Sammendrag
Abstract
Background
Home nursing is an essential aspect of healthcare and can address future health challenges. The nature of nursing and its practical applications are of particular interest, as nursing involves technical knowledge, rational procedures, and diverse skills. It is consequential to explore nursing practices in context to understand how nurses navigate their work. This study aimed to explore the characteristics of home care nurse practices and how nurses solve tasks in the context of nursing in home care.
Methods
This is an exploratory qualitative research study using a descriptive phenomenological approach. We reported following the COREQ guidelines. Fifteen in-depth interviews with nurses from four Norwegian municipalities were conducted and analyzed according to stepwise inductive analysis.
Results
The analysis revealed three main patterns that characterize nursing practices in home care: ‘To be vigilant’, ‘To be an all-rounder', and ‘To act with independence'. The content and distinction of these patterns are discussed through a theoretical framework of ‘clinical mindlines’. There are multiple mindlines and complex realities for home-based care nursing. The nurses displayed great sensitivity in their practice, were knowledgeable about where they focused their attention, adapted their actions to the context, and demonstrated their independence as professionals.
Conclusion
Nurses’ vigilance and contextual insight are critical to their practice approach and task-solving abilities. These professionals need to manage emergent organizations and exercise independence and professional judgment when adapting their work to the context of home care patients. Future health policy should not strictly be based on standardized guidelines; depending on the context, it is also appropriate to focus on nurses’ practical knowledge and the importance of mindlines.
Keywords:
Care Trajectory Management, Clinical Mindlines, Home Care, Home nursing, Nurse role, Professional Independence, Situational awareness
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