title: Nursing staff interactions during the older residents' transition into long-term care facility in a nursing home in rural Norway: an ethnographic study.
abstract: BACKGROUND
  Future challenges in many countries are the recruitment of competent staff in long-term care facilities, and the use of unlicensed staff. Our study describes and explores staff interactions in a long-term care facility, which may facilitate or impede healthy transition processes for older residents in transition.
  
  
  METHODS
  An ethnographic study based on fieldwork following ten older residents admission day and their initial week in the long-term care facility, seventeen individual semi-structured interviews with different nursing staff categories and the leader of the institution, and reading of relevant documents.
  
  
  RESULTS
  The interaction among all staff categories influenced the new residents' transition processes in various ways. We identified three main themes: The significance of formal and informal organization; interpersonal relationships and cultures of care; and professional hierarchy and different scopes of practice.
  
  
  CONCLUSIONS
  The continuous and spontaneous staff collaborations were key activities in supporting quality care in the transition period. These interactions maintained the inclusion of all staff present, staff flexibility, information flow to some extent, and cognitive diversity, and the new resident's emerging needs appeared met. Organizational structures, staff's formal position, and informal staff alliances were complex and sometimes appeared contradictory. Not all the staff were necessarily included, and the new residents' needs not always noticed and dealt with. Paying attention to the playing out of power in staff interactions appears vital to secure a healthy transition process for the older residents.
authors.affiliation: Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. marianne.eika@hit.no.|Telemark University College, Faculty of Health and Social Studies, Post box 203, , NO-3901, Porsgrunn, Norway. marianne.eika@hit.no.|Center for Caring Research, Telemark University College, Post box 203, , 3901, Porsgrunn, Norway. marianne.eika@hit.no.
authors.forename: Marianne
authors.initials: M
authors.lastname: Eika
authors.affiliation: Department of Health and Nursing Sciences, Agder University, Campus Grimstad, Post box 509, , N-4898, Grimstad, Norway. bjorg.dale@uia.no.|Center for Caring Research - Southern Norway, Campus Grimstad, Post box 509, , N-4898, Grimstad, Norway. bjorg.dale@uia.no.
authors.forename: Bjørg
authors.initials: B
authors.lastname: Dale
authors.affiliation: Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. geirae@svt.ntnu.no.
authors.forename: Geir Arild
authors.initials: GA
authors.lastname: Espnes
authors.affiliation: Telemark University College, Faculty of Health and Social Studies, Post box 203, , NO-3901, Porsgrunn, Norway. sigrun.hvalvik@hit.no.|Center for Caring Research, Telemark University College, Post box 203, , 3901, Porsgrunn, Norway. sigrun.hvalvik@hit.no.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Hvalvik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009664:Norway; D009735:Nursing Homes; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010360:Patient Transfer; D012424:Rural Population; D055815:Young Adult