Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-11T12:09:29Z No. of bitstreams: 1 Thalita Rocha Oliveira.pdf: 1015961 bytes, checksum: fb3d76408d8af20b45998afc2f204461 (MD5) / Made available in DSpace on 2015-12-11T12:09:29Z (GMT). No. of bitstreams: 1 Thalita Rocha Oliveira.pdf: 1015961 bytes, checksum: fb3d76408d8af20b45998afc2f204461 (MD5) Previous issue date: 2010 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / A comunicação constitui-se em um instrumento básico à prática de enfermagem ao estabelecer a expressão do cuidado. Assim, a presente pesquisa utilizou como referencial teórico alguns pressupostos e conceitos da Teoria Interacionista de Joyce Travelbee e teve como objetivo geral analisar a comunicação enfermeira-paciente no cuidado de enfermagem em Unidade de Pronto Atendimento 24h (UPA 24h). De caráter descritivo, abordagem qualitativa elegeu como instrumento de coleta de dados a entrevista semi-estruturada aplicada a dez enfermeiras 2º Tenentes Bombeiro Militar no cenário da UPA 24h situada no município de Belford Roxo. Os resultados apontaram que a maioria das depoentes estão na faixa etária de 20 a 29 anos e formação concluída nos últimos quatro anos. A análise temática das falas possibilitou evidenciar três categorias: a comunicação revelada na prática de enfermagem; a comunicação enfermeira-paciente nos espaços de cuidado da UPA 24h e aspectos da relação interpessoal enfermeira-paciente na UPA 24h. Na primeira, a comunicação é percebida pelas depoentes como essencialidade do cuidado e interação, além de possibilitar o sentimento de confiança explicitado por Travelbee. A outra aponta a comunicação como estratégia de escuta, aproximação, direcionamento do cuidado, intervenção e sensibilidade. Quanto às especificidades da relação enfermeira-paciente na UPA 24h foram descritas atitudes que significam a relação interpessoal como escuta, solicitude, cordialidade, atenção o que são para elas consideradas como abordagem humanística. Mas, as falas expressam ainda atitudes de imparcialidade e defesa que objetivam a relação de cuidado. Em relação aos pressupostos teóricos destacamos que neste estudo a interpretação dada a relação enfermeira-paciente como objetividade não é entendida como a superficialidade definida por Travelbee. Concluindo, embora a organização e a orientação de fluxos instituídas na UPA 24h sejam ferramentas consideradas facilitadoras de condutas profissionais pertinentes aos vários espaços de cuidado, os dados mostraram que a comunicação enfermeira-paciente e o cuidado implementados acontecem em suas faces objetivas e subjetivas independente do ambiente por ser uma relação ser humano-ser humano. Deste modo, a compreensão destas questões deve incentivar reflexões na prática assistencial e novas pesquisas, principalmente, por se tratar de uma política pública de saúde que tende à expansão no cenário nacional. / Communication constitutes a basic instrument to the nursing practice since it establishes the expression of care. Thus, the present research used as theoretical reference some presuppositions and concepts of the Joyce Travelbee`s Interactionism Theory and it had as general objective to analyze the nurse-patient communication in the nursing care in a 24-hour Emergency Room Unit (UPA 24 horas, in Portuguese). With a descriptive character and qualitative approaching it defined as data collecting instrument the half-structured interview applied to ten 2nd Military Fireman nurses of UPA 24 h located at the Belford Roxo county. The results indicated that most of the deponents are between 20 and 29 years old and has graduation concluded in the last four years. The thematic analysis of the statements made it possible to evidence the existence of three categories: the communication shown in the practice of nursing; the nurse-patient communication in the premises of the UPA 24 h; and aspects of the interpersonal nurse-patient relationship at the UPA 24 h. In the first one, the communication is observed by the deponents as the essenciality of the care and interaction, besides of making possible the feeling of confidence observed by Travelbee. The other shows communication as the listening strategy, approximation, directionality of the care, intervention and sensibility. As to the specificities of the nurse-patient relationship at UPA 24 h they described attitudes that mean that the interpersonal relationship as listening, solicitude, cordiality, attention – what is considered to them as humanistic approaching. But the statements still express attitudes of impartiality and defense that aim the relation of care. As to the theoretical presuppositions, we emphasize that in this study the interpretation given to the nurse-patient relationship as objectivity is not understood as the superficiality defined by Travelbee. In conclusion, although the organization and orientation of flows instituted at UPA 24 h are tools considered as facilitating the personal behaviors appropriated to several spaces of caring, data showed the nurse-patient communication and the caring implemented occur in its objective and subjective aspects, independently the environment for being a human being-human being relationship. This way, the understanding of these aspects should foster reflections in the assistance practice and new researches, especially for being a public health policiy management that has the perspective of expansion in the national universe.

