Bakgrund: Den avancerade kirurgin inom operationsverksamheten ställer höga krav på operationssjuksköterskans kompetens och hon verkar i en ständigt utvecklande miljö. Operationssjuksköterskans perioperativa kunskaper gör henne till en nyckelspelare i operationsteamet. Den nyfärdiga operationssjuksköterskan saknar både erfarenhet av yrket och fördjupad yrkeskompetens som kan hjälpa henna att hantera kraven i arbete. Syfte: Syftet med denna studie var att ta reda på vilka utmaningar nyfärdiga operationssjuksköterskor upplever och vilka copingstrategier de använder sig av. Metod: Sex nyfärdiga operationssjuksköterskor, verksamma på en operationsavdelning med multidisciplinär och avancerad kirurgi med mellan sex till tolv månaders erfarenhet, intervjuades. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Att vara nyfärdig operationssjukksöterska innebar splittrade känslor inför sitt yrke och yrkesroll. En tillfredsställelse över att få utvecklas och bygga upp sin kompetens innebar samtidigt en arbetssituation som upplevdes kravfylld och många gånger övermäktig. Utmaningarna med yrket var att komma in i rollen som operationssjuksköterska, att erhålla den kunskap som krävs och att acceptera sin roll som novis. Att förhålla sig till situationen genom att distansera sig eller ha kontroll över sina känslor var två vanliga strategier. Slutsats: Att bli en kompetent operationssjuksköterska kan underlättas av att de utmaningar som de nyfärdiga operationssjuksköterskorna ställs inför uppmärksammas och att de får stöd i sin utveckling. Stöd i form av mentorskap och tid för reflektion för att förebygga negativa känslor som stress och osäkerhet. / Background: Today’s advanced surgery demands the theatre nurse to be highly skilled and competent. The theatre nurse is working in a constant developing environment. Her specific knowledge of perioperative care makes the theatre nurse a key-player in the operating team. The newly graduated theatre nurse lacks deeper competence in both working experience and professional skills that could help her meet the highly set standards in surgery. Aim: The aim of this study was to examine which challenges newly graduated theatre nurses experience and which coping strategies they use. Method: Six newly graduated theatre nurses working in an operating setting, with six to twelve months of working experience, were interviewed. The narrative data was analyzed with qualitative content analysis. Results: Being a newly graduated theatre nurse with lack of previous working experience created mixed feelings about the profession and the role. The experiences were characterized a satisfaction in learning and developing skills but at the same time experiencing feelings of being overcome by work burden. The challenges they encountered were entering the role of an operation theatre nurse, allowing one self to gain competence and accepting the situation of being a novice. Adjusting to the situation by adopting different strategies became a way of coping with the experienced challenges. Conclusion: Gaining access to the role of becoming a competent theatre nurse can be supported by acknowledging the challenges experienced by newly graduated theatre nurses and by mentoring their progress to prevent negative feelings such as insecurity and stress.

Bakgrund: Stress är vanligt förekommande för såväl student som för sjuksköterska. Vid negativ stress uppstår det en obalans mellan förmåga och krav och hälsan blir drabbad. Att få ett större ansvar samt vara oerfaren är väldigt krävande för den nyutexaminerade sjuksköterskan.  Syfte: Syftet var att belysa upplevelserna av yrkesrelaterad stress vid övergången från student till sjuksköterska. Metod: En kvalitativ litteraturstudie med induktiv ansats. Genom en litteraturöversikt har resultatet från tio kvalitetsgranskade artiklar analyserats och sammanfattats till ett nytt resultat. Resultat: Kategorierna som presenteras är: Från teori till praktik, Vikten av kunskapsutveckling och Hindrande och underlättande faktorer för sjuksköterskan. Många hade svårt att identifiera sig med sin nya roll och ökat ansvar satte prestationsförmågan på prov. Slutsats: Övergången från student till sjuksköterska upplevs många gånger svår och introduktion samt kollegor har en stor inverkan på hur övergången upplevs. Konsekvenserna av yrkesrelaterad stress framträder som emotionell och fysisk påverkan på hälsan, bristande självförtroende och överväganden att lämna professionen. / Background: Stress is a common occurrence for both students and nurses. In the case of negative stress, there is an imbalance between ability and demands and health is affected. Getting more responsibility and being inexperienced is very demanding for the newly graduated nurse. Purpose: The purpose was to illustrate the experiences of occupational stress during the transition from student to nurse. Method: The method is a qualitative literature study with manifest content analysis. Through a literature review, the results from ten quality-reviewed articles have been analyzed and summarized into a new result. Results: The categories presented are: From theory to practice, The importance of knowledge development and the obstructive and facilitating factors for the nurse. Many had difficulty identifying themselves with their new role and increased responsibility put performance skills to the test. Conclusion: There are various factors in the experience of what triggers occupational stress. The consequences of occupational stress appear as emotional and physical impact on health, lack of confidence and consideration for leaving the profession.

