When patients and families come to the emergency department seeking medical attention, they come in with many mixed emotions and thoughts. The fast paced, rapid turnover of patients and the chaotic atmosphere may leave patients who visit the emergency department with the perception that staff is uncaring. The purpose of this project was to implement a patient care delivery model, relationship-based care, in the emergency department. The model is comprised of several caring theories including Jean Watson's model of human care and Kristen Swanson's middle range theory of caring. The main goals of the project were to help staff enhance the patient and caregiver interaction, strengthen co-worker relationships, and gain appreciation of the importance of self-care. The intervention was an educational workshop about the relationship-based care model. Eight participants were consented, given a preassessment survey, educated about the model, and then given a postassessment survey. Prior to education, 83% of participants believed strongly that patients and families need to feel cared for during an emergency department visit; this increased to 100% posteducation. Perception about the importance of coworkers' relationships being trusting went from 38% to 50% and the importance of caring for one's self increased from 63% to 100%. It was recommended that the model be implemented in all emergency departments and all staff educated in its use as a way to promote social change through intentional focus on caring in every patient interaction.

Bakgrund: En graviditet ses hos många kvinnor som något positivt och för med sig mycket glädje, men en graviditet innebär också en risk för missfall. Omkring 20–30 procent av alla gravida kvinnor kan komma att drabbas. Ett missfall kan göra kvinnor extra sårbara och utsatta. Det är betydelsefullt att undersöka kvinnors upplevelser vid missfall för att få ökad förståelse och kunskap om hur missfall kan upplevas.  Syfte: Syftet var att beskriva kvinnors upplevelser vid missfall.  Metod: En litteraturöversikt har använts som metod för arbetet. Tio vetenskapliga originalartiklar med kvalitativ metod har analyserats utifrån Fribergs analysmodell. Litteraturöversikten utgick från kvinnor som haft missfall innan graviditetsvecka 22. Resultat: Resultatet innehåller tre huvudteman: Kvinnors emotionella smärta, Stöd från familj och vänner, Omvårdnad vid missfall samt två underteman: Missfall - ett stigma, och Känslig omvårdnad. Slutsats: Slutsatsen i denna litteraturöversikt var att kvinnor upplever en emotionell smärta med känslor av sorg, tomhet och hjälplöshet, och ett stöd från familj, vänner och andra kvinnor som genomgått missfall är viktigt för att de ska kunna bearbeta sitt missfall. Kvinnor beskrev att omvårdnaden var avgörande i hur de upplevde sitt missfall, och en känslig omvårdnad där vårdpersonalen visar empati och förståelse för kvinnan är väsentligt för hennes välmående vid ett missfall. / Background: A pregnancy is seen by many women as something positive and brings a lot of joy, but a pregnancy also entails a risk of miscarriage. Around 20-30 percent of all pregnant women may be affected. A miscarriage can make women extra vulnerable and exposed. It is important to investigate women's experiences of miscarriage in order to gain increased understanding and knowledge of how miscarriage can be experienced.  Aim: The aim was to describe women’s experiences of miscarriage. Method: A literature review has been used as a method for this work. Ten original scientific articles using a qualitative method have been analyzed based on Friberg’s model of analysis. The literature study was based on women who had miscarried before 22 weeks of pregnancy.  Results: The result contains three main themes: Women's emotional pain, Support from family and friends, Nursing care in case of miscarriage, and two sub-themes: Miscarriage - a stigma, and Sensitive care.  Summary: The conclusion of this literature review was that women experience an emotional pain with feelings of sadness, emptiness and helplessness, and support from family, friends and other women who have experienced a miscarriage is important for them to be able to process their miscarriage. Women described that the care was decisive in how they experienced their miscarriage, and sensitive care where the care staff shows empathy and understanding for the woman is essential for her well-being in the event of a miscarriage.