Bakgrund: Palliativ vård bygger på ett förhållningssätt med syfte att lindra lidande och öka livskvaliteten under den sista tiden i livet. Sjuksköterskans uppgift i den palliativa vården är att utifrån en personcentrerad vård skapa förutsättningar för en god död. Trots att det finns möjlighet för vård i hemmet eller på palliativ vårdenhet händer det att patienter i ett sent palliativt skede ändå söker sig till akutmottagningen. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter i ett sent palliativt skede, på akutmottagning. Metod: En litteraturöversikt har gjorts för att besvara syftet. Elva vetenskapliga orginalartiklar har inkluderats och dessa har granskats, analyserats tematiserats för att urskilja likheter och skillnader. Resultat: Två huvudteman och sex underteman identifierades. Det första huvudtemat var Sjuksköterskans erfarenheter av faktorer som utgör hinder för god palliativ vård, med tillhörande underteman vårdmiljön som ett hinder, avsaknad av nödvändiga resurser, kurativ mentalitet och anhöriga som ett hinder för god palliativ vård. Det andra huvudtemat var sjuksköterskans erfarenheter av faktorer som främjar en god palliativ vård, med tillhörande underteman en underlättande vårdmiljö och resursers betydelse för god palliativ vård. Diskussion: Diskussionen framhäver vårdkulturens betydelse för den palliativa vården på en akutmottagning. Författarna diskuterar tre fenomen, resurser, kurativ mentalitet och akutmottagningens utformning i relation till Katie Erikssons caritativa vårdteori.

Clinical learning is regarded as a vital component in nursing programmes and students need to work in various clinical environments. In the emergency nursing programme presented at a tertiary nursing education institution, the pre-hospital environment is used as a clinical learning environment in which students rotate for approximately eight weeks. The clinical experience that they gain may assist in them developing the necessary knowledge and skills. It also assists in theory-practice correlation. The purpose of this study was to evaluate the value of the pre-hospital environment utilised as part of the clinical learning component of the emergency nursing programme. A qualitative approach was utilised since the researcher wanted to study a particular phenomenon, namely the pre-hospital learning environment. Therefore, the research design was a descriptive design whereby the researcher could describe the real life situation in the pre-hospital learning environment as experienced by the emergency nurse students. The target population for the study was emergency nurses who had already obtained their qualification as a registered emergency nurse, as well as emergency nurse students that had completed their rotational period in the pre-hospital learning environment. For the purpose of this study the identified sample consisted of students enrolled for the emergency nursing programme at a tertiary nursing education institution in Gauteng. The sample was adequate to provide the researcher with sufficient in-depth data and was also representative of the accessible population. The final sample size was 45 emergency nurse students who had completed the pre-hospital rotational period between 2008 and 2011. Data collection was done by means of Appreciative Inquiry, a method used that not only focuses on the positive, but which is also a stimulating way of looking at organisational change. Stories (narratives) were shared by the emergency nurse students pertaining to their real life experiences. Initially stories were shared in writing on an Appreciative Inquiry interview schedule. For the purpose of data saturation, individual Appreciative interviews were conducted by an independent interviewer, utilising the Appreciative Inquiry interview schedule as a guide. Data analysis was conducted by the interviewer, supervisors and an independent data analyser to ensure trustworthiness. Four themes were identified, namely clinical exposure, competencies, team work and future recommendations. From the data analysis and the four themes recommendations could be made with regard to programme refinement. Copyright / Dissertation (MCur)--University of Pretoria, 2013. / Nursing Science / unrestricted

