Background: The nursing workforce needs to be adequately prepared to deliver care to an increasingly diverse patient population in the United Kingdom (UK). The Nursing and Midwifery Council (NMC) expects newly qualified nurses (NQNs) to deliver culturally sensitive and respectful care. Aim: The study aimed to explore NQNs’ perceptions of culturally competent practice during the first 9 months post qualification. Methods: A qualitative longitudinal study was conducted with a volunteer sample of 14 NQNs recruited from 3 Higher Education Institutions in the north of England. Data was collected using directed reflections (at 2-3 and 5-6 months) and semi-structured interviews (at 8-9 months) and analysed using a phenomenological approach informed by symbolic interactionism. Results: Perceptions of culturally competent nursing practice were associated with core concepts such as individualised patient care, compassionate and respectful care, respecting individual differences, professionalism and patient trust. Specific behaviours were associated with verbal and non-verbal communication, care planning and diversity-specific adjustments. Discussion: Self-perceived competence and confidence in caring for, and interacting with, patients from diverse backgrounds developed and changed throughout the transition period with experience and interaction opportunities. An ability to reflect upon and learn from novel experiences, plus an enabling ward culture and environment which responded positively to nurses seeking advice and support was important. Conclusion: Educational preparation may have enabled NQNs’ opportunities to develop some but not necessarily all of the skills and behaviours required to demonstrate culturally competent practice. During transition, supported development and professional socialisation can assist in enhancing competence and confidence.

Bakgrund: Varje år utexamineras cirka 4000 sjuksköterskor i Sverige. Nyutexaminerade sjuksköterskors ansvarsområde är omvårdnad och att som nyutexaminerad börja arbeta som sjuksköterska kan upplevas olika. Syftet: var att beskriva hur det upplevs att arbeta som nyutexaminerad sjuksköterska. Metod: En allmän litteraturstudie genomfördes och tolv vetenskapliga artiklar analyserades och beskrevs. Resultat: De nyutexaminerade sjuksköterskorna upplevde det som utmanande, stressande, oroande och utvecklande men kände sig otillräckliga i sitt arbete som sjuksköterska. Detta upplevdes när de arbetade självständigt och samarbetade med arbetskamrater och patienter. Praktiska moment som nyutexaminerade sjuksköterskor inte var vana vid att utföra väckte negativa känslor såsom oro och stress. Att få stöd av omgivningen i form av en bekräftande kommunikation och att ingå i vårdlaget var betydelsefullt. Diskussion: Det är därför av vikt att blivande sjuksköterskor får praktiskt träna skilda moment i omvårdnaden under utbildningens gång samt får stöd av omgivningen. / Background: Four thousand nurses graduate every year in Sweden. Although newly qualified nurses' responsibility lies in the caring of patients their experiences at starting work may differ. The objective: was to describe how it feels to work as a newly qualified nurse. Method: A literature review was conducted and twelve scientific articles were analyzed. Results: The newly qualified nurses experienced challenge, stress, worry, development and felt inadequate in her job as a nurse. This was experienced when they worked independently and collaborated with colleagues and patients. Practical steps that graduates nurses were not accustomed to performing aroused negative emotions such as anxiety and stress. Getting support of colleagues and others in the form of an affirmative communication and being part of the care team was also significant. Discussion: It is therefore important that prospective nurses are supported by their colleagues and are used in the training process of different operations in the nursing care.

Background: The nursing workforce needs to be adequately prepared to deliver care to an increasingly diverse patient population in the United Kingdom (UK). The Nursing and Midwifery Council (NMC) expects newly qualified nurses (NQNs) to deliver culturally sensitive and respectful care. Aim: The study aimed to explore NQNs’ perceptions of culturally competent practice during the first 9 months post qualification. Methods: A qualitative longitudinal study was conducted with a volunteer sample of 14 NQNs recruited from 3 Higher Education Institutions in the north of England. Data was collected using directed reflections (at 2-3 and 5-6 months) and semi-structured interviews (at 8-9 months) and analysed using a phenomenological approach informed by symbolic interactionism. Results: Perceptions of culturally competent nursing practice were associated with core concepts such as individualised patient care, compassionate and respectful care, respecting individual differences, professionalism and patient trust. Specific behaviours were associated with verbal and non-verbal communication, care planning and diversity-specific adjustments. Discussion: Self-perceived competence and confidence in caring for, and interacting with, patients from diverse backgrounds developed and changed throughout the transition period with experience and interaction opportunities. An ability to reflect upon and learn from novel experiences, plus an enabling ward culture and environment which responded positively to nurses seeking advice and support was important. Conclusion: Educational preparation may have enabled NQNs’ opportunities to develop some but not necessarily all of the skills and behaviours required to demonstrate culturally competent practice. During transition, supported development and professional socialisation can assist in enhancing competence and confidence.

