Sammanfattning
Background: Care and respect for individual human life and dignity are fundamental values in
nursing. Financial management systems in healthcare, based on objectives and results, are external
framework factors that can challenge these values. Objective: To explore how external framework
factors can influence nurses’ priorities in practice, and what consequences this influence can have
for the nursing identity. Method: The study has a qualitative design, where data is collected through
focus group interviews with nurses in community health services and specialist services. Results:
External requirements and frameworks affect the working day and set difficult conditions for
traditional nursing values by prioritising tasks that are measured and controlled, while patients'
psychosocial needs and activities are downgraded. Other needs - such as oral hygiene and nutrition -
that must be understood within the context of necessary medical care, can also suffer. Discussion:
The external requirements and frameworks may be seen in connection with the introduction of New
Public Management (NPM) as a management tool in healthcare services. NPM is based on
measurement and reporting, and helps to ensure that nurses prioritise tasks that are measured and
controlled. This makes nurses more task-centred. In the long term, this could affect the nursing
identity at the societal level and leave less space for the care perspective and for patient
relationships. Conclusion: The models of economic management in healthcare should take up
perspectives that safeguard patient-centred care and give a stronger position to the nursing
profession’s fundamental values.