Trauma caused by accidents and violence is a serious public health problem in Brazil, not only by its magnitude but also because victims are young people in working age. This study had proposed to characterize victims of accidents and violence assisted in an emergency unit in the State of Sergipe. This is a descriptive, prospective cross-sectional based on quantitative approach research. The study was conducted in a public hospital from Aracaju city, which is a reference center in assisting trauma victims in the State of Sergipe. Study sample was purposive, consisting of 504 victims of accidents or violence in the State of Sergipe, assisted trough November, 2010, aging 12 or higher that. Results showed that the trauma victims had an average age of 31.28 years old, most of them were male, single, coming the area called "Grande Aracaju", having an average schooling of 6.64 years and they were involved in wage-earning activity. The man trauma mechanism was traffic accident, with alcohol abuse and illicit drugs reports, lacerations blunts on the upper and lower limbs, followed by lesions in the region of face, head and neck. The initial evaluation at hospital evidenced that for most victims trauma was considered mild, scoring from 13 to 15 in Glasgow Coma Scale, Revised Trauma Score, and unaltered cardiac and respiratory rates was inalterad, with mild intensity pain reports. Immobilization and peripheral venous access were the most frequent basic and advanced support procedures performed in pre-hospital care. Bandages and medication were prevalent within the emergency room. Regarding assistance, the assistance's outcome was the discharge from the emergency room. There had been statistically significant association between traffic accidents and violence regarding schooling, income, occupation and provenance. There was also association of falls to age, schooling, income, gender, marital status and disability reports. Regarding associations between risk factors (reports of drinking of alcoholic beverages, drug consumption, non-use of personal protective equipment and physical, visual, auditory or mental disabilities) and accidents and violence there was also significance / No Brasil, o trauma por acidentes e violência constitui um grave problema de saúde pública no Brasil, não só pela sua magnitude como também por atingir vítimas jovens em idade produtiva. O objetivo do estudo foi caracterizar as vítimas de acidentes e violências atendidas em um serviço de urgência em Sergipe. Trata-se de uma pesquisa descritiva, prospectiva de corte transversal e com abordagem quantitativa. Foi realizada em um hospital público do município de Aracaju, referência no atendimento às vítimas de trauma do Estado de Sergipe. A amostra foi intencional, composta por 504 pessoas atendidas em novembro de 2010, com idade igual ou superior a 12 anos, vítimas de acidentes ou violência do estado de Sergipe. Os resultados evidenciaram que as vítimas de trauma tinham idade média de 31,28 anos, a maioria era do gênero masculino, solteiro, procedente da Grande Aracaju, com escolaridade média de 6,64 anos e atividade remunerada. O mecanismo do trauma foi o acidente de transporte, com relato de abuso alcoólico e drogas ilícitas; com ferimento corto contuso, nos membros superiores e inferiores, seguidos de lesões na região da face, cabeça e pescoço. A avaliação inicial na unidade hospitalar evidenciou que a maioria das vítimas sofreu trauma leve, com escore da Escala de Coma de Glasgow entre 13 a 15; Revised Trauma Score, com frequência cardíaca e respiratória inalteradas; e relato de dor com intensidade leve e moderada. As imobilizações e o acesso venoso periférico foram os procedimentos de suporte básico e avançado mais frequentes, realizados no atendimento pré-hospitalar. As imobilizações e as medicações ocorreram em sua maioria no setor de urgência. No segmento de atendimento, o desfecho foi a alta no setor de urgência. Houve associação estatisticamente significante entre acidentes de transporte e violência, com a idade, escolaridade, renda, ocupação e procedência. As quedas tiveram associação com idade, escolaridade, renda, gênero, estado civil e relato de deficiência. Na associação entre os fatores de risco (relato de abuso da bebida alcoólica, consumo de drogas, não utilização do equipamento de proteção individual e a deficiência física, visual, auditiva ou mental) e os acidentes e violências também houve significância.