Syfte: Studien syftar till att kartlägga uppgiftsväxling från undersköterskor inom äldreomsorgen till andra yrkesgrupper eller digitala och tekniska hjälpmedel.  Avsikten är att personal med kompetensförsörjningsansvar inom kommuner ska kunna ha användning av kartläggningen i sitt arbete. Metod: Studien har en deduktiv ansats och en kvalitativ forskningsstrategi. En fallstudie genomfördes med sex respondenter från ett äldreboende i Kalmar kommun med semistrukturerade intervjuer.  Slutsats: Resultatet visar att uppgiftsväxling sker på boendet mellan undersköterskor och lokalvårdare som sköter städning, samt biträden som sköter köks- och måltidshantering. Uppgiftsväxlingen sker även från undersköterskorna till digitala och tekniska hjälpmedel i viss mån. Uppgiftsväxlingen som sker på boendet kan utökas genom att arbetsuppgifter rörande administration omfördelas samt mer uppgiftsväxling till biträden gällande köks- och måltidshantering. Även digitala och tekniska lösningar kan utvecklas för att arbetsuppgifter ska förenklas eller omfördelas. Resultaten visar även att det finns faktorer som kan påverka i vilken grad uppgiftsväxling kan ske och vara framgångsrikt. Detta kan handla om personalens attityder, samarbete mellan yrkesgrupper, omsorgstagarens säkerhet, tydliga rollfördelningar och ekonomiska förutsättningar. Uppgiftsväxling på boendet har frigjort arbetstid för undersköterskor, vilket tyder på att fortsatt utveckling av uppgiftsväxling kommer leda till att kompetens kan användas effektivare än vad det gör idag.

The aim of this study was to understand how assistant nurses in the care of elderly experiences partial shifts. It was based on six different semi-structured interviews with assistant nurses in the elderly care and then analyzed. It is a qualitative research of subjective thoughts and experiences from assistant nurses. The study shows that the assistant nurses experienced dissatisfaction with the work environment due partial shifts and low fact of influence on the schedule. The assistant nurses complained of deficiencies in care of the elderly, which ought to be correlated with the structure of partial shifts and the lack of energy and patience that brings with it. On the other hand some participants could find positive aspects of partial shifts regarding time to rest and be there for the caretakers. The impact of the private life was palpable, and despite some aspects to have time to rest, the work-life balance was hard to fulfill and all assistant nurses with schedules containing partial shifts on the weekdays wanted a schedule without it.

The aim was to increase understanding of the ethical dilemma that assistant nurses in special accommodation for people with dementia experienc, how they handle them, and how they perceive and deal with emotional stress. We used a qualitative approach in form of semi-structured interviews and vignettes. Our selection were assistant nurses working in dementia care in southern Sweden. We found that ethical dilemmas in dementia care are many and affects different areas. The one thing they have in common was that at least two choices conflict with each other and none of them lead to any positive result for the residents. We have found three common categories for how the caregivers handle the dilemmas: attract and clamoring, white lies and the healthy. The caregivers experience and are influenced by ethical in different ways. But everyone finds it hard when plans don’t turn out the way they thought from the beginning. The assistant nurses found that external factors were most stressful because external factors are difficult to change. All the assistant nurses are affected, but in which way, and to what degree, depends on the individual. They handle the emotional stress in similar ways by taking a walk, taking a five minutes break or to consider the residents best interest. Our conclusion was that nurses deal on a daily basis with ethical dilemmas and that they experience a lot of stress because of them.

