Bakgrund: Globaliseringen gör att den kulturella kompetensen hos sjuksköterskan är viktig. Studier har visat att sjuksköterskestudenter som varit på internationellt utbyte och haft sin verksamhetsförlagda utbildning (VFU) i utland utvecklat en kulturell medvetenhet och personlig utveckling. Få studier har undersökt hur utbytet påverkat studenters professionella utveckling i rollen som sjuksköterska. Syftet var att beskriva sjuksköterskestudenters uppfattning om vad de lärt sig under VFU i utland som de tror har betydelse för deras framtida omvårdnadsarbete. Metod: Studien hade en kvalitativ ansats med en deskriptiv karaktär. Fem intervjuer genomfördes med studenter som deltagit i VFU i Indien. Därefter utfördes en kvalitativ innehållsanalys med induktiv ansats. Resultat: Tre övergripande kategorier: "Lärdom om sin profession", "Lärdom om sig själv" och "Lärdom om olikheter" med respektive underkategorier skapades under analysprocessen. Studenterna fick en förståelse för vad omvårdnad är och betyder för deras profession. De upplevde en personlig utveckling i form av ökad självsäkerhet, ett kritiskt förhållningssätt samt att de blev mer öppna och ödmjuka inför det som är annorlunda. Studenterna har också insett hur viktigt det är med den kulturella kompetensen. Slutsats: Lärdomarna upplevdes vara av betydelse för sjuksköterskestudenternas framtida omvårdnadsarbete, varför det är viktigt att fler studenter får möjlighet att delta i VFU utomlands. / Background: Globalization makes cultural competence important for nurses. Studies have shown that nursing students who have been on an international exchange and participated in clinical practice abroad have developed a cultural awareness and increased their personal development. Few studies have described how exchange programs have influenced the professional development in the role as a nurse. The aim of this study was to describe nursing students' view on what they think they learned during their exchange abroad and how it will influence their role as nurses. Method: this study has a qualitative approach with a descriptive character. A systematic selection was made and five interviews were conducted with students that had been on internships in India. Subsequently, a qualitative content analysis with an inductive approach was implemented. Result: Three general categories: "Learning about profession", "Learning about oneself" and "Learning about differences" and additional subcategories were created during the analysis process. The students had gotten an understanding of what nursing is and means for their work as a nurse. They also experienced a personal development in terms of growing in confidence and critical approach. The students became more open minded and humble to things that are different. They also experienced how important it is with cultural competence. Conclusions: Nursing students' view is that these lessons will influence their role as a nurse; therefore it's important that more students get the opportunity to participate in an international exchange.

Nursing students in South Africa are exposed to various clinical environments as part of the prescribed curriculum (SANC, 2008). These clinical environments not only positively or negatively influence nursing students but also greatly influence their decisions regarding future specialization. This relationship between the influence of the clinical environment and the decision to apply at a specific hospital was established by Andrews et al. (2005:147), but little is known about how it affects the decision of nursing students to specialize in a specific area. According to the South African Nursing Council‟s statistical data, an additional qualification in operational theatre is one of the least qualifications applied for (SANC, 2012b). This indicates that not many nursing students choose, for example, the theatre as a specialization area when their studies are completed. In light of this evidence, this study aimed to explore the influence that the clinical environment has on the decision of nursing students to specialize in a specific area. An explorative and descriptive design, which is qualitative in nature, was followed to conduct this study. The data collection was conducted in two phases. Phase one: Nursing students‟ experiences after exposure to theatre as a clinical environment were explored by means of reflective essays. Data was analysed according to the principles of Tesch as described in Creswell (1994:154). Meetings between the researcher and an experienced co-coder resulted in consensus regarding the findings. Three main themes and eleven sub themes were identified and provided clarity on the influence of the clinical environment on nursing students. Phase two, consisting of two focus group discussions facilitated by an expert in focus group facilitation, was completed to validate the findings from the reflective essay. This data was transcribed, analysed and the findings validated by the existing data from phase one. Conclusions drawn from this study were that the clinical environment does influence the students‟ decision to specialize in operating theatre, but many choose not to specialize in theatre due to personal preferences. / MCur, North-West University, Potchefstroom Campus, 2014

