Svåra samtal förekommer på samtliga arbetsplatser, dock resulterar de oftast i misslyckanden (Bradley & Campbell, 2016). Därför krävs det av ledare att anamma vissa strategier för att nå ett tillfredsställande resultat. Studiens fokus är att från ett ledarskapsperspektiv öka förståelsen om hur mellanchefer hanterar svåra samtal på sina arbetsplatser och hur de hanterar möjliga risker av svåra samtal både för sig själva och organisationen. Således utgår studien från tre frågeställningar där den första berör mellanchefernas användning av empati för svåra samtal och den andra om vilka strategier mellancheferna använder för svåra samtal. Vidare handlar den tredje frågeställningen om att undersöka vilka risker mellancheferna upplever kan uppkomma av svåra samtal både för sig själva och organisationen. Studiensempiri har samlats in genom semistrukturerade intervjuer samt att den bygger på en hermeneutisk forskningsansats. Empirin har vidare analyserats med hjälp av SCARFmodellen som handlar om den neurologiska påverkan hos anställda baserat på vilka strategierledare använder sig av under svåra samtal. Resultatet visar att mellanchefernas upplevelse av svåra samtal är både positivt och negativt, för både dem och för organisationen. Exempelvis upplever mellancheferna en känsla av obehag inför svåra samtal men att det i efterhand ofta resulterar i en förbättring, både på ett personligt och organisatoriskt plan. Resultatet visar även de strategier mellancheferna tenderar att använda sig av under svåra samtal samt hur de använder sig av empati för att öka sin kommunikationsförmåga under svåra samtal. Till exempel visar studien att mellancheferna använder den empatiska kompetensen för att bättre förstå sina medarbetares situation. Vidare använder mellancheferna sig av olika strategier, som exempelvis att visa att de förstår situationen genom att agera på det medarbetarna berättar. / Difficult conversations occur at all workplaces, although they tend to result in failure (Bradley & Campbell, 2016). Therefore it is required that leaders embrace certain strategies in order to reach a satisfying result. The aim of the study is to, through a leadership perspective, increase the understanding regarding how middle managers handle difficult conversations both for themselves as well as the organization. Thus, the study utilizes three questions whereas the first one refers to the middle managers adaptation of empathy during difficult conversations and the second refers to what strategies the middle managers adapt during difficult situations. Furthermore, the aim of the third question is to examine what risks middle managers believe can occur from difficult conversations both for themselves as well as the organization. The empiric was gathered through semi-structured interviews and is based on a hermeneutic research approach. The empiric has been further analyzed by dint of the SCARF model about how the employees neurologic influence is affected by the strategies used by the middle managers. The result shows that the experience of handling difficult conversations affects the middle managers both positively and negatively, for both themselves and the organization. For example, the middle managers experience a sense of discomfort before difficult conversations but in the end it results in improvement, both on a personal level and an organizational level. In addition, the result shows how those strategies the middle managers tend to adapt during difficult conversations as well as how they use empathy in order to increase their communication skills. For example, the study shows how the middle managers use their empathic competency as a way of increasing their understanding of the employees situation. Furthermore, the middle managers use different strategies, for example they show understanding of the employees situation by reacting to what they say.

Bakgrund: Under Covid-19-pandemin använde skolsköterskor på gymnasiet videosamtal för att kommunicera med sina elever. Enligt kompetensbeskrivningen ska skolsköterskan kunna ta ny teknik i anspråk och använda informations- och kommunikationsteknik för att kommunicera. Syfte: Syftet med studien var att beskriva skolsköterskors upplevelser av videosamtal med gymnasieelever under Covid19-pandemin. Metod: En kvalitativ metod med induktiv ansats användes. Data samlades in genom en webbenkät med öppna frågor. Fritextsvar från totalt 24 respondenter analyserades genom kvalitativ innehållsanalys. Resultat: Analysen resulterade i två huvudkategorier: Videosamtal inverkar på kommunikationen mellan skolsköterska och elev; samt Olika praktiska aspekter av att erbjuda eleven videosamtal. I de två huvudkategorier framkom sex underkategorier. Konklusion: Videosamtal ökar tillgängligheten till elevhälsan och medverkar till att skolsköterskankan arbeta mer flexibelt. Elever som av olika anledningar inte kan vara i skolan kan speciellt främjas av videosamtal som mötesform. / Background: During the Covid-19 pandemic school nurses in high school used video calls to communicate with their students. According to the skills description, the school nurse must be able to use modern technology, information, and communication technology to communicate. Aim: The aim of the study was to describe school nurses' experiences of video calls with high school students during the Covid-19 pandemic. Method: The study uses a qualitative method with an inductive approach. Data were collected through an online survey with open-ended questions. Free text responses from a total of 24 respondents were analysed through qualitative content analysis. Results: The analysis resulted in two main categories: Video calls affect communication between school nurse and student; Several practical aspects of offering the student video calls. In the two main categories, six subcategories emerged. Conclusion: Video calls increase accessibility to student health and contribute to the school nurse being able to work more flexibly. Students who cannot attend school for various reasons can particularly benefit from video calls.

