District nurses' experience of working in home care in Sweden

Abstract

Background: Home care was previously included in healthcare centers in county councils in Sweden. Today, home care is the responsibility of municipalities. Consequently, the work of district nurses from healthcare centers has changed, and they face a new mission and new challenges. The aim of this study was to explore district nurses' experiences of working in home care after the municipalization. Methods: The design was descriptive with an inductive approach. Five district nurses working in different municipalities were interviewed. Qualitative content analysis was used. Results: The district nurses experienced their work through the following themes: organization, local environment and leading the team, and defined the themes in terms of inadequacy, collaboration, control, comfort, continuity and own competence. Their work was free and pleasant with more time for the patients. At the same time they at time had difficulties to carry out their work. Recipients' condition in municipality home care experienced as better as a consequence of cross‐border cooperation, compared to earlier organisation of home care. District nurses work involved a great nursing responsibility and required leadership. They experienced losses of competence as well as new competence. Conclusions: District nurses' work was at times difficult because of organisational barriers. There is need of improvements and tools for district nurses to carry out their work and to promote their competence development. The organisation is not functioning optimally in municipal home care. Cooperation between municipality, primary care and inpatient care needs improvement.