Bakgrund: Varje år dör 90 000–100 000 personer i Sverige, varav många erhåller palliativ vård den sista tiden. Vård i livets slut är en del av den sena palliativa fasen där målet är att skapa välbefinnande och lindra lidande. Sjuksköterskan har det övergripande ansvaret vid vård av patienter i livet slut. Dock erbjuder sjuksköterskehögskolorna begränsad utbildning i palliativ vård. Syfte: Syftet i litteraturöversikten var att beskriva sjuksköterskestudenter och nyutexaminerade sjuksköterskors upplevelse av att vårda patienter i livets slut. Metod: En litteraturöversikt har framställts där elva vetenskapliga artiklar har analyserats utifrån Fribergs (2017) analysmetod. Artiklarna har varit av kvalitativ karaktär varav två även använt kvantitativ metod. Databaserna som användes var CINAHL Complete och PubMed. Resultat: Litteraturöversikten resulterade i tre teman: Emotionella och kommunikativa utmaningar, Föreställningar om döden och Att möta vårdverkligheten – utbildning, erfarenhet och stöd. Sjuksköterskorna upplevde emotionella påfrestningar i samband med vård i livets slut. Personliga erfarenheter och värderingar påverkade de oerfarna sjuksköterskornas idéer om vad en god död innebär. Sjuksköterskorna ansåg att utbildningen inte förberett dem inför vård av patienter i livets slut. Diskussion: Författarna diskuterade i metoddiskussionen styrkor och svagheter med litteraturöversikten. I resultatdiskussionen diskuterade författarna huvudfynden i arbetet utifrån Travelbees omvårdnadsteori om den mellanmänskliga relationen samt mot bakgrunden och annan forskning. / Background: In Sweden 90 000-100 000 people die each year, many of whom require palliative care during the last period. End of life care is a part of the late palliative phase and solely involves care that relieves suffering and creates well-being. The nurse has the overall responsibility in the end of life care. However, the nursing universities provide a limited education in palliative care. Aim: The aim of the literature review was to describe undergraduate nursing students and new graduated nurses experience of caring for people in the end of life. Method: A literature review has been developed, were eleven scholarly articles emerged and analyzed using the Friberg (2017) method. The articles have been qualitative, while two also used a quantitative method. The databases CINAHL Complete and PubMed were used. Results: The literature review resulted in three themes: Emotional and communicative challenges, Notions about death and Facing the reality – education, experience and support. The nurses experienced emotional challenges when working in end of life care. Personal experiences and values effected the novice nurses’ ideas of a good death. The education did not prepare the nurses for end of life care. Discussion: The authors discussed strengths and weaknesses of the literature review in the method discussion. The result discussion discussed the main findings using Travelbees human-to-human relationship model and previous research.

Novice nurses (NNs) are entering critical care environments with limited knowledge, skills, and decision-making expertise. They are expected to care for complex patients in a dynamic healthcare setting. The research question for this project examined whether NNs improve their knowledge and skills by participating in a nursing decision-making skills curriculum. The purpose of the project was to develop and validate a nursing decision-making skills education curriculum working in an intermediate critical care unit. Taba's instructional theoretical model was used to guide the new curriculum development along with current evidence based practice found in the current literature. Scaffolding approach theory encouraged the use of more knowledgeable peers or educators to assist NN with skill acquisition. Project participants consisted of 5 local learning specialists in critical-care nursing with a minimum of a bachelor's of science degree in nursing as well as national certifications. Upon curriculum review completion, each of the 5 specialists were asked to complete a 5-point Likert scale survey to evaluate the content of the newly developed curriculum. Descriptive analysis was completed on the survey data. Three of the 5 learning specialists agreed and 2 strongly agreed that the program met its stated objectives. Three of the learning specialists strongly agreed and 2 agreed that the course content was relevant to NNs' day-to-day roles and that the material and resources facilitated the development of decision-making skills. Adjunct NN education may promote positive social change by providing an effective strategy for improving decision-making skills among NNs, potentially leading to improved patient outcomes in a healthier community with a skilled healthcare workforce.

