Magister Curationis - MCur / The nursing profession is the backbone of the healthcare system glob-ally. However, due to the ongoing shortage of nurses there is a growing demand for nurses across the world. This demand puts pressure on the continued recruitment of new nursing students. The factors that influence students’ reasons for entering nursing vary and require investigation to improve recruitment practices.

This study was the first to examine the impact of immigrant-focused public policy on the educational outcomes of Latinx students in professional nursing. Between 2001-2020, 34 states adopted policies that either provided or prohibited in-state resident tuition (ISRT) and/or state financial aid (SFA) to undocumented students. Deferred Action for Childhood Arrivals Act (DACA) passed in 2012 gave a new group of largely Latinx, college-age immigrants unprecedented access to public higher education and employment. A rapid increase in the proportion of nursing degrees earned by all Latinx students, not just those who were undocumented, occurred concurrently with these federal and state-level policy changes. This study utilized fixed-effects panel analysis to estimate the relationship between DACA, ISRT, and SFA policies for undocumented students on the percent of nursing degrees earned by Latinx students between 2005-2020. None of the policies analyzed in this study were significant predictors of Latinx nursing degree completions. Broad cohesion among all models instead pointed toward the importance of gains in overall degree production among all Latinx college students, underscoring the important role of higher education in the creation of environments that support the success of students from this target population.

Bakgrund: Under större delen av 1900-talet präglades sjuksköterskeutbildningen av medicinsk vetenskap och en naturvetenskaplig syn på människan var påtaglig. I och med Vård -77-reformen blev omvårdnadsvetenskap karaktärsämne och en holistisk syn på människan införlivades i utbildningen. Sjuksköterskeutbildningens utformning och övergripande innehåll styrs av Högskoleförordningen och sjuksköterskans kunskaper inom yrket styrs av Socialstyrelsens kompetensbeskrivning för legitimerade sjuksköterskor. Kritik har riktats mot dagens utbildning och forskning har påvisat att nyutexaminerade sjuksköterskor tenderar att brista i många praktiska moment. Syfte: Studiens syfte var att belysa erfarna sjuksköterskors uppfattning om nyutexaminerade sjuksköterskor. Metod: Empirisk intervjustudie med deskriptiv kvalitativ ansats. Resultat: Under intervjuerna framkom att nyutexaminerade sjuksköterskor är inspirerade av ny kunskap och kan se på gamla rutiner med nya ögon. Stress och högt arbetstempo påverkar arbetsutförandet negativt. De uppfattades inneha gedigen teoretisk kunskap, dock påtalades svårigheter med att omsätta denna i praktiken. Nyutexaminerade beskrevs som noggranna och fokuserade men med svårigheter i att se helheten i arbetet. Vidare upplevdes de samarbeta väl i team men vara bristfälliga i den arbetsledande rollen. Slutsats: Nyutexaminerade sjuksköterskor är inte alltid redo för de krav som i verksamheten ställs. Främst beror detta på att de saknar erfarenhetsbaserad kunskap. Resultatet av studien tyder på att nuvarande utbildning inte är tillräckligt yrkesförberedande. Klinisk betydelse: Studiens resultat kan genom vidare forskning få betydelse för sjuksköterskeutbildningens framtida utformning. De områden som framförallt bör ses över är undervisning i praktiskt utförande samt i ledarskap. Dessa bör få större plats i utbildningen. / Background: For the major part of the 20th century, the nursing education was dominated by medical science and a scientific view on the human being was distinct. As a result of the Vård-77-reform, nursing science became the main subject of the education and a holistic view of the human being was established. The nursing education is guided by The Higher Education Act, and the competence and knowledge required of the nurse is guided by The National Board of Health and Welfare´s description of competence regarding registered nurses. The nursing education has been criticized and research has shown that newly registered nurses are insufficient in several practical elements. Aim: To examine experienced nurses’ perception of newly registered nurses. Method: An empirical interview-study with a qualitative descriptive approach. Results: Newly registered nurses are inspired by new knowledge and look at old routines with new eyes. Stress and a high workload affect them in a negative way. They were perceived to have a great deal of theoretical knowledge, but were said to have difficulties in applying those to practice. Newly registered nurses were perceived as accurate and focused but with difficulties seeing the work as a whole. They were said to work well in teams but don’t seem to have the ability of leading them. Conclusions: Newly registered nurses are not always well enough prepared for the demands which are required in clinical practice. This is primarily due to lack of experience based knowledge. The result of the study shows that the current education isn’t vocational. Clinical implication: The result of the study can, through further research, be of importance for the future nursing education. The areas that above all need to be investigated are the education in practical skills and leadership. Those subjects need to get more focus in the education.

