An exploration of the role and status of nurses working in nursing homes for older people: a hermeneutic phenomenological study

Thompson, Juliana (2015) An exploration of the role and status of nurses working in nursing homes for older people: a hermeneutic phenomenological study. Doctoral thesis, Northumbria University.

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Abstract

Older people residing in nursing homes have complex needs requiring the input of nurses skilled in managing multi-morbidities and psychosocial issues. However, in England, nursing homes have proven to be unappealing work settings for potential staff, while nurses who do work in these settings are often afforded low status. Such contradictions pervade current understanding of the nature of work in nursing homes. To-date, few studies have investigated the views and experiences of nursing home nurses themselves regarding the contradictions that arise from role and status issues.

This study explores English nursing home nurses’ views regarding status and role. The aims of the study were constructed as follows:
 To explore the experiences and views of nursing home nurses working with older people regarding their status and role.
-To generate an understanding of how and why these experiences and views occur.
-To explore whether emerging insights regarding nursing home nursing can inform workforce development processes.

The methodology utilised was hermeneutic phenomenology, based upon the philosophies of Gadamer and Iser. Thirteen nurses from seven nursing homes were each interviewed five times using an episodic interview technique. Data analysis methods were adapted from Van Manen’s hermeneutic phenomenological approach, and Iser’s literary reception theory methods.

Four categories emerged from the data - nursing ‘residents’ rather than ‘patients’, business role, stigma, and isolation and exclusion. From these categories, three themes were ascertained - uncertainty about role identity, unpreparedness for the demands of the role, and low occupational status.

Participants feel uncertain, unprepared and stigmatised because they are positioned at the intersection of health and social care – a location where health and social care funding issues cross, and healthcare and social care work overlaps. Understanding generated from this study can inform workforce development processes.

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