This project study addressed the lack of formal preparation encountered by novice nurse educators within a nursing program located in the southeastern region of North Carolina. This problem is significant at both the local and national levels because expert clinicians are needed to fill nurse educator vacancies that have led to qualified students being denied admission to nursing programs. A qualitative case study research design was employed to explore the perceptions of novice nurse educators in one nursing program transitioning from clinical nursing practice to the nurse educator role. The theoretical framework to guide this study was Benner's novice to expert model that outlines the journey of how novice nurse educators transition into an educator role. Guiding research questions focused on understanding the motives, challenges, positives experiences, and perceptions of support that novice nurse educators encountered during transition from clinical practice to academia. Purposeful sampling was used to recruit 7 novice nurse educators within an associate degree nursing program. Data collection included interviews with novice nurse educators, review of a 2012 self-study report, and demographic characteristics of participants. Interviews were transcribed verbatim, coded, and analyzed to identify themes. Five themes were identified: (a) work is always with you, (b) teaching in the dark, (c) making a difference, (d) a shoulder to lean on, and (e) more structure/mentoring. Findings indicated the need for a mentorship/orientation program, which was developed to assist in role transition for novice nurse educators. Implications could contribute to a positive social change by helping clinicians to transition effectively to meet society's need for qualified nurse educators.

La pandémie de COVID-19 apporte son lot de défis à relever pour les nouvelles infirmières du Québec, dans un contexte déjà difficile pour elles. Le début de carrière étant particulièrement éprouvant, le préceptorat, qui facilite l’intégration des infirmières débutantes en les jumelant avec une collègue expérimentée en début d’emploi, a largement démontré son efficacité pour pallier le problème de rétention qui touche la relève infirmière. La pandémie de COVID-19 mérite cependant qu’on s’attarde au vécu de ces nouvelles infirmières, dans ce contexte particulier, étant donné les difficultés supplémentaires auxquelles elles doivent faire face, perturbant possiblement leur entrée dans la profession. Le but de cette étude est donc d’explorer les perceptions de nouvelles infirmières et candidates à l’exercice de la profession infirmière en médecine et en chirurgie au regard du préceptorat vécu durant la pandémie de COVID-19 dans un centre hospitalier universitaire du Québec. Pour cette étude qualitative, des entrevues semi-dirigées ont été menées auprès de sept nouvelles infirmières. Une analyse thématique a permis de mettre en lumière trois éléments qui seraient décisifs durant le préceptorat selon les nouvelles infirmières, soit la préceptrice, la structure du préceptorat et l’équipe de travail. Ces trois éléments peuvent faire une immense différence durant cette période cruciale, allant jusqu’à influencer la décision des nouvelles infirmières de poursuivre dans leur emploi ou non. Cette étude suggère la nécessité de considérer ces trois éléments au moment de planifier un programme de préceptorat, dont les modalités doivent être bien établies, claires et connues par les personnes concernées. Certaines caractéristiques sont à rechercher lors de la sélection des préceptrices, qui doit être faite de manière réfléchie, et l’impact d’une équipe accueillante et aidante ne devrait pas être négligé. / The COVID-19 pandemic brings an additional set of challenges facing new nurses in Quebec, in an already difficult context for them. Since the start of the career is particularly trying, the preceptorship, which facilitates the integration of novice nurses by pairing them with an experienced colleague at the start of their employment, has amply demonstrated its effectiveness in overcoming the retention problem among new nurses. However, more attention should be focused on the experience of these new nurses in this context of pandemic given the new difficulties that they have to face, possibly disrupting their entry into the profession. The aim of this study is therefore to explore the perceptions of new nurses and candidates to the profession of nursing in medicine and surgery units about the preceptorship experienced during the COVID-19 pandemic in a university hospital in Quebec. For this qualitative study, semi-structured interviews were conducted with seven new nurses. A thematic analysis brought out three decisive elements during preceptorship, for new nurses: the preceptor, the structure of the preceptorship and the work team. Those three elements can make a huge difference for nurses during this period, going as far as influencing their decision to continue in their job, or not. This study suggests the necessity to keep these concepts in mind when preparing a preceptorship program, its terms needing to be well established, clear, and made known to both the preceptor and the novice nurse. There are certain characteristics to look for when selecting preceptors, and this selection should be made with careful thought. Moreover, the importance of a welcoming and supportive team should not be overlooked.

