Multitasking and acting
healthcare apprentices' strategies to meet demands and expectations
DOI:
https://doi.org/10.7577/sjvd.5110Keywords:
Lærlinger i helsearbeiderfaget, hjemmesykepleie, krav og kontroll, emosjonelt arbeidAbstract
There is a growing need to recruit and retain health professionals. Much of the care has been transferred to the municipalities, hospital stays have decreased and patients are sicker when they return home. In this complex and emotional working context, the apprentices must develop as professionals. The health worker education and the community of practice must facilitate competence that makes students and apprentices able to meet the demands and expectations they encounter in the profession. The research question the article answers is: How do apprentices in the health profession experience demands and expectations during the apprenticeship in home nursing care?
Individual interviews and observations were considered an acceptable method. 12 apprentices and newly qualified health care professionals were interviewed individually. Two of the apprentices were followed and observed by the first author over 5 days in practice. The study shows how healthcare apprentices maneuver in a field consisting of different demands and expectations. In homecare nursing, the time of the individual patient is limited. They acquire organizational skills such as multitasking, acting, prioritizing, adapting and setting boundaries. This means that they perform several tasks at the same time, have double attention in situations, they hide internal stress, and they adapt to the patients at the same time as they prioritize and set limits. Skills that seem necessary both in the work of looking after a decision-based work list consisting of a varied and complex group of patients living at home, as well as necessary to be equipped as a future healthcare worker.
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References
Andersen, L. L., Fishwick, D., Robinson, E., Wiezer, N. M., Mockałło, Z. & Grosjean, V. (2017). Job satisfaction is more than a fruit basket, health checks and free exercise: Cross-sectional study among 10,000 wage earners. Scandic Journal of Public Health, 45(5), 476-484. https://doi.org/10.1177/1403494817698891
Aronsson, G., Theorell, T., Grape, T., Hammarström, A., Hogstedt, C., Marteinsdottir, I., … Hall, C. (2017). A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health, 17(1), 264-264. https://doi.org/10.1186/s12889-017-4153-7
Bach, S. (2022). Book Review: Who Cares? Attracting and Retaining Care Workers for the Elderly. I(bd. 28, s. 147-149). SAGE Publications. https://doi.org/10.1177/10242589221099980
Beyrer, S., Hjemås, G., Skjøstad, O. & Hansen, J. (2019). Helsefagarbeideres arbeidssted og nyutdannede helsefagarbeideres tilknytning til arbeidslivet (Rapporter 2019/20). Statistisk sentralbyrå. https://ssb.brage.unit.no/ssb-xmlui/handle/11250/2627239
Bjornsdottir, K. (2018). ‘I try to make a net around each patient’: Home care nursing as relational practice. Scandinavian Journal of Caring Sciences, 32(1), 177-185. https://doi.org/10.1111/scs.12443
Brennan, J. P. (2020). 323 - I’d prefer to stay at home but I don’t have a choice’: Irish social workers’ experiences of decision-making in care planning with older people with dementia. International psychogeriatrics, 32(S1), 81-81. https://doi.org/10.1017/S1041610220002239
Creswell, J. W. & Creswell, J. D. (2018). Research design: Qualitative, quantitative & mixed methods approaches (5. utg.). SAGE Publications.
Dapi, B., Gjefsen, H. M., Sparrman, V., Stølen, N. M. & Cappelen, Å. (2018). Framskrivinger av arbeidsstyrken og sysselsettingen etter utdanning mot 2035 (Rapporter 2018/36). Statistisk sentralbyrå. https://www.ssb.no/arbeid-og-lonn/artikler-og-publikasjoner/_attachment/367350
Dostálová, V., Bártová, A., Bláhová, H. & Holmerová, I. (2020). The needs of older people receiving home care: a scoping review. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-020-01505-3
Egeland, C. & Drange, I. (2014). Frivillig deltid - kun et spørsmål om tid? (AFI-rapport 4/2014). Arbeidsforskningsinstituttet. https://doi.org/10.7577/afi/rapport/2014:4
Elstad, J. I. & Vabø, M. (2021). Lack of recognition at the societal level heightens turnover considerations among Nordic eldercare workers: A quantitative analysis of survey data. BMC Health Services Research, 21(1), Artikkel 747. https://doi.org/10.1186/s12913-021-06734-4
Fangen, K. (2017). Deltagende observasjon (2. utg.). Fagbokforlaget.
