| 1. |
- Abelsson, Anna, 1971-, et al.
(författare)
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Nurse students learning acute care by simulation : Focus on observation and debriefing
- 2017
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 24, s. 6-13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Simulation creates the possibility to experience acute situations during nursing education which cannot easily be achieved in clinical settings. Aim: To describe how nursing students learn acute care of patients through simulation exercises, based on observation and debriefing. Design: The study was designed as an observational study inspired by an ethnographic approach.MethodData was collected through observations and interviews. Data was analyzed using an interpretive qualitative content analysis.Results: Nursing students created space for reflection when needed. There was a positive learning situation when suitable patient scenarios were presented. Observations and discussions with peers gave the students opportunities to identify their own need for knowledge, while also identifying existing knowledge. Reflections could confirm or reject their preparedness for clinical practice. The importance of working in a structured manner in acute care situations became apparent. However, negative feedback to peers was avoided, which led to a loss of learning opportunity.Conclusion: High fidelity simulation training as a method plays an important part in the nursing students' learning. The teacher also plays a key role by asking difficult questions and guiding students towards accurate knowledge. This makes it possible for the students to close knowledge gaps, leading to improved patient safety.
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| 2. |
- Allvin, Renée, 1956-, et al.
(författare)
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Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden : a cross-sectional survey
- 2020
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Ingår i: BMC Nursing. - : BMC. - 1472-6955 .- 1472-6955. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (<= 0,5 year, > 0,5-5 years, and >= 6 years). Methods A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. Results Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
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| 3. |
- Bisholt, Birgitta, 1963-, et al.
(författare)
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Nursing students' assessment of the learning environment in different clinical settings
- 2014
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 14:3, s. 304-310
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings.AIM: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students.DESIGN: A cross-sectional study with comparative design was conducted.METHOD: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement.RESULTS: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives.CONCLUSION: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.
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| 4. |
- Bisholt, Birgitta, 1963
(författare)
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Nyutexaminerade sjuksköterskor yrkessocialisation - Erfarenheter av ett introduktionsprogram
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT Through the ”VÅRD 77” amendment and the higher education reform from 1993, nursing education has been changed from vocational to academic. Theoretical aspects of nursing have been emphasised above clinical ones, and since 1993 clinical training has been reduced in such a way that the traditional professional and clinical skills of newly graduated nurses have changed. An increased theoretical focus and decreased clinical training have resulted in sharp criticism from health care institutions against the content of the nursing education programme, specifically regarding the fact that newly graduated nurses fail to meet demands and expectations on the professional skills and competence of a nurse. As a consequence of this criticism, employers offer newly graduated nurses introduction programmes after they have completed their nursing education. This study focuses on the newly graduated nurses´ experience of an introduction programme as they are about to enter the labour market. The aim is to analyse and describe the learning process of newly graduated nurses in professional situations and how they are socialised into the profession and seek meaning in their encounter with that environment. The theoretical framework is symbolic interactionism, used to understand how the newly graduated nurse interacts with other members of the staff as well as the environment in which interaction takes place. The research method is ethnographic, and the empirical material is based upon data from participant observations, interviews and field notes. The result shows that all eight workplaces use the master-apprentice system as a model for supervising newly graduated nurses during the introduction programme. In this model, the novices learn how to imitate and seek knowledge through the experienced nurses. The fact that workplaces are free to choose among supervision models may explain why the traditional model is used in the introduction programme. This model primarily offers the novices an opportunity to practice practical and technical tasks and learn how to act like the master. The result also shows that the novices have theoretical knowledge and know what action to take, but that they may have trouble assessing which part of their knowledge to use, which shows that they do not have the readiness to act or the competence required in the profession. The introduction programme must therefore give newly graduated nurses the opportunity to practice professional skills in different patient situations and allow them to perform tasks independently to a higher degree. Results also show that the staff questions and strongly doubts the professional skills of the novices, which means that they must constantly prove their professional ability in order to attain member status. Through various sanctions and master suppression techniques employed by the staff, the novice is formed into a nurse oriented towards medicine/science. The novices end up as outsiders if they deviate from the norms and expectations associated with the professional role. This explains why several of the novices in this study become outsiders. Novices must therefore adapt in order to avoid becoming outsiders. The result further shows that there is tension between the academic environment of the nursing college and the professional environment. Within nurse education the ideology of nursing and the development of critical thinking have been prominent, but within the profession the emphasis is on good vocational skills. This means that novices end up posited between two cultures, something which can be described as being in a marginal situation. One conclusion that can be drawn from the result of this study is that the introduction programme, as it is structured today, posits an obstacle in the professional development of the novices.
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| 5. |
- Bisholt, Birgitta, 1963-
(författare)
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The learning process of recently graduated nurses in professional situations : Experiences of an introduction program
- 2012
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 32:3, s. 289-293
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Tidskriftsartikel (refereegranskat)abstract
- An increased theoretical focus and decreased clinical training have resulted in sharp criticism from health care institutions of the content of the nursing education program. As a consequence of this criticism, employers offer introduction programs to recently graduated nurses after they have completed their nursing education. This study is part one of a larger research study. The aim of the present study was to analyze and describe how recently graduated nurses learn at the place of work and how they seek a meaning in their encounter with that environment. The research method was ethnographic, and the empirical material was based upon data from participant observations, interviews and field notes. The results disclosed that workplaces using the master–apprentice system as a model for supervising recently graduated nurses during the introduction program. The results also showed that the novices have acquired theoretical knowledge and know what action to take, but may have trouble assessing which part of their knowledge to use. The introduction program constitutes an obstacle in the professional development of the novices.