NYUTEXAMINERADE SJUKSKÖTERSKORS UPPLEVELSE AV ARBETSRELATERAD STRESS EN LITTERATURSTUDIE TILLIE GERLING ROBINSSON PAULA WINHOLT NORDGREN Gerling Robinsson T, Winholt Nordgren P. Nyutexaminerade sjuksköterskors upplevelse av arbetsrelaterad stress. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, institutionen för vårdvetenskap, 2020. Bakgrund; Det finns vetenskaplig evidens för att förhållandena på arbetsplatsen har betydande effekt på utveckling av stressymptom vilket kan leda till både psykiska och fysiska problem. Enligt Socialstyrelsen beror en stor del av långtidssjukskrivningarna i Sverige på psykisk ohälsa som är relaterad till arbetet, vilket uppmärksammats speciellt i yrken som innebär mycket kontakt med och ansvar för andra människor. Arbetsförhållanden spelar en stor roll i eventuell utveckling av stressrelaterade symtom. Det finns evidens för samband mellan arbetsrelaterad stress och långtidssjukskrivningar. I denna litteraturstudie belyses stressorer som är kopplade till arbetsrelaterad stress hos nyutexaminerade sjuksköterskor. Syfte; Syftet är att belysa arbetsrelaterade stressorer i den nyutexaminerade sjuksköterskans arbetsmiljö. Metod; Litteraturstudie som är baserad på 10 vetenskapliga artiklar med kvalitativ design. Artiklarna i studien är hämtade från två databaser, den ena med inriktning på omvårdnad och den andra med inriktning på psykologi. Artiklarna analyserades med metoden innehållsanalys. Resultat; Fyra huvudteman och tre subteman identifierades vid analys av artiklarna. Huvudteman var: Överväldigande inför verkligheten, känslan av vilsenhet i den nya professionella rollen, känslan av ensamhet vid bristande mentorskap och att vänja sig vid skiftarbete. Konklusion; Nyutexaminerade sjuksköterskor står inför en utmanande första tid som kliniskt verksamma. I studierna framkom det flera stressrelaterade faktorer som kan komma att påverka den enskilde individen både fysiskt som psykiskt. Organisation, arbetsmiljö och socialt stöd spelar en stor roll i utvecklingen av stressrelaterade symtom. Individer kan reagera olika på stressrelaterade faktorer, vanligt förekommande symtom som återkom i studierna var koncentrations- och minnesproblematik, sömnstörningar, fatigué, försämrat immunförsvar, gastrointestinala problem samt hjärt- och kärlpåverkan. Genom att uppmärksamma och minimera stressrelaterade faktorer i början av yrkeslivet och ha ett fungerande socialt stöd underlättas den utmanande första tiden för de nyutexaminerade sjuksköterskorna. Nyckelord: Nyutexaminerad, sjuksköterska, stress, stressorer, upplevelse. / NEWLY GRADUATED NURSE’S EXPERIENCE OF WORK-RELATED STRESS A LITERATURE REVIEW TILLIE GERLING ROBINSSON PAULA WINHOLT NORDGREN Gerling Robinsson T, Winholt Nordgren P. Newly graduated nurses' experience of work-related stress. A literature study. Degree project in nursing 15 Credits. Malmö University: Faculty of Health and Society, Department of Care Science, 2020. Background; There is scientific evidence that conditions in the workplace have a significant effect on the development of stress symptoms that can lead to both mental and physical problems. According to the National board of health and welfare in Sweden a large part of long-term sick leave in Sweden is due to mental ill-health related to the work, which has been paid special attention in occupations that involve contact with and responsibility for other people. Working conditions play a major role in the possible development of stress-related symptoms. In order for the newly graduated nurse to get a good start in her professional life, it is crucial that the conditions are the best possible so that good and safe care can be practiced. Aim; The purpose is to elucidate the experiences associated to work-related stressors in the newly graduated nurse's work environment. Method; A literature study based on 10 scientific articles with qualitative design. The articles in the study are taken from two databases, one with a focus on nursing and the other with a focus on psychology. The articles were analyzed using the content analysis method. Result; Four main themes and three sub-themes were identified when analyzing the articles. The main themes were: overwhelming