Exploring registered nurses' perspectives as mentors for newly qualified nurses: a qualitative interview study.

OBJECTIVE: Existing research has focused mostly on mentees' experiences of mentoring rather than mentors' experiences. Therefore, this study describes registered nurses' experiences of being a mentor for newly qualified nurses. DESIGN: A qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis. PARTICIPANTS AND SETTING: A purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%-100% as a registered nurse and to be able to communicate in Swedish or Norwegian. RESULTS: Our study's findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support. CONCLUSION: Being a mentor is a complicated role for registered nurses. The mentoring role is beneficial-ie, positive and rewarding-if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses' perspectives and needs regarding being a mentor and the study's findings make an important contribution to the field of nursing regarding the facilitation of mentoring.

Being a Newly Qualified Nurse: A Nordic Focus Group Study.

Introduction: The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments. Objective: To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession. Methods: This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results. Results: Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders. Conclusions: This study sheds light on the importance of creating a workplace culture where NQNs' learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.

Understanding nursing personnel's health while working in end-of-life care-A hermeneutical study.

AIM: This study aimed to explore nursing personnel's health while working in end-of-life care. INTRODUCTION: End-of-life care is challenging both for nursing personnel and for the healthcare organisation, as retaining nursing staff is difficult. Although end-of-life care involves the risk of burnout, it also encompasses protective factors that can lead to personal and professional development and satisfaction, and that can enable personnel to encounter their own inner selves. In order to focus on the health of nursing personnel we chose the theory of caritative caring as our theoretical perspective. METHOD: A qualitative inductive research design with a hermeneutical approach was chosen to explore nursing personnel's health while working in end-of-life care. Two assistant nurses and six registered nurses with experience in end-of-life care at a palliative care unit participated. The study was approved by a Regional Ethical Review Board. RESULTS: The results are presented on three levels: rational, structural and existential. In the rational level, fellowship and togetherness with colleagues, as well as being able to distinguish between private life and work were important for nursing personnel's strategies for maintaining their health. At the structural level, social togetherness, sharing emotions and being involved in each other's emotions were important for nursing personnel's health. The existential level showed that the nursing personnel's own existential situation was affected when their inner self was emotionally affected by the patients' suffering. The awareness of suffering, life and death made the nursing personnel feel inner security, both as nursing professionals and as human beings. CONCLUSION: A common perspective based on a theory of caritative care may be helpful for retaining nursing personnel. While the study highlights nursing personnel's health while working in an end-of-life care context, the results may also be applicable to nursing professionals' health in other contexts.

The Caring Mission - Nursing Personnel's Inner Driving Force in End-of-Life Care.

Constantly facing human suffering and impending death can generate anxiety and insecurity in nursing personnel in end-of-life care. The aim of the study is to reveal nursing personnel's inner driving force in end-of-life care. A phenomenological hermeneutical method was used to search for meaning in the narrative data collected in this study. The structural analysis resulted in four themes: The appeal in the patient's vulnerability, The appeal in the patient's joy, Facing one's own existence in vulnerability, and Being at home with colleagues. Both vulnerability and joy motivated nursing personnel in caring. The care was often emotionally engaging and oscillated between grief and joy, which required a great deal from the nursing personnel both as professionals and fellow human beings. At the same time the emotionally engaging constituted an inner driving force, which gave them courage to do the best for the patients at the end of life.

"Suffering as a Lifelong Companion: A Phenomenological-Hermeneutic Study of Men Living With Severe Psychiatric Illness"Lidelse som livslang følgesvenn: En fenomenologisk-hermeneutisk studie av menn som lever med alvorlig psykiatrisk sykdom.

Accumulation of suffering in later life due to severe psychiatric illness has received surprisingly little interest in nursing research. Suffering in daily living seems to be more demanding for men, a phenomenon still debated in the literature. This phenomenological-hermeneutic study aims at describing and interpreting the perspectives of adult men and their experiences of suffering in daily living with severe psychiatric illness, diagnosed as schizophrenia. Data were collected in dialogical conversations with four men aged between 20 and 40 years, living alone in northern Norway. The themes created from the structural understanding illuminate the participants' suffering as simultaneously struggling against the grasp of the illness and for reshaping the future. The theoretical interpretation unfolds the multidimensionality of their suffering and the need for confirmation of the suffering and reconciliation with the losses from illness, thus making reorientation to the future possible.

Relationships influencing caring in first-line nursing leadership: A visual hermeneutic study.

