Mid Sweden University

Background

Home care has become an increasingly central part of healthcare organizations and in the future, an extended part of health care is expected to be provided in patients’ homes.Because a home represents a safe foundation with high personal integrity, it can cause ethical and emotional challenges for the nurse in encountering the patient. Hence, it is of the utmost importance to understand the emotional and ethical dimensions of encountering patients in home care, and pay more attention to how it impacts the way nurses practice their profession.

Aim

To illuminate the meaning of nurses’ lived experiences of encountering patients in home care.

Method

A qualitative design with a phenomenological hermeneutic approach was used and individual narrative interviews were performed with a purposive sample of 11 RNs working in home care. Ethical approval to perform this research was obtained from the Swedish Ethical Review Authority.

Findings

The findings are presented under three main themes: (1) “Being receptive to the other” (with subthemes “Caring about the encounter,” and “Establishing trusting relationships”). (2) “Handling the unpredictable” (with subthemes “Being alone in the encounter” and “Being experienced and competent”). (3) “Managing frustration” (with subthemes “Feeling insufficient” and “Feeling restricted”. Having overall nursing responsibility challenged the nurses’ self-confidence in providing care trustfully.

Conclusions and implications

The nurse could not always perceive the needs as conveyed by the patient and respond to the ethical demand. This was facilitated by shifting the focus from efficiency and solutions on parts to getting to know the person in front of them as a whole, perceiving their needs and wishes. By enriching the understanding of the complex encounters between nurses and patients, the patients’ health and well-being can be better supported.