Digital inclusion – invisible work and grey zones for nurses, acting as frontline workers

TL;DR

This study explores how nurses in Norway help patients with digital challenges despite lacking formal guidelines, revealing the invisible work and grey zones they face.

Contribution

The paper provides new insights into the informal digital assistance provided by nurses and the challenges they encounter in digitally advanced societies.

Findings

Nurses frequently assist patients with digital technology, including hardware, software, and health-related services.

This assistance is driven by professional ethos but often lacks guidelines and support, creating a grey zone for nurses.

Digital assistance takes time away from core tasks and causes concern among nurses about the adequacy of their help.

Abstract

The high degree of digitalization in Scandinavian countries has led to challenges for those who find themselves digitally excluded, facing several barriers to participation in society. Many may receive help from “warm experts”, i.e. family members or friends, but that is not possible for all. Different groups of frontline government workers may also act as helpers, even if they do not have assistance with digital public services as a core part of their remit. In Norway, health personnel often care for citizens in their home settings and may frequently be asked to help with digital challenges.

This study aims to explore the nature of the work that nurses do in helping citizens with digital challenges, and challenges that they face in doing this.

This explorative study is based on a survey of 3.044 nurses working in the Norwegian municipal sector. The survey constitutes a combination of a qualitative (open ended questions) and quantitative approach (closed questions), The open-ended questions were thematically analyzed and the close questions were used for descriptive statistics.

The findings show that nurses do considerable invisible work in helping patients with digital technology. They frequently help with both basic hardware and software challenges, as well as with specific services, some of which are related to health. Many do this driven by their professional ethos, believing this is vital to patients´ well-being. This takes time from other (core) tasks. They often worry about the help they provide and find themselves in a grey zone exacerbated by a lack of guidelines and support from peers and colleagues.

The paper contributes to a deeper understanding of the invisible work nurses do due to digitalization of public services, and why they do this. Furthermore, the paper highlights the grey zone which many nurses must navigate, and the challenges they encounter. Although our findings are from a specific context, they may also apply to nurses and healthcare workers in other countries with high degrees of digitalization, and to some extent to other groups of frontline workers. Implications include better digital training but also more concrete guidelines for nurses on what to do when asked for digital help.

The online version contains supplementary material available at 10.1186/s12913-026-14040-0.

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