Registered nurses’ perception of their professional role regarding medication management in nursing care of the elderly

Background: The role of the registered nurse (RN) in the municipality regarding medication management in care for the elderly is rarely discussed. Organizational issues related to medication management often contribute more to the management than needs of the patients, nursing skills, and collaboration with the physician in primary care. Objective: The aim of this study was to describe RNs’ perceptions of their professional role, especially regarding medication management in nursing of the elderly. Design: The study is descriptive with a qualitative approach. Interviews with 16 RNs working at nursing homes were analysed by content analysis. Results: The findings can be grouped into seven categories showing the RN in different roles while performing different aspects of her or his work: as controller, executer, messenger, supervisor, initiator, visionary and solitary worker. These themes were identified in the interviews and characterized the nurses’ own judgements and actions taken, especially regarding drug treatment. Overall, the RNs described nursing in elderly care as an undefined profession lacking leadership regarding medication management. Conclusions: The study concludes that medication management ought to be promoted in care for the elderly. To handle the challenge and risks of polypharmacy there must be sufficient and adequate reporting based on the RNs’ nursing and skills to monitor and evaluate the drug treatment in teamwork with the physician. This requires leadership with understanding of the integration of services in care for the elderly, and of the medical processes and nursing skills involved.