AIM: To explore and interpret relationships that influence caring in nursing leadership, in the context of Nordic municipal health care, from first-line nurse managers' perspectives. DESIGN AND METHOD: We chose a visual hermeneutic design. A three-stage interpretation process outlined by Drew and Guillemin, based on Rose, was used to analyse drawings and the following reflective dialogue from three focus groups, with a purposive sample of 11 first-line nurse managers. The study was conducted from February to May 2018. RESULTS: The findings demonstrated that first-line nurse managers struggled to balance their vision with administrative demands. Caring for patients implied caring for staff; however, they often felt as if they were drowning in contradictory demands. First-line nurse management could be a lonely position, where the first-line nurse managers longed for belonging based on increased self-awareness of their position within an organisation. Superiors' support enabled first-line nurse managers' in their primary aim of caring for patients. CONCLUSION: First-line nurse managers showed deep roots to their identities as nurses. Caring for patients included caring for staff and was their main concern, despite demanding reforms and demographic changes affecting leadership. Superiors' support was important for FLNMs' self-confidence and independence in leadership, so the first-line nurse managers can enact their vision of the best possible patient care. This study adds knowledge of the significance of caring in nursing leadership and the caritative leadership theory. IMPACT: In order to recognise FLNMs as vulnerable human beings and provide individual confirmation and support, a caring organisational culture is needed. FLNMs need knowledge based on caring and nursing sciences, administration and participation in formal leadership networks. These findings can serve as a foundation for developing educational programmes for nurse leaders at several organisational levels.

First-Line Nurse Managers' Challenges at the Crossroads of Norwegian Health Care Reforms.

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions.

Safeguarding the patient in municipal healthcare-A hermeneutic focus group study of Nordic nursing leadership.

AIM: This study illuminates the meaning and purpose of clinical presence in nursing leadership in municipal home care from the first-line nurse manager's own perspective. BACKGROUND: Being a first-line nurse manager in the context of home care is demanding due to demographic changes and an ever-increasing number of elderly suffering from chronic diseases. Leading in this context entails leading from a distance because patients live and receive care in their homes. First-line nurse managers express the importance of clinical presence. However, there is a paucity of studies from home care of the meaning and purpose of presence. The theory of caritative leadership and the model of caring in nursing leadership served as the starting point for this study. METHODS: Hermeneutic abductive approach using a purposive sample of three semistructured focus group interviews with 11 first-line nurse managers in home care in three Nordic countries. RESULT: This study shows that first-line nurse managers described the meaning and purpose of their clinical presence in home care as safeguarding the patient by taking overall responsibility for care, securing the patients' voices, building and maintaining trustful relations, and securing a sensible economy. CONCLUSION: Our findings indicate that clinical presence serves the purpose of taking the overall responsibility for care and safeguarding the patient. Presence is perceived a necessity to verify staff providing the best possible care. First-line nurse managers acted metaphorically as a shield to protect patient care, which is the main concern in their leadership. The findings add new knowledge to the significance of caring in nursing leadership and the theory of caritative leadership. IMPLICATIONS FOR NURSING MANAGEMENT: First-line nurse managers need to be clinically present in order to safeguard the patient and to fulfil their threefold responsibilities for the patient, the staff and the economy. This study might also contribute to the political discussion concerning why nurses has to be first-line nurse managers and cannot be replaced by economists.

The caring encounter in nursing.

BACKGROUND:: The concept 'encounter' occurs in caring literature as a synonym for dialogue and relation describing deeper levels of interaction between patient and nurse. In nursing and caring research, the concept 'caring encounter' is often used without further reflection on the meaning of the concept. Encounters are, however, continuously taking place in the world of caring, which calls for a clarification of the concept. OBJECTIVES:: This study is an analysis of the concept of caring encounter in nursing from the patients' and nurses' point of view. METHOD:: Rodgers' evolutionary view guided the concept analysis within the theoretical perspective of caritative caring. DATA SOURCES:: Peer-reviewed articles in English published between 1990 and 2014 were retrieved from the databases: CINAHL, PubMed, Web of Science, ScienceDirect (Elsevier), Springer Link, Primo Central (Ex Libris) and Academic Search Premier (EBSCO) using different combinations of encounter, caring and nursing as keywords. In all, 28 articles related to caring encounters were included in the analysis after applying inclusion and exclusion criteria. ETHICAL CONSIDERATIONS:: This study was conducted according to good scientific practice. RESULTS:: Four antecedents to the caring encounter are found in the nurse's way of being: a reflective way of being; openness, sensitivity, empathy and ability to communicate; confidence, courage and professionalism; and showing respect and supporting dignity. The attributes are as follows: being there, uniqueness and mutuality. As a consequence, the caring encounter influences both patient and nurse. DISCUSSION AND CONCLUSION:: The caring encounter is an encounter between two equal persons where one is nurse and the other is patient. They encounter in mutuality, in true presence, and both have allowed themselves to be the person they are. The results clarify the conceptual differences between relationship and caring communion as the mutuality in the caring encounter differs from the dependence on the other pronounced in the relationship.

