Something else than usual hospital nursing care: An ethnographic study of nurse case managers’ everyday practices

Support interventions, such as nurse case managers, has been developed in response to the inequality in health and a growing population with multi-morbidity. The aim of the present study was to explore the everyday practices of nurse case managers at a Danish university hospital. An ethnographic approach with a constructionist perspective was applied. Data generation entailed participant observation and one group interviews with all nurse case managers in a Danish region (n = 4). The data were analysed using thematic analysis. The everyday practices of nurse case managers were characterised by providing something else than the usual hospital nursing care by continuously establishing and maintaining relationships with their patients. They emphasised the patient's psychosocial needs in a biomedical context and accompanied patients across different healthcare settings. The nurse case managers’ everyday practices resonate with the key values of nursing. These values are under pressure in healthcare dominated by technical rationality and efficiency leading to increased inequality in health. Further exploration of the potential benefits for multi-morbidity and co-existing social issues is needed. There is a need for continued critical debate about the conditions for caring for patients’ psychosocial needs. The implications of continuing to neglect patients’ psychosocial needs are related to further increasing inequality in health and impeding equal access to services.