Organisational and leadership skills towards healthy workplaces: an interview study with registered nurses in Sweden.

BACKGROUND: According to shortage of registered nurses, organisational and leadership aspects grounded in person-centrered approach, are highlighted to ensure high quality of care. Therefore, it is interesting to develop knowledge regarding registered nurses working environment. AIM: The aim of the study was to investigate registered nurses' reason to end their employment at a university hospital setting (internal medicine, emergency department). METHOD: Qualitative content analysis with an inductive methodological approach was used to analyse registered nurses' experiences regarding their former employment. Inclusion criteria; all nurses (n = 55) who ended employment during one year (first of July 2020-30th of June 2021) were invited, and 38 semi-structured interviews were conducted. RESULTS: Three categories were identified: Limited organisational support, Lack of visible leadership, and Limited healthy working environment, followed by six subcategories: Longing for organisational support, Being a tile in a box, Need for professional relationship, Limitation of supportive leadership, Imbalance of work versus personal life, and Ethical stress. CONCLUSION: To improve registered nurses working environment and commitment to work, balance between time at work and personal life is significant. Therefore, organisational support and leadership skills grounded in a person-centred approach are crucial to develop a healthy working environment. A person-centred leadership could improve collaboration and shared decision-making in partnership with those involved, managers, nurses, and team members.

"Struggling with life": narratives from women with signs of postpartum depression.

AIM: The aim of this study was to explore and describe how Swedish women with signs of postpartum depression two months postpartum experience the first months with their child. METHOD: A grounded theory approach was chosen. Twenty-two women who showed signs of depression, i.e. scored 10 or more on the Edinburgh Postnatal Depression Scale (EPDS), were interviewed at an average of 80 days after the delivery. RESULTS: The new mothers were struggling with life related to the self, the child, and the partner. They expressed feelings of loss of who they are, felt overwhelmed by the responsibility for the child, and were struggling with feelings of abandonment, worries, and breastfeeding problems. They often felt like "bad mothers" but they never blamed the child. Most mothers were reluctant to speak about their feelings and they assigned their depressed mood to personal weakness rather than illness. In relationship to the partner the mothers were struggling to keep their equality in the new situation and to get him involved in childcare. CONCLUSIONS: The findings suggest that depressed feelings postpartum may be explained in terms of losses and changes. However, postpartum depressive symptoms remain hidden and it is important to understand the complexity of postpartum depressive mood, described here as struggling with life related to three different dimensions: the self, the child, and the partner.