Bakgrund: Enligt studier kan möten med föräldrar som föder barn som inte lever framkalla sorg, skuld och stress hos vårdpersonal och stöd är något som efterfrågas. Trots behovet finns begränsad forskning om vilket typ av stöd som behövs. Syfte: Syftet med studien var att identifiera barnmorskors och undersköterskors behov av stöd samt vilket typ av stöd de behöver vid möten med föräldrar som föder barn som inte lever. Metod: Åtta barnmorskor och fem undersköterskor fördelade i tre fokusgrupper intervjuades på en mellanstor förlossningsavdelning i Mellansverige. Semistrukturerade frågor ställdes utifrån en intervjuguide. Analysmetoden var kvalitativ innehållsanalys. Resultat: Ett tema och fem kategorier identifierades. Temat var: Viljan att göra gott. Kategorierna var: Kollegialt stöd, Verksamhetsstöd, Utbildning, Handledning och Reflektion samt Att vara oerfaren. Slutsats: Behovet av stöd varierade men samtliga deltagare ansåg att de fanns för varandra som stöd samt upplevde behov av kontinuitet i möten med föräldrarna och någon typ av utbildning. Fasta handledningstillfällen där deltagarna kunde träffas tvärprofessionellt önskades. Deltagare med lång erfarenhet av förlossningsvård kände sig tryggare i möten med föräldrar som föder barn som inte lever, än de med kortare erfarenhet. Klinisk tillämpbarhet: Studien skulle kunna leda till att stöd implementeras i verksamheten, vilket på sikt kan leda till att drabbade föräldrar får ett bättre bemötande. / Background: According to research health professionals are feeling grief, guilt and stress when they meet parents giving birth to stillborn babies. They are in need of support but research about what kind of support is limited. Aim: To identify midwives’ and assistant nurses’ need of support and what kind of support they need meeting parents giving birth to stillborn babies. Method: Eight midwives and five assistant nurses were interviewed and distributed in three focus groups. They were asked semi-structured questions based on a questionnaire. The analysis method was qualitative content analysis. Results: One theme and five categories were identified. The theme was: The will to do good. The categories were: Collegial support, Education, Support from the hospital management, Tutorial and Reflection and To be inexperienced. Conclusion: The need of support varied but all participants considered they were there for each other as a support and a need of continuity and education in their meetings with parents. They also wished for tutorials with regular occasions where they could meet with different professions in a group. Those participants with longer experience from childbirth care felt more secure in their meetings with parents giving birth to stillborn babies, compared with those with shorter experience. Clinical application: The study could lead to support being implemented in maternity units, which in the end could lead to better treatment for the affected parents.

Background: Most likely given the increase in sick leave absence with mental health issues as the dominant cause, the Swedish Work Environment Agency has released a new regulation regarding the organisational and psychosocial work environment. Shiftwork has been given special attention. Nurses often perform shiftwork and are one of the professions most vulnerable to work stress, ill health and burnout syndrome. Swedish municipalities has therefore initiated an organisational change to implement a schedule model that considers research on work health, but also to solve staffing issues and keep the budget in balance. Assistant nurses have taken to social and traditional media to raise objections to these new schedules.  Objectives: The aim is to examine how discursive practices are used in opinion texts to argue against the organisational change within Swedish municipalities through looking at the narrative structure of the texts and how the nurses’ identities are made relevant in the text.  Methods: A discursive psychological analysis that examines the way language is used to establish the definition of the situation and gain control over the narrative. Data sources included 27 opinion texts from Swedish media newspapers that were publicly available. Results: Three themes were identified: the structure of the narrative, the issue of money and the construction of the nurses. The structure of narrative drew on two linguistic trends: pseudo-academic language and emotive language to describe the situation at hand. In the issue of money they attributed saving money and greed as behind the implementation of the new schedule model, rather than concern over the staff’s welfare. In contrast they constructed themselves as being humble, reasonable and caring about the care receivers. Conclusions: The assistant nurses used language in the opinion texts to take control over the narrative by drawing on aspects relating to health, attributions of motive for the implementation of this organisational change and constructing themselves as being reasonable, humble and caring for the care receivers in contrast to a calculating, greedy employer who cares only about money. The nurses’ working environment is constructed as impacting on the well-being of care-receivers. The nurses position themselves against discourses relating to cost efficiency, rationalisation, and emphasis on administration.

