The Institutional Practice

Ågotnes, Gudmund

doi:10.17585/noasp.12.38

Cited by 6 publications

(1 citation statement)

References 64 publications

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“…The majority of Norwegian nursing homes are run by municipalities and financed by service fees and taxes. A small percentage of Norwegian nursing homes are managed by private for-profit agencies (5%) or non-profit organizations (5%) [43]. The Ministry of Health and Care Services provides specific regulations regarding leadership, staffing and residents´ rights in Norwegian nursing homes.…”

Section: The Norwegian Nursing Home Contextmentioning

confidence: 99%

Legitimizing neglect - a qualitative study among nursing home staff in Norway

Lund

Skolbekken

Mosqueda

et al. 2023

BMC Health Serv Res

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Introduction Residents in nursing homes do not always get qualitatively good nursing care, and research shows that residents’ basic care needs are sometimes neglected. Neglect in nursing homes is a challenging and complex issue, yet a preventable one. Nursing home staff are at the frontline of detecting and preventing neglect but may also be the ones causing it. It is essential to understand why and how neglect happens in order to recognize, expose, and prevent its occurrence. Our aim was to generate new knowledge on the processes leading to and allowing neglect to continue in Norwegian nursing homes, by studying how nursing home staff perceive and reflect on when nursing home residents are neglected in their daily practice. Methods A qualitative exploratory design was used. The study was based on five focus group discussions (20 participants, total) and ten individual interviews with nursing home staff from 17 different nursing homes in Norway. The interviews were analysed according to Charmaz constructivist grounded theory. Results In order to make neglect an acceptable practice, nursing home staff apply different strategies. These strategies were identified as when the staff legitimize neglect by neglecting neglect, when the staff are not recognizing their own behaviour as neglectful, as expressed in their actions and language, and normalizing missed care when resources are lacking and nursing staff are rationing care. Conclusions The gradual shift between judging actions as neglectful or not are made possible when nursing home staff legitimize neglect by not recognizing their practice as neglective, thus neglecting neglect or when they are normalizing missed care. Increased awareness and reflections on these processes may be a way of reducing the risk of and preventing neglect in nursing homes.

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Section: The Norwegian Nursing Home Contextmentioning

confidence: 99%

Legitimizing neglect - a qualitative study among nursing home staff in Norway

Lund

Skolbekken

Mosqueda

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

Resident-to-resident aggression in Norwegian nursing homes: a cross-sectional exploratory study

et al. 2020

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Background: Resident-to-resident aggression in nursing homes is a public health problem of growing concern, impacting the safety, health and well-being of all residents involved. Despite this, little research has been conducted on its occurrence particularly in large-scale national studies. The aim of this study was to explore the extent and nature of resident-to-resident aggression in Norwegian nursing homes, as reported by nursing staff. Methods: We conducted a cross-sectional exploratory study, where nursing staff in 100 randomly selected Norwegian nursing homes completed a pen and paper survey measuring how often they had observed incidents of resident-to-resident aggression during the past year. These rates were separated according to nursing home size, location and units of workplace. Results: Of the 3693 nursing staff who participated (response rate 60.1%), 88.8% had observed one or more incidents of resident-to-resident aggression during the past year, with acts of verbal and physical aggression being the most commonly reported. Nursing staff working in dementia special care units, larger nursing homes and nursing homes located in suburban/urban municipalities, reported more incidents of resident-to-resident aggression than staff in short-term and long-term units, small institutions, and nursing homes located in rural municipalities. Conclusions: This is the first national study of resident-to-resident aggression in Norwegian nursing homes and is one of the largest surveys worldwide exploring the extent and nature of resident-to-resident aggression in long-term care settings. Overall, we found a high occurrence of all types of aggression, suggesting a need for strategies to improve residents' safety and quality of life in nursing homes.

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“Just pee in the diaper” - a constructivist grounded theory study of moral distress enabling neglect in nursing homes

Lund,

Malmedal,

Mosqueda

et al. 2024

BMC Geriatr

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Background A growing body of evidence shows that many nursing home residents’ basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: “How do nursing home staff manage their moral distress related to neglectful care practices?” Methods A qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway. Results Nursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes. Conclusions Our findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.

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The Institutional Practice

Cited by 6 publications

References 64 publications

Legitimizing neglect - a qualitative study among nursing home staff in Norway

Legitimizing neglect - a qualitative study among nursing home staff in Norway

Resident-to-resident aggression in Norwegian nursing homes: a cross-sectional exploratory study

“Just pee in the diaper” - a constructivist grounded theory study of moral distress enabling neglect in nursing homes

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