Co-operation with family members : a challenge for registrered nurses in community elder care

Abstract

The overall aim of this thesis was to gain knowledge of how Registered Nurses (RN) are able to work together with family members of older people living in community elder care facilities.

A questionnaire was distributed to all RNs (N= 314) with permanent appointments in community elder care in one province, and 67 percent (n = 210) answered after two reminders (I, II). The age of the participants was from 23 to 64 years and half of the participants worked in urban areas. About half of the participants had experience of work in elder care of five years or more.

Study I focused on the RNs view of co-operation with family members of the old person and what influenced that co-operation. The working situation for RNs in community elder care showed that nearly half, 46 % of the RNs were not satisfied with their working situation. It was the nurses with more than five years of working experience that were unhappy with their working situation. The limited organisational and personnel resources influenced their ability to co-operate with the family members. The RNs expressed dissatisfaction and frustration when they could not spend enough time caring for the old people or communicating with their family members. The RNs believed that it was important for family members to show their involvement in the care of the old person. The results showed that cooperation would be more complicated if there was a conflict of interest between the RN and the family member. Furthermore, the RN pointed out the importance of family members taking care of the older person s interest.

Study II focused on what the RNs described as positive, negative or problematic in their cooperation with family members of old people. Content analysis was used in the analysis of the three open-ended questions. Three themes emerged from the answers of the three open-ended questions, namely Problems within the system, Interaction with families and Caring in nursing work. The co-operation between the RN and the family member was especially important when the old person was suffering from dementia. An exchange of information about the person before illness was especially important as it was then possible to provide better care and understanding for the old person.

The development of community elder care will put increasing demands on the RNs in community elder care in the future and there is a need for further support and guidance. Her working situation involves both working alone and being a part of a team. Informal care giving is also expected to increase as the elder population increases and by that the registered nurse will be even more important in community elder care as more persons are dependent on her competence. Conclusions drawn imply that the RN in community elder care is dependent on the organization of elder care and the organization is dependent on RNs competence.