[pt] A presente pesquisa tem como objetivo a busca de entendimentos sobre o poder de veto no contexto escolar e os caminhos que os praticantes do processo de ensinoaprendizagem podem construir para uma aprendizagem dialógica. Ancorada na abordagem da Prática Exploratória, entendo alunos e professores como praticantes do processo de ensino-aprendizagem (ALLWRIGHT e HANKS, 2009), uma vez que ambos possuem um papel importante no processo. Algumas perguntas são centrais para guiar meu olhar nesse estudo: Que poder de veto é esse? Por quem ele é praticado? Por que e de que maneira? Quais são as consequências desse poder para os alunos e os professores? Como trabalhar diante do poder de veto? O trabalho alinha-se à concepção de discurso que evidencia o uso da linguagem como prática social. Assim, é na relação entre discurso e sociedade que analisei o poder de veto praticado e sofrido pelos participantes do processo de ensino-aprendizagem, sejam eles alunos ou professores, dentre outros (MOITA LOPES, 2003). Entendendo que os praticantes possuem a capacidade de agirem como construtores de seu próprio processo de aprendizagem (MILLER, CUNHA e ALLWRIGHT, 2020), é essencial estimular conversas exploratórias entre alunos e professores. A pesquisa ocorreu em uma escola pública do estado do Rio de Janeiro onde atuei como professora de língua portuguesa em turmas de ensino médio. Os dados foram gerados a partir de conversas exploratórias com alunos e professores participantes sobre suas experiências em relação ao poder de veto. As conversas foram gravadas em áudio para posterior transcrição conforme as convenções referentes ao modelo Jefferson de Conversação (LODER, 2008). Além de suas contribuições teóricometodológicas, este estudo poderá, sobretudo, estimular a capacidade do protagonismo dos alunos assim como sua atitude investigativa a respeito das questões que são relevantes para eles. / [en] This research aims to seek understandings about the power of veto in the school context and the paths that practitioners of the teaching-learning process can build for dialogic learning. Aligned with the Exploratory Practice approach, I understand students and teachers as practitioners of the teaching-learning process (ALLWRIGHT and HANKS, 2009), since both play important roles in the process. Some questions are central to guide my study: What is the power of veto? Who is it practiced by? Why and in what way? What are the consequences of this power for students and teachers? How are we to work in the face of power of veto? The research is aligned with the concept of discourse that highlights the use of language as social practice. Thus, it is in the relationship between discourse and society that I analyzed the power of veto practiced and suffered by participants in the teachinglearning process, whether they are students or teachers, among others (MOITA LOPES, 2003). Understanding that students have the ability to act as builders of their own learning process (MILLER, CUNHA e ALLWRIGHT, 2020), it is essential to engage students and teachers in order to seek understandings about coconstruction paths for dialogic learning. The research took place in a public school in the state of Rio de Janeiro where I acted as a Portuguese language teacher in high school classes. Data were generated by engaging in exploratory conversations with participating students and teachers about their experiences in relation to the power of veto. The conversations were audio-recorded for later transcription according to the conventions referring to the Jefferson Conversation model (LODER, 2008). In addition to its theoretical-methodological contributions, this study will be able, above all, to stimulate the students capacity as protagonists as well as their investigative attitude regarding the issues that are relevant to them.

Research shows that conversations and daily interaction among teachers and children is crucial for their development. Observing children and interpreting their thinking processes is a significant factor in intentionally planning curriculum that emerges from children’s thinking, assists them in making connections, and extends their learning. This article presents findings of a single case design study investigating the effects of the observation and interpretation processes in a Cycle of Inquiry System (COI) (Broderick and Hong in Early Childh Res Pract 13:1–14, 2011) intervention on preschool teachers’ productive conversations with children. The intervention for each teacher consisted of pre and post interviews, a 1-day COI training, use of COI observation and interpretation forms, and coaching meetings with the researcher. The participants were 4 preschool teachers in Northeast Tennessee. Teachers were videotaped in their classrooms working with children during the free play time and coded for productive and non-productive conversation strategies for determining the baseline and changes during the intervention. All the teachers show an increase in productive conversation strategies to differing degrees. The non-overlapping pairs analysis for all participants is represented by a large value. The findings indicate the benefit of training teachers to observe and interpret the meaning of children’s conversations to intentionally plan for productive conversations that impact learning.