Reflecting on one's own death: The existential questions that nurses face during end-of-life care.

OBJECTIVE: When registered nurses care for patients at the end of life, they are often confronted with different issues related to suffering, dying, and death whether working in hospital or community care. Serious existential questions that challenge nurses' identities as human beings can arise as a result of these situations. The aim of our study was to describe and gain a deeper understanding of nurses' existential questions when caring for dying patients. METHOD: Focus-group interviews with registered nurses who shared similar experiences and backgrounds about experiences in end-of-life care were employed to gain a deeper understanding about this sensitive subject. Focus-group interviews were performed in hospice care, in community care, and in a palliative care unit in western Sweden. A qualitative hermeneutic approach was employed to interpret the data. RESULTS: Nurses' existential questions balanced between responsibility and guilt in relation to their patients, between fear and courage in relation to being professional caregivers and fellow human beings, and between hope and despair in relation to the other's and their own death. SIGNIFICANCE OF RESULTS: Nurses in end-of-life care experience various emotions from patients related to things physical, spatial, and temporal. When nurses encounter these emotions as expressing a patient's suffering, they lead to challenges of balancing between different feelings in relation to patients, as both professional caregivers and fellow human beings. Nurses can experience growth both professionally and as human beings when caring for patients at the end of life.

Ethical principles in the work of nurse educator-A cross-sectional study.

BACKGROUND: The application of ethical principles within the teaching profession and nursing practice forms the core of the nurse educator's professional ethics. However, research focusing on the professional ethics of nurse educators is scarce. OBJECTIVES: To describe ethical principles and issues relating to the work of nurse educators from the perspectives of both nurse educators themselves and nursing students. DESIGN: A descriptive study using cross-sectional data and content analysis. SETTINGS: Nursing education program involving students from nine polytechnics in Finland. PARTICIPANTS: Nursing students (n=202) and nurse educators (n=342). METHODS: Data were derived from an online survey, with two open-ended questions: Nursing students and nurse educators were asked to name the three main ethical principles that guide the work of nurse educators and also to describe ethical issues involved in the work. RESULTS: Students most often named professionalism, justice, and equality as the main ethical principles for a nurse educator. Nurse educators considered justice, equality, and honesty as the main ethical principles. The content analysis showed that professionalism and the relationship between educator and student were the key categories for ethical issues as perceived by nursing students. Nursing students most often identified inequality between the nurse educator and nursing student as the ethical issue faced by the nurse educator. CONCLUSIONS: Nursing students and nurse educators differed somewhat both in their views of the ethical principles guiding an educator's work and in the ethical issues arising in the work.

The space of togetherness--a caring encounter.

Encounters in relation to the nurse-patient relationship are often discussed within nursing and caring literature without a reflection on the actual meaning of the concept. Assuming that an encounter is essential for nursing care, this article seeks to create a deeper understanding of the concept through a hermeneutic approach to texts by the philosophers Buber and Marcel. Presence, recognition, availability and mutuality seem to be essential prerequisites for an encounter. As these prerequisites are fulfilled within and between human beings who encounter each other, it is possible to speak of a space of togetherness, a mutual existence, where life's mystery shines forth and caring is realized. The challenge lies in creating these encounters within nursing care.

Semantic analysis according to Peep Koort--a substance-oriented research methodology.

The aim of this article is to describe the hermeneutic semantic analysis created by professor Peep Koort (1920-1977) and to discuss it as a methodology for research within caring science. The methodology is developed with a hermeneutic approach that differs from the traditions of semantic analysis in philosophy or linguistics. The research objects are core concepts and theoretical constructs (originally within the academic discipline of education science, later on within the academic discipline of caring science), focusing deeper understanding of essential meaning content when developing a discipline. The qualitative methodology of hermeneutic semantic analysis is described step by step as created by Koort, interpreted and developed by the authors. An etymological investigation and an analysis of synonymy between related concepts within a conceptual family guides the researcher to understand and discriminate conceptual dimensions of meaning content connected to the word studied, thus giving opportunities to summarise it in a theoretical definition, a discovery that can be tested in varying contexts. From a caring science perspective, we find the hermeneutic methodology of semantic analysis fruitful and suitable for researchers developing their understanding of core concepts and theoretical constructs connected to the development of the academic discipline.