BakgrundTransitionen från student till yrkesverksam sjuksköterska kan vara svår och utmanande och än mer utmanande som ny inom akutsjukvården. Författarna kommer beskriva sjuksköterskans profession, vad det innebär att vara nyexaminerad sjuksköterska samt vad som menas med transition. Även begreppet akutsjukvård och dess olika kontexter kommer beskrivas. Vidare beskriver författarna Duchschers (2008) transitionsteori. SyfteAtt sammanställa kunskap om nyexaminerade sjuksköterskors upplevelser av att arbeta inom akutsjukvård. MetodStrukturerad litteraturstudie med inslag av grunderna för systematisk litteraturöversikt. ResultatSammanställningen av artiklarna i denna litteraturstudie resulterade i tre kategorier Första tiden i yrket, Vikten av support och Upplevelsen av arbetsmiljön. Samt åtta subkategorier Upplevelsen av transition, Introduktion på arbetsplatsen, Utveckling inom professionen, Upplevelsen av teamwork, Kommunikation, Behov av stöd, Brist på erfaren personal och Arbetsbelastning. SlutsatsTransitionen från student till sjuksköterska kan vara utmanande på flera sätt, både inom yrkesrollen och privat. Minskad arbetsbelastning och en adekvat introduktion skulle kunna hjälpa till i transitionen från student till yrkesverksam sjuksköterska. Viljan av utveckling och skapande av erfarenheter var stärkande för nyexaminerade sjuksköterskor i tron på sin kompetens. / BackgroundThe transition from being a student nurse to becoming a registered nurse can be hard and challenging, even more challenging by being new in the emergency care. The writers will describe nurses’ profession, what it means to be a newly graduated nurse and also explain transition. Further on the writers will describe the concept emergency care and the different context where emergency care can occur. The writers will also describe Duchscher (2008) transition theory. AimTo compile knowledge of newly graduated nurses´ experiences of working in acute caresetting. MethodA review of literature with the basics from a systematic review. ResultsThis review resulted in three categories Early in the profession, The importance of support and Experience of the work environments. Eight subcategories were identified these were Experience of transition, Introduction in the workplace, development within the profession, Teamwork experience, Communication, Need for support, Lack of experienced staff and Workload. ConclusionsThe transition from student nurse to registered nurse can be challenging in many ways, both within the profession as well as the private life. Reduced workload and an adequate introduction could help in the transition from student to professional nurse. The will of development and the hunt for experiences were empowering for the newly graduated nurses in the beliefs in their own competence.

The lecture room instructional management competence of novice nurse educators (NNEs) in the Republic of South Africa (RSA) was investigated. No comprehensive set of generic roles, outcomes and competences for instructional management of nurse educators could be traced in the literature, therefore an analytical study was undertaken. Adhering to the principles for outcomes-based education, three models were established: Q a model for the professional development of nurse educators Q an Education, Training and Development nurse practitioner model, consisting of roles and outcomes for lecture room instructional management Q a model for lecture room instructional management that served as evaluation criteria used in the instrument during the quantitative survey These models were presented to, and evaluated by nurse educators of five universities. The influence of mentorship, reality shock, and professional development on the NNEs' lecture room competence was investigated. The target group consisted of NNEs, their mentors and students in nursing schools in the RSA. A number of respondents were also interviewed and observed. The analysed data indicated that NNEs were not competent when they started teaching, and needed support and supervision from mentors. Findings also indicated the positive influence of mentorship and professional development on competence acquisition. NNEs experienced reality shock requiring support to acquire competence. These aspects justify further research. The recommendations based on this study include that nursing schools use specific evaluation criteria for le<,1ure room competence and for in-service training of NNEs and mentors. Nursing schools should take a more active role in mentoring programmes. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

