The goal of nursing is to promote health and alleviate suffering. Using Appreciative Inquiry, this study explored the possibilities for the nursing profession to reduce the health implications of poverty. Select Saskatchewan registered nurses (RNs) engaged in appreciative interviews that identified positive experiences working with low income clients. The participants were activists challenging the status quo through their practice. Analysis illuminated the best practices of these RNs, constructing a vision for change rooted in their understanding clients realities and communicating those realities through advocacy. By bringing their personal passions to client interactions, and connecting with a broader social justice context, RNs create an opportunity to respond to the effects of income inequities on health.

SAMMANFATTNING BAKGRUND: I och med Ädelreformen flyttades vården av äldre till kommunen och sjuksköterskor började arbeta inom den kommunala äldreomsorgen. Arbetet saknar tydliga riktlinjer och rutiner. Det innebär ett stort ansvar för sina arbetsuppgifter samt patientansvar. Vid konsultarbete ansvarar sjuksköterskan för ett stort antal människor och förmåga att prioritera och snabbt göra bedömningar av arbetsuppgifter och sjukdomstillstånd krävs. SYFTE: Syftet med studien var att utifrån sjuksköterskors berättelser beskriva deras upplevelser av sitt arbete inom den kommunala äldreomsorgen. METOD: Det är en deskriptiv studie. Information samlades in genom semi-strukturerade fokusgruppsintervjuer. Totalt tio sjuksköterskor deltog uppdelade på intervjugrupper. Det insamlade materialet bearbetades sedan genom tematisk kvalitativ innehållsanalys. RESULTAT: Resultatet visar att sjuksköterskorna upplever ett stort ansvar för sina bedömningar och arbetsuppgifter. De upplever att de inte har några tydliga riktlinjer för sin specifika funktion i kommunen vilket innebär att de ofta får ansvar för uppgifter som inte är deras. Det ökade administrativa arbetet leder till minskad tid för patienter och omvårdnadsarbete vilket leder till frustration och en känsla av otillräcklighet. SLUTSATS: Sjuksköterskans funktion i kommunen behöver preciseras så att hon kan minska sina administrativa uppgifter och få mer tid till patienter och omvårdnadsarbete. Även teamarbetet behöver utvecklas för att stärka yrkeskategorierna och göra riktlinjerna tydligare. Nyckelord: registered nurse, eldercare, residential homes, professional role, focus group

Syftet var att beskriva arbetstillfredsställelsen hos intensivvårdssjuksköterskor samt undersöka om arbetssituationen förändrats senaste året. Syftet var vidare att se om skillnader förelåg i arbetstillfredsställelsen mellan intensivvårdssjuksköterskor som arbetade treskift och som inte arbetade treskift. Studien var deskriptiv med kvantitativ ansats. Sextiofyra sjuksköterskor deltog och bortfallet var 29 %. Enkäter testade gällande validitet och reliabilitet för arbetstillfredsställelse användes i studien. Arbetstillfredsställelsen var genomgående hög, intensivvårdssjuksköterskorna upplevde sig mötas med respekt av överordnade och samarbetsklimatet var bra. De var en del av ett team, arbetet var intressant och autonomin var hög. Majoriteten upplevde att personaltätheten var otillräcklig för arbetsbelastningen, beslut från överordnade gick inte att påverka och nästan en tredjedel upplevde sig inte få beröm vid bra utfört arbete. Trots genomgående hög arbetstillfredsställelse funderade nästan tjugo procent på att byta jobb. Senaste året hade arbetsbördan ökat med mer administrativt arbete och mindre tid för patientvård. Förtroendet för den offentliga sjukvården hade minskat. Inga signifikanta skillnader fanns gällande arbetstillfredsställelsen mellan intensivvårdssjuksköterskor som arbetade treskift och som inte arbetade treskift. Nattarbetet ansågs behöva värderas högre med mer tid för återhämtning. Konklusion: Arbetstillfredsställelsen var genomgående hög men arbetsbördan hade ökat senaste året, utbrett missnöje förekom gällande återhämtningstiden vid nattarbete. / The objectives were to describe the work satisfaction amongst intensive care nurses, and to investigate if the work situation has changed over the last year. A further purpose was to see if there were any differences in the work satisfaction between intensive care nurses who worked three-shift and those who did not. The study was descriptive with a quantitative approach. Sixty-four nurses participated and the 29 percent decided not to participate. Questionnaires tested regarding validity and reliability for work satisfaction were used in the study. Work satisfaction was overall high; the intensive care nurses perceived themselves as being respected by superiors, and the work situation as good. They felt part of a team; the work was interesting and the levels of autonomy high. The majority perceived that the staffing levels were insufficient for the workload, they could not affect the decisions made by their superiors, and almost a third experienced that they do not get praise for work well done. Despite the overall high work satisfaction almost twenty percent were thinking of changing jobs. During the last year, the workload had increased with more administrative work leaving less time for patient care. The trust in public healthcare had decreased. No significant differences were found regarding the work satisfaction between intensive care nurses working three-shift and those who did not work three-shift. The general opinion was that night work needed to be valued higher, and that more time was needed for recovery. Conclusion: The work satisfaction was overall high, but the workload had increased over the last year, and there was a widespread dissatisfaction regarding recovery time after night work.

