Institutional Work in a Palliative Unit: “There is Less Time for Patient Contact”

Abstract

The encounter between divergent institutional logics may be challenging for nurses, since they must balance different expectations in their daily institutional work. These challenges increase when new reforms are introduced. Our research question is: How do actors linked to a palliative care unit experience the consequences of the Coordination reform in their daily performance of care work? Our study is based on a qualitative study in a palliative care unit in a nursing home where we interviewed patients, their relatives, and nurses/department leaders. Our findings show that by downgrading the professional logic because of the Coordination reform, the focus is on efficiency and budget instead of proper healthcare. This is not satisfactory for any of the actors in our study. We contribute to the research on the reforming of the healthcare sector by focusing on how different actors experienced day-to-day activities in a context where different institutional logics were involved.