It is late at night on February 14th. Nurse Svanhild Furre Johannessen has just gone off duty. She sits in her car and picks up the phone. – It has been absolutely terrible. And I don’t feel like work tomorrow, says Svanhild as she stares into the mobile camera. Recently, the nurse has documented parts of her everyday work for news Brennpunkt. She works at Nærøy living and treatment center, a nursing home in Nord-Trøndelag. – I got a call at one o’clock today that I was going to be alone as a nurse. We have a patient who was acutely ill and was dying. We had several with intravenous treatment. Then a patient dies, she says crying into the mobile camera. Svanhild Furre Johannessen cries on the way home from work. Photo: Privat This evening, Svanhild has received over 60 telephone calls at work. She has had to stand up for relatives who lost a loved one suddenly. It has come at the expense of other patients. – Several patients have not received their medicine on time. Antibiotics are staggered. Other patients have not received the emergency medicine that they desperately need. No, it hasn’t been any good. A foretold crisis It is not the first time Svanhild goes home in tears after a long day at work. And it’s not the first time she’s talked about it. In recent months, she has tried to tell the nursing home management about insufficient staffing and competence. This leads to haste and prioritization that have damaging consequences. Not only for her, but also for the patients. – What we see is that we only cover the very basic needs. And on the busiest days, unfortunately, we don’t even make it, she says. On the busiest days, they do not have time to give the patients the right care, food and drink. They do not get to help elderly people in need of care to the bathroom at the right time. They don’t get to give them medication on time. – We are struggling to make these ends meet for all our patients. And that scares me. Some days the nurses don’t have time to look after the residents’ basic needs, says Svanhild. Photo: Ole Jørgen Kolstadbråten / news It also scares her colleague. Linda Hellesø, who works at the same nursing home, has been more than a conversational partner. They have both documented their everyday life, and both have complained internally. – As the situation is now, we nurses are constantly committing offences, says Linda. There must be two people who check medicines to be dispensed. This is to ensure that patients do not receive the wrong medication or dose. But several times they do this alone because colleagues are busy. As a result of the complaints, the nursing home sets up working groups to investigate what can be improved. But Svanhild and Linda feel that the situation is so acute that something more must be done. Together with seven other employees at Nærøy living and treatment center, they decide to notify. – You get sick of it, you hear that you have a duty of loyalty. But we must be more loyal to our patients than to the employer, says Linda. They send a letter to the Norwegian Labor Inspection Authority and to the State Administrator. The notice is picked up by Namdalsavisa, and the news that the nurses do not trust the nursing home management spreads in the local community. Together with Svanhild and several colleagues, Linda has notified the conditions at the nursing home. Photo: Privat Going out alone 900 kilometers south of the country, another carer is in a similar situation. For the past ten years, Elisabeth Andersson has worked as an auxiliary nurse at Furuheim nursing home in Larvik. She has felt powerless for a while. And she needs to speak out about what she believes to be neglect in the workplace. Elisabeth says she has spoken up internally, and in May 2022 she will take the magazine out of her mouth. She goes anonymous in Østlands-Posten. A few months later, she meets news openly. – Now I think it is important that it is revealed what it is actually like in the nursing home, says Elisabeth. Elisabeth Andersson says some days at Furuheim are like a “rat race”. Photo: Rune A. Hansen / news The nursing home she works at is a certified Life Joy Home. This means that the nursing home must go to great lengths to look after the social, cultural and spiritual needs of the elderly. But according to Elisabeth, everyday life is not what it looks like on paper. – It’s not just joy and fun, that we have so much time, are on trips, bake cakes and read photo albums. It’s not that nice. At times we have time for that, but on the whole, it’s a rat race inside the nursing home. Elisabeth says that she has found a patient sleeping in a lift above the toilet, when she was on night duty. She does not know how long the patient had been hanging there. She says that unskilled people give medicines to patients after a few hours of training. Furuheim nursing home in Larvik is one of the nursing homes Brennpunkt is investigating. Photo: Rune A. Hansen / news What touches her the most is when older people die alone. She has experienced that patients have died alone on her watch, because staff have to be in several places at the same time. – I feel that it does something to me. I get sad and I get very angry. That it should be like this in Norway, one of the world’s richest countries, the old people should not be allowed to have someone with them when they die. – Very regrettable Municipal manager for health and coping in Larvik municipality, Guro Winsvold, says it is demanding to hear what Elisabeth tells. – I know that we have a lot of employees at Furuheim who do not have that experience, and that you can assess situations differently. So I don’t really have any comment, beyond the fact that what she has said must be at her expense, says Winsvold to news. She emphasizes that they provide medicine courses to everyone at the nursing home, and that she is proud of what the employees at Furuheim