Fair Nursing Care When Resources Are Limited: The Role of Patients and Family Members in Norwegian Home-Based Services

Abstract

The purpose of the study was to investigate nurses' priority decisions and the provision of home-based nursing care services. Interviews were conducted with 17 nurses in various positions in this service. The data were interpreted and analyzed according to interpretive hermeneutic methodology. The authors particularly address the nurses' descriptions of the role of the patient and his or her family members for the provision of home-based care. Cooperative patients and family members represent an important resource for care and can make it possible for nurses to provide services for all the patients on an egalitarian basis and to prioritize those who live alone. However, demanding and resourceful patients and family members may "rule" the service at the expense of other patients who also have legitimate care needs--a practice that the nurses describe as unfair. In this article, the authors discuss how a fair and impartial distribution of common benefits can be achieved without some parties being unjustly treated.

Health‐care professionals’ experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy

“…39 Further, patient participation is shaped by organizational structures, 40 the patients' condition, 41 resources, 11 staff attitudes 42,43 and support from relatives. 44,45 Still, there is great variation in how patient participation is managed and experienced by patients and relatives. 15,16,[46][47][48] Thus, health-care professionals in IC need to have extensive skills within geriatric rehabilitation including patient participation and communication techniques, taking into account the complex needs of older patients whose health status often fluctuates.…”

“…Successful patient participation within IC services is associated with satisfaction with health‐care services, a lower number of readmissions, better treatment outcome and has the potential to prevent the need for nursing home placement . Further, patient participation is shaped by organizational structures, the patients’ condition, resources, staff attitudes and support from relatives . Still, there is great variation in how patient participation is managed and experienced by patients and relatives .…”

Nordic homecare nursing from the perspective of homecare nurses—a meta-ethnography

“…Homecare nurses typically work under time pressure (Tønnessen et al, 2009;Berland et al, 2012;Pusa et al, 2015) because of an extensive workload and staff shortages (Tønnessen et al, 2011); often, they feel forced to focus on the physical needs of their clients (Turjamaa et al, 2013). Being in a hurry may compromise the quality of care (Tønnessen et al, 2009;Berland et al, 2012;Dahl and Clancy, 2015), which may generate a feeling of shame among homecare nurses who may be disappointed with their own practice when they do not live up to their own ideals (Eilertsen and Kiik, 2016).…”

“…To make up for the lack of resources in homecare nursing, spouses or partners often provide care without being asked (Tønnessen et al, 2009). Also, homecare nurses may skip lunch breaks or meetings to spend the time on care activities (Saeterstrand et al, 2015).…”

Faglige forutsetninger for forsvarlighetsbegrepet

“…I helsetjenesten er det et misforhold mellom de oppgaver og tjenester kommunene er pålagt å yte og de ressursene de har til rådighet (3, [8][9]. For sykepleierne innebaerer dette daglig vanskelige prioriteringer, der grensene for hva som oppleves som god fagutøvelse utfordres (10)(11)(12)(13). Pasientene sykepleierne skal ivareta er syke og har et redusert funksjonsnivå enten fysisk og/ eller mentalt.…”