The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after the loss of an infant in the neonatal intensive care unit (NICU) at Arkansas Children's Hospital (ACH). Due to the lack of educational preparation, the NICU nursing staff members had demonstrated inexperience, awkwardness, and insecurity in their provision of the end-of-life care activities and family support interventions. The purpose of this doctor of nursing practice project was to develop an evidence-based neonatal palliative care educational program to support the NICU nursing staff and families at ACH. The educational program is multimodal in approach to address the cognitive, affective, and psychomotor domains of adult learning through the use of palliative care informational modules, videos, and simulation training. The clinical outcome of this new palliative care educational program will promote a positive change in the NICU nursing staff's clinical practice during the provision of nursing care when faced with neonatal end-of-life situations at ACH. This capstone project on adult education should be read by professional frontline nursing staff who care for these fragile patients in the specialized intensive care world of neonatology.

Healthcare agencies and stakeholders expect registered nurses to be competent at all times. When nurses are not confident in competencies, negative patient outcomes can occur. The purpose of this quantitative quasiexperimental with posttest only study was to investigate Quality and Safety Education for Nurses (QSEN) competency confidence levels of 2 groups of new nurses who had 5-6 months of clinical experience. Framed by the Duchscher theory and the QSEN framework, the research question was developed to examine the differences between QSEN competency confidence levels of new nurses who participated in a prelicensure program plus a residency program and nurses who only attended the residency program. Sixty-eight new nurses from 1 health facility answered the Nursing Quality and Safety Self-Inventory (NQSSI). An independent t test was used to compare each knowledge, skills, and attitudes (KSA) QSEN competency confidence levels for two groups. The results of this study demonstrated a difference between QSEN competency confidence levels between the 2 groups, but not all 18 NQSSI items reached a statistically significant difference. The 7 items that reached a statistically significant difference included the QSEN competency confidence level in knowledge and skills in evidence-based practice, quality improvement, and informatics. A statistically significant difference was also noted in the QSEN competency confidence level for patient-centered care skills. A 3-day professional development (PD) workshop was developed based on the results. Participating in the PD workshop could further increase the new nurses' QSEN competency confidence levels which can enhance patient outcomes resulting in positive social change.

A projected deficit in the perioperative workforce of 32,000 perioperative nurses retiring by 2024, creates an inability to meet the nursing needs of the United States population. The need for experienced perioperative nurses has been increasing while the availability of nurses with perioperative education has been decreasing. The purpose of this phenomenological study was to explore the lived experience of post-licensure nurses who participated in a perioperative clinical rotation within their baccalaureate nursing program and did that experiential experience affect the recruitment and employment for perioperative nursing to halt the impending shortage. The integrations of Kolb’s experiential learning theory and Bandura’s theory of self-efficacy model was the framework that supported the study. Thirteen interviews were conducted using van Manen’s (1990) method for researching the lived experience. The two themes emerging from the data were value and attitude. Subthemes under value are gaining knowledge and skill set and a different type of nursing. Subthemes under attitude are (a) communication with the medical team and advocacy for families and patients. The experiential perioperative clinical rotation affected the study participants’ interest for working in the operating room (OR). Most had a highlighted interest in the specialty, and those participants’ not choosing the OR as their choice of employment expressed that the experience positively affected the type of nurse they are today. Experiential learning can build the fundamental knowledge necessary to understand the novice perioperative nurse’s role as a career choice.

Forty years after Kramer's (1974) seminal work, Reality Shock, new graduate nurses continue to have difficulty transitioning to the registered nurse (RN) role. The purpose of this phenomenological study explores the lived experience of new graduate nurses who completed a Veterans Affairs externship program in their senior year of nursing coursework and its perceived impact on their successful transition into the practice role 3-24 months following graduation. Benner's (1984) Novice-to-Expert Model, Karmer's (1974) Reality Shock Theory, and Selder's (1989) Life Transition Theory support a framework for this study. Twelve telephone interviews were conducted using van Manen's (1990) method for researching the lived experience. One overarching theme "feeling confident" and three main categories, "transitioning to the RN role," "making decisions," and "interacting with professionals," were identified from the data. Externship programs assist the student to comfortably and smoothly transition as a new graduate nurse by offering additional clinical and practice experiences. Given the complexity of today's health care environment, there is a growing need to better prepare the graduate nurse for their transition into nursing practice. Externship programs can serve this purpose.