Nursing students in South Africa are exposed to various clinical environments as part of the prescribed curriculum (SANC, 2008). These clinical environments not only positively or negatively influence nursing students but also greatly influence their decisions regarding future specialization. This relationship between the influence of the clinical environment and the decision to apply at a specific hospital was established by Andrews et al. (2005:147), but little is known about how it affects the decision of nursing students to specialize in a specific area. According to the South African Nursing Council‟s statistical data, an additional qualification in operational theatre is one of the least qualifications applied for (SANC, 2012b). This indicates that not many nursing students choose, for example, the theatre as a specialization area when their studies are completed. In light of this evidence, this study aimed to explore the influence that the clinical environment has on the decision of nursing students to specialize in a specific area. An explorative and descriptive design, which is qualitative in nature, was followed to conduct this study. The data collection was conducted in two phases. Phase one: Nursing students‟ experiences after exposure to theatre as a clinical environment were explored by means of reflective essays. Data was analysed according to the principles of Tesch as described in Creswell (1994:154). Meetings between the researcher and an experienced co-coder resulted in consensus regarding the findings. Three main themes and eleven sub themes were identified and provided clarity on the influence of the clinical environment on nursing students. Phase two, consisting of two focus group discussions facilitated by an expert in focus group facilitation, was completed to validate the findings from the reflective essay. This data was transcribed, analysed and the findings validated by the existing data from phase one. Conclusions drawn from this study were that the clinical environment does influence the students‟ decision to specialize in operating theatre, but many choose not to specialize in theatre due to personal preferences. / MCur, North-West University, Potchefstroom Campus, 2014

Bakgrund: Som sjuksköterska består en stor del av arbetet i att bemöta människor. Det har visat sig att då bemötandet upplevs som sämre, så upplevs även övriga omvårdnaden som dålig. En förutsättning för att kunna ge ett gott bemötande är att ha reflekterat över begreppets innebörd och funderat på vilka faktorer som påverkar bemötandet så att det blir gott, respektive sämre. Syfte: Studiens syfte var att undersöka vad blivande sjuksköterskor i termin sex anser är ett gott/sämre bemötande samt orsakerna till varför bemötandet blir gott eller sämre. Metod: Tolv sjuksköterskestudenter intervjuades i fokusgrupper och kvalitativ innehållsanalys användes för att analysera data. Resultat: Sjuksköterskestudenterna betonade betydelsen av tid, respekt samt personliga ställningstaganden och egenskaper i ett bemötande. Exempel på olika orsaker som leder till ett gott bemötande både stämmer överens med de intervjuade sjuksköterskestudenterna och studerad litteratur, var vänlighet, hjälpsamhet, beröring och ögonkontakt. Dessutom framkom även en ”skyll-dig-själv”-attityd som en orsak till ett sämre bemötande, och som inte tidigare nämnts i varken litteratur eller forskning. Slutsats: Yttre omständigheter samt personliga egenskaper hos sjuksköterskan påverkar  bemötandet. Dock behöver sjuksköterskestudenter en bättre förståelse för begreppet bemötande. Därför föreslås att rollspel och seminarium, angående bemötande, bör införas i sjuksköterskeutbildningen. Vidare forskning behöver göras för att undersöka hur patienter och yrkesutövande sjuksköterskor, reflekterar kring bemötandet, för att därmed kunna förtydliga rådande riktlinjer. Den ökade kunskapen anses kunna bidra till ökad vårdkvalitet, bättre arbetsmiljö samt ett ökat välmående för både sjuksköterska och patient. / Background: Being a nurse means a lot of interacting with people. It has been found that when the interaction is perceived as bad, the other health care is perceived as bad. A prerequisite for being able to make a well interaction, you have to reflect the meaning and thoughts about the factors that can affect the interaction and make it good or worse. Aim: The aim of the study was to examine what the nursing students from last semester believe is a good / bad interaction, and the reasons why the interaction is better or worse. Methods: Twelve nursing students were interviewed in focus groups and qualitative content analysis was used to analyze the data. Results: Nursing students emphasized the importance of time, respect, empathy, personal standpoints and characteristics in an interaction. Examples of different causes that lead to good interaction is both consistent with the interviewed nursing students, and studied literature, was the friendliness, helpfulness, touch and eye contact. In addition, also revealed a "blame-yourself"-attitude as a cause of a worse interaction, and are not mentioned in either literature or research. Conclusion: External circumstances and personal characteristics affect the interaction. However, nursing students need a better understanding regarding the concept of interaction. It is therefore proposed that roleplay and seminar, concerning interaction, should be included in nursing education. Further research needs to be done to examine how patients and professional practice nurses, reflects of interaction, in order to be able to clarify current guidelines. The increased knowledge is considered to contribute to improved quality of care, better working environment and increased well-being for both nurses and patients.

Nursing has come a long way to become a subject of university study. Clinical placement is a vital part of the study in preparing students for future nursing roles as providers of care to patients. The placement within nursing homes is a compulsory part of the clinical studies. Major actors in the clinical placement are supervisors. Their actions and support are determinant for the nursing student’s experiences, in learning and development of their clinical skills.

The problem with which this study is concerned is the attrition of freshman and sophomore students who enroll in a baccalaureate nursing program. The purpose of this study is to identify and describe factors that may contribute to the nursing student attrition problem at a state-supported university.