The lecture room instructional management competence of novice nurse educators (NNEs) in the Republic of South Africa (RSA) was investigated. No comprehensive set of generic roles, outcomes and competences for instructional management of nurse educators could be traced in the literature, therefore an analytical study was undertaken. Adhering to the principles for outcomes-based education, three models were established: Q a model for the professional development of nurse educators Q an Education, Training and Development nurse practitioner model, consisting of roles and outcomes for lecture room instructional management Q a model for lecture room instructional management that served as evaluation criteria used in the instrument during the quantitative survey These models were presented to, and evaluated by nurse educators of five universities. The influence of mentorship, reality shock, and professional development on the NNEs' lecture room competence was investigated. The target group consisted of NNEs, their mentors and students in nursing schools in the RSA. A number of respondents were also interviewed and observed. The analysed data indicated that NNEs were not competent when they started teaching, and needed support and supervision from mentors. Findings also indicated the positive influence of mentorship and professional development on competence acquisition. NNEs experienced reality shock requiring support to acquire competence. These aspects justify further research. The recommendations based on this study include that nursing schools use specific evaluation criteria for le<,1ure room competence and for in-service training of NNEs and mentors. Nursing schools should take a more active role in mentoring programmes. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Introduction: A nurse preceptorship is essential in the transition period (TP) of novice nurses. Especially in intensive care workplaces, where training for highly specialized and demanding care is provided. TP thus becomes a sensitive period in which the employee decides whether to remain in the workplace or even in the profession. Methodology: This is qualitative study with the main focus of the survey on the specific experience of preceptors with TP management. Data collection was performed using semi-structured interviews with preceptor nurses in one selected workplace of intensive care. Data analysis was performed in 4 steps, open coding and sorting of data into categories and subcategories were used. Results: Six main topics were identified: Preceptors' experience from their own transition, TP organization attributes, Evaluation and feedback, The role of the preceptor nurse, Critical moments and Factors influencing the TP. The experience of trainers from their own TP is a significant predictor for their individual way of training and leading novice nurses. Evaluation and feedback have a culture and should be performed regularly in cycles to achieve the purpose. The preceptor has many roles, participates in the creation of social relationships with the novice, he himself strives to establish...

Every year, millions of medical errors are committed, costing not only patient health and satisfaction, but thousands of lives and billions of dollars. Errors occur in many areas of the healthcare environment, including the profession of nursing. Nurses provide and delegate patient care and consequently, standard nursing responsibilities such as medication administration, charting, patient education, and basic life support protocol may be incorrect, inadequate, or omitted. Although there is much literature about errors among the general nurse population and there is indication that new nurses commit more errors than experienced nurses, not much literature asks the following question: What are the factors contributing to the commission of errors, including the omission of standard nursing care, among new nurses? Ten studies (quantitative, qualitative, and mixed-mode) were examined to identify these factors. From the 10 studies, the researcher identified the three themes of lack of experience, stressful working conditions, and interpersonal and intrapersonal factors. New nurses may not have had enough clinical time, may develop poor habits, may not turn to more experienced nurses and other professionals, may be fatigued from working too many hours with not enough staffing, may not be able to concentrate at work, and may not give or receive adequate communication. Based on these findings and discussion, suggested implications for nursing practice include extended clinical experience, skills practice, adherence to the nursing process, adherence to medications standards such as the five rights and independent double verification, shorter working hours, adequate staffing, no-interruption and no-phone zones, creating a culture of support, electronically entered orders, translation phones, read-backs, and standardized handoff reports.