Middle managers' ethos as an inner motive in developing a caring culture

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School nurses’ engagement and care ethics in promoting adolescent health

Background: The school is a key environment for establishing good health habits among pupils. School nurses play a prominent role in health promotion, since they meet with every single adolescent. Research aim: To describe care ethics in the context of school nurses’ health-promoting activities among adolescents in secondary schools. Research design: An explorative descriptive methodology in which semi-structured interviews were used to collect data and content analysis was performed Participants and research context: Data were collected from eight school nurses in a municipality in Western Sweden. Ethical considerations: This study was conducted according to the ethical principles of the Swedish Research Council (2011), and the written informed consent of the participants was obtained. Findings/Discussion: A caring relation, based on care ethics, is the basis for successful health-promoting activities among adolescents. The school nurses show strong engagement in and commitment to caring for and caring about adolescents by being attentive and listening to their expressed feelings and needs, both spoken and unspoken. Furthermore, the school nurses have a deep sense of responsibility in supporting and empowering adolescents to trust their own capabilities. To enhance health and well-being, school nurses emphasize low-threshold counselling, flexibility, openness, early intervention and continuity, as well as good collaboration with the health team at school and with parents. Conclusion: Creating a trustful and supportive caring relation is the foundation for successful health promotion among adolescents. Additionally, the meaning and significance of care ethics should be recognized in strengthening person-centred health care and a resilient environment in schools. Key words School-nurse, care ethics, caring relation, health promotion, adolescentspublishedVersio

Middle managers' ethos as an inner motive in developing a caring culture

Background - Middle managers play a key role in promoting a caring culture in nursing homes. However, there is limited knowledge about middle managers’ inner motives and their experiences of their responsibility in developing a caring culture. Research aim - The aim of the study is to get a deeper understanding of middle managers’ motives and their experiences of their responsibility to develop a caring culture in nursing homes. Research design - A qualitative design with a hermeneutic approach inspired by Gadamer was chosen which guided the interpretation of data. Qualitative semi-structured interviews were conducted. Participants and research context - Data were collected from thirteen middle managers in nursing homes, in six municipalities in northern Norway in September and October 2021. Ethical considerations - The study was approved by the Norwegian Centre for Research Data. Oral and written informed consent was obtained from participants. Findings - The findings show that the middle managers had non- egoistic motives to promote a caring culture as expressed in their attitudes and actions. They felt responsible to promote a caring culture where both patients and staff experienced care and were respected and recognized as unique individuals. Middle managers as good role models are responsible for being present and raising awareness of the importance of care in the nursing home culture by systematically reflecting on care values. However, a strong focus on the financial and administrative demands limits the middle managers’ possibilities to promote a caring culture and prevented them from always acting as they wanted to act, which often causes moral distress. Conclusion - Being in contact with inner motives, enables the leader to promote a homelike and caring culture where both patients and staff feels respected and recognized as unique individuals. This study highlights the importance of systematic reflection on caring values in nursing homes which leads to value awareness among all actors

Implementation of evidence based practice in a development project on nurse students’ clinical education

Synopsis: The evidence based practice (EBP) movement started at the beginning of 1970s in the field of medicine. The famous definition by Sackett et al. (1997, p. 2) defined evidence-based medicine as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’. The idea of EBP was later introduced to other fields of professional practice in health and social care, as well as to the education of health professionals such as nursing education. The project named Knowledge in development (KID) focused on the development of clinical preceptorship in the context of nursing. Clinical preceptors are registered nurses and practical nurses who have the responsibilities of caring for patients and teaching nursing students at the same time. Nursing teachers working in the KID project were enthusiastic to implement the evidence based practice approach in the project work, by using different evidence bases. Purpose: The purpose of this article is to present how evidence based practices in the project work were implemented and to describe the experiences of the project group members about the implementation of EBP. Project setting: Two universities of applied sciences, two vocational institutes and four health-care organizations in Western Finland. Year of project: 2009-2013 Target readers: Primarily project practitioners, project managers and teachers on the health care sector. Lessons learned: Based on the experiences gained in this project, the use of an evidence based practice approach in planning and implementing a development project in health care clinical and educational settings is recommended.   Competencies highlighted: Information literacy Related theory: The structure of different evidence bases presented by Rycroft-Malone et al. (2004), including research, clinical experience, patients, clients and carers, and local context and environment

Home health nurses’ views on participating in pre-ambulance emergency treatment : A qualitative descriptive study