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-06T14:37:07Z No. of bitstreams: 1 paulosergiopinto.pdf: 1007302 bytes, checksum: e83dc5bb206e88c1c5c634a16811b8d1 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:35:47Z (GMT) No. of bitstreams: 1 paulosergiopinto.pdf: 1007302 bytes, checksum: e83dc5bb206e88c1c5c634a16811b8d1 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:36:32Z (GMT) No. of bitstreams: 1 paulosergiopinto.pdf: 1007302 bytes, checksum: e83dc5bb206e88c1c5c634a16811b8d1 (MD5) / Made available in DSpace on 2016-01-25T16:36:32Z (GMT). No. of bitstreams: 1 paulosergiopinto.pdf: 1007302 bytes, checksum: e83dc5bb206e88c1c5c634a16811b8d1 (MD5) Previous issue date: 2015-08-11 / Esta pesquisa objetivou compreender os valores e os conceitos relativos ao significado da aplicação do Sistema de Triagem de Manchester para o enfermeiro do serviço de urgência e emergência. Trata-se de uma pesquisa de natureza qualitativa. O cenário da pesquisa foi uma Unidade de Pronto Atendimento da Zona da Mata Mineira, tida como referência macrorregional no atendimento de urgência e emergência aos usuários do Sistema Único de Saúde, a qual utiliza o Sistema de Triagem de Manchester como sistema de classificação de risco. A amostra dos participantes do estudo configurou-se como de seleção completa, numa população de oito enfermeiros, os oito aceitaram participar da pesquisa. Os dados da pesquisa foram colhidos por meio da entrevista semiestruturada e da técnica da observação participante. A partir das informações colhidas, ocorreu a análise temática dos dados, desta emergiram cinco categorias: valores atribuídos pelos enfermeiros ao Sistema de Triagem de Manchester no cotidiano: “Ajuda? Ajuda! Desde que ele seja realmente funcionante [...]”; conceitos conflitantes relativos ao Sistema de Triagem de Manchester: “Ah, doutor, prefiro não comentar isso aí”; concepções da enfermagem relativas à comunidade sobre o Sistema de Triagem de Manchester: “[...] Há mais desgaste com a população, porque eles acham que é a enfermagem que põe pra dentro [...]”; des-valores que prejudicam o cotidiano do enfermeiro na aplicação do Sistema de Triagem de Manchester: “[...] O protocolo tem suas falhas, eu acho que a gente tem que adaptar essas falhas”; Sistema de Triagem de Manchester: valores do treinamento e aplicação e relevância para a enfermagem. Os achados deste estudo permitiram compreender que o Sistema de Triagem de Manchester pode possibilitar ao enfermeiro na produção do cuidado integrar conhecimentos que conduzam a uma compreensão do atendimento para além das relações de causa e efeito pertinentes à condição clínica do usuário, desde que sejam realizadas de modo efetivo. Também permite ao enfermeiro adotar um agir que extrapola o modelo biomédico, apesar dos conflitos que podem ocorrer entre as categorias profissionais envolvidas. O estudo mostra que os enfermeiros participantes conhecem o que a comunidade pensa sobre este sistema de triagem e que o referido sistema precisa de adequações a situações diversas, com capacitação periódica dos profissionais para a aplicação. Apesar de a atividade de classificação de risco por meio do Sistema de Triagem de Manchester ser de incorporação recente nos Serviços de Urgência e Emergência, o enfermeiro tem demonstrado atributos indispensáveis à aplicação desta ferramenta de forma exitosa, galgando a conquista deste espaço de atuação importante dentro da estrutura de saúde do país. Contudo esta conquista ainda pode ser ampliada pelos cursos de graduação em enfermagem com a inclusão da temática classificação de risco em suas grades curriculares. É preciso registrar que este estudo retratou um panorama local da temática sob a perspectiva apenas do enfermeiro, dessa forma, outros estudos precisam ser desenvolvidos em outros cenários e também sob a visão de outros profissionais e do próprio usuário. / This research aimed to understand the values and the concepts relating to the meaning of the application of the Manchester Triage System for nurses of the emergency care service. It is a qualitative research. The research scenario was one Emergency Unit of the Zona da Mata Mineira, taken as macro-regional reference in urgent care and emergency users of the Unified Health System, which uses the Manchester Triage System as a risk classification system. The sample of the study participants was configured as a full selection of a population of eight nurses, eight agreed to participate. The survey data were collected through semi-structured interviews and participant observation technique. From the information collected, there was a thematic analysis of the data, this five categories emerged: values attributed by nurses to the Manchester Triage System on daily life: "Help? Help! Since it is