The aim of the study was to explore how far the perceptions of care of nurses in Finland take into account the preferences of the older patient and the patient's family members and to evaluate related background factors. The data were collected by questionnaire with nurses (n=167) working in a geriatric hospital. The questionnaire contained items about shared decision-making, attitudes to nursing patients, assessment of patients' functional ability and need for care, goal-setting, evaluation of outcomes and discharge planning. This study showed that taking into account the preferences of the patient and the patient's family members regarding the patient's care was challenging for the nurses in practice. About one-third of the nurses reported making the decisions on a patient's care themselves and not respecting patient autonomy in situations where patients are not able to assess their own situation. In addition, the nurses reported asking for the views of patients less frequently than those of family members when assessing and setting patient care goals. In practice, nurses need to be aware of this, during the transition from routine-centred care to patient-centred care.
These are challenging times for gerontological nurses, due to the increasing need for older people care services and nursing expertise and to the burdensome nature of older people care. These changes also challenge professional ethics. Traditionally, literature has focused more on nurses' duties and responsibilities, rather than on their rights.
The aim was to explore the concept of nurses' rights from the perspective of nurses in gerontological care.
A qualitative study conducted among gerontological nurses (n = 29) in the older people care of two publicly provided municipal older people care organisations in two mid-range towns in Finland. Participation in the study was voluntary, and the participants were recruited in collaboration with a nurse executive. The data, collected in 11 interviews (1-4 participants in each) using open-ended interview method, were analysed by inductive content analysis.
Based on our findings, nurses' rights are an integral part of everyday nursing. As professionals, nurses pointed out that their rights are based on legislation and ethics, and their rights involve colleagues, managers, organisation, and patients and relatives. Their rights were connected to nurses' professional expertise and their well-being at work, but at the end, they were a factor to improving quality of older people care. This required that nurses' rights were taken as visible and elementary part of management.
On the basis of our findings, especially in very demanding areas of nursing, like older people care, nurses' rights deserve major visibility and should be taken into consideration when planning care.
Nursing turnover continues to be a problem for healthcare organizations. Longitudinal research is needed in order to monitor the development of turnover intentions to leave the profession over time.
The objectives were: (1) to investigate the prevalence of new graduates' intentions to leave the nursing profession, (2) to prospectively monitor the development of intention to leave during the first five years of professional life, and (3) to study the impact of sex, age, occupational preparedness and burnout (i.e. exhaustion and disengagement) on the development of intention to leave the profession.
Longitudinal observational study.
Participants were recruited from first-year nursing students at any of the 26 universities in Sweden offering nursing education. Of the 2331 student nurses who were invited to participate in the study, 1702 (73%) gave informed consent and thus constituted the cohort. This cohort was prospectively followed yearly (three times during education and five times post graduation) from late autumn 2002 to spring 2010. Of the 1501 respondents who continued to participate after graduating, 1417 worked as nurses at the time of data collection and responded to the items regarding intention to leave the nursing profession during at least one wave of measurement; these constituted the sample of the present longitudinal study.
The outcome variable was intention to leave the nursing profession. This was measured using a scale of three items, covering thoughts of leaving the profession. The main predictor was burnout, and this was measured by the exhaustion and disengagement scale from the Oldenburg Burnout Inventory. Data were analysed using latent growth curve modelling.
After five years, every fifth nurse strongly intended to leave the profession. The longitudinal analysis of change in intention to leave showed that levels increased during the first years of employment. High levels of burnout were related to an increase in intention to leave.
It is important for organizations employing new graduates to pay attention to nurses who show early signs of burnout, and provide a resourceful work environment with a suitable workload, sufficient introduction, management support, satisfactory collaboration with colleagues, and role clarity.
Telenursing is a rapidly expanding actor in the Swedish healthcare system, as in other Western nations. Although rare, tragic events occur within this context, and are reminders of the importance of giving patient safety the highest priority. As telenurses' main sources of information are their dialogues with the callers, the provision of safe care can depend on the quality of this dialogue. The aim of this study was to identify issues that could threaten patient safety in telenurses' dialogues with callers. As part of an educational intervention, a researcher visited a sample of six telenurses five to six times at their workplace to listen to and discuss, together with the telenurses, their dialogues with callers in stimulated recall sessions. Each call and the following discussion between researcher and telenurse was tape-recorded and transcribed as text, resulting in a total of 121 calls. Qualitative content analysis of the reflections and following discussions revealed that threats to patient safety could be related to the surrounding society, to the organisation of telenursing, to the telenurse and to the caller. This study gives insight into significant problem areas that can affect patient safety in telenursing in Sweden. Issues that need to be focused on in telenursing educational programmes and future research are suggested, as well as the need for organisational development.
