Facing diversity under institutional constraints: Challenging situations for community nurses when providing care to ethnic minority patients
Peer reviewed, Journal article
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Date
2014-02-25Metadata
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Abstract
Aims. To explore the challenges faced by community nurses when providing
home health care to ethnic minority patients.
Background. Norway has a growing number of immigrants, including older
immigrant patients. Community nurses who provide home care encounter
considerable challenges when delivering services to an increasingly diverse patient
population.
Design. A qualitative study based on a hermeneutics approach.
Methods. A qualitative study was conducted involving 19 nurses in Norwegian
home health care districts, which had high proportions of minority patients. Data
were collected in 2008.
Findings. We identified three critical aspects of the encounters between
community nurses and minority patients. The first was intimate care. Nurses
perceived the fear of mistakes and crossing boundaries related to the cultural and
religious practices of minority patients as particularly stressful. The second was
rehabilitation after stroke. The beliefs of nurses in the benefits of rapid
rehabilitation conflicted with those of the minority patients and their relatives
who favoured extended rest during recovery. Third, the commitment of
community nurses to transparency in the care of dying patients was tested
severely when they met relatives who believed in religious explanations for the
destinies of patients and who wanted to conceal the true diagnosis from
terminally ill patients.
Conclusion. Community nurses encountered various challenges due to a lack of
experience with highly diverse patient populations. This situation will continue to
create difficulties for nurses and minority patients if management support and
appropriate training measures are not provided.