Fjørtoft, A. K., Oksholm, T., Førland, O., Delmar, C. & Alvsvåg, H. (2020). Balancing contradictory requirements in homecare nursing—A discourse analysis. Nursing open, 7(4), 1011-1019. https://doi.org/10.1002/nop2.473
Førland, O., Skutle, O., Alvsvåg, H. & Hjelle, K. M. (2021). Ambisjoner og realiteter i kommunenes prioriteringer av helse- og omsorgstjenester – en casestudie fra tre norske kommuner. Tidsskrift for velferdsforskning, 24(4), 19-34. https://doi.org/10.18261/issn.2464-3076-2021-04-02
Førland, O. & Folkestad, B. (2016). Hjemmetjenestene i Norge i et befolknings- og brukerperspektiv: En populasjonsstudie basert på innbyggerundersøkelsene fra 2010, 2013 og 2015. Senter for omsorgsforskning. https://omsorgsforskning.brage.unit.no/omsorgsforskning-xmlui/handle/11250/2429236
Giorgi, A. (1985). Phenomenology and psychological research. Duquesne University Press.
Gjerberg, E. & Amble, N. (2009). Pleie- og omsorgssektoren som lærende organisasjon. Sykepleien forskning, 4(1), 36-42. https://doi.org/10.4220/sykepleienf.2009.0021
Grandey, A. A. (2000). Emotion regulation in the workplace: A new way to conceptualize emotional labor. Journal of Occupational Health Psychology, 5(1), 95-110. https://doi.org/10.1037/1076-8998.5.1.95
Grandey, A. A. (2003). When "The show must go on": Surface acting and deep acting as determinants of emotional exhaustion and peer-rated service delivery. Academy of Management Journal, 46(1), 86-96. https://doi.org/10.2307/30040678
Grandey, A., Foo, S. C., Groth, M. & Goodwin, R. E. (2012). Free to be you and me: A climate of authenticity alleviates burnout from emotional labor. Journal of Occupational Health Psychology, 17(1), 1-14. https://doi.org/10.1037/a0025102
Hedlund, M., Ingstad, K. & Moe, A. (2021). God helse – Kunnskap for framtidens kommunehelsetjeneste. I M. Hedlund, K. Ingstad & A. Moe (Red.), God helse – Kunnskap for framtidens kommunehelsetjeneste (s. 9-19). Universitetsforlaget. https://doi.org/10.18261/9788215042985-2021-01
Helsedirektoratet. (2020). Omsorg 2020 - Årsrapport 2019. https://www.helsedirektoratet.no/rapporter/omsorg-2020-arsrapport-2019
Hochschild, A. R. (2012). The managed heart: Commercialization of human feeling (Rev. utg.). University of California Press. https://doi.org/10.1525/9780520951853
Holm, S. G. & Angelsen, R. O. (2014). A descriptive retrospective study of time consumption in home care services: How do employees use their working time? BMC Health Services Research, 14(1), 439-439. https://doi.org/10.1186/1472-6963-14-439
Holm, S. G. (2017). Knapt med tid i hjemmetjenesten: Om kjøreruter, skjulte tjenester og tidspress: En dokumentanalyse av enkeltvedtak og ukeprogram [Doktorgradsavhandling, Nord universitet]. Nord Open. http://hdl.handle.net/11250/2498474
Holmberg, M., Valmari, G. & Lundgren, S. M. (2012). Patients′ experiences of homecare nursing: Balancing the duality between obtaining care and to maintain dignity and self-determination. Scandinavian Journal of Caring Sciences, 26(4), 705-712. https://doi.org/10.1111/j.1471-6712.2012.00983.x
Hvid, H. (2009). To be in control — vejen til godt psykisk arbejdsmiljø, læring og innovation? Tidsskrift for Arbejdsliv, 11(1), 11-30. https://doi.org/10.7146/tfa.v11i1.108763
