The role of the hospital in the home registered nurse: A phenomenological study

The role of the hospital in the home registered nurse: A phenomenological study

Healthcare and societal expectations change over time, with Hospital in the Home (HITH) registered nurses (RNs) increasing in community profile in Australian nursing domains. The COVID-19 pandemic created pressures on HITH RNs to maintain the health and wellbeing of patients with acute and chronic illness management. A critical understanding of the HITH RN’s role is needed because large variations in current position descriptions (PDs) and role functions exist. In this research, I explored the HITH RN role and key functions through a qualitative interpretive phenomenological lens. I also conducted a critical PD evaluation of the duty statements, responsibilities, and accountability to identify the requirements of HITH nurses. In doing so, I revealed HITH RN roles to be complex, encompassing communication, accountability, and responsibilities in autonomous care-delivery settings. Thematic analysis of the data highlighted the challenges and successes of HITH roles. Three key areas emerged: professionalism, knowledge, and responsiveness, but there was a mismatch between scope of practice in the PDs. Overall, in this research I identified challenges in the day-to-day role and function of the HITH RN. The HITH RN undertakes complex roles, working within generic PDs that lack core components of the required autonomous practice, experience, and knowledge. This thesis contains outcomes and strategies that link national and international literature. It also contains recommendations for clarity and improvement in HITH RNs’ role, scope, and function. Redefining the principles of the HITH RN role at an advanced level has implications for policy and practice. The advanced care practice rewards achievement and develops role clarity that enables the provision of acute care in the community through a collaborative, timely, efficient, and effective approach.

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