. Theme: patients must adapt themselves to the
circumstances
Talk about the patient is conspicuously absent from the
interviews with the pool nurses. Throughout the interviews,
the nurses implicitly and explicitly assumed that
patients have no influence on the care culture.
I have never thought about it before but it is a bit
strange that you try to adapt to fit in at the personnel
and at the ward but you do not have the same focus to
adapt to the patient.
The patients seemed to lack power, and they had to
adapt to the ward’s culture and routines.
The nurses expressed a belief that the patients, like the
nurses, get a clear picture of the atmosphere on the ward.
One nurse described how the patient perceives the care
culture:
Then I think that the patients aren’t stupid. They read
me. They probably see more than I know. Of course I’m
influenced if there’s something I’m not happy with on
the ward. It might show on my face, my intonation. I
might be quite transparent. The patients can read me
like a book.
Patients can tell by the nurses’ facial expressions what
the mood is like on a ward, and they try to be as flexible as
possible.
If it is stressful on the ward, patients say they do not
require help. The nurses described how a personnel team
that works well with each other gives positive signals
throughout the ward, which in the end affects patients’
overall satisfaction with the care provided.
The nurses mentioned that patients who do not adapt to
routines and customs on the ward are classified as
troublesome. These are above all patients suffering from
dementia and mental illness, as they lack the capacity to
adapt to the care culture and demand more caring time
compared to other patients. These patients are troublesome
because they do not accept the ward’s routines and
the norms for how they should behave.