Syftet med studien var att beskriva yrkeserfarna sjuksköterskors upplevelser av att arbeta med och stödja nyutexaminerade sjuksköterskor. En kvalitativ och beskrivande design användes. Undersökningsgruppen bestod av åtta kvinnliga sjuksköterskor från ett sjukhus i mellansverige. Huvudresultatet visade att de yrkeserfarna sjuksköterskorna var nöjda med nyutexaminerade sjuksköterskors arbetsinsats. En viktig aspekt var att nyutexaminerade sjuksköterskor frågade vid osäkerhet för att känna tillit. Sjuksköterskorna ansåg att stöd och uppskattning för att komma in i arbetet och gemenskapen var viktigt för att nyutexaminerade sjuksköterskor skulle känna sig trygga. Trots att sjuksköterskorna upplevde att nyutexaminerade sjuksköterskor var snabblärda, duktiga och nyfikna på att ta in ny lärdom i yrket, kom det dock fram att det fanns svårigheter att fokusera och prioritera rätt. Genomgående ansågs nyutexaminerade sjuksköterskor fokusera mer på dokumentation än omvårdnadsarbetet. Sjuksköterskorna betonade att mer praktik behövdes i grundutbildningen för att bättre förbereda nyutexaminerade sjuksköterskor i klinisk verksamhet. Vidare framkom det att längre introduktionstid behövdes i klinisk verksamhet för att komma in i rutinerna och sjuksköterskerollen. Slutsatsen visade att yrkeserfarna sjuksköterskor var nöjda med arbetsinsatsen från nyutexaminerade sjuksköterskor. Det ansågs viktigt att fråga vid osäkerhet och att mer fokus behövdes på omvårdnadsarbetet. Mer praktik ansågs nödvändigt för att lättare klara av den kliniska verksamheten. / The aim of the study was to describe professional experienced nurses' experiences of working with and supporting newly qualified nurses. A qualitative and descriptive design was used. The study group consisted of eight female nurses from a hospital in central Sweden. The main results showed that the professional experienced nurses were satisfied with the graduates’ nurses’ job performance. An important aspect was that newly qualified nurses asked if unsure to feel confident. The nurses felt that support and appreciation to get into work and community was important for newly qualified nurses to feel safe. Although the nurses felt that newly qualified nurses were quick to learn, skilled and curious to take on new learning in the profession, was however shown that there were difficulties to focus and 0Tprioritize the right0 Consistentlyconsidered graduates nurses to focus more on documentation than nursing. The nurses emphasized that more training was needed in basic education to better prepare graduate nurses for clinical practice. It was also found that longer introduction where needed in clinical practice to get into the routine and the nursing role. The conclusion showed that experienced nurses were satisfied with the effort from newly graduates’ nurses. It was considered important to ask if in doubt and that more focus was needed on nursing. More training was needed to help manage the clinical operations.

The path to a career in nursing begins on the first day of nursing training and is not completed until the nurses have worked one year in their profession. During the training period, the student nurses have training elements in two different activitysystems: the higher education institution and the healthcare sector. The aim of this study is to examine and highlight the relationship between the different parts of the training as well as how the relationship is manifested during the newly qualified nurses’ initial period in the profession. The research’s overall question is what makes the newly qualified nurses’ learning and knowledge development easier or harder in relation to the different parts of the nursing training. Interviews have been used to create data which have been analysed based on activity theory, a social theory of learning and different ways of describing knowledge. The research findings show that the activity systems have different knowledge cultures, learning processes and patterns of action. The study participants describe the differences in terms of being in ‘different worlds’. The newly qualified nurses do not always have the practical skills that are sought after and, therefore, cannot always act as independent subjects, but become marginalized non-participants who observe the course of events. Supervision and the rounds are the two most demanding duties during the first year in the profession, since these duties have been practiced to a limited extent during the nurse training placement. The supervisory function appears different to newly qualified male and female nurses. The women in the study feel that it is problematic to be a supervisor for older experienced assistant nurses, in that the assistant nurses do not accept them as supervisors. The men do not indicate this as being a problem, rather emphasizing that the assistant nurses support them in the supervisory function. During the rounds, the nurses must inform the doctor of the state of the patients’ health and care needs. The participants feel that it is difficult to live up to the doctors’ demands ahead of the rounds. In summary, my findings show that the different knowledge cultures in the higher education institution and the healthcare sector make the newly qualified nurses’ learning and knowledge development more difficult. During the first year in the profession, the newly qualified nurses learn to be nurses, and they talk about themselves as nurses in a totally different way than at the start of that year. The changed way of talking about themselves indicates that they have recreated their identity from student nurses to nurses.

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)