title: Practical nurses in elder care and changes in Finnish society - a biographical study.
abstract: BACKGROUND
  Substantial changes in the socio-economic circumstances in Finnish society over the past century have resulted in major changes in the case of older people, and in the status of nursing staff who care for them.
  
  
  OBJECTIVE
  The purpose of this study was to describe and analyse the work of practical nurses in elder care through the experiences and life cycles of two practical nurses with a long working experience.
  
  
  METHODS
  The data consisted of oral biographical narratives produced by the two nurses in repeated interviews. The data were analysed using inductive content analysis.
  
  
  RESULTS
  The following chronological stages and periods of the work of the informants emerged as the core themes of elder care: (1) Collective institutionalized care in the 1950s-1970s: The lowest caste in training, obedient subordinates, undemanding service and routine work; (2) Elderly orientated institutionalized care in the 1980s and 1990s: From subordination to co-operation as an experienced nurse, recognizing the specific qualities of the elderly; (3) Prospects of elder care from the 1990s onwards: Returning to custodial care?
  
  
  CONCLUSIONS
  The themes are related to the more general changes that have taken place in Finnish society and health care. The future prospects of practical nurses seem challenging because the principles of social work and health care in Finnish society have shifted from institutionalization towards community care. As a consequence, practical nurses are required to have higher qualifications.
authors.affiliation: Department of Nursing and Health Administration, University Hospital, University of Oulu, Finland. lpaasiva@cc.oulu.fi
authors.forename: Leena
authors.initials: L
authors.lastname: Paasivaara
authors.forename: Merja
authors.initials: M
authors.lastname: Nikkonen
authors.forename: Kaisa
authors.initials: K
authors.lastname: Backman
authors.forename: Arja
authors.initials: A
authors.lastname: Isola
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003152:Community Health Nursing / Q000379:methods / Q000639:trends; D005387:Finland; D005851:Geriatric Nursing / Q000379:methods* / Q000639:trends; D006801:Humans; D024802:Nurse's Role / Q000523:psychology*; D009743:Nursing, Practical / Q000193:education / Q000379:methods* / Q000639:trends