Bakgrunden till studien bygger på diskriminering av personal som har en annan etnisk tillhörighet än svensk tillhörighet. Utifrån Diskrimineringslagen (2008:567) utgör etnisk tillhörighet en av de sju diskrimineringsgrunderna, och avses när någon eller några personer tillhör en grupp med samma nationella eller etniska ursprung, hudfärg eller annat liknande förhållande utsätts för diskriminering. Diskrimineringen av en annan etnisk tillbehörighet kan leda till en utveckling av olika psykosociala arbetsmiljöproblem, både på samhälls- och individnivå även organisationsnivå. Följande studie belyser vård och omsorgspersonals upplevelse av diskriminering utifrån etnisk tillhörighet inom omsorgsorganisationer. Syftet är att ge en förståelse om och i så fall hur undersköterskor upplever diskriminerande behandling, utifrån deras etniska tillhörighet, i organisationer inom omsorg. Därmed också dess påverkan på deras psykosociala arbetsmiljö med hänsyn till vilken roll chefen har när det handlar om den här behandlingen. Den valda metoden innefattar en intervjustudie med semistrukturerade frågor där åtta informanter deltog. Intervjuarna analyserades med hjälp av kvalitativ innehållsanalys. Resultatet visar att deltagarna i studien upplever orättvis behandling, vilket påverkar deras psykosociala arbetsmiljö på ett negativt sätt. Resultat redovisar dessa två huvudkategorier, hur anställda upplever diskriminering, och hur ledarskapet påverkar upplevelserna av diskriminering. Sammanfattningsvis framträdde ett stort behov av chefens stöd, samt att / The background of the study is based on the discrimination that applies to a group of staff that has a different ethnic accession than a Swedish accession. Based on the discrimination law (2008:567) ethnic accession is based on one of the seven main causes of discrimination, and refers to when someone or a few people belongs to a group with the same national or ethnic origin, skin colour or other similarities are exposed for discrimination. The discrimination of another ethnic origin can lead to the development of various psychosocial problems at the individual level as well as in the community level. The following study highlights care and social care staff's experience of discrimination based on ethnic affiliation within care organizations. The purpose of this qualitative research study is to provide an understanding of how the assistant nurses experience discrimination, based on their ethnic affiliation, at organizations within the care sector, as well as the discriminations impact on their psychosocial work environment. The study is based on the interview guide around assistant nurse’s experiences on discrimination as well as the managers support and awareness. The chosen method includes an interview study with semi-structured questions where eight informants participate. The interviews were analysed with the support of a qualitative content analysis which means that meaning units that equals with the purpose are extracted, after which the material is condensed, coded and categorized systematically. The results showed that the participants in the study experience unfair treatment, which affects their psychosocial work environment in a negative way. Results report these two main categories, how employees experience discrimination, and how leadership affects the experiences of discrimination. In the conclusion emerged a need for the managers support, as well that women feel as they are more affected by discrimination based on their clothes, especially Muslim women.

Titel: ”Att känna att man är en fast man är två” Aktionsforskning om hurundersköterskor på en intensivvårdsklinik uppfattar och definierardelaktighet.Nivå: C-uppsats i Ledarskap och organisation, 15 hpFörfattare: Pia Brorsson och Sara EkerothHandledare: Cecilia Franzén och Jonas LundstenProblemområde: En medarbetarenkät som genomfördes på enintensivvårdsavdelning visade förbättringspotential inom områdetdelaktighet. I uppsatsen har vi valt att undersöka hurundersköterskor på en intensivvårdsavdelning uppfattar delaktighetsamt hur de ser på sin egen delaktighet.Metod: Aktionsforskning där ett problem diagnostiserades. Aktionen blevdels de kvalitativa gruppintervjuerna samt aktion inomorganisationen som var baserat på resultatet. Detta kommer attutvärderas. För att ha ett bättre underlag till intervjuerna har vistuderat teorier som varit kopplade till ämnet. Avslutningsvis hardet empiriska materialet analyserats och diskuterats utifrån deinitiala teorierna.Resultat: Resultatet av undersökningen visar på fyra teman om vadundersköterskor på en intensivvårdsavdelning tycker ökar känslanav delaktighet. Temana var en god kommunikation, ett gottteamarbete, respekt för sitt medarbetarskap och feedback både pådet individuella som det organisatoriska planet.Vidare forskning: En yrkeskategori inom den undersökta organisationen som hade ettavvikande resultat i ovan nämnda undersökning var läkarna. Detskulle vara intressant att göra en jämförande undersökning på justden yrkesgruppen.Uppsatsens bidrag: Uppsatsen bidrar till att skapa en förståelse för vilka teman somökar delaktigheten för undersköterskor på Intensivvårdsavdelning. / Title: ”To feel like one when you are two” Action research about howassistant nurses in an intensive care ward apprehend and definesparticipation.Level: Bachelor in Leadership and organization, 15 hpAuthors: Pia Brorsson and Sara EkerothAdviser: Cecilia Franzén och Jonas LundstenProblem: A study on co-workers that had taken place in an Intensive careunit showed improvement possibilities in the subject participation.In this study we have chosen to examine how assistant nurses in anIntensive care ward apprehend and define participation.Method: Action research where a problem was diagnosed. The actioncontained qualitative interviews and the action within theorganization that was based on the result. This will be evaluated.In a preparation phase to the interviews theories aboutparticipation were studied. Finally the empirical materials havebeen analyzed and discussed in relation to the chosen theories.Conclusion: The result of the study showed four themes on what assisted nursesin an Intensive care ward feel improve the participation. It was agood communication, a good teamwork, respect for theirprofession and that feedback was given both on an individual andan organizational level.Further research: One profession within the studied organization that had a divinedresult in the primary study was the doctors. Because of that itwould be interesting to perform the same study on that category.Contributions: The study has a purpose of creating understanding for what themesthat improves participation for assisted nurses in an Intensive careunit.

