Professional pride: A qualitative descriptive study of nursing home staff's experiences of how a quality development project influenced their work

Aims and objectives: To explore and describe how daily work at a nursing home had been influenced by a quality improvement project, from the perspective of direct care staff.

Background: Deficiencies in nursing home care are widely reported, often with a focus on lack of competence among direct care staff. The present trend in quality development in nursing homes brings direct care staff's perspectives into focus through participatory action research approaches. Still, little is known about how staff experience the impact of such projects on their everyday work.

Design: The study was designed as an interpretive descriptive study, based on interviews with nursing home staff. The methods were conducted in accordance with the SRQR guidelines.

Results: The analysis revealed that the participants reasoned on whether the improvement project contributed to their possibilities perform their work at the unit for the benefit of the residents. This was strongly connected to their professional pride. The participants reflected on this through three changes generated by the project: (a) participating in project activities-supporting or threatening daily work at the unit, (b) from performing individual duties towards a shared responsibility and (c) confirming and strengthening competence that brings the everyday situation of residents into focus.

Conclusion: The importance of professional pride identified in this study points towards a need for reducing barriers for direct care staff to express and develop competences they regard as part of their professional identity. The findings also shed some light on competence that brings the everyday situation of residents into focus as a driving force behind lack of compliance and resistance to change.

Relevance to clinical practice: The findings indicate a call for quality development designs to reduce barriers for care staff to express and develop knowledge that they regard as part of their professional identity.