Clinical placement constitutes a significant part of developing a professional identity and an essential bridge to future professional work as a registered nurse (Vabo et al., 2021). In traditional supervision in Sweden, the student follows the workplace supervisor, where the focus is on teacher-driven learning (Hellström-Hyson et al., 2012), or student-driven such as peer learning (Jassim et al., 2022). Due to high staff turnover, there is a need to develop pedagogical supervision models that are sustainable over time. Therefore, a student-centered model was developed in collaboration between healthcare staff, hospital educators, university teachers and nursing students, to ensure the quality of clinical placement for students.

The Student-Centered Supervision Model

The supervision model is based on Cajvert’s (2021) description of integrated learning and focuses on how the workplace supervisor can help students reflect on their work. The content of the model is based on the learning objectives specified in the curriculum of the nursing student’s course. Gibbs’ (1988) reflective cycle model is included to stimulate each student’s ability to create care relationships and be prepared for the future profession by training responsibility, reflection, critical thinking, and cooperation. The supervision model implies that instead of merely following the workplace supervisor’s work, students follow the selected patient's care trajectory during their clinical placement. The number of patients for which they are responsible increases over time. While the student is not connected to one workplace supervisor, one nurse is assigned as the main supervisor. Each student's learning is followed via documents stored in a personal folder outlining their expected development. During the week, each student's learning is documented together with a workplace supervisor.

Theoretical Framing

According to the sociocultural perspective (Vygotsky, 1978), the learning process requires communication, interaction, reflection and meaning-making to be successful. The clinical environment connects and encourages learning for a future professional function. According to Zegwaard et al. (2023) work-integrated learning can be defined as an educational approach in which the student, educational institution and an external stakeholder are included and where experiences are developed in the organization as part of the program syllabus. The student's learning takes place through active engagement together with purposeful work tasks. This allows the integration of theory with meaningful practice relevant to the student's professional development.

Aim

This study aimed to describe nursing students’ experiences of learning with the student-centered supervision model based on patient-oriented care during their clinical placement.

Background

In an increasingly strained maternity care system with a shortage of midwives and great demands for service, pregnant women in their early labour are at risk of receiving insufficient support. Women make calls and visit the labour ward on multiple occasions before being admitted. A video call with a labour ward midwife during early labour is an unknown practice but could support pregnant women and their partners during this uncertain period.

Aim

The study aimed to describe women’s experiences of remote video calls with a labour ward midwife during early labour.MethodsA qualitative study comprising nine semi-structured interviews followed by an inductive thematic analysis was conducted.

Results

The results revealed that video calls prepared women and their partners by means of practical support. They received an assessment of early labour and the interaction with labour ward midwives prepared them for the impending birth. The participants reported feeling secure and strengthened by being met at their current stage of labour. Furthermore, they found the service accessible, easy to use and emphasised the need for increased availability and continuity.

Conclusion

This study highlights the positive impact of video calls in early labour when conducted by competent labour ward midwives. The perceived accessibility and ease of use e-health system underscore a demand for extended availability. These findings indicate the potential benefits of integrating video calls in labour care to enhance support, security, accessibility and overall satisfaction for pregnant women and their partners.

The nursing profession is close to clinical practice and vital to the student’s professional development. Innovative learning activities and models are sought to improve clinical placements. A student-centered supervision model based on patient-oriented care was introduced in a medical ward. The aim of this study was to describe nursing students’ experiences of learning with a student-centered supervision model based on patient-oriented care during their clinical placement. A qualitative descriptive study involving interviews with 12 nursing students analyzed through inductive qualitative content analysis was conducted in accordance with COREQ. The findings revealed that the nursing students viewed learning as personal, knowledge, and professional development. Their learning experiences can be seen as a process in which the scaffolding is gradually reduced in line with each student’s ability to act independently and establish a professional identity. The model can enhance structure and support in the practice setting to maximize learning.

Nursing education and the nursing profession have an artisanal character, which has dominated the profession for a long time. Work-integrated learning in nursing education means that theoretical studies are integrated with a clinical placement. The aim of the study was to describe how nursing students experience work-integrated learning in nursing education. The study has a qualitative descriptive design. Qualitaitive content analysis was used and the analysis focused on both the manifest and latent content of the material. The analysis resulted in the theme Sustainable learning during education and for the future profession as a nurse, revealing students' experiences of work-integrated learning during their education. The categories Different methods, Collaboration and Bringing the parts together as a whole constitute the integrated learning process during the education and depend on each other for increased understanding. When the students practice their theoretical knowledge in the clinical placement, work-integrated learning can facilitate them to bring the parts together as a whole, thus giving them an opportunity to enhance their learning process and develop professional skills.

Background: Social interactions between registered nurses, older patients and their relatives are essential and play a central role in developing a successful care relationship in healthcare encounters. How nurses interact with patients affects the patient’s well-being. Limited time and demands for efficiency influence the encounter and complaints from patients and relatives often concern social interactions. Therefore, the aim of this study was to explore the social interaction in encounters between registered nurses, older patients and their relatives at a department of medicine for older people.

Methods: The study has an ethnographic approach including participatory observations (n = 21) and informal field conversations (n = 63), followed by a thematic analysis with an abductive approach reflecting Goffman’s interactional perspective.

Result: The result revealed a pattern where the participants manoeuvred between interplay and context. By manoeuvring, they defined roles but also created a common social situation. Nurses led the conversation; patients followed and described their health problems, while relatives captured the moment to receive and provide information. Finally, nurses summarised the encounter using ritual language, patients expressed gratitude through verbal and non-verbal expressions, while relatives verbally confirmed the agreements.

Conclusion: The social interaction between registered nurses, older patients and relatives was shaped by a pattern where the participants manoeuvred between interplay and context. When all participants assume responsibility for the social interaction, they become active and listen to each other. The approach adopted by nurses is crucial, thus training in communication and social interaction skills are important. When the asymmetry due to imbalance, is reduced, less misunderstanding and a satisfactory care relationship can be achieved.

BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.

OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.

DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.

METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.

RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.

CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.

AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.

BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.

DESIGN: An ethnographic design informed by the sociocultural perspective was applied.

METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.

RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.

CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.

RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.

AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.

BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.

DESIGN: An ethnographic study was informed by a sociocultural perspective.

METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.

RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.

CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.

RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.