As part of the Health Care Interaction project that was rolled out in western Sweden, home health nurses were called on as first responders to provide emergency treatment to patients, while waiting for the ambulance to arrive. The aim of this study was to evaluate how the home health nurses were prepared for the project before they were enrolled and what competencies they needed to develop to feel confident about their new role. In this qualitative descriptive study, eleven home health nurses from six municipalities that implemented the project were interviewed, and the data were analysed by content analysis. The COREQ guidelines were followed in the reporting of this study. The findings show that some municipalities did not have a training or preparation course in place, and guided the nurses to refer to self-education material. The nurses emphasised the importance of continuously updating their knowledge and skills through regular training. Further, feedback and reflection were considered important as reinforcement of learning. Keywords: registered nurse, emergency treatment, clinical competence, interview, descriptivepublishedVersionPaid Open Acces

Quality of clinical education A three-year follow-up among undergraduate nursing students in Finland and Sweden

The purpose of this study was to compare the experiences of a group of Swedish and two Finnish groups of student nurses (n=86) on the quality of clinical education over time. The data was collected using an instrument including four factors. In the comparison of the years 2009, 2010 and 2011/2012 (n=86), there were no statistically significant differences between years in the whole data. In year 2009 Swedish students (n=41) evaluated clinical preception and learning in clinical education lower than Finnish students (n=45). In the year 2010 Finnish students’ evaluated clinical preception lower than Swedish students. In year 2011/2012 Swedish students evaluated learning objectives in clinical education lower than Finnish students. The follow-up group and the dropout group did not differ from each other regarding the background variables or reports on the quality of clinical education

Hemmet som ethos : en idéhistorisk studie av hur hemmet som ethos blev evident i hälsosysterns vårdande under 1900-talets första hälft

The home as ethos, an ethical dimension of human beings, is this study’s focus of interest. Can the home as ethos comprise motive and driving force for a human being? This dissertation has a mainly hermeneutic approach with a Caring Science interpretive horizon. Firstly, the purpose of this study is to develop the concept “home” through etymological and semantic analysis. The concept’s Caring Science content is also investigated. Secondly, the purpose of this study is to investigate, through the use of a history of ideas method, how the home as ethos is made visible and evident in public health nurses’ caring during the first half of the 20th century. Which motives compromise the driving force behind public health nurses’ caring? Which idea patterns are stressed? Material for the study’s concept determination consists of tymological dictionaries as well as Swedish language dictionaries published from 1850 – 2001. The results of the concept determination provide a preliminary idea-model, where dimensions such as ethos as a human being’s innermost room, human beings’ manner of being, and the metaphor “my home is my castle” are stressed. These results comprise the background of the history of ideas portion of the study. The study’s history of ideas investigation occurs through the evaluation and interpretation of historical sources focusing on the caring provided by public health nurses. Public health nurses comprise both the context and prevalent traditions during the time-period studied. The historical sources consist of three different types of sources, namely textbooks, archived material, and the professional nursing journals Epione and Sairaanhoitajatarlehti. The purpose is to rediscover fundamental idea-patterns through the thematic structuring of the patterns appearing in the historical sources. Three main idea-patterns and underlying themes are rediscovered: love- a fire which burns inside human beings; reverence for human beings and home; and the honor of responsibility. The emerging patterns are tightly interwoven and form a pattern. A new interpretation occurs, widening the study’s horizon and leading to the emergence of the theory-model’s contours. The study’s theory-model is formed from three different levels. Ethos as a human being’s innermost room- the spirit, encompasses a human being’s value base and the spirit that he/she is permeated with. Fundamental values are converted into an internal ethic, becoming visible in human beings’ manner of being- the manner of conduct. The metaphor “my home is my castle”- the tone, symbolizes the room where a human being’s abstract or concrete being lives. The spirit, the ethos, is expressed in a home’s culture and atmosphere, that is to say the tone of a home or how one lives in a room. Communion is a significant component in the creation of a culture and atmosphere. This study’s theory-model gives rise to a new perspective that can generate new patterns of action. The study’s theory-model results in a new historically-based view that create new patterns of action in care and Caring Science today.Hemmet som ethos, en etisk dimension inom människan, utgör forskningsintresset i denna studie. Kan hemmet som ethos utgöra motiv och drivkraft för människan? Avhandlingen har en övergripande hermeneutisk ansats med en vårdvetenskaplig tolkningshorisont. Studien har som syfte att för det första göra en begreppsbestämning av begreppet ’hem’ för att utreda dess etymologiska och semantiska innebörd. Därtill utreds begreppets vårdvetenskapliga innehåll. För det andra är syftet, att genom en idéhistorisk metodansats undersöka, hur hemmet som ethos blir synligt och evident i hälsosysterns vårdande under 1900-talets första hälft. Vilka var de motiv som utgjorde drivkraften i hälsosysterns vårdande? Vilka idémönster framtonar? Materialet för den ontologiska begreppsbestämningen består av etymologiska ordböcker samt svenska ordböcker utgivna 1850–2001. Resultatet från begreppsbestämningen utmynnar i en preliminär idealmodell, där dimensioner såsom ethos som människans innersta rum, människans sätt att vara och metaforen ”Mitt hem är min borg” framtonar. Dessa delresultat utgör bakgrund till den idéhistoriska undersökningen. En idéhistorisk undersökning görs genom att granska och tolka historiska källor med fokus på hälsosysterns vårdande. Hälsosystern representerar kontexten och den rådande traditionen under nämnda tidsperiod. De historiska källorna utgörs av tre olika typer källor nämligen, läroböcker, arkivmaterial och facktidskrifterna Epione och Sairaanhoitajatarlehti. Strävan är att återupptäcka bärande idémönster genom att tematisera mönster i de historiska källorna. Tre övergripande idémönster med underliggande teman har återupptäckts: kärleken – en eld som brinner inom människan, vördnad inför människan och hemmet samt ansvaret som en hederssak. Idémönstren går in i varandra som trådarna i en väv och bildar ett mönster. En ny tolkning görs och horisonten vidgas vilket leder till att konturerna till en teorimodell tonar fram. Teorimodellen formas av tre olika skikt. Ethos som människans innersta rum – andan. Ethos som människans innersta rum innesluter människans värdegrund, den anda hon genomsyras av. Grundläggande värden omformas till en inre etik och blir synliga i människans sätt att vara – hållningen. Metaforen ”mitt hem är min borg” – tonen symboliserar det rum som bebos av människan abstrakt eller konkret. Andan, ethoset, kommer till uttryck i hemmets kultur och atmosfär, d.v.s. tonen i hemmet eller hur man bor i rummet. Gemenskapen ingår som en betydelsefull beståndsdel vid skapandet av kulturen och atmosfären. Teorimodellen ’öppnar upp’ för ett nytt seende som kan generera nya handlingsmönster i nutid. Utgående från teorimodellen kan implikationer härledas för vårdandet och vårdvetenskapen i dag med utgångspunkt i det historiska