Ibarra, H. (1999). Provisional selves: Experimenting with image and identity in professional adaptation. Administrative Science Quarterly, 44(4), 764-791. https://doi.org/10.2307/2667055
Indregard, A.-M. R., Knardahl, S. & Nielsen, M. B. (2016). Emotional dissonance and sickness absence: A prospective study of employees working with clients. International Archives Occupational Environmental Health, 90(1), 83-92. https://doi.org/10.1007/s00420-016-1176-9
Johnson, J. V. & Hall, E. M. (1988). Job strain, workplace social support, and cardiovascular
disease: A cross-sectional study of a random sample of the Swedish working population. American Journal of Public Health, 78(10), 1336-1342. https://doi.org/10.2105/AJPH.78.10.1336
Johnson, J. V., Hall, E. M. & Theorell, T. (1989). Combined effects of job strain and social
isolation on cardiovascular disease morbidity and mortality in a random sample of the
Swedish male working population. Scandinavian Journal of Work, Environment and Health,15(4), 271-279.
Kamp, A. & Hvid, H. S. (2012). Elderly care in transition: Management, meaning and identity at work: A Scandinavian perspective. Samfundslitteratur.
Karasek, R. A. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly, 24(2), 285-308. https://doi.org/10.2307/2392498
Kirchhoff, J. (2010). De skjulte tjenestene: Om uønsket atferd i offentlige organisasjoner Karlstad University. https://www.diva-portal.org/smash/get/diva2:287297/FULLTEXT01.pdf
Kornstad, T., Jia, Z., Hjemås, G. & Beyrer, S. (2021). Regional mobilitet og yrkesaktivitet blant helsefagarbeidere og sykepleiere: Personer utdannet i 2009. Statistisk sentralbyrå. https://www.ssb.no/helse/artikler-og-publikasjoner/_attachment/444802?_ts=17762869090
Kvale, S. & Brinkmann, S. (2018). Det kvalitative forskningsintervju (3. utg.). Gyldendal akademisk.
Larsson, A., Karlqvist, L., Westerberg, M. & Gard, G. (2012). Identifying work ability promoting factors for home care aides and assistant nurses. BMC Musculoskeletal Disorders, 13(1), Artikkel 1. https://doi.org/10.1186/1471-2474-13-1
Lee, L. & Madera, J. M. (2019). Faking it or feeling it: The emotional displays of surface and deep acting on stress and engagement. International journal of contemporary hospitality management, 31(4), 1744-1762. https://doi.org/10.1108/IJCHM-05-2018-0405
Liu, H., Zou, H. Y., Wang, H. J., Xu, X. & Liao, J. Q. (2020). Do emotional labour strategies influence emotional exhaustion and professional identity or vice versa? Evidence from new nurses. Journal of Advanced Nursing, 76(2), 577-587. https://doi.org/10.1111/jan.14266
NOU 2023:4 (2023). Tid for handling. Personellet i en bærekraftig helse- og omsorgstjeneste. Helse- og omsorgsdepartementet. https://www.regjeringen.no/no/dokumenter/horing-nou-2023-4-tid-for-handling.-personellet-i-en-barekraftig-helse-og-omsorgstjeneste/id2961754/
OECD. (2020). Realising the potential of primary health care (OECD Health Policy Studies). https://doi.org/10.1787/a92adee4-en
Peplau, H. E. (1997). Peplau's theory of interpersonal relations. Nursing Science Quarterly, 10(4), 162-167. https://doi.org/10.1177/089431849701000407
Postholm, M. B. (2010). Kvalitativ metode: En innføring med fokus på fenomenologi, etnografi og kasusstudier (2. utg.). Universitetsforlaget.