achieve in terms of enjoyment of life. The feedback from several relatives is that they are satisfied, says Winsvold. – If it is the case that someone has died alone, then it is very regrettable. We strive to prevent that from happening. Guro Winsvold is municipal manager for health and coping in Larvik municipality. Photo: Rune A. Hansen / news Although Elisabeth stands alone in the media about this, she is not the only one who has tried to speak out. The deviations tell news has been given access to several notices of deviations at Furuheim nursing home. They show that employees here have reported several times about a hectic working day – and the consequences it has. These are some extracts from notices of deviations that were submitted in 2021 and 2022. Guro Winsvold tells news that these deviations have been handled in line with the nursing home’s procedures. – It is important to emphasize that several of the deviations were reported during the pandemic, during periods of high sickness absence and restrictions and strict orders on the institutions, says Winsvold. A completely ordinary nursing home? In connection with the documentary “Brennpunkt: Care behind closed doors”, news has spoken to relatives and staff at several nursing homes. In addition, we have looked at national statistics. The numbers tell a story of their own about the situation in nursing homes in Norway. According to figures from the Directorate of Health, 45 per cent of residents in nursing homes are malnourished or about to become so. The number has increased over the past five years. Almost as many patients, just over 42 per cent, have not had a drug review in the past year. This despite the fact that it must happen at least once a year. The reported use of coercion in nursing homes has increased by 46 per cent in recent years. When the State Administrators have investigated the use of coercion in the country’s municipalities, they have found violations of the law in more than half of the inspections. Who will report this? When employees at nursing homes experience failure at work, they have the opportunity to report – both internally and to external agencies. In total, state administrators in Norway have received 86 notifications in the last five years from health personnel about conditions in Norwegian nursing homes. Sometimes it leads to oversight. The fact that nurses give notice can therefore have an effect. It can help ensure that offenses are documented and cracked down on. Of the health institutions the state administrators investigated in 2021, which were mainly nursing homes, they found violations of the law in more than half. Nærøy living and treatment center is the nurses’ workplace. Photo: Rune A. Hansen / news And one of the places they found violations of the law last year was at the workplace of Linda and Svanhild in Nærøysund. A duty to notify – If notifying internally does not lead to improvement, healthcare personnel actually have a duty under the Healthcare Personnel Act to notify the State Administrator of conditions that go beyond patient safety, says county doctor in Trøndelag, Jan Vaage. Jan Vaage is the county doctor in Trøndelag. Photo: Rune A. Hansen / news After the inspection at Nærøy housing and treatment center, the State Administrator wrote in his report that the nursing home was not being run properly. The municipality was criticized for lacking both ruins and systems to catch errors. This means that the municipality broke the law. Municipal manager in Nærøysund, Marit Pedersen, has read the report. – I don’t think that’s right at all. This should not occur. People must get help and care at the right time, says Pedersen to news. She says that the municipality was in a special situation with a new municipal structure, new employees, new managers and a pandemic. And that the municipality has had several unfilled positions for a long time. – It was getting enough personnel that was the most critical. But now it has stabilised, says Pedersen and continues: – That may explain something, but it does not excuse us. So I just acknowledge that it wasn’t good enough. Pedersen says that the municipality has been working on staffing conditions for a long time, and that they have now hired more managers and increased staffing significantly. Marit Pedersen is municipal manager in Nærøysund municipality. Photo: Rune A. Hansen / news Svanhild and Linda have also read the Statsforvalteren’s conclusion. – We now feel that we have done our job, we have done our duty, says Svanhild. Employees are sick and want to quit In Nærøysund, the nurses were so distraught last winter that they considered quitting. They are not alone in that. In 2021, the Nursing Service carried out a survey. Well over 1,000 nurses answered the question whether in the past year they have considered quitting as a nurse or changing jobs. 72 percent answered yes. The most important reason was that the staffing is not in accordance with the need. And the needs can eat away. The home service is the sickest in many areas. But employees in nursing homes have the most musculoskeletal problems, the most psychological problems and the most sleep problems of all workplaces in Norway. Ten years after completing their education, 1 in 5 nurses have left the health service. Norwegian municipalities notice this. Most Norwegian municipalities experience very big or fairly big challenges in recruiting nurses. This problem is unlikely to diminish. In the year 2035, it is calculated that we will lack 28,000 nurses and 18,000 healthcare workers. Watch news Brennpunkt’s documentary about nursing homes here: Employees say they break the law at work and relatives fear gross negligence. How is it in Norwegian nursing homes?
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Employees at Norwegian nursing homes warn of inappropriate conditions – news Dokumentar
