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  • 1.
    Athlin, Elsy
    et al.
    Karlstad University, Department of Nursing.
    Larsson, Maria
    Karlstad University, Department of Nursing.
    Söderhamn, Olle
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    A model for a national clinical final examination in the Swedish bachelor programme in nursing2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 1, p. 90-101Article in journal (Refereed)
    Abstract [en]

    Aim To describe the development and evaluation of a model for a national clinical final examination in the bachelor nursing education.

    Background After the transfer of nursing education to the academy, concerns have been raised among nurses, nurse leaders, lecturers and researchers about the nursing students clinical competence at the entrance to professional life.

    Methods During 2003 to 2005, a collaborative project was carried out between four universities and adjunctive health-care areas supplying clinical placements in Sweden. A two-part examination was agreed upon comprising a written theoretical test and a bedside test. An assessment tool for the bedside test was created. Nursing students, nurses and clinical lecturers participated voluntarily in the evaluation.

    Results The model was highly appreciated, and its relevance, usability, and validity were considered quite good for the assessment of nursing students clinical competence at the final stage of their education. Several deficiencies were revealed, which led to further development of the model.

    Conclusions and implications for nursing management The development and first evaluation of the model proved encouraging for further use, but it needs further evaluation. Involvement of nursing managers is necessary in order to satisfy new demands on competence and staffing of clinical nurses.

  • 2.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    University of Stavanger, Faculty of Social Sciences.
    The significance of nurse supervisors' different ethical decision-making styles2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 8, p. 637-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The role of the nurse supervisor is very important, because of his/her ability to influence the atmosphere within the clinical nursing supervision group. AIM: To present and interpret nurse supervisors' different ethical decision-making styles. METHOD: A hermeneutic interpretation of three studies on nurse supervisors' different ethical decision-making styles. RESULTS: The significance of the nurse supervisor's ethical decision-making style is reflected in the awareness of their responsibility for creating a relationship with the supervisee. The supervisors focus on ensuring safety, integrating theoretical knowledge and clinical practice, willingness and preparedness to supervise on the substance of nursing, sharing the supervisees' feelings and challenging them, reflecting on the content of clinical nursing supervision as well as promoting justice and integrity in clinical nursing supervision. CONCLUSIONS: The interpretation highlights the importance of the nurse supervisor's style for the outcome of clinical nursing supervision, as they are role models for the supervisees. There is a need for further research to explore the advantages and disadvantages of nurse supervisors' different ethical decision-making styles, especially in relation to the influence of clinical nursing supervision on the quality of care and various support systems.

  • 3.
    Bégat, Ingrid
    et al.
    University West, Department of Nursing.
    Berggren, Ingela
    University West, Department of Nursing.
    Ellefsen, Bodil
    University of Oslo, Ullevål Hospital, Institute of Nursing Science.
    Severinsson, Elisabeth
    Hedmark College, Department of Nursing Education.
    Australian nurse supervisors' styles and their perceptions of ethical dilemmas within health care2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 1, p. 6-14Article in journal (Refereed)
    Abstract [en]

    AIM: To examine clinical nurse supervisors' styles, in terms of models, organization, focus on supervision and theories used in supervision, as well as their perceptions of ethical dilemmas within health care. BACKGROUND: The importance of clinical supervision in clinical practice has been reported. However, literature dealing with its implementation is rare. METHODS: This study is a descriptive-correlational study. Data were collected by means of a questionnaire from two groups of nurse supervisors randomly selected from a university (n = 55) and a hospital (n = 31). Data were analysed using descriptive and inferential statistics. RESULTS: The models most frequently used were 'case-oriented' and 'decision-making oriented'. The nurse supervision was reported as being organized on a one-to-one basis. The focus of supervision was on 'patient problems' and 'cooperation in team'. The theory most commonly used was the theory of reflection. The supervisors' perceptions of moral dilemmas were related to 'decision making' and actions impacting on quality of care resulting from their supervisor styles. CONCLUSION: By correlating the supervisors' styles and their perceptions of ethical dilemmas, we conclude that it is important to contribute to further research on supervisors' styles in order to ensure successful supervision.

