Nowadays, it is common that newly built hospitals are designed with single‐room accommodation, unlike in the past, where shared accommodation was the favoured standard. Despite this change in hospital design, very little is known about how single‐room accommodation affects nurses' work environment and nursing care. This study evaluates how the single‐room design affects nurses and nursing care in the single‐room hospital design. Nurses working in the single‐room design predominantly work alone with little opportunity for peer training, interaction and reflection. In (...) addition, the single‐room design affects the nurses' work environment due to changes in sensory stimulation and increased walking distances. Furthermore, a change in the discourse, namely, regarding the single room as the patient's home, makes the nurses react to queries, demands and tasks in a new way. Overall, the new hospital design forces the nurses into a more reactive role and affect their way of providing nursing care. Despite this, the nurses find single‐room accommodation beneficial for the patients and their nursing care. (shrink)

ABSTRACT In this discussion paper, we aim to call attention to artefacts, such as for example doors, as fruitful sources for understanding subtle aspects of clinical practice. We draw on a post‐phenomenological approach and argue that this perspective can be helpful in identifying changes in clinical practice, which often remain unnoticed in nursing research. We present the post‐phenomenological idea that artefacts are not only passive tools or frames for clinical practice but mediate and transform human actions and people's perceptions of (...) themselves. Three examples of analytical applications are elaborated to illuminate the potential of this methodological perspective. The examples originate from a previously conducted realistic evaluation study, which served as the starting point for the discussion in this article. During this previous research process, we became aware of differences in how nurses entered and left the patient rooms in a hospital design with all single‐room design compared to a shared‐accommodation design. To reflect further on these unexpected observations, we moved away from the critical realism approach and adopted a post‐phenomenological approach. We became particularly inspired by the concept of ‘hospes’, which may mean both host and guest and which served as a theoretical lens, allowing us to explore the differences in how the nurses, patients and relatives acted when they stayed in, entered, or left a room, and when they spoke about their views on, for instance, privacy during hospitalisation. In this article, we further discuss how actors' interactions with doors and rooms constitute different roles and responsibilities for the patients, their relatives and the nurses. (shrink)

This study critically examines how home care nursing is constructed as a policy problem in the 2024 Danish Health Reform. Drawing on Bacchi's “What is the Problem Represented to be?” (WPR) framework, we analyze the reform document to uncover the discursive mechanisms through which home care nursing is problematized, framed, and governed. The analysis identifies four dominant problem representations: unequal access to care, fragmented patient trajectories, insufficient municipal competencies, and an overreliance on hospital‐based services. These representations legitimize the centralization of (...) healthcare governance and the transfer of specialized nursing tasks from municipalities to regions. In this framing, home care nursing is discursively positioned as “general” and less complex, despite its central role in coordinating care and managing chronic conditions. Silences regarding working conditions, patient experiences, and structural determinants of health further marginalize nursing expertise. The reform's framing produces discursive, subjectification, and lived effects that risk undermining care continuity and professional recognition. We argue that the reform reflects a technocratic logic that privileges specialization and structural reorganization, while neglecting the relational and contextual dimensions of nursing practice. This study contributes to critical nursing inquiry by highlighting the need for inclusive policy processes that recognize the complexity of home care nursing and the value of frontline professional knowledge. (shrink)

Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of (...) revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2. (shrink)

Several studies describe intersectoral collaboration in Western healthcare as hampered by lack of coordination of care and treatment and incoherent patient pathways. We performed an ethnographic study following elderly patients from admission to an emergency unit (EMU) to discharge and further treatment and care at other facilities in the healthcare system. The aim was to explore how health professionals work together across sectors in the Danish healthcare system and how they create patient pathways for elderly patients (+65) with multiple chronic (...) illnesses. Intersectoral collaboration was identified as distant relations between large numbers of health professionals, where communication was conveyed by electronic health record (EHR) formats which promoted information delivery that focused on patients’ immediate symptoms. Other significant ‘mediators’ of communication were the telephone that seemed to resemble face‐to‐face communication and the patient who delivered information from one professional to another. We suggest that the communication among professionals at various facilities interacts with the format and functionalities of the EHRs, which typically fall short in delivery of information across sectors, because the often complex needs of patients with multimorbidity do not fit in with the available functionalities of the EHR. (shrink)