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“我们收尾善后”:不断变化的医疗保健格局下的居家护理

"We Tie Up the Loose Ends": Homecare Nursing in a Changing Health Care Landscape.

作者信息

Melby Line, Obstfelder Aud, Hellesø Ragnhild

机构信息

SINTEF, Trondheim, Norway.

Norwegian University of Science and Technology, Gjøvik, Norway.

出版信息

Glob Qual Nurs Res. 2018 Dec 14;5:2333393618816780. doi: 10.1177/2333393618816780. eCollection 2018 Jan-Dec.

Abstract

During the last decades, the work of homecare nurses has been affected by several changes, including an aging population, the decentralization of health care, nursing recruitment crises and the scarcity of public resources. Few scholars have analyzed how these changes have impacted homecare nursing. In this article, we describe and discuss aspects of homecare nurses' work, with specific focus on nurses "organising work." We outline three phenomena that are increasingly occurring: (a) homecare nurses are frequently involved in negotiating care level and, consequently, what kind of care the patient will receive; (b) homecare nurses' clinical practice has become increasingly advanced; and (c) and homecare nurses play an important role in coordinating care among interdependent actors. The article draws on material from participant observation and interviews with homecare nurses in two Norwegian studies. Changes in work practice increase the demand for nurses to be competent and have excellent organizational and collaborative skills.

摘要

在过去几十年中,家庭护理护士的工作受到了多种变化的影响,包括人口老龄化、医疗保健的分散化、护理人员招聘危机以及公共资源的稀缺。很少有学者分析这些变化如何影响家庭护理。在本文中,我们描述并讨论家庭护理护士工作的各个方面,特别关注护士“组织工作”的情况。我们概述了三种日益普遍的现象:(a)家庭护理护士经常参与协商护理级别,从而决定患者将接受何种护理;(b)家庭护理护士的临床实践日益复杂;(c)家庭护理护士在相互依存的行为者之间协调护理方面发挥着重要作用。本文借鉴了挪威两项研究中对家庭护理护士进行参与观察和访谈所获得的资料。工作实践的变化增加了对护士能力的要求,以及对其具备出色组织和协作技能的要求。

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