Left behind or at the front line of COVID-19: A descriptive phenomenological study

During the COVID-19 pandemic, nurses in the field examined were required to manage large numbers of patients suffering from COVID-19 in in-patient clinics necessitating relocation of registered nurses (RNs) from other clinics in the department to support the care of those patients. The aim of the study was to explore how RNs attribute meaning to their experiences during the organizational changes caused by the first wave of the COVID-19 pandemic. This descriptive phenomenological study is based on thematic analysis interviewing 47 RNs who either continued working in in-patient clinics, were relocated to in-patient clinics, or remained in out-patient clinics. The study methods complied with the COREQ. The main finding, ‘Sense-making in a changed reality of nursing’, shows how RNs attribute meaning or not to the organizational changes, and explains how meaning-making in RNs continuing in in-patient clinics reinforced their identity as RNs or, conversely, how feelings of meaninglessness in those relocated to in-patient clinics or remaining in out-patient clinics contributed to identity loss. This article suggests that managers, by paying attention to the narratives of meaning or meaninglessness in nurses during organizational changes, could be instrumental in managing the anger, frustration, and hopelessness arising from experiences of meaninglessness.

Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

Competence of clinical nurse educators in university hospitals: A cross-sectional study

The role of clinical nurse educators is essential in improving the quality of mentoring, supporting students’ learning and professional development during clinical training. The purpose was to explore the competence profiles of clinical nurse educators and background factors associated with these profiles. Data of this cross-sectional study were collected from clinical nurse educators ( n = 19) at Finnish university hospitals, using two instruments measuring the competence of healthcare educators. Data were analysed with K-means clustering and two profiles were identified based on sum variables. Significance between the differences of Profile 1 and Profile 2 was evaluated by comparing independent groups. The STROBE checklist was used as the reporting guideline for the manuscript. Educators’ competence varied between intermediate (2.50–3.49) and high (≥ 3.50) levels, and self-assessment of the Profile 1 was average higher than those in Profile 2. The results can be used to identify and develop the competence of clinical nurse educators and to consolidate the role and position of clinical nurse educators within healthcare education.

Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model: A qualitative interview study

An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.

Gender-specific nursing needs of people with multiple sclerosis: A scoping review

Women and men with multiple sclerosis (MS) experience different disease courses and occurring symptoms. These lead to different gender-specific needs. However, gender-specific needs are often elusive for nurses and therefore difficult to address in daily care. Thus, our aim is to describe gender-specific needs of people with MS. A scoping review was conducted, covering papers published between 1999 and 2019. Overall, 26 studies were identified, and a deductive coding process was applied based on Henderson's Nursing Need Theory. The PRISMA-ScR checklist was used to write the scoping review. Different needs of female and male patients with MS are described in eight categories of Henderson’s Nursing Need Theory, occurring in mobility and elimination. The analysis shows differences in communication about the disease, individual needs, and the acceptance of support. To address these differences, training on gender-sensitive care should be offered in nursing education and for nurses.

Exploring hospital nurses’ transitional medication management for older patients with multi-morbidity: An ethnographic study

Transitional medication management, in which individual needs are balanced against organizational priorities, is crucial for safe discharge processes. The aim of this study was to explore hospital nurses’ transitional medication management in the discharge of older patients with multi-morbidity. Using an ethnographic approach the data were collected through participant observations at a mixed medical ward at a Danish university hospital for two weeks. The participants were five registered nurses, responsible for nursing care of 23 patients with multi-morbidity and planned for discharge. The data comprised field notes that were analysed using iterative processes of domain, taxonomic and component analysis. The reporting adhered to the COREQ checklist. Hospital nurses’ transitional medication management was characterized by unpredictability and inconsistency in patient situations, fragmentation and discontinuity in working processes and complexity in communication systems. Special attention to nurses’ needs assessment skills and clinical decision making in caring for patients with multi-morbidity in a single focused healthcare system is required.

Are we prepared to educate the next generation of bachelor nursing students? A discussion paper

This paper answers a call from Nordic colleagues for new strategies in education to meet the needs of a new generation of bachelor nursing students regarding the development of clinical skills. We, as they, believe that educational models targeting the development of clinical skills must be customised to meet the learning style of the current and future generations of bachelor nursing students. In this paper we put forward that using a comprehensive, collaborative, student-centred approach will assist younger generations’ learning processes. We describe a pedagogical model of peer learning that combines collaboration, reflection and assessment aligned with learning outcomes. Such an approach, we believe, is likely to be in line with expectations, needs and preconditions of the current and future generations of nursing students.

Applying the theory of human development by Erik and Joan Erikson when communicating with persons with advanced dementia diseases

Persons with advanced dementia disease (ADD), here labelled PADDs, are shown to preserve parts of their self, which has opened up possibilities for involving them in their own care and establishing strategies for improving their communication with the surrounding world. Using the well-known theory of human development proposed by Erik and Joan Erikson, here labelled EJET, can operate as an efficient structure for formal caregivers to support PADDs in reclaiming their space. However, very few studies have used EJET as a framework in improving formal caregivers’ competence and the quality of care. This article aims to demonstrate the feasibility of applying EJET in the care of PADDs through two examples of successful application of this framework in interacting with PADDs in residential care settings. The examples demonstrate the significance of competent caregivers and the important role of tailoring nursing care plans to specific situations of the PADDs in their present and previous developmental phases.

Socialising of nursing students into homecare practice in Denmark: a Berger and Luckmann-inspired interview study

In 2016, Denmark's nurse education eliminated diagnoses, age and care settings from the curriculum. How students are trained for homecare is unknown. This article illuminates how students of non-Danish origin were socialised into homecare practice during nurse education in Denmark. Semi-structured interviews with eight students and a theoretical inspired latent thematic analysis of data were conducted. The SRQR checklist was used. The results are presented under three themes: Unprepared students stepped out from university college, Clinical supervisors as instructive and questioned role models, and Patients and relatives acted as co-supervisors. Theoretical highlights on homecare nursing were scarce from students’ perspectives. Clinical supervisors and encounters with patients and relatives in their homes socialised students into professional roles within homecare. The organisation of education in homecare pointed to a clinical, professional socialisation of nursing students in patients’ homes rather than a theoretical socialisation with an inherent formation at university college.

Content and structure of ward rounds focusing interprofessional collaboration on an internal medicine ward: An observational study of interprofessional collaboration

Ward rounds are crucial for the exchange of information among healthcare professionals to achieve joint planning and shared decision-making in healthcare to enhance patient safety. The aim of this study was to describe the content and structure of ward rounds focusing on interprofessional collaboration on an internal medicine ward at a university hospital in Western Sweden. An inductive qualitative approach was used to explore 13 participatory observations of ward rounds (sitting/team rounds). Qualitative content analysis was used. The analysis revealed one category, titled interprofessional teamwork, that utilises all available resources, which consisted of three subcategories: usefulness of specialist competencies, collaboration for patient safety, and leading healthcare to achieve goal fulfilment. It was also found that the participating specialists’ competencies were not being optimally used before patients were discharged from the hospital. Therefore, communication and leadership skills were revealed as ways to improve interprofessional teamwork to achieve goal fulfilment and patient safety regarding care and treatment issues on the ward. We found that reversing the order of ward rounds to start with the sitting round followed by the team round (i.e. hybrid distance participation methods), with the same ward round leader who has skills in leadership and interprofessional teamwork, could eliminate the need for healthcare providers to repeat questions and tasks (i.e. double work) on their ward rounds. Second, patient involvement is grounded in collaboration, and can be emphasised through person-centred care to facilitate patient safety during hospital stays.