Bakgrund: När sjukdomar inte längre går att bota och det inte finns kurativ behandling att tillgå, då övergår vården till symtomlindrande och bromsande behandling dvs. palliativ vård. I Sverige är majoriteten av alla dödsfall förväntade dödsfall och ca. 60% registreras i palliativregistret. Drygt hälften har erbjudits ett brytpunktssamtal innan de dör. Ett samtal där patienterna och deras närstående ska ha möjlighet att förberedda sig såväl fysiskt, psykiskt, socialt och emotionellt i samband med övergången till palliativ vård. Syfte: Syftet var att belysa sjuksköterskors erfarenheter av brytpunktssamtal i livets slutskede. Metod: Studien är en litteraturöversikt med kvalitativ ansats. Där 16 vetenskapliga artiklar har analyserats enligt Friberg för att kunna svara till studiens syfte. Av texten som analyserats framkom två huvudtema och fem subtema. Resultat: Resultatet visar att kommunikationen med patienten, närstående och vårdteamet har stor betydelse i brytpunktsamtalet. Sjuksköterskans roll och samarbete mellan vårdteamet minskar lidandet hos patienterna och närstående. Patientens ålder, religion/tro, kulturella aspekter, sjuksköterskornas okunskap och oerfarenhet är några exempel på utmaningar i brytpunktssamtalet. Sjuksköterskans, patienternas och närståendes känslor är alltid påverkade i samband med detta. Slutsats: Slutsatsen är att resultatet kan leda till ökad förståelse om vilka upplevelser sjuksköterskor har i samband med samtalen och ge en insikt i de olika utmaningar de brottas med i samband med detta. Det finns ett behov av att utbilda, för att öka kunskaperna i ämnet, då både i hur ett samtal skall utföras praktiskt och för att teamet ska kunna skapa bästa samarbetet för att säkerställa möjligheterna till bästa förberedelserna för patienterna och närstående till en trygg och individuell övergång. / Background: When diseases can no longer be cured and there is no curative treatment available, then the care is transferred to symptom-relieving and slowing treatment called palliative care. In Sweden, most of all deaths are expected deaths, and approximately 60% are registered in the palliative care register. But only over half of these patients have been offered a breaking point conversation before they die. This is a conversation where patients and their relatives would have the opportunity to prepare physically, mentally, socially, and emotionally in connection with the transition to palliative care. Aim: was to shed light on nurses' experiences of breaking point conversations in the final stages of life. Method: The study is a literature review with a qualitative approach. Where 16 scientific articles have been analyzed to corresponds to the purpose of the overview. During the analysis, two main themes and five sub-themes emerged. Result: The results show that communication with the patient, relatives and the health team is of great importance in the breaking point conversation. The nurse's role in the breakpoint conversation and cooperation between the health team reduces the suffering of the patients and relatives. The patient's age, religion / belief and cultural aspects, the nurses' ignorance and inexperience are some examples of the challenges in the breaking point conversation. The emotions of the nurse, patients and relatives are always affected in connection with this. The conclusion is that the result may lead to an increased understanding of nurses’ experiences in connection with conversations and give an insight into the different challenges they struggle with in connection with it. There is a need for education, to increase the knowledge in the subject, both in how a conversation should be carried out in practice and for the team to be able to create the best collaboration, to ensure the opportunities for the best preparation for patients and relatives to a safe and individual transition.

