The position of home‐care nursing in primary health care: A critical analysis of contemporary policy documents

Abstract

Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home-care nursing plays a large role. In this article, we investigate how home-care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough-inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies on current primary health care. In the documents, we identified several complementary and conflicting understandings about home-care nursing. Home-care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home-care nursing in the health-care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks.

Autonomy conquers all: a thematic analysis of nurses’ professional judgement encountering resistance to care from home-dwelling persons with dementia

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Developing and Testing Digital Ethical Reflection in Long-Term Care: Nurses’ Experiences

“…Ethical challenges and dilemmas are everyday experiences for nurses working in nursing homes and home care services ( Hopia et al, 2016 ; Suhonen et al, 2018 ). An aging population and short hospital stays, together with limited public funding and a lack of qualified staff, put pressure on the nurses who are responsible for providing care to patients in these settings ( Fjørtoft et al, 2021 ; Leknes et al, 2018 ). Nurses often feel that they cannot do the “right thing” when practicing nursing and struggle with discrepancies between their professional and personal values, which in turn can lead to moral distress ( Haahr et al, 2019 ; Koskenvuori et al, 2018 ).…”

Nurses' professional discretion in the purchaser‐provider split in home care in Norway

“…Effective collaboration among the staff is necessary to complete the increasing number of care tasks, although registered nurses play a key role in providing professional home nursing based on the principles of high‐quality care and a holistic approach to patient care and treatment. To practise home nursing involves the complexity of working in another person's home and requires considerable competence (Allen, 2014; Armstrong, 1983; Fjørtoft, Oksholm, Førland, et al, 2021; May, 1992). National legislation regulates the work of nurses and other health care personnel and the rights of the patients (Health and Care Services Act, 2011; Healthcare Personnel Act, 1999; Patient Rights Act, 1999).…”