The goal of nursing is to promote health and alleviate suffering. Using Appreciative Inquiry, this study explored the possibilities for the nursing profession to reduce the health implications of poverty. Select Saskatchewan registered nurses (RNs) engaged in appreciative interviews that identified positive experiences working with low income clients. The participants were activists challenging the status quo through their practice. Analysis illuminated the best practices of these RNs, constructing a vision for change rooted in their understanding clients realities and communicating those realities through advocacy. By bringing their personal passions to client interactions, and connecting with a broader social justice context, RNs create an opportunity to respond to the effects of income inequities on health.

Methicillin Resistant Staphylococcus aureus (MRSA) is the most commonly isolated multi-drug resistant organism in the hospital setting. MRSA can result in death among people who have no identified risk factors for infection. One-third of MRSA infections are cross-transmitted as Healthcare-Associated Infections (HAIs). It is well known that the single most effective means for decreasing the risk of HAIs is hand hygiene (HH), yet poor performance among registered nurses persists. The theoretical framework used to guide the study was the Health Belief Model (HBM). The purposes of the study were to: explore the RNs’ self-reported HH performance rate; explore the RNs’ knowledge related to MRSA; identify relationships between MRSA knowledge and HBM constructs; explore the RNs’ barriers to HH performance; identify relationships between barriers and self-reported HH performance; explore relationships among HH behaviors and constructs in the HBM; explore predictors of ‘overall HH’ performance; and identify if certain demographic characteristics are related to MRSA knowledge, self-reported HH, and HBM constructs. A cross sectional descriptive study was conducted with a sample of RNs who were randomly selected. The questionnaire mailing, which included the survey, consent, and the return-stamped envelope were distributed to 684 RNs. Completed surveys (n=120) from RNs who met the sample inclusion criteria were returned within four weeks. Self-reported HH were highest during times of increased perceived susceptibility for infection. In addition, nurses were more likely to overcome barriers to HH during ‘moments’ associated with the highest perceived susceptibility. Although MRSA knowledge did not correlate with ‘overall HH’ performance, there was a significant relationship identified with self-efficacy (r=.27, p<.01), which may influence HH behaviors. The most commonly identified barriers to HH performance were system factors (e.g. ‘a high workload’). Self-efficacy and barriers represented 26% of the variability in the regression model when applying significant correlations among HBM constructs and ‘overall HH.’ The phenomenon of the RN’s HH decision making is not completely understood. More research is needed to explain predictors for HH among registered nurses. This understanding will allow researchers to plan interventions aimed at increasing knowledge and understanding about perceived susceptibility, which may in turn improve self-efficacy behaviors for HH, which could decrease HAI rates. / text

Although older Canadians constitute a large portion of patients in hospital, many receive less-than-optimal drug care. Most registered nurses (RNs) and other health care professionals who provide older adults (OAs) with drug therapy lack pre-professional education about that practice. Concurrently, there is little research available about how RNs learn about drug therapy for OAs. Using a qualitative method, this thesis explores hospital RNs’ insights about their knowledge about drug therapy for OAs, their associated learning needs and strategies, and contextual influences on their learning. The findings illuminated RNs’ extensive knowledge, their learning needs and varied learning strategies, and constraints and facilitators of their learning. Drug therapy for OAs is a complex activity. RNs play a pivotal role in that care and have ample knowledge. RNs’ learning is holistic, ongoing, mostly informal, and reflective of many adult-learning theories. By learning, RNs build and transform their repertoires of knowledge to stay current with the quickly changing landscapes of health care, gerontological know-how, and drugs and drug practices. As a result, sometimes RNs protect not only OAs but also other hospital stakeholders from the negative effects of uninformed practice. Nurse educators should teach students about drug therapy for OAs and broaden their own views about RNs’ knowledge and learning strategies for that care. Nurse leaders should maximize chances for RNs to learn and prepare them to influence other stakeholders in ways that support learning. Hospital administrators and other stakeholders should recognize RNs’ pivotal role in drug care and support their learning through organizational changes. Communities should design strategies that ease RNs’ learning. Policymakers should replace corporatism with innovations that champion learning. Researchers and RNs should collaborate on novel projects that bolster RNs’ learning.

