The challenges of primary health care nurse leaders in the wake of New Health Care Reform in Norway
Permanent link
https://hdl.handle.net/10037/10157Date
2016-11-24Type
Journal articleTidsskriftartikkel
Peer reviewed
Abstract
Background: The local municipality, whose management style is largely inspired by the New Public Management
(NPM) model, has administrative responsibilities for primary health care in Norway. Those responsible for health care
at the local level often find themselves torn between their professional responsibilities and the municipality’s
market-oriented funding system. The introduction of the new health care reform process known as the
Coordination Reform in January 2012 prioritises primary health care while simultaneously promoting a more
collaborative and multidisciplinary approach to health care. Nurse leaders experience constant cross-pressure in
their roles as members of the municipal executive team, the execution of their professional and administrative
duties, and the overall political aims of the new reform. The aim of this article is to illuminate some of the major
challenges facing nurse leaders in charge of nursing homes and to draw attention to their professional concerns
about the quality of nursing care with the introduction of the new reform and its implementation under NPMinspired
municipal executive leadership.
Method: This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation.
Result: Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality’s hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership.
Conclusion: The priorities of municipal senior management and the focus of the municipality’s care service need clarification in the light of this reform. The voices of those at the frontlines of the caring services need to be heard as the restructuring of the caring services may have implications both for funding allocation and for the quality of patient care.
Method: This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation.
Result: Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality’s hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership.
Conclusion: The priorities of municipal senior management and the focus of the municipality’s care service need clarification in the light of this reform. The voices of those at the frontlines of the caring services need to be heard as the restructuring of the caring services may have implications both for funding allocation and for the quality of patient care.
Description
© The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License, which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.e. The Creative Commons Public Domain Dedication waiver applies to the data made available in this article, unless otherwise stated.
Publisher
BioMed CentralCitation
BMC Nursing 2016, 15:66Metadata
Show full item recordCollections
Related items
Showing items related by title, author, creator and subject.
-
Cochrane Collaboration Systematic Reviews may be based on trials not approved by a research ethics committee
Jokstad, Asbjørn (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-10-27)Systematic reviews (SR) may potentially contain reports of primary trials with ethical problems. The Cochrane Collaboration SRs are considered as the highest standard in evidence-based health care resources. All SRs completed during the last 5 years (2013–2017) under the management of the Oral Health Group of the Cochrane Collaboration were identified. All primary trials included in the Oral Health ... -
Pembrolizumab as second-line therapy in non-small cell lung cancer in northern Norway: budget impact and expected gain—a model-based analysis
Norum, Jan; Antonsen, Margaret Aarag; Tollåli, Geir; Al-Shibli, Khalid; Andersen, Gry; Svanqvist, Kristin-Helene; Helbekkmo, Nina (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-07-29)1 Norum J, et al . ESMO Open 2017; 2 :e000222. doi:10.1136/esmoopen-2017-000222 Open Access Abstr A ct Background P embrolizumab is a new drug approved in several countries for second-line therapy in non-small cell lung cancer (NSCLC) being programmed cell death ligand (PD-L1) positive. This drug has a high cost, and the cost- effectiveness ratio has been debated. Patients ... -
The Use of eHealth and Provider-Based Health Services by Patients with Diabetes Mellitus: Protocol for a Cross-Sectional Study
Hansen, Anne Helen; Bradway, Meghan; Brož, Jan; Claudi, Tor; Henriksen, Øystein; Wangberg, Silje C; Årsand, Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-10-31)<b>Background:</b> The prevalence of diabetes and the use of electronic health (eHealth) resources are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great significance in this regard. However, little is known about the extent to which different kinds of eHealth tools are used, and how the use of eHealth is associated ...