reality, the feeling of disorientation in the new professional role, the feeling of loneliness in the absence of mentoring and getting used to shift work. Conclusion; Newly graduated nurses are facing a challenging first time as a clinically active. The studies revealed several stress-related factors that may affect the individual individually both physically and mentally. Organization, work environment and social support plays a major role in the development of stress-related symptoms. Individuals may react differently to stress-related factors, commonly occurring symptoms that emerged in the studies were concentration and memory problems, sleep disorders, fatigue, impaired immune system, gastrointestinal problems and cardiovascular effects. By paying attention to and minimizing stress-related factors at the beginning of the professional life having a functioning social support, the challenging first time for the newly graduated nurse is facilitated. Keywords: Experience, newly graduated, nurse, stress, Stressors

Bakgrund: Efter avslutad sjuksköterskeutbildning kan en legitimation ansökas om från socialstyrelsen som garanterar tillräcklig kompetens och färdigheter för yrket. Sjuksköterskeutbildningen är i konstant behov av korrigering till följd av sjukvårdens kontinuerliga kunskapsutveckling samt stora krav på kvalité och effektivitet som samhället ställer. Gapet mellan verksamhetens krav och den förberedande kunskapen från utbildningen medför en stor omställning vid övergången. Syfte: Syftet är att beskriva hur nyutexaminerade sjuksköterskor upplever övergången från utbildning till yrkesverksam. Metod: Studien gjordes som en litteraturöversikt innehållande 18 artiklar med kvalitativa och kvantitativa data samt mixad metod. Artikelsökningar genomfördes i databaserna CINAHL och PubMed. Resultat: I resultatet framkom flertalet olika faktorer som påverkade nyutexaminerade sjuksköterskors upplevelser under övergångsperioden. Tre huvudtema uppdagades: utbildning, övergång och arbetsmiljö med respektive underteman. Huvudresultatet visade att gapet mellan utbildning och praxis, brist på handledarskap samt dålig arbetsmiljö var tre av de mest framträdande tillkortakommanden som bidrog till upplevelsen av övergångschock. Konklusion: Övergångsperioden är en komplex process med flertalet bakomliggande påverkbara faktorer. Det krävs en djupare förståelse från utbildningsansvariga, yrkesverksamheten och andra nyckelaktörer för att kunna skapa förutsättningar för en lyckad och tillfredsställande övergång till yrkesrollen för nyutexaminerade sjuksköterskor. / Background: Upon completion of nursing education, a certificate can be applied for from the National Board of Health and Welfare, which guarantees adequate competence and skills for the profession. Nursing education is in constant need of correction as a result of the continuous development of health care and the high demands on quality and efficiency that society places. The gap between the operational requirements and the preparatory knowledge from the education entails a major change in the transition. Aim: The purpose was to describe how newly graduated nurses experience the transition from education to vocational practice. Method: The study was conducted as a literature review containing 18 articles with qualitative and quantitative data and mixed method. Article searches were performed in the databases CINAHL and PubMed. Results: In the result, a number of different factors emerged that affected newly graduated nurses' experiences during the transition period. Three main themes were discovered: education, transition and working environment with respective sub-themes. The main result showed that the gap between education and practice, lack of preceptorship and poor working environment were three of the most prominent shortcomings that contributed to the experience of transition shock. Conclusion: The transition period is a complex process with a number of underlying influences. A deeper understanding is required of education officers, the profession and other key players in order to create the conditions for a successful and satisfactory transition to the professional role of newly graduated nurses.