The aim of this study was to explore nurses' perceptions of climate and environmental issues and examine how nurses perceive their role in contributing to the process of sustainable development.
Climate change and its implications for human health represent an increasingly important issue for the healthcare sector. According to the International Council of Nurses Code of Ethics, nurses have a responsibility to be involved and support climate change mitigation and adaptation to protect human health.
This is a descriptive, explorative qualitative study.
Nurses (n = 18) were recruited from hospitals, primary care and emergency medical services; eight participated in semi-structured, in-depth individual interviews and 10 participated in two focus groups. Data were collected from April-October 2013 in Sweden; interviews were transcribed verbatim and analysed using content analysis.
Two main themes were identified from the interviews: (i) an incongruence between climate and environmental issues and nurses' daily work; and (ii) public health work is regarded as a health co-benefit of climate change mitigation. While being green is not the primary task in a lifesaving, hectic and economically challenging context, nurses' perceived their profession as entailing responsibility, opportunities and a sense of individual commitment to influence the environment in a positive direction.
This study argues there is a need for increased awareness of issues and methods that are crucial for the healthcare sector to respond to climate change. Efforts to develop interventions should explore how nurses should be able to contribute to the healthcare sector's preparedness for and contributions to sustainable development.
Why nurses remain in the profession is a complex question. However, strong values can be grounds for their remaining, meaning nurses evaluate the qualitative worth of different desires and distinguish between senses of what is a good life.
The overall aim is to explore and argue the relevance of strong evaluations for remaining in the nursing profession.
This theoretical article based on a hermeneutical approach introduces the concept strong evaluations as described by the Canadian philosopher Charles Taylor and provides examples of nurses' experiences in everyday nursing care drawn from a Norwegian empirical study.
Data collected in the original study consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service, inside as well as outside institutions.
The article uses data from an original empirical study approved by the Norwegian Social Science Data Services. Information was given and consent obtained from the participants.
Remaining in the nursing profession can be understood as revolving around being a strong evaluator. This has been concretized in issues of being aware of different incidents in life and having capacities as a nurse.
Why nurses remain is discussed in relation to how nurses have shaped themselves by reflecting on what is of significance in their life. However, being a strong evaluator cannot be seen as the casual condition for remaining.
Remaining in the nursing profession is obviously not a contingent matter, rather it is a matter concerned with the qualitative worth of different desires and values. Nurses' awareness of a life choice impacts on whether they remain or not. Consequently, nurses may need to articulate and reflect on their priorities for remaining.
The Swedish Education Act (2011) mandated a new combination of services to boost students' physical health, their mental health and special education through interprofessional pupil health and well-being (PH) teams. For Swedish school nurses, providing these services presents new challenges.
To describe how Swedish school nurses experience their work and collaboration within the interprofessional PH teams.
Twenty-five school nurses (SNs) were interviewed in five focus groups. Content analysis was used to examine the data and to explore SNs' workplace characteristics by using the components of the sense of coherence (SOC) framework.
SNs' experiences of work and collaboration within PH teams can be described using three domains: the expectations of others regarding SNs' roles, SNs' contributions to pupils' health and well-being, and collaboration among SNs within PH teams. The results indicate a discrepancy between SNs' own experiences of their contribution and their experiences of other professionals' expectations regarding those contributions. Some duties were perceived as expected, comprehensible, manageable and meaningful, while other duties - though expected - were perceived as less meaningful, taking time away from school-related matters. Other duties that were not explicitly expected - promoting general health and creating safety zones for pupils, teachers and parents, for example - were nonetheless perceived as meaningful. Collaboration within PH teams was considered meaningful, comprehensible and manageable only if the objectives of the team meetings were clear, if other professionals were available and if professional roles on the team were clearly communicated.
The SNs reported a lack of clarity regarding their role in PH and its implementation in schools, indicating that professionals in PH teams need to discuss collaboration so as to find their niche given the new conditions. SOC theory emerged as a useful framework for discussing concrete work-related factors in the school environment.