, & Selbaek, 2010;Selbaek, Kirkevold, & Engedal, 2008). This development leads to increased job demands and a need for more advanced nursing competence in nursing homes and home care (Bing-Jonsson, Hofoss, Kirkevold, Bjørk, & Foss, 2016;Bing-Jonsson, Bjørk, Hofoss, Kirkevold, & Foss, 2015;Tyrholm, Kvangarsnes, & Bergem, 2016). Seen against a service context that is becoming more task-driven and where nurses are expected to play an extended role in the medical management of residents, including the acute and critically ill, the capacity to meet the social needs of service users has become limited.…”