Ruotsalainen, S., Jantunen, S. & Sinervo, T. (2020). Which factors are related to Finnish home care workers' job satisfaction, stress, psychological distress and perceived quality of care? - a mixed method study. BMC Health Services Research, 20(1), Artikkel 896. https://doi.org/10.1186/s12913-020-05733-1
Røkenes, O. H. & Hanssen, P.-H. (2012). Bære eller briste: Kommunikasjon og relasjon i arbeid med mennesker (3. utg.). Fagbokforlaget.
Schein, E. H. (1980). Mennesker i utvikling (E. A. Fosheim, Overs.). Tanum-Norli. (Opprinnelig utgitt 1978)
Sjöberg, A., Pettersson-Strömbäck, A., Sahlén, K.-G., Lindholm, L. & Norström, F. (2020). The burden of high workload on the health-related quality of life among home care workers in Northern Sweden. International Archives of Occupational Environmental Health, 93(6), 747-764. https://doi.org/10.1007/s00420-020-01530-9
Skålholt, A., Høst, H., Nyen, T. & Tønder, A. H. (2013). Å bli helsefagarbeider: En kvalitativ undersøkelse av overganger mellom skole og læretid, og mellom læretid og arbeidsliv blant ungdom i helsearbeiderfaget (NIFU-rapport 2013:5). Nordisk institutt for studier av innovasjon, forskning og utdanning. https://nifu.brage.unit.no/nifu-xmlui/handle/11250/280399
Strandell, R. (2020). Care workers under pressure: A comparison of the work situation in Swedish home care 2005 and 2015. Health and Social Care in the Community, 28(1), 137-147. https://doi.org/10.1111/hsc.12848
Strandås, M., Wackerhausen, S. & Bondas, T. (2019). Gaming the system to care for patients: a focused ethnography in Norwegian public home care. BMC Health Serv Res, 19(1), 121-121. https://doi.org/10.1186/s12913-019-3950-3
Suh, C. & Punnett, L. (2020). Surface-acting emotional labor predicts depressive symptoms among health care workers over a 2-year prospective study. International Archives of Occupational Environmental Health, 94(3), 367-375. https://doi.org/10.1007/s00420-020-01585-8
Szebehely, M., Stranz, A. & Strandell, R. (2017). Vem ska arbeta i framtidens äldreomsorg? Arbetsrapport/Institutionen för socialt arbete, 2017:1. https://www.diva-portal.org/smash/get/diva2:1082859/FULLTEXT01.pdf
Thoresen, L., Rugseth, G. & Bondevik, H. (2020). Fenomenologi i helsefaglig forskning. Universitetsforlaget.
Utdanningsdirektoratet. (2022a). Læreplan i vg3 helsearbeiderfaget (HEA03-03). Fastsatt som forskrift. Læreplanverket for Kunnskapsløftet 2020. https://www.udir.no/lk20/hea03-03
Utdanningsdirektoratet. (2022b). Søkere til videregående opplæring - utdanningsprogram. https://www.udir.no/tall-og-forskning/statistikk/statistikk-videregaende-skole/sokere-vgs/sokere-utdanningsprogram/
Vabø, M., Drange, I. & Amble, N. (2019). Den vanskelige deltidsknuten en særnorsk utfordring som rammer unge helsefagarbeidere. Fagbladet Samfunn og Økonomi (1), 6-21.
Van der Doef, M. & Maes, S. (1999). The job demand-control (-support) model and psychological well-being: A review of 20 years of empirical research. Work and stress, 13(2), 87-114. https://doi.org/10.1080/026783799296084
Watz, S. & Ingstad, K. (2022). Keeping calm on a busy day: An interpersonal skill home care patients desire in health workers: Hermeneutical phenomenological method. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00825-1
Watz, S. M. (2022). Selvstendige helsefagarbeidere i morgendagens helsetjeneste. Nordic Journal of Vocational education and Training, 12(3). https://doi.org/10.3384/njvet.2242-458X.2212395
Wenger, E. (2004). Praksisfællesskaber: Læring, mening og identitet. Reitzel.
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