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Leder
(side 167-168)
av Bente Martinsen Woythal
Vitenskapelig publikasjon
(side 169-184)
av Carsten Juul Jensen
Sammendrag

Ideals of «the good death» have profound implications for newly qualified nurses’ ability to cope with emotional and physical stress when working with dying patients; this ideal can be difficult to address in medical units in patient-safe hospitals.

The study employs institutional ethnography to gather data via participant observations in medical units, interviews and analysis of newly qualified nurses’ and colleagues’ speech and behavior, complementary to analysis of texts in documents related to the ideology of the patients’ safety program.

The majority of work activities in medical units are related to survival of patients because doctors inspect unintended deaths of patients and identification of critical illness in patients, which could be essential for the survival of patients. However, doctors disclaim responsibility for survival if patients are incurably ill, and entrust nurses to define palliative care, because health, survival and productivity are no longer possible.

The ideology of patient safety programs are control and development; therefore, death may appear as a mistake, for which new nurses blame themselves in a society with increasing individual responsibility for failure and success; at worst, they consider themselves failed nurses if patients die.

Vitenskapelig publikasjon
(side 185-200)
av Lise Thorsen og Anne Brødsgaard
Sammendrag

Introduction: Patient involvement as a concept is used interchangeably when managers, hospitals, and politicians articulate the patient's role. Aim: To investigate how caregivers invite the family into partnership when providing nursing care to the new family. Methods: The study includes field research and interviews on two maternity wards in the Capital Region of Denmark. Data collection occurred in a two-week period, with a total of 85 observations corresponding to 55 hours, and interviews with 30 caregivers corresponding to three hours of interviews. A total of 31 caregivers participated in the study. Results: Nurses articulate patient involvement as an important part of nursing. Their actions are based on a standardized agenda. The involvements of families depend on the caregivers’ engagement. The nurses experienced that working in a system – the hospital – makes involvement difficult. Conclusion: Patient involvement in practice requires strong priority throughout all stages of the health system.

Fagartikel
Ambulatoriesygeplejens vilkår
– en interviewundersøgelse med fokus på ambulatoriesygeplejerskers oplevelse af muligheder og barrierer i forhold til at udøve sygepleje
(side 201-216)
av Tina Jensen, Kirsten Frederiksen og Vibeke Lorentzen
Sammendrag

Background: Hospital services currently undergo major changes with an increasing number of patients treated in outpatient settings. However, nurses´ perception of practicing nursing in outpatient clinics is only sparsely described.

Aim: To identify nurses´ perceptions practicing nursing in outpatient settings.

Method: An interview study based on interviews with six nurses. The method is inspired by hermeneutics and interview analysis according to Kvale and Brinkmann.

Results: Nurses in outpatient settings reported an increased focus on instrumental nursing and they perceived barriers in practicing relational nursing.

Conclusion: Nurses perceived barriers to practicing nursing caused by the dominating biomedical perspective and productivity-driven management systems in healthcare. Moreover, nurses in outpatient settings constituted a barrier themselves by only documenting instrumental nursing and assessing nursing professionalism and independence using terms originating from biomedicine. Relational nursing in outpatient settings thus remains invisible and the complexity of outpatient nursing is not acknowledged.

Frihed og kontrol
– hjemmebehandling med subkutan immunglobulin
(side 217-228)
av Christine Boholt Thuesen, Lene Baand Nielsen, Ida Frantzen, Lars Kjøbsted Markvardsen og Anita Haahr
Sammendrag

The aim of this study was to describe how people with Chronic Inflammatory Demyelinating Polyneuropathy or Multifocal Motor Neuropathy experienced being treated with subcutaneous immunoglobulin at home. Seven people were interviewed and data were analyzed using a phenomenological-hermeneutic approach. The findings revealed the main theme as the experience of freedom and flexibility in everyday life. This was associated with acknowledging the subcutaneous treatment as a natural part of life. Going from intravenous to subcutaneous treatment initially generated skepticism and worries about being confronted with the disease on a daily basis. However, adapting to the subcutaneous treatment eventually made it possible to live a life similar to that before the diagnosis.

This knowledge is important in order to understand patients’ reluctance and challenges when having subcutaneous treatment. Healthcare professionals must acknowledge and anticipate the process patients go through and offer support in dealing with the patients’ temporary feelings of being both more ill and having more responsibility for their own treatment.

(side 229-242)
av Louise Vissing Jakobsen og Niels Christian Hvidt
Sammendrag

Substantial research has been done on existential issues in end-of-life care, but only a few take into consideration the conditions for existential and spiritual care in the emergency department. The purpose of this paper is to explore the definition and practice of existential and spiritual care by emergency nurses in a Danish emergency department. Aiming at a narrative approach, inspired by John Dewey, interviews with nurses in the emergency department were conducted. Results show a lack of perception and definition of existential and spiritual care, resulting in poor familiarity with the concept. Only when dying and dead patients are being treated, does there seem to be some attention to the existential and spiritual care provided. When nurses are treating patients more holistically, they may feel more contented and feel a stronger sense of coherence, as suggested by Aaron Antonovsky.

Præsentation af ph.d.-afhandling

3/2018 Årgang 32

www.idunn.no/klinisk_sygepleje

Redaktør

Bente Martinsen Woythal, Aarhus Universitet

Vitenskapelig redaktør

Annelise Norlyk, lektor, ph.d., cand.cur., Aarhus Universitet, Institut for Folkesundhed, Sektion for Sygepleje

Redaksjonssekretær

Aud Aasen

Redaksjonens adresse

Aarhus Universitet v/ Bente Martinsen Woythal

Institut for Folkesundhed, Sektion for Sygepleje, Campus Emdrup

Tuborgvej 164, bygning B

2400 København NV

Redaksjonens e-post

E-post: klinisksygepleje@gmail.com

Redaksjonsråd

Ingrid Poulsen, Dr.med.sci., leder af Forskningsenheden, Afd. for Højt specialiseret Neuro­rehabilitering/ Traumatisk Hjerneskade, Glostrup HospitalFrederik Alkier Gildberg, cand.cur., ph.d., Center for Psykiatrisk Sygepleje- og Sundhedsforskning (CPS), Syddansk Universitet

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