Challenges and barriers in developing the division of labour between nurses in a Finnish acute hospital

Abstract Background: Ageing populations with high demands for healthcare require changes in nursing work. The right division of labour is one of the solutions contributing to efficiency, productivity and quality in healthcare. Objective: To determine challenges and barriers related to the development of division of labour between practical nurses and registered nurses. Methodology: This qualitative study reports as a part of a larger study of nurses (n=260), perceptions of challenges and barriers in developing the division of labour in one hospital district in Finland. The data was derived from an open-ended question and analysed by inductive content analysis. Results: The results showed that challenges and barriers in developing the division of labour were related to the individuals’ experiences and know-how and organisational factors. The most common factors in all groups were attitudes and prejudices, concern about competence and the limits and ambiguity of division of labour. Conclusions: The results were surprisingly similar in all groups (registered nurses, practical nurses, nurse managers). To improve productivity and quality in healthcare, we need uniform guidelines for wards, clear job descriptions, a culture of mutual respect, understanding of each group’s role, information about practical nurses’ education and continuous communication. Most of these issues are linked to management and its challenges