  • 4.
    Bégat, Ingrid
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Ellefsen, Bodil
    Institute of Nursing and Health Sciences, University of Oslo, Norway.
    Severinsson, Elisabeth
    Department of Health Studies, Stavanger University of Stavanger, Norway.
    Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of well-being -- a Norwegian study.2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 221-30Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Various studies have demonstrated that nursing is stressful and that the incidence of occupational stress-related burnout in the profession is high. AIM: This descriptive-correlational study examined nurses' satisfaction with their psychosocial work environment, their moral sensitivity and differences in outcomes of clinical nursing supervision in relation to nurses' well-being by systematically comparing supervised and unsupervised nurses. METHODS: Nurses were selected from two hospitals (n = 71). Data collection was by means of questionnaires and analysed by descriptive and inferential statistics. RESULTS: The nurses' satisfaction with their psychosocial work environment was reflected in six factors: 'job stress and anxiety', 'relationship with colleagues', 'collaboration and good communication', 'job motivation', 'work demands' and 'professional development'. The nurses' perceptions of moral sensitivity comprised seven factors: 'grounds for actions', 'ethical conflicts', 'values in care', 'independence patient-oriented care', 'the desire to provide high-quality care' and 'the desire to provide high-quality care creates ethical dilemmas'. Nurses well-being were reflected in four factors 'physical symptom and anxiety', 'feelings of not being in control', 'engagement and motivation' and 'eye strain sleep disturbance'. The moral sensitivity 'ethical conflicts' were found to have mild negative correlations with psychosocial work environment 'job stress and anxiety professional development' and with 'total score' psychosocial work, moral sensitivity factor 'independence were correlated with psychosocial work factor 'relationships with colleagues' and 'total score', moral sensitivity were mildly correlated with 'collaboration and good communication and had a negative correlation to psychosocial work factor 'work demands'. In addition, significant correlations were found between the nurses' well-being profile and demographic variables, between 'engagement and motivation' and 'absence due to illness' and between 'time allocation for tasks', 'physical symptoms and anxiety' and 'age'. Mild significant differences were found between nurses attending and not attending group supervision and between 'physical symptoms and anxiety' and 'feelings of not being in control'. CONCLUSIONS: We conclude that ethical conflicts in nursing are a source of job-related stress and anxiety. The outcome of supporting nurses by clinical nursing supervision may have a positive influence on their perceptions of well-being. clinical nursing supervision have a positive effect on nurses physical symptoms and their feeling of anxiety as well as having a sense of being in control of the situation. We also conclude that psychosocial work have an influence on nurses experience of having or not having control and their engagement and motivation.

  • 5.
    Bégat, Ingrid.
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Severinsson, Elisabet
    University of Stavanger, Faculty of Social Sciences, Department of Health Studies.
    Reflection on how clinical nursing supervision enhances nurses' experiences of well-being related to their psychosocial work environment2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 8, p. 610-616Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to make a synthesis of three studies that deal with the following research question: 'How does clinical nursing supervision enhance nurses' experiences of well-being in relation to their psychosocial work environment?' Background: Clinical nursing supervision is one way to support nurses in coping with their stressful work situation. Method: A hermeneutic approach was used to reflect and interpret nurses' experiences of well-being in relation to clinical nursing supervision and psychosocial work environment. Results: The findings suggest that clinical nursing supervision has an influence on nurses' experiences of well-being and in relation to their psychosocial work environment. Nurses attending clinical nursing supervision reported increased satisfaction with their psychosocial work environment. Conclusions: The significance of caring and nursing becomes evident when nurses realize and understand that clinical nursing supervision positively influences their existence and well-being. The value of work becomes clear when nurses reflect on themselves as professionals and as authentic human beings in clinical nursing supervision. This will lead to the emergence of self-recognition. © 2006 The Authors.

