Who Is Doing What in Home Care Services?

(1) Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-to-face time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively.

IDENTIFYING THE EFFECTIVE TEACHER: THE CONCEPTIONS OF PRE-SERVICE ASSISTANT NURSES

In this paper, we focus on the conceptions of effective teaching that pre-service assistant nurses hold about effective and ineffective teaching during their training in Public Vocational Training Institutes (DIEK) in Greece. We focused on three aspects of teaching effectiveness: 1) The model of Patrick and Smart (1998), who identified three groups of effective teacher characteristics includes; respect for students, ability to challenge students, organisation and presentation skills; 2) Considering the hands-on teaching experiences of pre-service assistant nurses, we explored their conceptions about teaching effectiveness in problem-based learning educational settings, based on Mayo, Donnelly, Nash and Schwartz (1993), who investigated, amongst others enthusiasm, active interaction and providing feedback. 3) The communicational aspect of teaching effectiveness, drawing upon the work of McCroskey and Richmond (1990) about socio-communicative styles, who identified two dimensions of interpersonal communication; namely assertiveness and responsiveness. All three aspects were explicitly investigated for both effective and ineffective teaching. A three-section (in line with the three-faceted conceptualisation of teaching effectiveness), 56 Likert-type items, questionnaire was completed by 125 students. Our analyses allowed us to identify which aspects of teaching characterise the effective teacher and which are present both in the effective and the ineffective teacher.

Cultural Diversity in Nursing Teams: Triggers, Team Process and Contingencies / Kulturelle Vielfalt in Pflegeteams: Triggers, Teamprozesse und Kontext

IntroductionThe study explored cultural diversity in nursing teams and the internal and external conditions under which cultural differences represent an asset or a liability for these teams.MethodsA qualitative design with content analysis was employed. In total, 18 interviews were conducted with nurses and assistant nurses with experience of working in culturally diverse teams in three distinct clinical settings.ResultsThree domains emerged in the study analysis: triggers, team process and contingencies. Each one encompassed a number of themes related to culturally diverse nursing team processes, triggers of team processes and context-specific contingencies, which represent the complexity of culturally diverse nursing team functioning.Discussion/implicationsThe study suggests how cultural differences in nursing teams can be managed and further explored from within the team and by individuals leading those teams, taking into account the disablers and enablers of their functioning.

Hygiene and labour protection of medical staff under conditions of COVID-19 pandemicovercoming. The second message: changes and challenges

Objective: We studied the dynamics and causes of acute occupational morbidity on COVID-19 in medical staff, changes in labour conditions and safety of medical workers, their protection with adequate and effective personal protective equipment in particular. Materials and methods: We applied bibliographic, hygienic, questionnaire and mathematical methods in the study. As a material for the study, we used the results of our own observations, questionnaires for a survey of medical staff, data of the WHO, the Ministry of Healthcare of Ukraine, the Center for Public Health of the Ministry of Healthcare of Ukraine, the State Labour Service of Ukraine, the State Statistics Service of Ukraine and thematic scientific sources of information. Results: The work of the doctors involved in COVID-19 pandemic overcoming is classified as dangerous (extreme). An increase in the degree of neuro-emotional stress and accumulation of fatigue was revealed in comparison with the data of the first report. A significant number of ergonomic and physiological and hygienic deficiencies in personal protective equipment were recorded. Nurses (38.43%), assistant nurses (22.69%) paramedics (3.72%), practicians of family medicine (2.91 %), therapists (2.86%) and anesthesiologists (2.52%) predominate among medical staff diagnosed with COVID-19 acute occupational disease. An extremely low number of commission investigations of the accidents (COVID-19 diseases in medical workers), completed as of June 22, 2020, was revealed. Conclusions: The incidence rates of medical workers for COVID-19 and a significant number of the deaths in medical staff as a result of the infection with SARS-CoV-2 coronavirus indicate the insufficient attention of the state to the issues of labour protection in medical industry.

Validation arrangements for formally low-qualified staff in geriatric care: The Design-based Research project KomBiA

Validation arrangements aim to increase the visibility and recognition of non-formal and informal learning. For geriatric care in Germany, such validation arrangements currently do not exist. The workplace learning of assistant nurses is therefore yet to be documented and certified. The Design-based Research project KomBiA was initiated in order to solve this practical problem. The interventions, which were developed, tested and evaluated, are based on the CEDEFOP model for the validation of non-formal and informal learning in Europe, which had to be adapted and modified according to the national and sectoral specifics of geriatric care in Germany. The project set-up focused on the development of an innovative solution to the problem that could gain support among all major stakeholders. Hence, the project included practitioners representing different interests. The collaborative development of the prototype was tested and evaluated in a two-cycle-approach. On this basis, a viable model of validating non-formal and informal learning in the field was designed and corresponding design principles were deduced.

Assistant Nurses’ Positioned Accounts for Prioritizations in Residential Care for Older People

Background and Objectives Swedish eldercare is strained by an increased administrative workload, which draws time away from individual care of and interaction with older people. This study explores how eldercare staff, working closely with residents in Swedish special housing (nursing homes), make accounts for how they prioritize work tasks. Research Design and Methods Openly structured, thematic interviews were conducted with 12 permanently employed, female assistant nurses, including a group interview with 3 of them. Positioned accounts (small stories) concerning prioritizations due to insufficient resources were analyzed, using Bamberg’s three-level positioning analysis. Results The analysis shows that the staff take a favorable position toward the older people by distinguishing between care and “the other things.” They also justify prioritizations at odds with their care values. The assistant nurses present themselves as doing the best they can in organizationally restricted situations. Organizational demands limit the space for care, giving rise to an idealization of “icing on the cake.” Morale is complex in residential care. A narration of “the torn carer” was found as a co-constructed storyline explaining why the staff did not perform eldercare consistent their care values. Discussion and Implications When ideals and practice differ, interaction in the peer group becomes important in order to maintain a positive professional identity. “The torn carer” is a way for the staff to escape blame for not living up to care values, but it also victimizes them. Staff could be empowered by a working environment characterized by a reflective practice.