Elevhälsan - Licentiatavhandling av Siv Morberg ”Ensam i sin profession i skolans värld"



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Licentiatavhandling av Siv Morberg ”Ensam i sin profession i skolans värld"

Publicerad: 2009-02-15
I Oktober 2008 på Karolinska Institutet försvarade Siv Morbergs sin Licentiatavhandling ”Ensam i sin profession i skolans värld – skolsköterskans upplevelser av förutsättningarna att utöva och utveckla yrket”.
Siv Morberg, Universitetsadjunkt, Licentiat i Omvårdnad är utbildad distriktssköterska och vårdlärare och har arbetat 13 som skolsköterska. Numera arbetar Siv som vårdlärare på Karolinska Institutet.

Siv har intervjuat 24 kvinnliga skolsköterskor i kommuner runt Stockholm. I studien ingår 9 kvinnliga skolsköterskor med ledningsansvar.

 Studiens syfte

Det övergripande syftet med studien var att belysa skolsköterskors uppfattning om sitt yrke, sin arbetssituation och möjligheter till att utöva hälsoarbete i skolans kontext. Syftet var också att belysa hur skolsköterskans yrke påverkas i pedagogisk kontext och vilka möjligheter det finns att i pedagogisk kontext utveckla skolhälsovården och skolsköterskans yrke.

Ett smakprov ur början av Sivs resultatdiskussion

Resultatet illustrerar att skolsköterskans roll är otydlig och att skolsköterskorna fann det svårt att argumentera för sitt arbete. Tid och tillgänglighet sågs som en förutsättning för skolsköterskans stödjande roll i förhålande till eleverna, där tillgängliget sågs som skolsköterskans viktigaste uppgift. De intervjuade skolsköterskorna menade att stödet till eleverna skulle ses ur ett helhetsperspektiv på elevens hela situation, något som sågs som en kompetens men som var svår att synliggöra och få legitimitet för i pedagogisk kontex.

Läs den spännande fortsättningen och ta del av hela avhandlingen Läs avhandlingen (PDF) Avhandlingen finns på Svenska och Engelska.

Läs mer på Karolinska Institutets webbplats

Läs mer om Siv Morberg

Är du intresserad av att läsa hela avhandlingen i bokform (även på svenska) så kan köpa ett ex genom att kontakta Siv Morberg siv.morberg@ki.se 

 Här kan du läsa Abstract:

School health care is stipulated in Swedish law. The Swedish National Board of Health and Welfare is the institution which has the overall responsibility for school health care in Swedish primary and secondary schools. The municipalities are responsible for providing school health care. In several areas in Sweden, a ‘head of school nursing’ has the overall responsibility for school health care within a defined area. Most of the school nurses are employed by schools, with a head teacher as their line manager. Their competence is based on training as a district nurse or a paediatric nurse. Studies have shown that the school nurse’s role is unclear and that there is limited support for their work.

Subsidiary study 1. The purpose of this article was to gain a deeper understanding of school nurses’ perceptions of their opportunities for practicing and handling health support work within the educational system. The study was based on data collected through focus group interviews with 24 school nurses from areas in Sweden with different geographical locations, socioeconomic status and cultural background. The questions concerned the school nurses’ views of various aspects of their work situation. The results described the conditions for practicing health supporting work within the educational system. The school nurses expressed concern about practicing individual health supporting work due to poor legitimacy and space within the educational context. Being the link between the school and the medical service in individual health related cases, i.e. transferring the needs of these children from the medical to the school setting provided a more clear position and legitimacy of school health personnel.  All participants viewed their availability, individual support and giving time for pupils as one of the most important functions in practicing school health care. Being available was considered as a prerequisite for their supporting role. The participants experienced their work positively related to their autonomy but negatively as regards their experienced isolation from colleagues. Lone working could entail a sense of uncertainty and vulnerability when faced with difficult decisions. Limited opportunities for further professional development were also described. In most cases, the school nurses relied on their previous medical experience and experience gained during their working life. The clear and explicit need to be accessible and flexible was central in almost all interviews and could at times be experienced as a dilemma. The participants discussed the dilemma of how to increase the school health work’s profile. To make their work more evident and with a clearer profile was viewed by most as important in order to argue for the importance of the school nurse’s profession in the future.

Subsidiary study 2. The purpose of this article was to gain a deeper understanding of how Swedish head school nurses perceive their leadership in developing school health care and school nurses’ work. The study was based on 11 individual interviews with nine head school nurses. For verification one more interview was held by telephone. The questions focused on the way in which they coordinated school health care and the strategies they used to implement it within the educational system and schools. The results described how head school nurses experienced their leadership in developing school health care and school nurses’ work. Overall school health care, stipulated by law, was described by the head school nurses as a formalised part and an important arena for promoting the health of children and young people. Limited opportunities and restricted conditions and regulations, as well as lack of interest and knowledge about school health care, made it difficult for the head school nurse to inform political and organisational leaders about the contribution of school health care as well as the work done by school nurses. The restricted conditions experienced by the head school nurses were described and understood in the sense of background and perspectives in school health care differing from those of the educational organisation. The head school nurses’ specific position was experienced as a pioneering job, working alone and in isolation, but also with some autonomy in interpreting school health care, and some freedom in creating their own goals for school health care,given some set frameworks and financial restrictions. The head school nurses described that there were no clear goals for their competence development. Knowledge and experience as a local school nurse was seen as an important qualification on which to base working as a head school nurse. To strengthen the school nurses in their lone working situation, the head school nurses stressed the importance of giving individual support to school nurses. Sometimes these practical tasks were described as taking too large a part of the head school nurse’s time, which had an impact on developing school health care for the future.

 

 






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