  • 6.
    Hedberg, Berith
    et al.
    Göteborg University, Sahlgrenska Academy, Institute of Health Care Pedagogics.
    Cederborg, Ann-Christin
    Linköping University, Department of Behavioral Sciences.
    Johanson, Marita
    University West, Administration .
    Care-planning meetings with stroke survivors: Nurses as moderators of the communication2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 2, p. 214-221Article in journal (Refereed)
    Abstract [en]

    Introduction: Stroke survivors often have communicative disabilities. They should, however, be involved when decisions are made about their care treatment. Aim: To explore and describe how nurses act as moderators of the communication in cooperative care-planning meetings and what kind of participant status the patients achieve in this type of multi-party talk. Method: Thirteen care-planning meetings were audio-recorded and transcribed. Nurses, social workers and stroke survivors were the main participants for the meetings. A coding scheme was created and three main categories were used for the analysis: pure utterance types, expert comments (EC) and asymmetries. Results: The nurses never invited the patients to tell their own versions without possible influence from them. Mostly the nurses gave ECs. The nurses acted as the patients' advocates by talking for or about them. They rarely supported the patients' utterances. Conclusion: There is an urgent need for nurses to learn how to involve the patients in the communicative process about their treatment. Assessment of the patients' communicative abilities before the care-planning meetings as well as knowledge about how to invite them can improve the patients' participant status. © 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd.

  • 7.
    Lindblom, Anna-Karin
    et al.
    Primary Health Care Research, Development and Education Centre and County Administration of West Sweden, Vänersborg.
    Bäck-Pettersson, Siv
    Department Research and Development, NU-Hospital Organisation, Uddevalla.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    A quality registers impact on community nurses' in end-of-life care: a grounded theory study2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 206-214Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the study was to identify the impact of a quality register in end-of-life-care, from community nurses' perspective. Background There is a lack of knowledge about the impact of such a register in end-of-life care. Method Data were collected by means of focus group interviews with a total of 12 nurses, from two communities in the western part of Sweden. Data analysis was based on grounded theory. Result Feedback is the core category that influences all other processes. Two main categories emerged: 'Becoming aware of' and 'Acting accordingly'. These influenced the nurses and led to improved quality of care. Conclusion A quality register gives the users (nurses) feedback on the care provided, which starts a process of change. Implications for nursing management The value of working with a quality register as a feedback system can be applicable to all professions working with quality assurance. The experiences will increase the motivation and understanding the value of using quality registers as a tool for enhanced quality. Further, nurse managers can use such a register as a feedback system, not only as a motivating tool when implementing a quality register, but in the evaluation of its outcomes. © 2012 Blackwell Publishing Ltd.

  • 8.
    Olofsson, Brita
    et al.
    Northern Elvsborg County Hospital .
    Bengtsson, Claire
    Northern Elvsborg County Hospital .
    Brink, Eva
    University West, Department of Nursing.
    Absence of response: a study of nurses' experience of stress in the workplace2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 5, p. 351-8Article in journal (Refereed)
    Abstract [en]

    It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.

  • 9.
    Olsson, Maivor
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Larsson, Lena
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Flensner, Gullvi
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Bäck-Pettersson, Siv
    Department of Research and Development, NU-hospital Organization.
    The impact of concordant communication in outpatient care planning: nurses' perspective2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, p. 748-757Article in journal (Refereed)
    Abstract [en]

    Aim: To elucidate nurses’ (RNs) experiences of co-ordinated care planning in outpatient care. Background: Co-ordinated care planning has been studied from the perspectives of both patients and nurses in inpatient care, but it is missing in outpatient care.

    Method: Qualitative content analysis of interviews with ten registered nurses participating in two focus groups.

    Results: An overall theme was identified: creating concordant communication in relation to patient and health-care providers. The result is based on four categories and nine sub-categories.

    Conclusions: Nurses need extraordinary communication skills to reach concordance in outpatient care planning. Apart from involving and supporting the patients and next of kin in the decision-making process, the outcome of the nursing process must be understood by colleagues and members of other professions and health-care providers (non-nursing).