Bakgrund: Transperson är ett paraplybegrepp för personer som upplever att det kön de fötts med inte överensstämmer med deras identitet. Många upplever lidande till följd av transidentiteten och kan få hjälp med könskorrigerande vård. Gruppen är även i risk för fysisk och psykisk ohälsa. Många transpersoner upplever positiva möten med vården, men de flesta har även erfarit möten som varit det motsatta. Detta leder till att många undviker att söka vård. Syfte: Att beskriva sjuksköterskors och sjuksköterskestudenters upplevelse av att vårda transpersoner. Metod: En litteraturbaserad metod användes, där systematisk sökning gjordes i två databaser. Nio kvalitativa artiklar analyserades och sammanställdes till ett nytt resultat. Resultat: Ur analysen identifierades fyra teman: blandade känslor, bristande kunskap, svårigheter vid bemötandet samt en vilja att lära mer. Dessa utgjordes av 14 underteman. Konklusion: Mer kunskap och erfarenhet behövs för att kunna erbjuda en god och jämlik vård till transpersoner. Detta skulle även bidra till sjuksköterskans känsla av säkerhet i yrkesrollen. / Background: Transgender is an umbrella term describing people experiencing that their gender assigned at birth differs from their identity. Many experience suffering because of their transidentity and can receive help with gender-affirming care. The community is at risk of physical and mental illness. Many trans people experience positivee ncounters with health care, but most have also experienced encounters that have been the opposite. This results in many people avoiding seeking care. Aim: To describe nurses and nursing students experiences in caring for transgender people. Method: A literature-based method was used, and systematic searches were conducted using two databases. Nine qualitative articles were analyzed and compiled into new findings. Findings: From the analysis, four themes were identified: mixed emotions, lack of knowledge, difficulties in the approach anda desire to learnmore. These consisted of 14 sub-themes Conclusion: More knowledge and experience is needed to be able to offer a good and equal care to transgender people. This would also contribute to the nurse’s sense of security in the professional role.

Bakgrund: Varje år examineras det cirka 4300 sjuksköterskor i Sverige. Under deras utbildning varvas teori och praktik för att studenterna efter examen ska kunna utföra omvårdnadsuppgifter med skicklighet och leda omvårdnadsarbetet. Den verksamhetsförlagda utbildningen är en viktig del av utbildningen som ska ge studenterna kompetens och bygga upp en trygghet inför deras kommande yrke. Handledningen är viktig för att stödja studenterna i att kunna utvecklas och bygga upp ett självförtroende.   Motiv: För att kunna arbeta med att förbättra kvaliteten på handledning under verksamhetsförlagd utbildning är det viktigt att veta hur studenterna faktiskt erfar handledning.    Syfte: Syftet med studien var att belysa sjuksköterskestudenters erfarenheter av handledning under verksamhetsförlagd utbildning.    Metod: För att besvara syftet användes en kvalitativ intervjustudie med öppna frågor, resultatet baserades på åtta intervjuer från studenter som gjort verksamhetsförlags utbildning på ett regionsjukhus i södra Sverige.    Resultat: Analysen resulterade i tre kategorier, ”omhändertagandet av studenterna”, ”handledarens sätt att handleda” och ”reflektionens betydelse” samt nio subkategorier. I resultatet framkom det att studenter har både bra och mindre bra erfarenheter av sin VFU. För studenterna var det viktigt med ett bra bemötande och att VFU platserna var förbereda och engagerade i studenternas lärande. VFU gav studenterna kunskap och kompetens och gjorde att dem blev mer redo inför sitt kommande yrke som sjuksköterska.   Konklusion: Genom att arbetsplatser och handledare visar engagemang och har förberett sig inför att studenterna ankomst skapas bättre förutsättningar för att kunna inhämta kunskap och kompetens under VFU. Det är även viktigt att studenterna får handledare med förmågan att kunna handleda studenter. Ett dåligt bemötande under VFU kan påverka sjuksköterskestudenters möjlighet till inlärning negativt. VFU:n är en viktig del av studenternas utbildning och förbereder dem inför sitt kommande yrke. / Background: Every year, approximately 4,300 nurses are examined in Sweden. During their education, theory and practice are alternated so that the students after graduation can perform nursing tasks with skill and lead the nursing work. The clinical practice is an important part of the education that will give the students competence and build a sense of security for their future profession. The supervision during VFU is important to support the students in being able to develop and build self-confidence.   Motive: In order to be able to work on improving the quality of supervision during clinical practice, it is important to know how the students actually experience the supervision.    Aim: The aim of the study was to illuminate nursing students' experiences of supervision during clinical practice.   Methods: To answer the purpose, a qualitative interview study with open-ended questions was used. The results are based on eight interviews from students who had done clinical practice on a hospital in the southern Sweden.   Result: The analysis resulted in three categories, "The care of the students", "the supervisor's way of supervising" and "the significance of the reflection" as well as nine subcategories. The results showed that students have both good and less good experiences of their clinical practice. It was important for the students to have a good attitude and that the clinical practice units were prepared and engaged in the students' learning. The clinical practice gave the students’ knowledge and skills and made them more ready for their future profession as a nurse.   Conclusion: When workplaces and supervisors show commitment and have prepared for the arrival of students, better conditions are created for being able to acquire knowledge and skills during clinical practice. It is also important that students get supervisors with the ability to supervise students. A bad attitude during clinical practice can affect nursing students' opportunities for learning negatively. The clinical practice is an important part of the students' education and prepares them for their future profession.

AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Objective: To implement and evaluate training session related to smoking during pregnancy for baccalaureate nursing students in rural Southern Appalachia. Design: Nursing students attended training on dangers and intervention techniques related to smoking during pregnancy. Sample: Third year students beginning clinical rotations in obstetrics. Methods: One and one half hour training including pre‐ and post tests. Implementation Strategies: Four months later, a follow‐up survey assessed gains in knowledge, skill, comfort, and willingness to address smoking during pregnancy. Results: During seven semesters, 659 nursing students were trained. Substantial gains in knowledge of issues related to smoking during pregnancy were seen from pre‐ to post testing, and knowledge was retained at 4‐month follow‐up. The percentage of students who felt they lacked skills to intervene with pregnant smokers dropped from 39% at pretest to 6% at same day post test. In addition, the percentage who reported they would be uncomfortable talking with pregnant women about smoking dropped from 10% to 1%; the percentage who indicated they would always make time to address smoking with pregnant women increased from 54% to 87%. While most students did address smoking with multiple pregnant patients during clinicals, and more than half felt the patients benefited from their actions, only 58% were confident in their intervention skills at 4‐month follow‐up. Finally, 83% felt the training had been beneficial, and more than 90% committed to addressing smoking with pregnant patients once they graduated. Conclusion/Implications for Nursing Practice: Rates of smoking during pregnancy in the rural South are twice as great as national averages and contribute to poor birth and long‐term outcomes for affected women and children. Efforts to intervene during prenatal care with pregnant women have been hampered by lack of knowledge, skill, comfort, and commitment from prenatal providers and their nursing staff. Regional community providers and staff have been reluctant to participate in available trainings, and even those who do seldom exhibit attitude and practice change long term. Therefore, efforts to educate healthcare professionals on the dangers of smoking during pregnancy and to provide necessary skills for intervention efforts may need to occur before students enter practice, and ongoing education may be needed to promote skills and confidence long term. In the rural South, where smoking rates are high and provider efforts to address pregnancy smoking are inconsistent, educating future nurses could have substantial impact on rates of smoking during pregnancy and birth outcomes into the future.

AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Objective: To implement and evaluate training session related to smoking during pregnancy for baccalaureate nursing students in rural Southern Appalachia. Design: Nursing students attended training on dangers and intervention techniques related to smoking during pregnancy. Sample: Third year students beginning clinical rotations in obstetrics. Methods: One and one half hour training including pre‐ and post tests. Implementation Strategies: Four months later, a follow‐up survey assessed gains in knowledge, skill, comfort, and willingness to address smoking during pregnancy. Results: During seven semesters, 659 nursing students were trained. Substantial gains in knowledge of issues related to smoking during pregnancy were seen from pre‐ to post testing, and knowledge was retained at 4‐month follow‐up. The percentage of students who felt they lacked skills to intervene with pregnant smokers dropped from 39% at pretest to 6% at same day post test. In addition, the percentage who reported they would be uncomfortable talking with pregnant women about smoking dropped from 10% to 1%; the percentage who indicated they would always make time to address smoking with pregnant women increased from 54% to 87%. While most students did address smoking with multiple pregnant patients during clinicals, and more than half felt the patients benefited from their actions, only 58% were confident in their intervention skills at 4‐month follow‐up. Finally, 83% felt the training had been beneficial, and more than 90% committed to addressing smoking with pregnant patients once they graduated. Conclusion/Implications for Nursing Practice: Rates of smoking during pregnancy in the rural South are twice as great as national averages and contribute to poor birth and long‐term outcomes for affected women and children. Efforts to intervene during prenatal care with pregnant women have been hampered by lack of knowledge, skill, comfort, and commitment from prenatal providers and their nursing staff. Regional community providers and staff have been reluctant to participate in available trainings, and even those who do seldom exhibit attitude and practice change long term. Therefore, efforts to educate healthcare professionals on the dangers of smoking during pregnancy and to provide necessary skills for intervention efforts may need to occur before students enter practice, and ongoing education may be needed to promote skills and confidence long term. In the rural South, where smoking rates are high and provider efforts to address pregnancy smoking are inconsistent, educating future nurses could have substantial impact on rates of smoking during pregnancy and birth outcomes into the future.