The informants feel that there is no overall strategy for professional development. Earlier studies have shown the same (8, 39, 41). Nurses with specialty training or other forms of expertise consider their own competencies to be relevant and important for their personal professional development and for their workplace community, but find that their skills are not always put to use.
Employers may not be aware of the skills of their nurses, and staff representatives are never present when the matter of professional development is up for discussion. The officer who heads the municipal health service is responsible for ensuring that the appropriate competencies are available and for facilitating opportunities for employees to acquire these competencies (2).
Nevertheless, it is important to point out that the nurses generally report to have found the changes to their work responsibilities to be interesting and challenging; this has been similarly demonstrated by a number of studies in recent years (3, 8–10). Mid-career changes may make working for the municipal health service a more attractive proposition, and this will be an important factor in the future when more staff and skills will be required to care for patients (8, 11).
The nurses feel that in many areas they have the required competencies, but that due to the way the service is organised, their skills are not put to use where they are needed (5, 8). The results show that competencies relating to substance abuse, mental health and complex disorders are in demand among nurses. Nurses have only limited earlier experience of these areas of practice because they have never been prioritised by the municipal health service.
The study’s weaknesses
Only a limited number of informants took part in the study, and they were all recruited from a restricted geographic area. Population numbers are relatively low in both municipalities represented in the study. It is not possible to generalise on the basis of this qualitative study, and the results may well have been different if the study had been carried out in different municipalities.
Nevertheless, it is our opinion that the findings are consistent with the findings of earlier studies, and that a repeat of the study in different municipalities would probably generate similar results.
Nurses have a duty to keep professionally updated in order to meet the demands of the health service, but nurses cannot achieve this on their own. Our findings show that nurses frequently acquire new knowledge by turning to unplanned activities such as learning within the community of practice, looking up nursing issues on the Internet and contacting specialists in the field to discuss a patient’s case. They need the assistance of their management if they are to plan their work and organise their services so that professional development becomes a natural part of their working day. It appears that this is not the case today.
Furthermore, local authorities need to put in place a strategy for the professional mapping and development of their nurses. Despite the problems, the nurses consider their working day to be challenging and exciting, and they enjoy their new responsibilities. Enjoyment may well lead to greater job satisfaction and enhanced motivation to stay in their jobs.
This study’s findings suggest it would be pertinent to conduct further research into what measures are conducive to professional development in the municipal health service. Professional development will constitute a challenge for our educational institutions in the years ahead, both in terms of safeguarding basic nursing competencies and in terms of customising postgraduate courses and master’s degree programmes so that they meet the challenges of the municipal health service.
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