    Implications for nursing management: An effective outpatient care-planning process requires that care managers understand the impact of communicating, transferring information and reaching agreement with other health-care providers, actively supporting employees in the outpatient care-planning process and contributing to the development of common goals and policy documents across organisational boundaries.

  • 10.
    Rudolfsson, Gudrun
    et al.
    University West, Department of Nursing, Health and Culture.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture.
    Nursing students' perspectives on the patient and the impact of the nursing culture: a meta-synthesis2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 6, p. 771-781Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore and interpret how nursing students develop their understanding of the patient as a human being.

    Background

    Understanding the patient is the main characteristic of good, caring performance. In addition, nurse leaders play an active role in creating a culture in which nursing students can flourish and improve.

    Method

    This meta-synthesis was based on Noblit and Hare's meta-ethnography.

    Results

    The overarching metaphor was interpreted as the nursing students' capacity for compassion. Two central metaphors were revealed, based on how nursing students developed their understanding of the patient as a human being. These central metaphors were labelled ‘The open door’, comprising seven key metaphors and ‘The closed door’ based on two key metaphors.

    Conclusion

    During practical training, the students observed both virtuous and unkind nurses. Virtue is a skill that can be taught, but not all students were able to learn it. Some students acquired the ability to reflect on ethical issues, while others did not. Therefore, good role models are of major importance.

    Implication for nursing management

    The nurse leader should function as a facilitator in the students' efforts to gain the capacity to face the suffering patient and to develop an understanding of the patient's situation.

  • 11.
    Rudolfsson, Gudrun
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Flensner, Gullvi
    University West, Department of Nursing, Health and Culture.
    Suffering and suffering with the other: the perspective of perioperative nurse leaders2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 278-286Article in journal (Refereed)
    Abstract [en]

    Aim To capture and interpret meanings of suffering from the perspective of perioperative nurse leaders.Background There are few studies focusing on suffering and the meaning of being a nurse leader in a perioperative context.Method Hermeneutic interpretation of interviews with nurse leaders.Results A main theme of suffering emerged as learning and non-learning. Suffering as learning comprised struggling to come to terms with being misunderstood, struggling to wait patiently to be allowed to help, struggling to manage daily tasks and struggling to be worthy of the trust of superiors. Suffering as non-learning comprised feeling alone when in charge, feeling guilty about not managing dailytasks, feeling mistrusted by superiors, feeling unfairly criticized,  feeling humiliated owing to loss of responsibilities and feeling unable to help. Conclusion Suffering is good when the mission of caring is mastered and the nurse leader feels recognized as unique and trustable, leading to his or her sense of dignity being preserved. Suffering is evil when the mission of caring is threatened, whenquestioned and not considered a unique and trustable person, leading to loss of dignity.Implications for nursing management Nurse leaders suffering needs to be acknowledged and a caring culture that permeates the entire organization should be developed.

  • 12.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Risk Management: evaluation of healthcare professionals reasoning about and understanding of maternity care2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1098-1278Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate healthcare professionals' explanations of the prerequisites for safe maternity care and understanding of risk management, including the underlying reasons for decision‐making intended to ensure safe care.Background: Risk management focuses on maintaining and promoting safe care by identifying circumstances that place childbearing women at risk of harm, thus reducing risks.Methods: A hermeneutic action research approach was chosen. Through a series of focus group sessions we uncovered healthcare professionals' explanations of risk management.Results: One overriding theme emerged; The consequences of what managers do or fail to do constitute the meaning of taking responsibility for team collaboration to provide safe care. Inadequate support, resources and staff shortages have consequences, such as inability to concentrate on team communication and collaboration, leading to the risk of unsafe care.Conclusion: Communication constitutes a prerequisite for both team collaboration and risk management. Thus, communication is linked to the ability of managers and healthcare professionals to provide safe care.Implications for Nursing Management: In terms of safety management, nurse managers have a significant role in and responsibility for supporting communication training, developing guidelines and providing the prerequisites for interprofessional team reflection.

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