In the year of 2035, it is expected that Sweden will have a surplus of 10 000 people educatedwithin human resources and behavioral sciences as a result of an increase in popularity for nonvocationaleducations. As a result, many graduates will not have the opportunity to work intheir area of competence. Studies show that contacts often are crucial for newly graduatedstudents to find work. The aims of this study are to find an understanding of how newlygraduated sociology students experience the importance of contacts; which parts of the socialnetwork that are used; and how they use their social network to establish themselves in the labormarket. Differences in how males and females use their social network are also examined.Previous findings show that social network and social capital are critical components of anindividual’s job search in a saturated labor market. Using qualitative semi-structured interviewsand analysis with theories about social network, social capital, and gender, this study finds thata majority of the respondent’s social network comes from previous workplaces and contactsfrom the university. This study shows that social network is important for gaining access to andestablishing oneself in the labor market; that social capital differs during the respondent career;and that women and men use their social network in gender differentiated ways.

PhD (Health Sciences) / Department of Advanced Nursing Science / Introduction: For newly graduated midwives to function effectively with regard to provision of quality midwifery services, successful transition from student status to professional status should be enhanced. It is therefore important that transition support programmes be put in place in order to provide a baseline for guidance and support of newly graduated midwives. Purpose: The purpose of this study was to develop a transition support programme to enhance effective support of newly graduated midwives during their transition period in Limpopo Province, South Africa. Setting: The study was conducted in maternity units of selected regional hospitals and a tertiary hospital in all the districts of Limpopo Province, South Africa. Methods: Phase 1: A qualitative, exploratory and descriptive design was used for the study. The population comprised of all newly graduated midwives who have undergone a comprehensive nursing programme (R425 of 19 February 1985, as amended) and qualified as nurses (General, Psychiatric and Community) and Midwifery from the universities and nursing colleges; as well as all professional nurses working at selected hospitals. A non-probability, purposive sampling method was used to select five newly graduated midwives who have been working for a period less or equals to one year following their successful completion of training, and were working in maternity units of the selected hospitals. Five professional nurses qualified as midwives and have been working in maternity units of the selected hospitals for at least five years, were also sampled through a non-probability, purposive sampling method. Data were collected through in-depth individual face-to-face interviews; a ABSTRACT vii voice recorder was used to capture information shared by participants, and field notes were also taken. An open-coding method was used to analyze data. Ethical principles and measures to ensure trustworthiness were considered. Major themes, themes and sub-themes were identified from the analyzed data. The following major themes emerged from data analysis: Experiences of being a newly graduated midwife in labour ward, Support provided by experienced midwives, Relationship between experienced and newly graduated midwives in labour ward, Expectations of experienced midwives from newly graduated midwives as well as Newly graduated midwives’ views related to placement in the labour ward. Empirical findings revealed that newly graduated midwives viewed labour ward as a traumatic environment as it is very busy with serious shortage of staff. Graduates also expressed a professional nurse’s role as stressful as it demands high level of responsibility and accountability which they did not have, resulting in frustration and anger. Newly graduated midwives felt that the support they received from the experienced midwives was ineffective, as they were neither mentored nor properly supervised and the environment was not conducive for learning. The relationship between graduates and experienced midwives was poor and some experienced midwives displayed negative attitudes towards the graduates. Results showed that graduates failed to meet experienced midwives’ expectations as they were unable to function independently, resulting in failure to reduce the workload. Newly graduated midwives recommended that their placement in maternity ward be extended from a period of six months to a year in order for them to build confidence in midwifery practice. Phase 2: Results of phase 1 of the study revealed transition support gaps which led the researcher to analyze ‘effective transition support’ as a core concept. Concept analysis was done in accordance with Walker and Avant’s method; in order to clarify its meaning. The findings of both phase 1 and concept analysis guided the ABSTRACT viii development of a transition support programme aimed to enhance effective support of newly graduated midwives during their transition