actually functioning [...] "; conflicting concepts for the Manchester Triage System: "Oh, doctor, I'd rather not comment on that here"; conceptions of nursing for the community on the Manchester Triage System: "[...] There is more wear with the people, because they think it is the nurse who puts inside [...]"; des-values that harm the nurse's daily life in the application of the Manchester Triage System: "[...] The protocol has its flaws, I think we have to adapt these failures"; Manchester Triage System: values training and application and relevance for nursing. The findings of this study allowed us to understand that the Manchester Triage System can enable the nurse in the care production integrate knowledge leading to an understanding of care beyond the cause and effect relevant to the clinical condition of the user, provided they are carried out effectively. It also allows nurses to adopt an act that goes beyond the biomedical model, despite conflicts that can occur between the professional categories involved. The study shows that participating nurses know what the community thinks about this screening system and that this system needs adjustments to different situations, with periodic training of professionals for the application. Although the rating activity by the Manchester Triage System be of recent incorporation in Urgent and Emergency Services, the nurse has shown attributes indispensable for the application of this successful form tool, climbing the achievement of this important performance space inside the health structure of the country. However this achievement can be further expanded by the undergraduate nursing courses with the inclusion of the theme risk rating in their curricula. You must register this study portrayed a local overview of the topic from the perspective only of nurses, thus further studies need to be developed in other settings and also in the view of other professionals and the users themselves.

Dissertation (M Cur (Trauma and Emergency Nursing))--University of Pretoria, 2006. / Nursing Science / unrestricted

Bakgrunden belyser att barnsjukvården arbetar utefter ett familjecentrerat förhållningssätt där familjen ses som en enhet. Separation av barn och föräldrar har negativa konsekvenser. Vårdpersonalen syn på föräldrars närvaro världen över är tveksamma till att låta föräldrar att närvara vid återupplivning av deras barn.  Syftet var att beskriva föräldrars upplevelse av att närvara vid deras barn återupplivning. Den valda metoden för denna studie var litteraturöversikt med systematisk metod. Sökningarna genomfördes i databaserna PubMed och CINAHL. Totalt inkluderades 16 vetenskapliga artiklar varav 12 kvaliativa studier, tre kvantitativa studer och en mixad studie. Efter kvalitesgranskningen var nio av god kvalité och sju av hög kvalitet. De inkluderade artiklarna analyserades i en integrerad metod.  Resultatet kategoriseras i fyra huvudkategorier "Föräldrar emotionella uttryck", "föräldras behov vid återupplivning", Föräldras relation till vårdpersonal" och "Närvaro vid ååterupplivning". Familjer Beskriver det inte bara som av högsta vikt at få närvara utan även som deras otvetydig rättighet, ett naturligt och instinktivt ansvar som förelder. Det är kritiskt för anhöriga att få basal och konkret information kring barnets tillstånd och att vårdpersonalen som ger dessa uppdateringar vet vad som pågår. Familjers närvaro vid återupplivning ger sällan avbrott i det medicinska teamets arbete.  Slutsats från studie var att majoriteten av föräldrarna vill närvara vid återupplivningen av deras barn. Närvaron påverkar föräldrar i efterhand positivt då det underlättar för sorgearbetet. Därtill är det av vikt att anhöriga erbjuds adekvat stöd och blir tillhandahållna kontinuerlig adekvat information angående barnets tillstånd för att bidra till att föräldrarna ska känna sig mer trygga i situationen. / The background highlights that pediatric care works from a family-centered point of view where the family is seen as a unit. Separation of children and their parents has negative consequences. Worldwide nurses' view of parents' presence during resuscitation of their children is hesitant. The purpose of this study was to describe parents´ experience of attending their child´s resuscitation. The chosen method for this study was a literature review with systematic method. The searches were performed in the PubMed and CINAHL databases. A total of 16 articles were included, of which 12 qualitative studies, 