# “Exploring vertical task shifting: perceptions and experiences of nurses and general practitioners in Norwegian general practice - a qualitative study”

## TL;DR

This study explores how nurses and doctors in Norway view vertical task shifting, emphasizing the importance of trust and organizational support in making it work.

## Contribution

The study provides new qualitative insights into the role of trust and organizational factors in vertical task shifting in Norwegian general practice.

## Key findings

- Trust is essential for successful vertical task shifting, developed through time and collaboration.
- Organizational structures and funding significantly influence the adoption and perception of task shifting.
- Vertical task shifting can expand nurses' roles and improve interdisciplinary relationships.

## Abstract

Task shifting between health care providers is seen as a strategy for combating increased demands in primary healthcare. This study explored the perceptions and experiences of general practitioners (GPs) and nurses regarding vertical task shifting in Norwegian general practice.

We employed a qualitative design. Data were collected through semi-structured interviews with nurses (n = 6) and GPs (n = 5) across six municipalities in Norway. The data were analysed using reflexive thematic analysis.

The analysis resulted in two main themes, each with associated subthemes: 1) Trust plays a pivotal role in task shifting processes; (i) Time is essential for cultivating mutual trust, (ii) Increased knowledge and mutual respect strengthen trust in nurses competencies and responsibilities, and 2) Drivers and barriers to vertical task shifting; (i) Organizational structures influence utilization and perceived value of vertical task shifting, (ii) Choosing to work in interdisciplinary teams despite a lack of funding, (iii) Contextual factors and experience influenced attitudes towards vertical task shifting.

Trust was described as pivotal to the success of vertical task shifting, with time and collaboration facilitating its development. In several cases, the process of task shifting expanded nurses’ roles and strengthened interdisciplinary relationships. However, organizational structures and funding significantly influenced the utilization and perception of task shifting. Attitudes toward task shifting varied based on individual and contextual factors.