In a world characterized by constant changes and increasing diversity, controversialevents unfold in society on a daily basis. Given the School's role in educating democraticcitizens, it is imperative for educational institutions to adapt and incorporate current andcontroversial topics into their curriculum. This thesis explores the perspectives of socialstudies teachers on controversial issues in the classroom. Employing a phenomenologicalapproach and conducting in-depth interviews with social studies teachers, the studyanalyzes their subjective experiences, definitions of the subject, and approaches toteaching controversial topics. Therefore, our purpose and research questions are groundedin three themes, which are also pervasive throughout the work: Teacher management,teacher experience, and teacher definition of controversial issues in education.In summary, the results from our interview study reveal that teachers acknowledge theemotional impact associated with these issues, a finding supported by prior research. Thechallenge lies in the complexity of these topics and the ability to strike a balance betweenintellectual challenge and emotional understanding. The study highlights the difficultyteachers face in maintaining objectivity while navigating through their own values, andthe intricate interplay between subject content, emotions, and the teacher's ownperspective. It is evident that a conscious effort is required to create a classroomatmosphere that fosters open dialogues and respectful confrontations to promotedemocratic values, where diverse perspectives can be included.

Syftet med denna studie är att beskriva och problematisera hur so- lärare i årskurs 4-6 förhåller sig till såväl som adresserar att undervisa elever om demokrati, genom demokrati för att sedan kunna verka för demokrati. Metoden som används för att få svar på forskningsfrågorna är kvalitativa semistrukturerade intervjuer med ostrukturerade inslag där sex yrkesverksamma lärare från fem olika kommuner blivit intervjuade. Denna studie har eftersträvat att synliggöra hur so-lärare använder sitt demokratiuppdrag i klassrumsundervisning för att tillföra eleverna redskap i form av inflytande, delaktighet och ansvarstagande. Fyra teman med underordnade aspekter som utgjorde intervjuerna föreföll i resultatet. Resultatet påvisar att upplevelsebaserad undervisning genererar mer handgriplighet och lärande. Det kan ske genom att exempelvis utföra olika studiebesök, skriva insändare till en tidning med innehåll som har inverkan på eleverna, samt diverse rollspel. Resultatet visar även att när kommer till att bringa kunskap i ett klassrum med elever som har olika erfarenheter och bakgrund, behövs fostran för att förstå att olikheter är en fördel. Det är fördelaktigt att elever urskiljer fenomen på varierande sätt och uppdraget för lärare är att ge elever verktyg till att uppfatta det som något berikade, att alla behövs. / The purpose of this study is to describe and problematize how the teaching assignment is addressed as well as how social studies teachers in grades 4-6, who teach students about democracy through democracy in order to then work for democracy, treat it. The method used to answer the research questions are qualitative semi-structured interviews with unstructured elements, where six participants from five different municipalities have been interviewed. This study has sought to make visible how social studies teachers use their democratic mission in classroom teaching by providing students with tools in the form of influence, participation and responsibility. Four themes with subordinate Aspect that made up the interviews appeared in the results. The result shows that experiential teaching generates more tangibility and learning, by carrying out various study visits, writing submissions to a newspaper, content that has an impact on the students, as well as various role-plays. The result also shows that bringing knowledge into a classroom with students with different experiences and backgrounds requires education to understand that differences are an advantage. It is beneficial for students to distinguish phenomena in varying ways, and the task for teachers is to give students the tools to perceive it, as something enriching, that everyone is needed.

Bakgrund: Under år 2022 vårdades cirka 42 200 patienter på IVA runtom i Sverige. Åtta % av de som vårdades på IVA avled. Detta innebär att intensivvårdssjuksköterskor möter patient och närstående i en svår tid. I arbetet som intensivvårdssjuksköterska förekommer brytpunktssamtal. Detta ställer krav på att intensivvårdssjuksköterskan är förberedd på att möta både patientens och närståendes känslor som uppkommer när beslut tas om att avbryta behandling. Syfte: Syftet med studien var att undersöka intensivvårdssjuksköterskors erfarenheter av brytpunktssamtal på en allmän intensivvårdsavdelning. Metod: En kvalitativ studie där intensivvårdssjuksköterskor harintervjuats i fokusgrupper. Materialet har analyserats med en kvalitativ innehållsanalys. Resultat: I resultatet framkom det fem kategorier; ”När vården ändrar riktning”, ”Att vara trygg i professionen”, ”Samverkan i det professionella teamet”, ”Konsten att förmedlabesked” och ”Ge utrymme för tid och känslor”. För intensivvårdssjuksköterskorna innebar ordet brytpunktssamtal att förmedla svårt besked till patient och närstående. Att ge tid till att svara på frågor, samarbete mellan olika professioner och resursbrist var det som belystes mest. Slutsats: Brytpunktssamtal påverkar alla inblandade, både patient, närstående och vårdpersonal. Intensivvårdssjuksköterskorna har en betydelsefull roll i hur brytpunktssamtalet förmedlas och tas emot. Förståelse för sin roll i brytpunktssamtalet är nödvändig för att kunna möta patient och närstående i en svår tid i livet. / Background: During 2022 circa 42 200 patients were treated in ICU’s in Sweden. Eight % of those treated deceased in ICUs. This means, ICU nurses encounter patients and relatives in a difficult time. Breakpoint conversations are guaranteed occurances for these nurses. This in turn requires the nurses to be prepared to respond appropriately to feelings of patients and relatives, when the decision to end treatment is taken. Aim: The aim of this study was to investigate nurses’ experiences of breakpoint conversations. Method: A qualitative study where nurses were interviewed in focus groups. The resulting material was analyzed with a qualitative content analysis. Results: Five categories were highlighted; ”When care changes direction”, ”To be comfortable in the profession”, ”Cooperation in the professional team”, ”The art of conveying information” and ”Allowing space for time and emotions”. For the nurses, the words breakpoint conversation, implies giving tough information to patients and relatives. Dedicating time to answering questions, cooperation between professions and lack of resources were highlighted in the results. Conclusion: Breakpoint conversations affects all who are involved, both patient, relatives and health-care professionals. Nurses have an impactful role in ho breakpoint conversations are formed and received. Understanding one’s role in breakpoint conversations is a necessity in encountering patients and relatives in a difficult situation.