3 quantitative studie and 1 mixed study. After the quality review, nine were of good quality and seven of high quality. The included articles were analyzed in an integrated method. The results are categorized into four main categories: “Parents´ emotional expression”, “Parents´ need during resuscitation”, “Parents´relationship to care staff” and “Attendance in resuscitation”. Families do not only describe it as the utmost importance to be present but also as their unequivocal right, an innate and instinctive responsibility as a parent. It is critical for relatives to receive basic and concrete information about the child's condition and furthermore that the care staff who provide these updates has knowledge regarding the resuscitation of the parents´child. The presence of families in resuscitation seldom interrupts the work of the medical team. The conclusion from the study was that the majority of parents want to attend the resuscitation of their children. The presence has a positive effect on parents afterwards as it facilitates the mourning. In addition, it is important that relatives are offered emotional support and are provided with continuous adequate information regarding the child's condition in order to help the parents feel more secure in the situation.

Bakgrund: Sjuksköterskors arbete på akutmottagningar beskrivs som krävande och påfrestande inte enbart relaterat till höga krav på kompetens och bedömning men även sett till arbetets oförutsägbarhet, hög arbetsbelastning, konfrontation med bredden av vårdbehov och exponering för traumatiska händelser. Sjuksköterskor på akutmottagningar kan uppleva arbetsrelaterad stress som inkluderar tillståndet utbrändhet, som enligt tidigare forskning på vårdenheter har visat leda till sämre arbetsmiljö, högre personalomsättning och bristande patientsäkerhet. Syfte: Syftet med litteraturstudien är att kartlägga faktorer som har ett samband med utbrändhet hos sjuksköterskor som arbetar på akutmottagningar. Metod: Litteraturstudie med systematisk sökning och sammanställning av originalartiklar med kvantitativ ansats. Sökningar genomfördes i databaserna CINAHL och Pubmed. Samtliga nio inkluderade artiklar använde sig utav MBI-enkäten (Maslach Burnout Inventory) för skattning av utbrändhet. Resultat: Kartläggningen av faktorer är uppdelad i två huvudkategorier med vardera två underkategorier: ”individuella faktorer” som omfattar ”personliga förutsättningar” samt ”attityder, känslor och etik”; och ”arbetsrelaterade faktorer” som omfattar ”organisatoriska och interpersonella faktorer” samt ”patientrelaterade faktorer”. Resultatet visade bland annat att ryggsmärta, nivå av mindfulness, nivå av socialt stöd från kollegor och ledning samt exponering för död och lidande var faktorer relaterade till utbrändhet. Slutsats: Kartläggningen av faktorer visar att utbrändhet hos sjuksköterskor som arbetar på akutmottagningar är multidimensionell och eventuella interventioner bör beakta såväl individuella som organisatoriska förhållanden. / Background: The challenges and demands of emergency nursing are not only related to high requirements of skills and patient assessment but also due to unpredictability of the work, high workload and exposure to a broad range of care needs and traumatic events. Emergency nurses can experience conditions like burnout, which previous research has shown can lead to increased turnover and worsening of the work environment and patient safety. Aim: The aim of this literature review is to compile the factors associated with burnout in emergency nurses. Method: A quantitative literature review. Searches were conducted in the CINAHL and Pubmed databases. All of the nine included articles utilized the MBI-survey (Maslach Burnout Inventory) for measurement of burnout. Results: The factors are classified into two main categories with each covering two subcategories: “individual factors”, encompassing “personal conditions” and “attitudes, feelings and ethics”; and “job related factors” which contains the subcategories “organizational and interpersonal-” and “patient related factors” respectively. The results show that backpain, level of mindfulness, level of social support from colleagues and supervisors and exposure to death and suffering were among the factors related to burnout. Conclusion: The compilation of factors shows that burnout among emergency nurses is multidimensional and any interventions should consider both individual as well as organizational conditions.