Although older Canadians constitute a large portion of patients in hospital, many receive less-than-optimal drug care. Most registered nurses (RNs) and other health care professionals who provide older adults (OAs) with drug therapy lack pre-professional education about that practice. Concurrently, there is little research available about how RNs learn about drug therapy for OAs. Using a qualitative method, this thesis explores hospital RNs’ insights about their knowledge about drug therapy for OAs, their associated learning needs and strategies, and contextual influences on their learning. The findings illuminated RNs’ extensive knowledge, their learning needs and varied learning strategies, and constraints and facilitators of their learning. Drug therapy for OAs is a complex activity. RNs play a pivotal role in that care and have ample knowledge. RNs’ learning is holistic, ongoing, mostly informal, and reflective of many adult-learning theories. By learning, RNs build and transform their repertoires of knowledge to stay current with the quickly changing landscapes of health care, gerontological know-how, and drugs and drug practices. As a result, sometimes RNs protect not only OAs but also other hospital stakeholders from the negative effects of uninformed practice. Nurse educators should teach students about drug therapy for OAs and broaden their own views about RNs’ knowledge and learning strategies for that care. Nurse leaders should maximize chances for RNs to learn and prepare them to influence other stakeholders in ways that support learning. Hospital administrators and other stakeholders should recognize RNs’ pivotal role in drug care and support their learning through organizational changes. Communities should design strategies that ease RNs’ learning. Policymakers should replace corporatism with innovations that champion learning. Researchers and RNs should collaborate on novel projects that bolster RNs’ learning.

Background: In pace with the increasingly aging population will the number of older people in nursing homes and with care in home grow. This means that the nurse will face related to the older more frequently and more widely. Nurses has overall responsibility over both the care of the elderly as a responsibility of maintaining good relationships with related parties. Related parties are of great importance for the older individual, it is therefore relevant for the nurse to be able to interact in a respectful and sensitive manner to involve the relatives in care. Aim: The aim with this study was to highlight nurse's experiences of interaction with related parties to elderly in community health care. Method: A literature review based on nine qualitative articles was conducted. Friberg design was used with the inspiration of Lundman and Hällgren Graneheim regarding the analysis of Articles. Results: The study resulted in four themes. They included information about nurse's experiences of interaction with related parties. These themes describes the importance of communication in the interaction, the attitudes various expressions, cooperation with related parties and experiences with related parties' participation in care. Conclusion: An important conclusion is that the nurse should take advantage of related parties skills and resources in health care around the elderly. The nurses sometimes has difficulties interacting with related parties. Nurses probably need to see the difficulties from different perspectives and seek help of colleagues.

Family day care providers operate at the interface of the private and the public. They are self-employed and work at home, yet their 'suitability' to provide childcare is scrutinised by officials and rules and regulations operating on different levels which can restrict their business opportunities. Family day care takes place in a particular cultural context concerning ideas of childrearing and against the backdrop of other childcare and educational provision. The focus of the thesis is the family day care provider, one of the members in the childcare triangle of child, parents and childcare worker. Previous research was mainly interested in the quality of childcare provided and parents' satisfaction. Here working conditions, such as hours worked, workload, income are examined, as are career prospects. Who are the women who become family day care providers and how do they see their future? The daily routines of family day care providers are examined and possible detenninants investigated. However, perceived needs of children may differ from demands arising out of parents' reason for using this kind of childcare service. Family day care providers accounts are examined in order to identify the various aspects of childcare arrangements and how to develop relationships that promote successful arrangements. Since family day care takes place in the home other family members are part of the setting and are affected by their mother's or wife's work. At the same time their contribution to the work of a family day care provider has to be included in the investigation ofthe working conditions. The comparison of family day care providers living in two different locations, four local authorities in the Northeast of England and one town in the Northeast of Germany allows the influence of family and childcare policies and the impact of cultural perceptions of good childrearing practices to be traced. A combination of quantitative and qualitative methods was employed. Apart from new insights into the actual working conditions of family day care providers, a better understanding of the intended and unintended effects of policies regulating family day care has been gained. The findings contribute to the debate on paid and unpaid work, and paid and unpaid care, as well as to the debate over equal opportunities, showing a more complicated relationship than just a gendered division.

Background: Human immunodeficiency virus (HIV) is a global problem and the total number of people living with HIV is approximately 34 million. Little is known about registered nurses’ experiences of caring for children with HIV/AIDS in South Africa.   Aim: The aim of the study was to describe registered nurses’ experiences of caring for children with HIV/AIDS in South Africa. Method: A qualitative research approach was used. Data was collected by interviews which were analyzed using content analysis. The interviews were conducted at a private hospital in Cape Town, South Africa. Results: The following ten topics were found; self-fulfillment, being supportive, being hopeful, being adaptable, being non-judgmental, helplessness, loneliness, sadness, stress and frustration. Conclusion: There is a constant balance between feelings of powerlessness and the ability of being mentally strong when caring for children with HIV/AIDS.   Keywords: HIV/AIDS, children, registered nurses’ experiences, South Africa