period. Development of a transition support programme was based on Duchscher’s transition theory as well as ADDIE’s model for training and instructional design, the steps of which were: analysis, design, development, implementation and evaluation. A developed transition support programme was validated using a quantitative approach, whereby exploratory and descriptive designs were employed. The main aim was to validate for effectiveness and applicability of a developed transition support programme. Validation was conducted in a similar setting as in phase 1, with the same population. Puposive sampling method was used to select participants who met inclusion criteria. A sample consisted of twelve (12) newly graduated midwives, thirty eight (38) experienced midwives of which thirteen (13) were operational managers. A self developed questionnaire was used for data collection. The validation process was based on a framework for programme evaluation in public health by the Centers for Disease Control and Prevention. According to the validation results, the developed transition support programme met the standard as it can be easily implemented, it is practical, utilizable, appropriate and will benefit patients, family members, health care facilities and the community at large. Recommendations: The developed transition support programme addressed the major challenges identified in the findings of the main study. Only aspects of the results which were not addressed by the developed transition support programme were covered in the recommendations. Recommendations were directed to the nursing education, nursing practice as well as future research. / NRF

Bakgrund: Sjuksköterskeyrket anses vara viktigt, där erfarenhet utvecklas över tid. Det finns flera förväntningar på sjuksköterskan från patienter, kollegor, anhöriga och den framtida sjuksköterskan. Arbetssituationen kan vara utmanande, med förändrade och varierande arbetsuppgifter. Syfte: Syftet var att beskriva nyutexaminerade sjuksköterskors erfarenheter av att arbeta som sjuksköterska under sitt första verksamma år och anpassningen som sker under övergången mot självständighet. Metod: En beskrivande litteraturstudie med ett resultat som baserades på 12 vetenskapliga artiklar som erhållits genom databassökning via PubMed och Cinahl. Litteraturstudien analyserade och tematiserade resultatets vetenskapliga artiklar. Huvudresultat: Nyutexaminerade sjuksköterskor upplevde svårigheter att komma in i arbetsgruppen, samtidigt kämpade de för att hinna utföra tilldelade arbetsuppgifter. Svårigheter kunde uppstå gällande att leva upp till krav och förväntningar från kollegor respektive arbetsgivare. Relationen till de nya kollegorna kunde påverka övergångsprocessen för nyutexaminerade sjuksköterskor, där konflikter och ovänligt bemötande från kollegor påverkade övergångsprocessen negativt. Stöttande kollegor och god handledning kunde emellertid främja övergångsprocessen. Slutsats: Svårigheter i form av osäkerhet, krav och förväntningar framgick i litteraturstudiens resultat. Gemensamt för bearbetade studier i denna litteraturstudie är behovet av stöd och handledning hos de nyutexaminerade sjuksköterskorna, då detta kunde underlätta övergångsprocessen. Många nyutexaminerade sjuksköterskor upplevde svårigheter gällande anpassningen och övergångsprocessen till sin nya roll mot självständighet. Fungerande relationer på arbetsplatsen, tydliga arbetsuppgifter och riktlinjer samt en trygg handledning kunde underlätta övergångsprocessen. / Background: The nursing profession is considered important, where experience develops over time. There are several expectations of a nurse from patients, colleagues, relatives, and the nurses in training. The work situation can be challenging with changing and varying tasks. Aim: To describe the newly graduated nurses´ experiences of working as a nurse during their first year in clinical work and the adaptation that takes place during the transition to independence. Method: A descriptive literature study which include 12 scientific articles in the result. The articles were found through the databases PubMed and Cinahl. The literature study analyzed and thematized the articles of the result. Main result: Newly graduated nurses experienced difficulties in participating with the working group, at the same time they struggled keeping up with assigned tasks. Difficulties could arise in terms of living up to the demands and expectations of colleagues and employers, respectively. The relationship with the new colleagues could affect the transition process for newly graduated nurses, where conflicts and unfriendly treatment from colleagues had a negative effect on the transition process. However, supportive colleagues and good guidance could promote the transition process. Conclusion: Difficulties in form of insecurity, demands and expectations were evident in the results of this literature study. A common subject in the processed studies in this literature study was the need for support and guidance for the newly graduated nurses, as this could facilitate the transition process. Many newly graduated nurses experienced difficulties regarding the adaptation and transition process towards independence in their new role. Functioning relationships in the workplace, completing tasks and following guidelines but also safe supervision could facilitate the transition process.

