"网约护士"上门服务真实工作体验的现象学研究

Phenomenological study on real work experience of"online nurses"door-to-door services

目的分析互联网模式下"网约护士"上门护理服务的真实工作体验,为政府及管理部门开展"互联网+护理服务"工作提供依据。方法根据现象学研究方法,于2019年8月—11月,采用立意抽样,以最大差异化为原则,选取宁波市某三甲医院及其托管单位社区卫生服务中心中提供过上门护理服务的20名护士进行半结构访谈,访谈资料用Colaizzi资料分析法进行整理分析。结果影响"网约护士"护理服务工作体验的2个主题,其中积极因素包括职业价值感明显提升,政策支持保障,患者需求剧增,保险保障,急救安全保障;消极因素包括投入与收获不平衡,服务费用未纳入医保,医疗垃圾处理不当,团队支持缺乏,"网约"护理服务宣传不足,多学科护理知识薄弱,"网约"护理病历标准化不规范。结论"网约"护士在服务体验中有职业价值感提高等正向性体验,同时也存在收支不平衡,团队支持不足等困难。需要进一步加强政府-医院-社区-企业间的协作,多角度多方位逐步完善"网约"护理服务规范,为网约护士提供良好的工作环境和安全保障,更好地服务于社会。

Objective To analyze the real work experience of"online nurses"door-to-door services under the Internet model so as to provide a basis for the government and management departments to carry out"Internet+nursing services"work.Methods According to the phenomenological research method,intentional sampling and the principle of maximum differentiation were used to select 20 nurses who had provided home care services in ClassⅢGrade A hospital and hosted community health service center in Ningbo for the semi-structured interview from August to November 2019.The interview data was organized and analyzed using the Colaizzi data analysis method.Results There were two themes that affected the work experience of"online nurses"nursing service.Among them,the positive factors included the obvious increase in professional values,policy support guarantee,the surge in patient demand,insurance protection and first aid safety guarantee;the negative factors included the unbalanced input and harvest,service costs not included in medical insurance,improper disposal of medical waste,lack of team support,insufficient publicity of"online"nursing services,weak multidisciplinary nursing knowledge,and lack of standardization of"online"nursing medical records.Conclusions The"online nurses"have positive experiences such as increased professional values in their service experience.At the same time,there are also difficulties such as imbalance in income and expenditure,and insufficient team support.It is necessary to further strengthen the government-hospital-community-enterprise collaboration,gradually improve the"online"nursing service standards from multiple angles and directions,provide a good working environment and the security for online nurses so as to serve society well.