Previous research emphasizes the importance of the psychosocial work environment among healthcare professionals and indicates a strong link between perceived poor psychosocial work environment and ill health. Nursing staff's psychosocial work environment is characterized by a high level of stress, which reduces their control at work and leads to work situations that are characterized by tense work. To ensure a good working environment, various laws and regulations are established that employers must ensure that they are complied with. The employer is responsible for creating a safe and stress-free working environment with good working conditions where there is the opportunity for action and control. The Covid -19 pandemic places demands on healthcare in Sweden like never before and has caused changes in work at both individual and organizational level. There are clear indications that the working environment and health have deteriorated during the Covid pandemic, however, the research testifies to a knowledge gap as the problem area is limited with Swedish studies. The purpose of this study is to examine nurses experiences of their psychosocial work environment and health during the Covid-19 pandemic. A qualitative research method has been used. Selection methods are partly goal-oriented selection and partly snowball selection method. Data collection has taken place through semi-structured interviews and a manifest content analysis has applied. The results show that the assistant nurses experience a poor psychosocial work environment during the pandemic, which is characterized by deteriorating working conditions and recovery opportunities, poorer control, increased work-related stress and higher demands. Furthermore, the assistant nurses feel that the managers are lacking in their role and that the assistant nurses lack direct cooperation with their managers. However, the results indicate improved collaboration between colleagues. In addition, the work is driven by the duty to work. In summary, the assistant nurses experience a perceived poor psychosocial work environment and health during the Covid-19 pandemic overall.

Sammanfattning  Introduktion; Det finns mätningar som visar att 58%, av äldre som bor på särskilt boende, ligger i riskzonen för att bli undernärda. Undersköterskor är en yrkesgrupp som möter äldre som inte vill äta och riskerar att drabbas av undernäring. Varför äldre inte vill äta kan bero på olika anledningar exempelvis vilken mat som serveras, hur och var den serveras. Nutrition är ett icke prioriterat område inom vård- och omsorg av äldre, däremot finns kunskap hos vårdpersonal om att undernäring påverkar kroppen negativt och ett gott nutritionsstatus bidrar till ökad hälsa. Syfte; Syftet med denna studie var att beskriva undersköterskors erfarenheter av att vårda äldre på särskilt boende som inte vill äta. Metod; Studien hade en deskriptiv design med kvalitativ ansats. Semistrukturerade intervjuer genomfördes med sju undersköterskor och data analyserades utifrån en manifest och latent innehållsanalys. Huvudresultat; Det underliggande temat var ”Att vara lyhörd och känna tillit i att vårda äldre i deras hälsa och ohälsa.” Temat bestod av fyra kategorier som var Att vilja äta, Att inte vilja äta, Betydelse av omvårdnad och Utmaningar i arbetet. Slutsats; Det var vanligt förekommande att undersköterskor mötte äldre som inte ville äta. När sådan situation uppstod började undersköterskorna att utreda varför den äldre inte ville äta, därefter utfördes lämpliga åtgärder och insatser. Tillit mellan den äldre och undersköterskan skapade förutsättning för att goda omvårdnads-insatser kunde genomföras.

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