Bakgrund: Anestesisjuksköterska är ett avancerat yrke som ställer höga krav på kompetens och självständighet. Forskning visar att nyexaminerade anestesisjuksköterskor upplever stress och otrygghet i sin nya profession. Syfte: Studiens syfte var att beskriva hur nyexaminerade anestesisjuksköterskor upplever sin första tid på en operationsavdelning. Metod: Deskriptiv design med kvalitativ ansats. Totalt tio anestesisjuksköterskor, från två medelstora och ett litet sjukhus i Mellansverige, inkluderades i studien. Studien har använt ett ändamålsenligt urval. Genom semi-strukturerade intervjuer med utgångspunkt från samlades data in. Data har analyserats med hjälp av en kvalitativ innehållsanalys. Huvudresultat: Ur anestesisjuksköterskornas beskrivningar framkom fyra huvudkategorier; den nya professionen, personlig utveckling, erfarenhet och organisatoriska faktorer och totalt tio subkategorier; att vara ny anestesisjuksköterska, att uppleva ansvar, att ha prestationskrav, känna tilltro till egen förmåga, att känna arbetsglädje, att utvecklas, brist på erfarenhet, erfarenhet skapar trygghet, brist på stöd från organisationen samt stöd från organisationen. Studien visar att anestesisjuksköterskorna upplevde sin första tid på en operationsavdelning som påfrestande men även som intressant och utvecklande. Nya arbetsuppgifter och stort ansvar upplevdes som betungande i början. Bristen på erfarenhet var stundtals påfrestande men stöd från kollegier bidrog till att majoriteten av anestesisjuksköterskorna upplevde trygghet. Då bristande stöd ökade deras upplevelse av otrygghet och ensamhet, framkom en önskan om mentorskap och mer handledning under anestesisjuksköterskornas första tid. Slutsats: Föreliggande studie beskriver nyexaminerade anestesisjuksköterskors upplevelse och resultatet visar att stress och en känsla av ensamhet präglade den första tiden. Bristande erfarenhet kunde vara påfrestande men med stöd från kollegier upplevde de en ökad trygghet. Resultatet visar att det fanns en önskan om mer stöd i form av mentorskap och handledning under anestesisjuksköterskornas första tid. Överlag ger studien en ökad förståelse för hur nyexaminerade anestesisjuksköterskor upplever sin första tid. / Background: To be a Nurse Anesthetist is advanced and involves high demands for competence and independence. Research has shown that newly graduated nurse anesthetists experience stress and insecurity in their new profession. Aim: The study was aimed to describe how newly graduated nurse anesthetists experience their first time at a surgical ward. Method: Descriptive design with qualitative approach. A total of ten nurse anesthetists from two middle-sized and one small hospital in Sweden were included in the study. Purposive sampling has been used. The data were collected by semi-structured interviews with help from an interview guide. The data have been analyzed with a qualitative content analysis. Findings: The nurse anesthetist’s descriptions in the interviews were sorted in to four main categories and ten subcategories. The main categories were; The new profession, Personal development, Experience, and Organizational elements. The subcategories were: Newly graduated nurse anesthetist’s, To have responsibility, Performance anxiety, Belief in own ability, Job satisfaction, To progress, Lack of experience, Experience creates security, Lack of support from the organization and Support from the organization. The nurse anesthetists describe their first period at the surgical ward as demanding but also interesting and stimulating. New assignments and the large responsibility were described as burdensome at first. The lack of experience was at times hard to deal with but the support from the organization increased their feelings of security. In the study, nurse anesthetists’ wanted more support in the form of mentorship and coaching, as lack of support increased their feelings of insecurity and loneliness. Conclusion: The study describes how newly graduated nurse anesthetists’ experience feelings of stress and loneliness during their first period in a surgical ward. Lack of experience was demanding at first but with support from colleagues their feelings of security increased. The results show that newly graduated nurse anesthetists’ wanted more support in the form of mentorship and coaching. The study provides a deeper understanding of how newly graduated nurse anesthetists’ experience their first period in a surgical ward.