The licentiate thesis examines what spending time in a forest garden can offer children when this environment is used for teaching aimed at sustainability. What do the children remember from their visits to the forest garden? What do they find special or memorable? What can the children learn there? To answer such questions, walk-and-talk conversations were conducted with children who for a three-year period had regularly visited a forest garden during school hours. The overall purpose of the licentiate thesis is to deepen knowledge about what spending time in a forest garden in a school context can offer children, reflected from the children's perspectives. Furthermore, the thesis aims to deepen knowledge about walk-and-talk conversations as a data collection method when children are respondents. This leads to the research questions: 1. In what ways can walk-and-talk conversations as a data collection method reflect children's perspectives in an environment and in relation to places? What are the possibilities and limitations of the method? 2. What significance do forest garden visits in a pedagogical context aimed at learning for sustainability have from the children's perspective? The theoretical starting points of the licentiate thesis draw on social studies of childhood, ecological literacy and affordances. Another concept that emerged in the analysis process was plant blindness. Data consisted of audio-recorded walk-and-talk conversations, children's photographs and recorded informal, supplementary interviews. A total of 28 children (11 boys and 17 girls) participated in sub-studies II and III. The children were aged 7-9 years, but most were 9 years old. The licentiate thesis consists of three sub-studies: Sub-study I is a literature review that focuses on opportunities, limitations, and challenges in using walk-and-talk conversations as a data collection method with children and young people. Walk-and-talk conversations can increase opportunities to capture children's perspectives and help to reduce power imbalances between children and researchers. However, analysing data from child-led walks and conversations can be challenging, while awareness of the researcher's own position and assumptions becomes particularly important. Sub-study II deals with the forest garden from children’s perspective. The first category, ‘to appreciate the place the forest garden’, contained the following themes: physical work, relationships with animals and plants, aesthetic and edible aspects and food, and friends. Most of the children enjoyed staying in the forest garden with its natural features. They valued the care of living organisms and felt that spending time in the forest garden was fun and exciting. In the second category, ‘aspects of learning in the forest garden’, the following themes emerged; practical skills, coexistence and caring, and biological knowledge and ecological understanding. Sub-study III deals with the four most photographed phenomena in the forest garden. The first were the plants, including trees and shrubs, which provided sensual, aesthetic and emotional affordances. The second was the pond, which provided physical affordances and wishes, while the third, the barbecue area, provided social affordances. Finally, the tipi provided affordances for privacy and imagination. To conclude: children's forest garden visits, with learning and nature encounters, can contribute to sustainable development. The investigated forest garden was an outdoor environment designed for children with natural features and with a focus on organic farming, where the forest garden educators helped to create a framework for both learning and relational opportunities. Developing ecological literacy in the new generation is a crucial concern, and the results of the licentiate thesis suggest that establishing educational outdoor environments where children receive parts of their education can contribute to the development of such literacy. The creation of outdoor environments for children is thus an important sustainability issue. / Licentiatuppsatsen undersöker vad skogträdgårdsvistelser kan erbjuda barn när en sådan miljö används för undervisning riktad mot hållbarhet. Det övergripande syfte är att fördjupa kunskap om vad skogsträdgårdsvistelser i en skolkontext kan tillföra barn, speglat utifrån barnens perspektiv. Vidare syftar uppsatsen till att fördjupa kunskaper om samtalspromenader som datainsamlingsmetod när barn är respondenter. Licentiatuppsatsens teoretiska utgångspunkter tar avstamp i barndomssociologi (Social Studies of Childhood), ekologisk litteracitet och affordances. Ett annat begrepp som framkom efter analysprocessen var växtblindhet. Den undersökta skogsträdgården, var en natur- och utomhusmiljö med inriktning mot ekologisk odling designad för barn, där skogsträdgårdspedagogernas pedagogiska inramning bidrog till att skapa både pedagogiska och relationella möjligheter. Metodvalet har varit ljudupptagna samtalspromenader, barns fotografier samt inspelade informella, kompletterande intervjuer. Sammanfattningsvis visar resultaten att barns skogsträdgårdsvistelser, lärande och naturmöten bidra till hållbar utveckling. Utvecklandet av ekologisk litteracitet hos den uppväxande generationen måste betraktas som central, och licentiatuppsatsens resultat pekar mot att anläggandet av pedagogiska utomhusmiljöer där barn får delar av sin undervisning kan bidra till utvecklandet av sådan litteracitet. Tillskapandet av utomhusmiljöer för barn är därför en viktig hållbarhetsfråga.