School nurses’ engagement and care ethics in promoting adolescent health

Background: The school is a key environment for establishing good health habits among pupils. School nurses play a prominent role in health promotion, since they meet with every single adolescent. Research aim: To describe care ethics in the context of school nurses’ health-promoting activities among adolescents in secondary schools. Research design: An explorative descriptive methodology in which semi-structured interviews were used to collect data and content analysis was performed Participants and research context: Data were collected from eight school nurses in a municipality in Western Sweden. Ethical considerations: This study was conducted according to the ethical principles of the Swedish Research Council (2011), and the written informed consent of the participants was obtained. Findings/Discussion: A caring relation, based on care ethics, is the basis for successful health-promoting activities among adolescents. The school nurses show strong engagement in and commitment to caring for and caring about adolescents by being attentive and listening to their expressed feelings and needs, both spoken and unspoken. Furthermore, the school nurses have a deep sense of responsibility in supporting and empowering adolescents to trust their own capabilities. To enhance health and well-being, school nurses emphasize low-threshold counselling, flexibility, openness, early intervention and continuity, as well as good collaboration with the health team at school and with parents. Conclusion: Creating a trustful and supportive caring relation is the foundation for successful health promotion among adolescents. Additionally, the meaning and significance of care ethics should be recognized in strengthening person-centred health care and a resilient environment in schools. Key words School-nurse, care ethics, caring relation, health promotion, adolescent

En ontologisk begreppsbestämning av begreppet 'handling' ur ett vårdvetenskapligt perspektiv

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Understanding and formation—A process of becoming a nurse

Nursing is a complicated and multifaceted profession that sets high demands in preparing nursing students for the profession. In today's education, the emphasis is often on knowledge and skills, that is, epistemology. In caring science another approach is sought, an approach based on human sciences in which knowledge will serve a more profound understanding, that is, the ontology. Consequently, the question of what this ‘understanding’ in clinical education is and how it is promoted in clinical nursing education becomes important to clarify. Therefore, the aim here is to explicate the phenomenon of understanding in clinical education as experienced by third‐year undergraduate nursing students ready for graduation. This study, with a hermeneutic approach, is based on a secondary analysis of focus group interviews with undergraduate nursing students. The analytical expansion of the original material suggests three interrelated themes that illuminate the phenomenon of understanding in clinical education. These findings are deepened and enriched through philosophical abstraction. In the process of understanding, episteme, techne and phronesis can be viewed as inherent parts of the structure of thought in nursing. The perspective advanced in this study adds new aspects to the phenomenon of understanding and its meaning and significance in the dynamic process of formation and becoming in clinical education. The focus in clinical nursing education should be on learning reflective, critical thinking and the ways of being a nurse, rather than drilling students on particular skills. In the rapidly changing world of the 21st century, an understanding‐based education is needed as a more meaningful and authentic approach. Therefore, an ontological turn in nursing education, through which the main focus shifts from a traditional epistemology to an epistemology in the service of ontology, is suggested. Further studies are needed in the development and implementation of an understanding‐based, interpretative education in nursing