Shifting roles in healthcare: a constructivist grounded theory study of physiotherapists and occupational therapists in nursing positions

The Danish healthcare system faces serious challenges in recruiting nurses. One solution to this challenge has been to employ physiotherapists and occupational therapists in vacant nursing positions, enabling task-shifting from nurses to these professionals as needed and appropriate. However, the dynamics of nurse-therapist task-shifting are not well understood in practical settings. Using a constructivist grounded theory approach, we developed a context-specific theory of task-shifting from nurses to therapists. Three physiotherapists, two occupational therapists (rehabilitation therapists), and 25 nurses from three different inpatient wards at a Danish university hospital participated in the study. Through comparative data collection and analysis, we identified a shared main concern in nurses' and rehabilitation therapists' task-shifting: The fear of losing professional identity. To address this, they used various strategies in task-shifting: (a) Equal, (b) Asymmetrical, (c) Non-coordinated, and (d) Negotiated. The findings contribute to understanding task-shifting between nurses and therapists in practice.