Bakgrund: Att vårda patienter i akuta skeden innebär ofta en kaotisk situation som är känslomässigt påfrestande för både sjuksköterskan och patienten. Eftersom man som sjuksköterska inom akutsjukvården utsätts för många känslomässiga reaktioner samtidigt som allt fokus ska läggas på patienten är risken stor att arbetssituationen blir orimlig. Syftet med litteraturstudien var att belysa upplevelser av akut omvårdnad av patienter med trauma ur ett sjuksköterskeperspektiv. Metod: Studien genomfördes som en allmän litteraturöversikt med induktiv ansats. Resultatet baserades på tio vetenskapliga artiklar som visade att sjuksköterskor upplevde akut omvårdnad av patienter med trauma som ett svårt och stressigt arbete som oftast ledde till olika stressymtom som exempelvis utbrändhet, personlig stress, posttraumatisk stressyndrom och sekundär traumatisk stress. Slutsats: Sjuksköterskorna upplevde det känslomässigt svårast att behandla unga trauma patienter samt släktingar eller kollegors släktingar. Yngre oerfarna sjuksköterskor reagerade oftast starkare på trauma situationerna än vad erfarna sjuksköterskor gjorde. / Background: Caring for patients in trauma situations is often emotionally stressful for both the nurse and the patients. Since nurses in the emergency care often deal with emotional reactions while al the focus must be on the patient, there is a great risk that the work situation will be unsustainable. The purpose of the literature study was to elucidate experiences of trauma care from nurse’s perspective. Method: The study was designed as a structured literature review with an inductive approach. The result was based on ten scientific articles and showed that nurses experiences of trauma care was difficult and stressful and usually led to various stress symptoms such as burnout, personal stress, posttraumatic stress syndrome and secondary traumatic stress. Conclusion: The nurses found it emotionally difficult to treat young trauma patients as well as relatives or colleagues’ relatives. The younger inexperienced nurses usually responded stronger to the trauma situations than the experienced nurses did.

Introduction: Death is not an uncommon outcome for patients who seek immediate care in an emergency department. Although death is common in the emergency department there is little literature regarding end-of-life care in the emergency department. The purpose of this research study is to determine what changes emergency nurses would suggest to improve end-of-life care for dying patients and their families in emergency departments. Background: A national, geographically dispersed, random sample of 1000 emergency nurses were sent a questionnaire entitled, "Emergency Nurses' Perceptions of End-of-Life Care." Inclusion criteria included nurses who were members of the Emergency Nurses Association, could read English, worked in an emergency department, and had cared for at least one emergency patient at the end-of-life. Results: There was an overwhelming consistency in recommended changes to improve care of the dying emergency department patient by the nurses participating in the study. Five major themes were identified: 1) increasing the amount of time emergency nurses have to care for dying patients and their families; 2) consistently allowing family presence during resuscitation; 3) providing a comfortable patient room; 4) providing for more privacy at the end-of-life; and 5) providing a family grief room. Conclusion: The emergency department will continue to be the primary access point for dying patients to receive medical and nursing care. Implementing changes based on emergency nurse recommendations may dramatically improve the experience for the dying patient as well as their family members.