Bakgrund: Det råder global brist på sjuksköterskor. Utbildningen i Sverige är på 180 högskolepoäng fördelat på tre år och efter avlagd examen har sjuksköterskan både en legitimation utfärdad av Socialstyrelsen samt en akademisk kandidatexamen i omvårdnad. Transitionsprocessen kan ses som en lärandeprocess, en övergång som sker under första året efter examen. Syfte: Syftet var att belysa nyexaminerade sjuksköterskors upplevelser av transition från student till yrkesverksam sjuksköterska under första året i yrket. Metod: Litteraturöversikten är av kvalitativ design med en deduktiv ansats. Referensramen som används är transitionsteori i tre steg ”göra”, ”vara” och ”veta”. Resultatet av de 11 artiklar som ingår analyserades med en analysstuktur i fem steg. Resultat: Analysen resulterade i tre kategorier: upplevelser av egen osäkerhet, teamsamverkan påverkar inklusive en ökad trygghet. Egen osäkerhet kan påverkas genom gemenskap i teamet och övergå till ökad trygghet mot slutet av första året, om transitionen varit lyckad. Slutsats: Nyexaminerade sjuksköterskor upplever krav och förväntningar på att komma in i klinisk kontext. Det är av vikt att högskolor samt verksamheterna har kunskap om transitionsprocessen. / Background: There is a global shortage of nurses. The education in Sweden is 180 higher education credits spread over three years and after graduation, the nurse has both a certificate issued by the National Board of Health and Welfare and a academic bachelor’s degree in nursing. The transition process can be seen as a learning process, a transition that takes place during the first year after graduation. Purpose: The aim was to highlight newly graduated nurses` experiences of transition from student to professional nurse during the first year of the profession. Method: The literature review is of qualitative design with a deductive approach. The frame of reference used is transition theory in three steps “doing”, “being” and “knowing”. The results of the 11 articles included were analysed whit an analysis structure in five steps. Results: The analysis resulted in three categories; experiences of own insecurity, team collaboration affects, including increased security. Own uncertainty can be affected through community in the team and transition to increased security towards the end of the first year if the transition has been successful. Conclusion: Newly graduated nurses experience demands and expectations of entering a clinical context. It is important that universities and the companies have knowledge of the transition process.

Bakgrund: Etisk stress är ett framtädande fenomen inom sjukvården och hos sjuksköterskor. Upprepad etisk stress leder till upplevelsen av etisk utmattning, då apati kan tillträda. Det leder även till att sjuksköterskor säger upp sig, byter arbetsplats eller byter yrke. Olika former av stress i kombination med den etiska stressen ställer nya sjuksköterskor inför svåra utmaningar under det första året som yrkesverksam. Syfte: Syftet med litteraturöversikten var att belysa upplevelsen av etisk stress på arbetsplatsen hos kliniskt verksamma nya sjuksköterskor. Metod: Metoden som användes var en litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Likheter, skillnader och mönster i artiklarna har jämförts samt sammanställts och presenteras i resultatdelen. Artiklar av både kvantitativ och kvalitativ ansats har använts. Resultat: Nya sjuksköterskor är under det första året extra sårbara och är i stor grad utsatta för etisk stress. De nya sjuksköterskorna anser att etiska principer bör hållas och har många tankar kring etik och moral. Trots det vågar de inte säga emot närstående till patienter och äldre kollegor i situationer de anser att den nya sjuksköterskan ska utföra vårdinsatser som går emot dennes etiska principer. Konsekvensen blir psykisk påverkan, missnöje och minskad patientsäkerhet. Slutsats: Etisk stress är extra påtagligt hos nya sjuksköterskor, som måste på ett professionellt sätt bemöta dilemman samtidigt som de försöker finna sig i sin nya yrkesroll. För att undvika de negativa konsekvenserna till följd av etisk utmattning hos sjuksköterskor är det av vikt att på organisationsnivå implementera rutiner kring bemötande och hantering av etisk stress. / Background: Ethical stress is a prominent phenomenon in all healthcare situations. As a result of repetitive instances of unresolved ethical stress, ethical burnout is experienced in nurses. Ethical burnout can cause nurses to quit their jobs or professions entirely. Already high stress levels leave new nurses especially vulnerable to ethical stress and burnout. Aim: The aim of this literature review was to shine light on new nurses experience of ethical stress in their workplace. Method: The methodology used was that of a literature review. Similarities and differences of the articles that were used have been compiled and presented in results. Both qualitative and quantitative articles have been chosen. Results: New nurses are especially vulnerable and exposed to ethical stress during their first year. Though new nurses have the will to provide ethically aligned patient care, circumstances such as pressure to please and fit in with more experienced co-workers can result in the new nurse acting in ways which are perceived as ethically incorrect. Consequentially, the quality of patient care and job satisfaction declines, which is shown to have negative psychological impacts in new nurses. Conclusion: Ethical stress is a blatant problem for new nurses, who have to deal with ethical dilemmas as a healthcare professional as they are still adjusting to their new role. To avoid the negative consequences of ethical stress, it is of importance to implement routines and strategies in order for new nurses to adequately manage ethical dilemmas in their workplace.