Nursing staff's actions during older residents’ transition into long-term care facility in a nursing home in rural Norway

Abstract

Working in long-term care units poses particular staff challenges as these facilities are expected to provide services for seriously ill residents and give help in a homelike atmosphere. Licensed and unlicensed personnel work together in these surroundings, and their contributions may ease or inhibit a smooth transition for recently admitted residents. The aim of the study was to describe and explore different nursing staff's actions during the initial transition period for older people into a long-term care facility. Participant observation periods were undertaken following staff during 10 new residents’ admissions and their first week in the facility. In addition 16 interviews of different staff categories and reading of written documents were carried out. The findings show great variations of the staff's actions during the older residents’ initial transition period. Characteristics of their actions were (1) in the preparation period: “actions of sharing, sorting out, and ignoring information”; (2) on admission day: “actions of involvement and ignorance”; and (3) in the initial period: “targeted and random actions,” “actions influenced by embedded knowledge,” and “actions influenced by local transparency.”

Nursing staff interactions during the older residents’ transition into long-term care facility in a nursing home in rural Norway: an ethnographic study

“…Jacobsen [42] also found that the assistants were a “fellowship of those who have no say” (p 86). For instance, during meals [20] with many cognitively able residents the local staff’s involvement with the new residents could shut the weekend supply staff off from participation. The enthusiastic allies were good at what they were doing and the supply staff could feel redundant.…”

“…Still, the dynamic interactions between all the staff suggest the strong interdependence among them. In our previous study [20], the task of writing the handwritten care plans was delegated to the primary auxiliaries to be performed shortly after the new resident had arrived. This indicate that the nurses supported the auxiliaries’ independent contributions.…”

“…In our first study [16], we explored the experiences of next-of kin during their older family members’ transition into LTC-placement. In the second study [20], we explored and described different nursing staff’s actions during the older residents’ initial transition period in the LTCF. This present study focuses on staff interaction based on the same ethnographic data as in the second study.…”

Health Problems of Institutionalized Elderly

“…The search for an ILP is due to several factors, but mainly by the lack of support from family members in the care binomial/assistance to that old or the option of the elderly, due to external factors such as loneliness, urban violence, family exclusion and the possibility of being cared for by a team [11,15].…”

“…This kind of situation creates vulnerability, increase in diseases linked to the immune system, depression, anxiety and suicidal thoughts [14][15][16].…”