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  • 1.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Nyström, Maria
    Nurses' lived experiences of moral stress support in the intensive care context.2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 2.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nyström, Maria
    A theoretical argumentation on the consequences of moral stress.2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-65Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.

  • 3. Eriksson, Susanne
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Supervisor experiences of supervising nursing staff in the care of older people2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, p. 876-882Article in journal (Refereed)
    Abstract [en]

    Aim To describe supervisors’ experiences of supervising nursing staff who care for older people in order to develop an understanding of the opportunities and limitations involved in supervision. Background Little is known of what group supervision of nursing staff means for the supervisor, particularly in regards to care of the old. Methods A reflective life-world research approach, based upon phenomenological epistemonology was used. Two supervisors with 2 years experience of supervising nursing staff caring for older people were interviewed. Conclusions Results point to the need for support for supervisors in order to enable them to develop their supervisory abilities and skills. Implications for nursing management Support is of crucial importance for both the ability to supervise and the quality of supervision.

  • 4. Gustafsson, Christine
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Asp, Margareta
    Supportive leadership in Swedish community night nursing2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 7, p. 822-831Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to examine the support night nurses' give to staff in community night nursing. Background Studies have shown that support given to staff is one of night registered nurses' (RNs') experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described. Methods All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. Results The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership . Conclusions Out of 'concern for the staff' the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs' awareness that by giving support to staff this affects the staffs' caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

  • 5. Kihlgren, Annica
    et al.
    Forslund, K
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Managements' perception of community nurses' decision-making processes when referring older adults to an emergency department 2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 6, p. 428-436Article in journal (Refereed)
    Abstract [en]

    In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nurses' exposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

  • 6. Magnusson, Annabella
    et al.
    Lützén, Kim
    Ersta Sköndal University College, Department of Health Care Sciences.
    Severinsson, Elisabeth
    The influence of clinical supervision on ethical issues in home care of people with mental illness in Sweden2002In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 10, no 1, p. 37-45Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate in what ways clinical supervision can influence district nurses', psychiatric nurses' and mental health care workers' ethical decision-making in home care of people with mental illnesses. BACKGROUND: Nursing staff frequently have to make difficult ethical decisions when caring for mentally disturbed patients in the home. METHODS: This study is a descriptive, correlational study. Data was collected by a cross-sectional survey that focused on psychiatric nurses, district nurses and mental health care workers (n = 660). RESULTS: Health care professionals, who received supervision as support in their clinical nursing work, perceived that they felt more secure in decision-making, felt safer in their relationship with the patient and had gained a deeper insight into the meaning of security for the patient as well as for the carer. Furthermore, they regarded taking over responsibility for the patient, when necessary, as their moral right and that care and treatment in the patient's home could mean that the patient's integrity was violated. CONCLUSIONS: The results emphasize the need for clinical supervision as support for nursing staff, as it leads to their acquiring a greater sense of self-esteem. There is also a need to clarify the professional role of nurses through integration of theoretical and clinical knowledge. The importance of supervision is illustrated by means of previous studies.

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