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En otydlig roll och kompetens som inte efterfrågas: En kvalitativ studie om specialistsjuksköterskans kompetens och roll inom psykiatrisk slutenvård
Ersta Sköndal University College, Department of Health Care Sciences.
2015 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
An unclear role and skills that are not in demand : A qualitative study of the Specialist Nurse competence and role in psychiatric inpatient care (English)
Abstract [sv]

Bakgrund: Den psykiatriska slutenvården liksom sjuksköterskans roll har förändrats sedan seklets början. Institutionalisering har ersatts av vård och behandling av patienten, vilket har förändrat kravet på utbildad personal liksom synen på kompetens. Historien förefaller dock fortsatt påverka dagens psykiatriska vårdkultur, och möjligheterna för specialistsjuksköterskan inom psykiatrisk slutenvård att använda sin specialistkompetens förefaller vara beroende av mer än sjuksköterskans egen kunskap och förmåga.

Syfte: Studiens syfte var att beskriva hur specialistsjuksköterskor och chefer inom psykiatrisk slutenvård ser på specialistsjuksköterskans kompetens och roll.

Metod: Datamaterialet samlades in genom individuella semistrukturerade intervjuer med specialistsjuksköterskor och chefer verksamma inom psykiatrisk slutenvård. Materialet analyserades med kvalitativ innehållsanalys inspirerad av Elo och Kyngäs. Materialet sorterades därefter in i en analysram inspirerad av Kings konceptuella system: det personliga systemet, det interpersonella systemet samt det sociala systemet

Resultat: Den kvalitativa analysen utmynnade i tre kategorier: Specialistsjuksköterskans fördjupade kompetens leder till inre trygghet (personliga systemet), specialistsjuksköterskans kompetens främjar patientens hälsoprocess (interpersonella systemet) och Specialistsjuksköterskans kompetens efterfrågas inte av organisationen (sociala systemet).

Diskussion: Specialistkunskapen beskrevs som internaliserad i den enskilda sjuksköterskan och det beskrevs att specialistkunskapen gynnade patientens hälsoprocess. Specialistsjuksköterskorna uttryckte dock att de inte fick det mandat de behövde för att implementera sin fördjupade kunskap i slutenvården och att chefen behövde efterfråga specialistkunskapen och bekräfta dem i rollen. Brist på möjlighet att påverka kan vara en anledning till att specialistsjuksköterskor inte stannar i slutenvården. Detta behöver studeras ytterligare och även diskuteras i klinisk praxis.

Abstract [en]

Background: Psychiatric inpatient care as well as the nurse’s role has changed since the beginning of the century. Institutionalization has been replaced by the care and treatment of the patient, which has changed the requirement of trained staff as well as the perception of competence. History seems however continued to affect today’s psychiatric culture, and opportunities for specialist nurses in psychiatric inpatient care to use their specialist expertise seems to be dependent on more than the nurse’s own knowledge and skills.

Aim: The aim of the study was to describe how specialist nurses and managers within psychiatric inpatient care views the specialist nurse competence and role.

Method: The data were collected through individual semistructured interviews with specialist nurses and managers active in psychiatric inpatient care. Data were analyzed using qualitative content analysis inspired by Elo and Kyngäs. Data were also divided into an analysis framework inspired by Kings Conceptual system: the personal system, the interpersonal system and the social system.

Results: The qualitative analysis resulted in three categories: The specialist nurse depth expertise leads to internal security (personal system), The specialist nurse competence promotes the health of the patient process (interpersonal system) and The specialist nurse competence is not requested by the organization (social system).

Discussions: Specialist knowledge was described as internalized in the individual nurse and it was described how specialist knowledge favored the patient’s health process. Specialist nurses described, however, that they were not given the mandate they needed to implement their in-depth expertise of inpatient care. The nurses expressed that the manager had to ask for specialist knowledge and confirm them in their role. Lack of ability to influence may be one reason that specialist nurses do not stay in inpatient care. This needs to be studied further and discussed within clinical practice.

Place, publisher, year, edition, pages
2015. , p. 46
Keywords [en]
Competence, Organization, Psychiatric inpatient care, Role, Specialist nurse
Keywords [sv]
Kompetens, Organisation, Psykiatrisk slutenvård, Roll, Specialistsjuksköterska
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-4650OAI: oai:DiVA.org:esh-4650DiVA, id: diva2:817796
Educational program
Postgraduate Diploma in Specialist Nursing - Mental Health Care
Uppsok
Medicine
Supervisors
Examiners
Available from: 2015-06-08 Created: 2015-06-06 Last updated: 2015-06-26Bibliographically approved

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