| 1. |
- Andersson, Maria, 1969-, et al.
(författare)
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Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study
- 2022
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic.Design/Methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.
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| 2. |
- Andersson, Maria, 1969-, et al.
(författare)
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Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic
- 2023
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Ingår i: Sage Open Nursing. - : SAGE Publications Inc.. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.Aims: To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.Method: Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.Results: Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.Conclusions: Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.
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| 3. |
- Andersson, Maria, et al.
(författare)
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The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic
- 2023
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe the Person-Centred Practice Framework’s four domains (prerequisites, care environment, person-centred processes, and person-centred outcomes) through the perspectives of critical care nurses working in intensive care units during the second year of the COVID-19 pandemic. Furthermore, the aim was to investigate the relationships between prerequisites, care environment, person-centred processes, and person-centred outcomes. Design/methods: A cross-sectional study involving questionnaires. Prerequisites were measured using person- related conditions, the care environment by using the Person-Centred Climate Questionnaire–Staff version, the person-centred processes by using the Person-Centred Care Assessment Tool and person-centred outcomes were measured with one question about present health and well-being and by using Self-rated Exhaustion Disorder. Descriptive and analytic statistics were used. Data was collected from July 2021 to November 2021. Setting: Critical care nurses (n =217) working in 15 Swedish adult intensive care units. Results: Participants’ average length of experience in intensive care units was 14 years, and most participants experienced increased nursing care responsibilities. They perceived the climate as safe but had limitations in terms of its everydayness and community. Participants perceived the organisations both supported and hindered personalized care. Most participants experienced a variety of exhaustion symptoms, and their health had positive relationship with community. Conclusion: By showing how prerequisites, care environment, person-centred process influences critical care nurses’ health and well-being, organisations might identify aspects in the work environment that require targeted interventions to reach healthy workplaces. Implications for clinical practice: To preserve the health and well-being of critical care nurses and to flourish as humans in their professional roles, they need to interact with and form relationships with their colleagues, patients, and relatives. Organisations should have a person-centred approach for every individual in the workforce to harness each critical care nurses’ knowledge and skills for individuals to growth in their roles.
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| 4. |
- 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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| 5. |
- 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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| 6. |
- 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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| 7. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Clinical group supervision for integrating ethical reasoning : Views from students and supervisors
- 2016
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Ingår i: Nursing Ethics. - London, United Kingdom : Sage Publications. - 0969-7330 .- 1477-0989. ; 23:7, s. 761-769
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical group supervision has existed for over 20 years in nursing. However, there is a lack of studies about the role of supervision in nursing students' education and especially the focus on ethical reasoning.Aim: The aim of this study was to explore and describe nursing students' ethical reasoning and their supervisors' experiences related to participation in clinical group supervision.Research design: The study is a qualitative interview study with interpretative description as an analysis approach.Participants and research context: A total of 17 interviews were conducted with nursing students (n = 12) who had participated in clinical group supervision in their first year of nursing education, and with their supervisors (n = 5).Ethical conciderations: The study was based on the ethical principles outlined in the Declaration of Helsinki, and permission was obtained from the Regional Ethical Review Board in Sweden.Findings: The analysis revealed that both the form and content of clinical group supervision stimulated reflection and discussion of handling of situations with ethical aspects. Unethical situations were identified, and the process uncovered underlying caring actions.Disscusion and conclusion: Clinical group supervision is a model that can be used in nursing education to train ethical reflection and to develop an ethical competence among nursing students. Outcomes from the model could also improve nursing education itself, as well as healthcare organizations, in terms of reducing moral blindness and unethical nursing practice.
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| 8. |
- Engström, Åsa, et al.
