Process of Experienced Visiting Nurses Realizing Multidisciplinary Care with Home-care Workers: Realization and Gratification with Multidisciplinary Care that Increase with “Timely Exchange of Episodes”

Abstract

We clarified the process of how experienced visiting nurses become involved with home-care workers and realize multidisciplinary care using the Modified Grounded Theory Approach. Over the course of deepening their understanding of home-care workers’ characteristics and practice, nurses were building relationships to be able to “aim for what’s best for the patient together” and were updating the extent and content of care from the perspective of what “we” can do to support the daily living of “that patient.” “Timely exchange of episodes” is a concept that plays a significant role in process development. Exchanging “episodes” enables a multifaceted assessment of the patient’s mental and physical condition. Furthermore, not only communicating the objective information, but also exchanging episodes that nurses and home-care workers want to relay to workers in other roles in a timely manner leads to the realization and gratification of practicing care as a member of a team, thereby promoting multidisciplinary care.