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| 6. |
- Bisholt, Birgitta, 1963-
(författare)
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The professional socialization of recently graduated nurses : Experiences of an introduction program
- 2012
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 32:3, s. 278-282
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Tidskriftsartikel (refereegranskat)abstract
- Nursing education entails a three-year program leading up to a Bachelor's degree. Recently graduated nurses lack theoretical as well as clinical skills, thus experiencing difficulties in taking on the professional role. Health care institutions have previously expressed great concern about the increase of theoretical focus at the cost of decreased clinical training and consequently employers presently offer introduction programs after the completion of the nursing education. The present study is part two of a larger study. The aim of the present study was to describe and analyze how recently graduated nurses are socialized into the profession. The research was conducted using an ethnographic approach and the empirical data was acquired by means of participant observations, interviews and field notes. The findings revealed that the staff questions the novices' nursing knowledge and strongly doubts their professional skills. In order for novices to attain member status at the clinical facility, they must constantly prove their professional ability. The findings showed furthermore that deviation by the novices from the norms and expectations associated with the professional role results in their becoming outsiders. Within nursing education the ideology of nursing is prominent, but within the profession the emphasis is on good occupational skills.
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| 7. |
- Blomberg, Ann-Catrin, PhD stud, 1956-, et al.
(författare)
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Operating theatre nurses' self-reported clinical competence in perioperative practice : A mixed method study
- 2019
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Ingår i: Nursing Open. - Hoboken : Wiley. - 2054-1058. ; 6:4, s. 1510-1516
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Tidskriftsartikel (refereegranskat)abstract
- Background: During many years the operating theatre nurse's clinical competence has been describing in relation to patient safety, but the nursing care of the patient remains unclear. Therefore, we want in this study to investigate the relationship between background factors of operating theatre nurses self-rated clinical competence and describe factors of importance for development of clinical competence in perioperative nursing.Methods: A cross-sectional study with a mixed method approach was chosen. The instrument Professional Nurse Self-Assessment Scale of Clinical Core Competence was used for self-rating operating theatre nurses' clinical competence in perioperative nursing, and an open-ended question was added to describe factors of importance for development of clinical competence. In total, 1057 operating theatre nurses in Sweden were asked to participate, and 303 responded (28 %). They had different educational backgrounds and professional experiences, and were employed in universities or central/regional and district hospitals.Results: Academic degree, professional experience and place of employment were significant for the development of the operating theatre nurses' clinical competence. Academic degree appeared to affect operating theatre nurse leadership and cooperation, as well as how consultations took place with other professions about patient care. Being employed at a university hospital had a positive effect on professional development and critical thinking.Conclusions: An academic degree influenced the operating theatre nurses' ability to act in complex situations, and along with professional experience strengthened the nurses' ability to use different problem-solving strategies and face the consequences of decisions made. Scientific knowledge and interprofessional learning and competence development in medical technologies should supplement nursing care for the development of clinical competence.
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| 8. |
- Blomberg, Ann-Catrin, PhD stud, 1956-, et al.
(författare)
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Operating theatre nurses' with managerial responsibility : Self-reported clinical competence and need of competence development in perioperative nursing
- 2022
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Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 9:1, s. 692-704
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self-rated clinical competence and need for competence development in perioperative nursing. Design: A cross-sectional study was applied using a modified version of Professional Nurse Self-Assessment Scale of Clinical Core Competence I. Method: Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results: OTNs with an academic degree and managerial responsibility self-rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1-year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.
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| 9. |
- Blomberg, Ann-Catrin, PhD stud, 1956-
(författare)
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Operationssjuksköterskans vårdande och kompetens inom perioperativ vård
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim was to describe and deepen the understanding of what operating theatre nurses experience as caring and responsibility as well as ethical problems in perioperative practice. The aim was also to investigate how operating theatre nurses perceive clinical competence in perioperative nursing.Methods: This research has a hermeneutic design. Qualitative, quantitative and mixed method was used. In the study (I), data were collected through interviews and analysed with phenomenographic method. In studies (II-III) the interview texts from the study (I) was reused. Secondary analysis were performed with hermeneutic text interpretation. In the study (IV), data were collected through a modified questionnaire PROFFSNurse SAS I, which was supplemented with an open question. These data were analysed using statistics and qualitative conventional content analysis.Results: Operating theatre nurses have the will to meet the patient, be involved and created continuity in the perioperative nursing process (I). Operating theatre nurses experience that they have a formal responsibility to ensure that patients are not at risk and maintain patient integrity and dignity based on personal ethical values (II). Ethical problems and value conflicts can occur if routines and habits prevent operating theatre nurses from caring and when their clinical competence are not utilized in perioperative practice (III). The operating theatre nurses’ self-assessment of clinical competence showed that academic degree, professional experience and interprofessional learning were important for the development of clinical competence. On the other hand, existing routines and habits, as well as inadequate resources, were an obstacle (IV).Conclusion: Perioperative nursing care includes a nursing process and the operating theatre nurses have responsibility based on ethical values. When the operating theatre nurses are prevented from being a caregiver or that their clinical competence is not utilized, stress of conscience can be caused. Important for the development of clinical competence is an academic degree, professional experience and interprofessional learning.
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| 10. |
- Blomberg, Ann-Catrin, PhD stud, 1956-, et al.
(författare)
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Responsibility for patient care in perioperative practice
- 2018
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Ingår i: Nursing Open. - Hoboken : John Wiley & Sons. - 2054-1058. ; 5:3, s. 414-421
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. Design: A hermeneutic design were used. Method: Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. Findings: The texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.
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