Objective
Research shows worsening working conditions for nurses in Swedish elderly care with shortcomings exposed during the COVID-19 pandemic. Although extensively debated during the pandemic, work environment and service quality improvements are needed. Registered nurses have a key role in elderly care, balancing medical and care responsibilities for older people. However, more knowledge is required about the expectations and organisational conditions for nurses executing the role in elderly care. Therefore, the study aims to explore first line managers’ role expectations of nurses in municipal elderly care and their perceptions of barriers to nurses’ role fulfilment.
Methods
A qualitative approach was used with the study set in two Swedish municipalities. We used purposeful sampling and recruited thirteen first line managers from municipal and private care providers with experience being responsible for nurses working in elderly care. Data was collected using semi structured interviews with the managers, and the data was analysed using thematic analysis.
Results
Two themes were identified in the analysis describing Role expectations in care practice and Barriers to fulfilling role expectations. The first theme highlights the expectations of nurses in elderly care to deliver evidence-based care, foster effective team collaboration, and demonstrate strong leadership in the care work. Together, these elements should ensure a supportive environment and high quality for the residents in elderly care. The second theme addresses barriers to meeting role expectations, including excessive administration, staffing shortages, and illegitimate tasks, resulting in high workloads for nurses.
Conclusions
There is conflicting logic between nurses’ role expectations in elderly care and the possibilities for nurses to execute the role due to organisational barriers. Heavy work and administrative tasks hinder nurses’ ability to focus on core responsibilities and deliver optimal elderly care. Improving the organisational conditions for nurses requires political action.