Non‐nursing tasks as experienced by nurses: a descriptive qualitative study

Abstract

Background Different concepts have been used to date (e.g. non‐nursing tasks, organizational work) to define tasks performed by clinical nurses other than nursing care. However, the true essence of nursing work is still poorly understood mostly because nurses are lacking an appropriate lexicon to describe their practice. Aims To describe non‐nursing tasks as experienced by nurses, exploring antecedents and consequences as perceived in daily practice. Methods A descriptive qualitative study from 2015 to 2016. A purposeful sample of nurses was approached. Semi‐structured interviews were used, and content analysis was performed on audio‐recorded and verbatim‐transcribed interviews. Findings A total of 22 nurses participated, the majority of whom were female (16; 72.7%) and their average age was 42.6 years. The concept of ‘Non‐nursing tasks’ is limited in describing what nurses experience in daily practice; the concept of ‘Being out of the nursing role’ emerged as being fully descriptive of the nurses’ experience and this can occur in two dimensions: outside and inside the role of other healthcare professions. The first dimension includes administrative work separating nurses from patients. The second dimension was reported to happen in proximity to patients but in three different directions towards professions requiring: (a) less education (e.g. healthcare assistants), (b) the same amount of education at university level (e.g. physiotherapists), and (c) higher education at university level as compared to nurses, thus performing activities expected by physicians. Antecedents of ‘Being out of the nursing role’ have been identified at the organizational, individual and educational levels; their consequences have been reported at the patient, professional and organizational levels. Conclusion Nurses play various non‐nursing roles, below, above and in the horizontal levels, both inside and outside other healthcare professionals’ role, mainly as a result of their felt moral obligation to offer the best to their patients, the organization's demand to nurses and the imprinting of nursing education. Implications for nursing/health policy Strategies at the nursing professional and policy levels are needed aimed at (a) supporting nurses in optimizing their professional identity, (b) sharing their sense of moral obligation towards patients with other healthcare professionals, and (c) implementing models of care based on interprofessional cooperation.

Nurses’ professional dignity in private health care: a descriptive phenomenological study

“…Nurses are challenged in fulfilling their duties in complex and demanding work environments (Combrinck 2018) which they described as painful and unbearable in a study conducted by Storaker et al (2017) in a university hospital in Norway. Exposure to excessive administration and ever‐increasing expectations towards nurses’ professional roles (Grosso et al 2019) leaves nurses vulnerable in their professional dignity. The discrepancy between desired and realized nursing practice prevents them from living their humanistic nursing values.…”

Registered nurses’ knowledge, attitude and practice regarding their scope of practice in Botswana

“…Nurses, as a professional cadre, are generalists who can be deployed in many settings and are more economically affordable compared with several other and often more expensive professionals employed in the health sector (Grosso et al 2019 ). Tasks are therefore expected to continue to shift to RNs in the foreseeable future to meet the health needs of populations; hence, the evolvement of the scope of practice appears inevitable.…”

“…Moreover, the overlapping roles of health workers (within nursing and across disciplines) appear prevalent. Grosso et al ( 2019 ) concluded that nurses, in their daily practice, occupy various non-nursing roles below, above and horizontal to their competencies. They found (Grosso et al 2019 ) that RNs function both in and outside other healthcare professional spaces and that the nurse’s role appears to be a contingent one.…”

“…Grosso et al ( 2019 ) concluded that nurses, in their daily practice, occupy various non-nursing roles below, above and horizontal to their competencies. They found (Grosso et al 2019 ) that RNs function both in and outside other healthcare professional spaces and that the nurse’s role appears to be a contingent one. In Africa, nurses are frequently forced or feel obliged to practice beyond their educational preparation and expand their practice to meet the health needs of the communities (Msuya et al 2017 ).…”

“…The absence of guidelines and frameworks in Botswana to guide and support RNs in decision-making when concerns or dilemmas regarding their scope of practice occur, may result in unsafe practices, risk-taking or potential exploitation, consequently compromising patient care (Boonstra et al 2002 , 2003 ; Boonstra, Lindbaek & Ngome 2005 ; Grosso et al 2019 ; Lubbe & Roets 2014 ; Zachariah et al 2009 ). In Botswana, RNs often perceive themselves to be working beyond their scope of practice, and there is little consensus between them and their employer regarding which interventions are considered within their scope.…”