(författare)
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Institutional Constraints as an Obstacle for Prioritizing Nursing Interventions During the COVID-19 Pandemic—Critical Care Nurses’ Experiences
- 2022
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The demands of the pandemic such as staff shortages and limited resources combined with new guidelines regarding infection control may have required the prioritizing of nursing interventions.Objectives: The aim of this study was to describe critical care nurses’ experiences of prioritizing nursing interventions for patients with COVID-19 in intensive care units (ICUs) during the pandemic.Method: A qualitative descriptive study was gathered from open-ended questions included in a cross-sectional online questionnaire. Characteristics were presented using descriptive statistics, and open-ended questions were analyzed using qualitative content analysis with an inductive approach. The study was conducted in Sweden and focused on critical care nurses working in ICUs during spring 2021 and the second year of the COVID-19 pandemic.Results: During the COVID-19 pandemic, 87% of the critical care nurses had provided orientations for new co-workers, and 52% had supervised intensive care nursing students. In all, 70 answered the question of whether they had prioritized nursing care differently during the pandemic; 86% reported that they had and 14% had not. The qualitative analysis resulted in one theme, Institutional constraints as an obstacle for nursing interventions, with three categories: Prioritizing lifesaving interventions, Performing nursing interventions less frequently, and Not able to provide the nursing care I wish to provide.Conclusion: Institutional constraints as an obstacle for nursing interventions is the overall theme. It illustrates how critical care nurses have been forced to prioritize, thereby not being able to provide the nursing interventions they wanted to do provide, and it describes their feelings in this situation. The nurses need recovery and possibilities for reflection. The organization must also recover and not only return to how it was before the pandemic but also to learn from recent events and take actions to reduce the long-term effects on staffing.
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| 9. |
- Gericke, Niklas, 1970-, et al.
(författare)
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Defining epigenetic literacy : How to integrate epigenetics into the biology curriculum
- 2023
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Ingår i: Journal of Research in Science Teaching. - : John Wiley & Sons. - 0022-4308 .- 1098-2736. ; 60:10, s. 2216-2254
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to define epigenetic literacy and describe how it can be included in school biology. Epigenetics is a new field of research in biology with abundant societal consequences and conceptual implications on how genetics is understood. Epigenetics explains how genes are regulated, thereby clarifying cell differentiation, and providing an understanding of how the environment interacts with genes. Students are bound to encounter epigenetic knowledge and applications related to issues such as health, food, and exercise in the media and their everyday lives. Consequently, there is a need to develop epigenetic literacy. Nevertheless, epigenetics is missing in biology curricula and is almost unknown among teachers and students. Research on epigenetics in science education is scarce, and we do not know what and how to teach. Therefore, we conducted a policy Delphi study with a panel of experts to define an epigenetic literacy framework for teaching in secondary education in relation to Robert's Vision I and Vision II perspectives on epigenetic literacy. Participants were 41 recognized international experts representing 11 countries and five areas of expertise. The experts suggested that epigenetics should be introduced in the lower secondary genetics course (students aged 13-15 years), but also addressed in other relevant areas of biology. The study generated six content themes: epigenetics as a metaphor; epigenetics connecting nature with nurture; epigenetics as a dynamic process; epigenetic mechanisms; epigenetics and inheritance; and epigenetics and nature of science, and five sociocultural themes for contextualization: epigenetics and lifestyle; epigenetics and diseases; epigenetics and ethics; epigenetics and policies; and epigenetics and forensics. Taken together, these themes constitute the epigenetic literacy framework. Further, we uncover divergent meanings in the expert panel & mdash;as is typical of policy Delphi studies & mdash;and connect the framework to genetic literacy and learning progressions in genetics education.
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| 10. |
- Lachmann, Hanna, et al.
(författare)
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Dual use of instruments for assessing nursing students professional- and clinical competence
- 2021
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 96
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Tidskriftsartikel (refereegranskat)abstract
- Background: Changes in demographics and the development of health systems have a direct impact on patients' nursing needs and nurses' ability to meet them. Modern and forward-looking nursing education programmes that will help nursing students to develop their professional competence require useful tools for assessment and self-reflection that can be combined in theoretical and clinical education. Objectives: To investigate the associations between the Nurse Professional Competence Scale - Short Form (NPC-SF), and the tool Assessment of Clinical Education (AssCE) tool, and to assess the graduating students' professional competence based on their self-assessment. Design: A cross-sectional descriptive study design was used. Participants and settings: A total of 151 nursing students at a Swedish university college completed the NPC-SF and the AssCE (response rate 77%). Methods: In their final weeks of the nursing programme, students were invited to respond to two questionnaires: the NPC Scale - Short Form (35 items) and the AssCE tool (21 items). Result: There are significant correlations between the nursing students' responses to the NPC-SF competence areas and the AssCE areas (r = 0.19-0.57). Students score in the NPC-SF were highest in Value-based Nursing Care and lowest in Development, Leadership and Organization of Nursing Care, and in the AssCE areas student scores were highest in Examination and treatment and Professional Approach and lowest in Management and Cooperation. Conclusion: The NPC-SF and AssCE are valid and reliable instruments, showing a high level of correlation. Results imply that dual use could strengthen student-centred theoretical and clinical learning as well as professional competence development. Additional research is needed to assess student's competence development during the nursing program.
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