Rationalisering av vården - en motstridighet i sig? : En kvalitativ studie om spänningar mellan sjuksköterskans professionella värderingar och den rationaliserade arbetssituationen

Sammanfattning: In recent decades, reforms under the collective name New Public Management have transformed the public sector in Sweden. In the light of more neoliberal methods, the aim of the reforms was to emulate governing principles in the private sector, in order to increase efficiency in the public sector. The effects of this are widely debated. The purpose of this study is to contribute to an increased understanding of whether nurses in the public sector can experience contradictions between the care they want to provide based on their values, and what they have organizational prerequisites for under the current regime of Swedish health care. The study consists of three main themes which also form the basis for question formulations – nurses’ professional values, nurses’ experiences of their working situation and finally, the perceived tensions between these. Previous research shows that nurses experience increasing pressure in their work situation, due to, for example conflicting demands between adhering to economic principles and working patient-oriented. The theoretical framework for this study is mainly Weber’s theory of rationalization and a theorisation of nurses’ values by Fagermoen. This study, based on qualitative interviews with nurses in the public sector, shows that nurses experience tensions between the way of working they strive for based on their professional values and the prevailing organizational conditions. The results show that the lack of time and resources that the informants experience, create contradiction and inhibit their ability to provide care according to their values. The focus on measurability also contributes to an experienced contradiction, since the nurse's values of what's important in their daily work sometimes goes beyond what can be measured.