Bakgrund: Inom den palliativa vårdkontexten förekommer både planerade och spontana existentiella samtal. Sjuksköterskors kompetens är avgörande och utgör basen för att möta dessa behov, särskilt viktiga för patienter med palliativa vårdbehov där de existentiella aspekterna av livet får ökad betydelse. Syfte: Att beskriva sjuksköterskors upplevelse av existentiella samtal med patienter i palliativ vård. Metod: 14 kvalitativa vetenskapliga artiklar användes som grund för den kvalitativa litteraturöversikten, där databaserna PubMed och CINNAHL Complete användes. Analysen baseras på Bettany-Saltikov och McSherrys niostegsmodell för analys av artiklarna. Phil Barkers tidvattenmodell har använts som teoretisk referensram för att analysera resultatet. Resultat: Resultatet genererade fyra teman med tillhörande subkategorier; uteblivna existentiella samtal, att känna sig trygg i sin yrkesroll, relation och kommunikation samt att bli känslomässigt engagerad. Resultatet påvisade möjligheter och hinder för att samtal kan äga rum, samt betonar komplexiteten i mötet med patienter och hur sjuksköterskor med hjälp av handledning kan utveckla dessa färdigheter. Samtal inom arbetsgruppen betonas som viktig då samtalen med patienterna kan väcka känslor och tankar även hos sjuksköterskor. Handledning och utbildning inom ämnet kan därför hjälpa sjuksköterskor att känna sig mer bekväma att föra samtal av existentiell karaktär. Slutsats: Individuella färdigheter som mod och erfarenhet påverkar sjuksköterskors förmåga att föra existentiella samtal. Att integrera utbildning och reflektion kring dessa samtal var av vikt för att stärka kompetensen. Sjuksköterskor kan uppleva att dessa samtal blir utmanande och emotionellt betungande, särskilt utan adekvat utbildning. / Background: Within the palliative care context, both planned and spontaneous existential conversations occur. Nurses´ competence is crucial and forms the basis for meeting these needs, especially important for patients with palliative care needs where the existential aspects of life gain increased importance.  Aim: To describe nurses´ experience of existential conversations with patients in palliative care. Method: 14 qualitative articles were used as the basis for the qualitative literature review, where the databases PubMed and CINNAHL Complete were used. The analysis is based on Bettany-Saltikov and McSherry´s nine-step model for analyzing the articles. Phil Barker´s tidal model has been used as a theoretical frame of reference to analyze the result. Results: The result generated four themes with associated subcategories; missed existential conversations, to feel secure in one´s role, relationship and communication and to become emotionally involved. The result demonstrated opportunities and barriers for conversations to take place and emphasize the complexity of meeting patients and how nurses can develop these skills with the proper training. Conversations within the group are emphasized as important as conversations with patients can arouse feelings and thoughts in nurses as well. Guidance and training on the subject can therefore help nurses feel more comfortable in having conversations of an existential nature. Conclusion: Individual skills such as courage and experience influence nurses´ ability to have existential conversations. Integrating education and reflection around these conversations was important to strengthen competence. Nurses may find these conversations challenging and emotionally heavy, especially without adequate training.