‘The responsibility of someone else’: a focus group study of collaboration between a university and a hospital regarding the integration of caring science in practice

Appropriation and application of caring science theory: Experiences of master education alumni in three Nordic countries

BACKGROUND

A theoretical foundation in caring science is invaluable for nursing care because it enriches practice by providing explanations, clarity and direction. However, after graduation, students experience the frustration of not being able to sufficiently intertwine caring science theories in practice. Consequently, the integration of caring science theories in nursing education and practice is considered an essential focus area to reduce this theory-practice gap.

AIM

This study aims to elucidate master alumni's experiences of appropriation and application of caring science after completing a master's education.

METHODS

The data were collected by semi-structured interviews with 21 alumni from Finland, Sweden and Norway who had recently completed a master's degree with caring science as the major subject. A thematic analysis was used.

FINDINGS

The analysis resulted in two main themes, both with three subthemes. Educator's bearing and a learning community are important for students' appropriation of caring science theories. Learning through reflection and the response of others evoke new paths of thought, and practice-related teaching promotes the intertwining and application of caring science theory in practice. The appropriated theory has significance to alumni by providing a guiding basis that strengthens alumni's professional bearing and way of being. The caring science theory guides alumni in providing nursing care with an increased ethical awareness and questioning approach that enables good patient care. Their professional identity and confidence in caring are also strengthened.

CONCLUSION

Educators' bearing is of outermost importance for appropriation and application of caring science theory. It has a key function in facilitating students' understanding and intertwining of caring science theory and practice. Appropriated caring science theory provides authority and courage to practice nursing care. The appropriated theory promotes alumni's ethical awareness, confidence and a sense of pride in the profession.

First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing

AIM

The aim was to explore first line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing.

DESIGN

A qualitative study with a phenomenographical approach.

METHOD

Data were collected through focus group interviews with 15 first line nurse managers' in four settings.

RESULTS

The results are presented in four categories of description headed: Manage the everyday work vs. evidence-based nursing; Uncertainties about evidence-based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness-towards an active approach to evidence-based nursing. The overarching category of description has been formulated as follows: The internal relation-how active leadership influences evidence-based nursing. The outcome space is presented as: The individual path-how to make vision and reality become a working entity around evidence-based nursing.

Developing preceptorship through action research: Part 1

Clinical preception in practice plays a significant role in both registered and practical nurse studies. As such, the cooperation between the faculty and working life is important to narrow the theory-practice gap, with emphasis being placed on a student-oriented approach promoting self-direction and lifelong learning. The aim of this project was to develop the preceptorship at five different units within the health-care sector in western Finland by implementing an action research (AR) approach. This article is the first of a two-part article on the project, focusing on a cultural analysis and the development of preception models conducted within the project. The five units participating in the study were the following: a long-term care ward in the community, a ward for people with dementia, a geriatric ward, a medical ward and a surgical ward representing specialised care. The starting point of the study was a cultural analysis, which was made in all the five units to obtain a 'bottom-up' perspective. In each of the five units 3-5 nurses were appointed to become members of the core groups. This meant that all the units would start from the perspective of their own working environment when creating a preception model that would fit into their particular workplace. During this process, the participants received continuous support from the researchers. Several workshops and seminars were also arranged to further support the core groups and staff. The models were implemented and tested during the academic year 2010-2011 followed by an evaluation of the project. The evaluation results will be presented in the second part of the two-part article. The project showed that reflective practice and critical thinking can be improved through an AR approach.

The challenge of giving written thesis feedback to nursing students

Providing effective written feedback on nursing student's assignments can be a challenging task for any assessor. Additionally, as the student groups tend to become larger, written feedback is likely to gain an overall more prominent position than verbal feedback. Lack of formal training or regular discussion in the teaching faculty about the skill set needed to provide written feedback could negatively affect the students' learning abilities. In this brief paper, we discuss written feedback practices, whilst using the Bachelor of Science in Nursing thesis as an example. Our aim is to highlight the importance of an informed understanding of the impact written feedback can have on students. Creating awareness about this can facilitate the development of more strategic and successful written feedback strategies. We end by offering examples of some relatively simple strategies for improving this practice.

Nursing students' perspectives and suggestions on patient safety--implications for developing the nursing education curriculum in Iran

BACKGROUND

Nursing students' close involvement in knowledge development about patient safety will enhance the integrity of the current content of nursing education and pave the way towards developing a nursing curriculum that facilitates achieving a safer health-care system.

OBJECTIVES

This study explores nursing students' perspectives and suggestions on developing patient safety aspects of the nursing curriculum in the context of Iranian culture.

DESIGN

A qualitative methodology involving three focus groups with a purposive sample of 18 nursing students from a large Iranian nursing school, utilising directed semi-structured interviews generated data, which was analysed using the content analysis process.

RESULTS

Two main themes emerged from content analysis: (1) "involving students fully in patient care" with subthemes 'building a trusting relationship between education and practice', and 'promoting inter-dependence between health-care providers', and (2) "structuring patient safety education" with subthemes 'transforming nursing routines to evidence-based care', and 'connecting care to patient safety issues'.

CONCLUSIONS

The extent of students' involvement in clinical practice and clinical nurses' roles in student education in practice requires clarification. The curriculum needs to incorporate patient safety aspects throughout, and include interdisciplinary education to ensure compliance with patient safety policies. Moreover, successful implementation of such a curriculum necessitates cooperation from nursing practice and instructors to meet nursing students' expectations.

Older patients' participation in team meetings-a phenomenological study from the nurses' perspective

Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM) to which the patient has been invited. The aim of this study is to highlight nurses' experiences of older patients' participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients' vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: "the need for a guide," "patient participation challenged by structures," and "creating space for the whole human being." In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.

Finnish and Swedish nursing students' experiences of their first clinical practice placement--a qualitative study

BACKGROUND

Nursing is a practice-based discipline. Clinical practice settings are important in preparing undergraduate nursing students for the role of registered nurse.

AIM

The aim of this Nordic qualitative study is to illuminate first year undergraduate nursing students' experiences of clinical practice during their first clinical placement, with a focus on preception, reflection, and the link between theory and practice.

METHOD

Data were collected by focus group interviews with 22 nursing students, and analyzed with qualitative content analysis.

FINDINGS

Positive experiences included stimulating and visible preceptors, a permissive atmosphere, and reflection as a matter of course. Negative experiences were related to feelings of abandonment and powerlessness when preceptors were invisible and the atmosphere at the ward was non-permissive. The implementation of research-based knowledge was insufficient.

CONCLUSIONS

A permissive atmosphere and visible preceptors are crucial if learning is to be maximized. Consequently, it is important to set aside time for preceptors to be more visible and to make the atmosphere at the clinical placement more permissive. The student must have the opportunity to combine scientific knowledge with evidence-based knowledge in order to develop nursing actions.