title: General practitioners' experiences as nursing home medical consultants.
abstract: OBJECTIVE
  To describe general practitioners' experiences of being the principal physician responsible for a nursing home.
  
  
  METHODS
  Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation.
  
  
  RESULTS
  Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety.
  
  
  CONCLUSIONS
  The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems.
authors.affiliation: Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Kirsebom
authors.affiliation: Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Mariann
authors.initials: M
authors.lastname: Hedström
authors.affiliation: Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Ulrika
authors.identifier: http://orcid.org/0000-0002-2867-0490
authors.initials: U
authors.lastname: Pöder
authors.affiliation: Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Barbro
authors.initials: B
authors.lastname: Wadensten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003253:Consultants / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D058005:General Practitioners / Q000458:organization & administration* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D036301:Qualitative Research; D013727:Terminal Care / Q000458:organization & administration* / Q000523:psychology
keywords: advance care planning; experiences; family members; general practitioners; nursing home