Balancing contradictory requirements in homecare nursing - A discourse analysis

Abstract

Aim : To explore prevailing discourses on nursing competence in homecare nursing to boost understanding of practice within this field. Design : A qualitative study with a social constructivist perspective. Methods : Six focus‐group interviews with homecare nurses in six different municipalities in Norway. Adapting a critical discourse analysis, data were linguistically, thematically and contextually analysed in the light of theories on competence, institutional logic and discourses. Results : The analysis found homecare nursing to be a diverse and contradictory practice with ever‐increasing work tasks. Presented as binary oppositions, we identified the following prevailing discourses: individualized care versus organizing work; everyday‐life care versus medical follow‐up; and following rules versus using professional discretion. The binary oppositions represent contradictory requirements that homecare nurses strive to balance. The findings indicate that medical follow‐up and organizational work have become more dominant in homecare nursing, leaving less time and attention paid to relational and everyday‐life care.