Enrollment in registered nurse-bachelor of science in nursing (RN-BSN) degree completion programs have increased in the last several years. Due to this increase, many programs have begun to offer their RN-BSN programs completely online or in a hybrid format. Often times, students who choose to pursue their degree online come from various cultural and ethnic backgrounds and speak English as a second language (ESL). There is limited research about the experiences of these students in this unique learning environment. The purpose of this study was to explore the lived experience of RN-BSN ESL nursing students who are engaged in learning online and understanding their process of cultural integration. Vygotsky’s sociocultural theory served as the theoretical framework and underpinning for this study. Ten individual interviews were conducted incorporating van Manen’s (1990) methodological steps for exploring the lived experience. Through phenomenological reflection, five major themes emerged: (a) understanding the online classroom, (b) expressing culture online, (c) alone but not lonely, (d) writing as a surmountable barrier, and (e) faculty role in the online journey. RN-BSN ESL nursing students who choose to pursue their degree completion completely online or in the hybrid format do so mainly for convenience and flexibility. Exploring their lived experiences offered insight into their personal challenges and triumphs with online cultural integration, writing, and obtaining the support needed to be successful.

This thesis explores the user experience, potential and design principles of a HUD-based user interface in combination with interactive 360-degrees videos in nursing education. A HUD-based 360-degrees video was designed around a previously recorded scenario in an emergency room and user tests were conducted on nurse educators, working nurses and a nurse student.  Data from the user tests were gathered both through observations and interviews. The results show that participants' experience was overall positive and that the technology is seen as a realistic, interesting and valuable way to educate nursing students. Although no definitive design principles could be established for interactive 360-degrees videos, the result suggests that focusing on key design principles for multimedia learning may provide a better user experience. These principles include managing extraneous, essential and generative processing. / Detta examensarbete utforskar användarupplevelsen,potentialen och begränsningarna avett HUD-baserat användargränssnitt i kombination med interaktiva 360-graders videos inom sjuksköterskeutbildning. Detta gjordes genom att designa och utveckla en HUD-baserad 360-graders video och utföra användar tester på lärare inom sjuksköterskeutbildning, arbetande sjuksköterskor och en sjuksköterskestudent. Data från användartester samlades in genom observationer samt intervjuer. Resultatet visar att deltagarnas upplevelse överlag var positiv och tekniken ses som ett intressant och fördelaktigt sätt att undervisa sjuksköterskestudenter. Resultatet tyder också på att fokus på designprinciper inom multimedielärande kan bidra med en bättre användarupplevelse.

Philosophiae Doctor - PhD / This dissertation documents the attempt to address one of the major problems in nursing education i.e. the existing gap between the educational philosophy of nursing and nursing education practices, by means of an action research project during the period 1991-1996. The research in this dissertation is recorded in three phases. Phase One elaborates on the biographical and professional background of the researcher and the reasons why action research was selected for the purpose of this particular project Since action research provides opportunities for teachers to change and transform their own teaching practices, it was obviously the best choice for the research. The emphasis was on collaboration and participation and the researcher was morally bound to consider and observe all internal and external factors which influence and limit her own teaching practice, in order to initiate change and transformation in teaching. In order to define and contextualize the problem and to describe the situation in which this particular problem has been identified, the role of the statutory body, the South African Nursing Council which governs the profession and basic professional nursing education were explored. The problem is formulated as the existing gap between the educational philosophy on which existing nursing and nursing education practices are theoretically grounded and the way in which both nursing and nursing education practices appear in reality. Phase One also deals with the historical and philosophical foundations and development of nursing and nursing education. In an attempt to describe the researchers's teaching practice appropriately, as a social practice, it was essential to consider not only the professional and social boundaries of nursing education, but also the current situation regarding national education, the existing health system and all factors related to education and health. The dissertation then draws the attention to the essential features and historical context of a progressive and critical pedagogy, as a foundation for action research. In this regard it was especially the contributions of Dewey, Habermas, Freire, Giroux and McLaren, which guided the research to approach nursing education from a critical perspective. Phase Two deals with the research methodology. For this particular research project John Elliotts's Action Research Framework for Self-Evaluation in Schools was used. Within this framework of Elliott the dissertation then describes the research methodology of this particular project: Ideal and Reality in Nursing Education and Nursing Practices in South Africa: An Action Research Approach. The rationale and the development of the project is first described, whereafter action research is discussed as a process which enables nursing .practitioners and tutors to become empowered and to initiate change and establish transformation within their own practices. A major part of the dissertation is dedicated to the project in action with two groups of participants during two action research cycles. Finally Phase Three of this dissertation draws the attention to the conclusions based on the outcomes of the project. with the emphasis on the urgent need for change and transformation within the nursing profession in order to lessen the extensive gap between nursing theory and nursing practices. The existing gap between the philosophy on which nursing practices are based and how existing nursing practices appear in reality, seems to be the major cause of the prevailing discontent in the nursing profession.