Nursing Staff Insufficiencies in Norway

August 20, 2019

Nursing Staff Insufficiencies in Norway

Proper health care is essential to older patients. Are nurses and health care workers doing their part to help? In a 2016 study in Norway, the results were unfortunate. It was discovered that a staggering number of healthcare workers has a severe lack of skills, techniques, and resources to care for their elderly patients properly.

A study conducted by BMC Nurs, to determine whether or not proper health care is provided to the elderly deeply investigated the competence of nursing staff inNorwegian community elderly care. The study consisted of 1,016 nursing staff members in nursing homes and home care services around Norway.

The Study

A cross-sectional survey of 1016 staff members, including registered nurses (RN)and assistant nurses (AN) were given multiple survey questions to determine their competence in their field of work. Using the “Nursing Older People –Competence Evaluation Tool,” the study was able to decide on the skill levels of the health care providers. The survey participants were comprised of 35% RNs, 52% ANs, and 9% assistants. The majority were female (93%), and most were working in a permanent position in the elderly health care niche (89%) and (54%) were permanently employed in a nursing home. The study included people with a wide range of ages (18-70) and their years of experience working in the field. The respondents were well-experienced, and the mean number of years at their current workplace was 8. The mean number of years working in the elderly care community as a whole was over 15 years.

Their individual knowledge, skills, personal abilities, and contextual aspects of competence in elderly care were looked at and measured using the “Nursing OlderPeople – Competence Evaluation Tool.” The nursing staff members were offered one hour off from their regular work to fill out the questionnaire at a computer during their working hours. All staff members were encouraged to participate by their managers. Participation in the survey was voluntary and confidential.

The Patients

A large portion of patients receiving elderly care in Norway suffers from cognitive impairment. Many older patients are in frail condition, meaning if their health care needs are not appropriately met, the risk of adverse outcomes becomes higher. Only a well-educated staff can meet the needs of these patients; therefore, the need for competent health care providers is essential.

Quick Facts
  • 83% of patients admitted to nursing homes suffer from dementia
  • 66% of those patients have other neuropsychiatric symptoms
  •  A number of studies have determined that inappropriate drug use is a significant factor in declining health among the elderly

The staff

Although there are ongoing efforts to improve the quality of elderly care in Norway, results still show inadequate health care. Should staff members be required to hold a degree, or at least have more formal training? Why are elderly patients in Norway falling under the cracks of the healthcare system?

Quick Facts
  • 30% of the elderly nursing staff in Norway are assistants without formal training
  • 60% of assistant nurses hold a degree of higher education
  • Increasing job demands have not allowed RNs to develop their competence further
  • The roles and daily tasks of RNs and ANs are relatively similar

The Study Findings

The main finding of the study was that RNs had more competent than ANs. While ANs displayed more competence than the assistants. However, there were a few notable exceptions. Some ANs scored higher than RNs on “nursing measures” and“simple procedures.”  

Another finding was that competence difference between nursing staff groups. The leaders of the elderly care community lack the tools to help staff develop the competence required to care for elderly patients. Overall, RNs are more competent than ANs and assistants. RNs and assistants did score higher than RNs in other areas. More research should be explored with more focus than just education/training and age. There can be many other factors to explain the difference between varying competency levels better.


Low influence of education and proper training on competence could be the reason for the poor standards in the elderly care community. More training, clearer role descriptions, and higher levels of self-confidence are recommended to improve the competence development of geriatric nursing care workers. Future research should be conducted to show the competence levels of nursing staff members further.

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