Nurses’ experiences with non-nurses involved in nursing care – A focus group study

The global shortage of nurses results in vacant nurse positions and requires healthcare systems to reconsider how and by whom nursing care can be delivered. One initiative is to employ allied health professionals, service assistants, and hospital porters (all referred to as non-nurses) to assist in delivering nursing care in hospitals. The changes in staff composition entail changes in nurses’ work conditions. Aim To explore nurses’ experiences of non-nurses being involved in delivering nursing care to hospitalized patients. Methods Sixteen nurses from twelve wards at a Danish university hospital participated in five focus groups. Data was analyzed using thematic analysis. Findings Three themes were generated: 1) Being supported in direct and indirect nursing care; 2) The complexities of delegating nursing care to non-nurses; and 3) Grasping a changed and undefined nursing role. The themes describe how nurses’ experiences are characterized by ambiguity. Nurses acknowledge that they need help from non-nurses and that their contribution release time for nursing care. However, the involvement of non-nurses results in feelings of increased responsibility and lack of clarity regarding the nurses’ role. Moreover, the complexity of delegating nursing care to non-nurses is related to the balance between the competencies of the non-nurses and patients’ care needs. If the non-nurses’ does not hold the needed competencies to support patients’ care needs, the nurses become unsure of what they can delegate to non-nurses.
Conclusion: Involving non-nurses in delivery of nursing care for hospitalized patients is complex and it changes the context for care. It is essential to clarify the expectations of the collaboration and the roles of both nurses and non-nurses to ensure that hospitalized patients receive the fundamental care they need. The results of this study can be used to ensure that fundamental care practice is embedded in wards with mixed staff composition.