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The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher Education Reform: the implementation of the so-called Bol ...

Effective pre-hospital treatment of a person suffering cardiac arrest is a challenging task for the ambulance nurses. The aim of this study was to describe ambulance nurses' experiences of nursing patients suffering cardiac arrest. Qualitative personal interviews were conducted during 2011 in Sweden with seven ambulance nurses with experience of nursing patients suffering cardiac arrests. The interview texts were analyzed using qualitative thematic content analysis, which resulted in the formulation of one theme with six categories. Mutual preparation, regular training and education were important factors in the nursing of patients suffering cardiac arrest. Ambulance nurses are placed in ethically demanding situations regarding if and for how long they should continue cardio-pulmonary resuscitation (CPR) to accord with pre-hospital cardiac guidelines and patients' wishes. When a cardiac arrest patient is nursed their relatives also need the attention of ambulance nurses. Reflection is one way for ambulance nurses to learn from, and talk about, their experiences. This study provides knowledge of ambulance nurses' experiences in the care of people with cardiac arrest. Better feedback about the care given by the ambulance nurses, and about the diagnosis and nursing care the patients received after they were admitted to the hospital are suggested as improvements that would allow ambulance nurses to learn more from their experience. Further development and research concerning the technical equipment might improve the situation for both the ambulance nurses and the patients. Ambulance nurses need regularly training and education to be prepared for saving people's lives and also to be able to make the right decisions.

Aims and objectives To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge. Background There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery – from injury to recovery. Design A qualitative approach was used. Methods Interviews with nine participants were subjected to thematic content analysis. Results One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended. Conclusions and relevance to clinical practice Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, ‘from realising the seriousness of the injury to regaining autonomy’. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process.

Summary Objectives It is limited research that focuses on people's experiences from prior to surgery to the postoperative period after a gastric bypass. The aim of this retrospective study was to describe people's experiences of undergoing gastric bypass surgery. Method A qualitative approach was used. Interviews with ten participants were subjected to qualitative content analysis. Results The analysis of the interviews resulted in one theme: from reaching the end of the road to a new lighter life. Prior to surgery participants described a sense of inferiority and that they were not able to ‘take any more’. Shortly after surgery participants felt both vulnerable and safe in the unknown environment and expressed needs of orientation and to have the staff close. Despite information prior to surgery it was difficult to imagine ones’ situation after homecoming, thus it was worth it so far. Conclusion The care given in the acute postoperative phase for people who undergo gastric bypass surgery, should aim to provide predictability and management based on individual needs. Being treated with respect, receiving closeness, and that the information received prior to surgery complies with what then happens may facilitate postoperative recovery after a gastric bypass surgery.

Background: To be cared for in an intensive care unit (ICU) after a complicated childbirth is often an unplanned and transforming experience, and there is lack of studies describing mothers' experiences of this phenomenon. Aim: The aim of this study was to describe the experiences of becoming a mother after a complicated delivery and a stay in an ICU. Methods: Qualitative personal interviews were conducted with eight mothers. The interview texts were subjected to qualitative thematic content analysis. Findings: The analysis resulted in one theme; wishing to be in control and together as a family, and six categories; being or not being prepared, feeling afraid, not being as ill as the others, knowing about the baby, worrying about the father and having someone to talk to. The findings highlight the need to receive continual information about what is happening, especially with the baby, and the need to be together as a family. Conclusion and relevance to clinical practice: The mothers need support and encouragement from the staff throughout their hospital stay, and sometimes afterwards. There is a need to receive information, especially about the baby, and to have one's family close by, when in an ICU despite illness severity. How the new family is met by the staff is of great importance.

In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master's level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students' postgraduate degree projects within the second cycle of higher education (master's level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes.

the aim of this pilot study was to describe family members' satisfaction with the care provided in a Swedish intensive care unit (ICU) based on the following needs: assurance, information, proximity, support, and comfort, which are all included in the Critical Care Family Satisfaction Survey (CCFSS).knowledge concerning satisfaction with care among family members with a critically ill relative in an ICU is important if the family is to be met professionally.the study design was descriptive and retrospective, with a consecutive selection of family members of critically ill people cared for in an ICU. In total 35 family members participated.quantitative analyses based on 20 questions, and a qualitative analysis, based on two open questions was used. The median, average value and percent were computed for every question. The open questions were analyzed using qualitative content analysis.the family members had a high level of satisfaction regarding all groups of needs. They were especially satisfied with flexible visiting hours and the high quality of treatment that the ill person received. The shortcomings that emerged were that family members wanted the physician to be more available for regular talks, the room for relatives was felt to be uncomfortable; and it was felt there were deficiencies in the preparations before the patient's transferral to a ward.the results highlight the family members' need for regular information and the need to improve the environment in the waiting rooms for family members. The ICU staff's competence and their way of encountering the ill person and their family seem to be important for family members' satisfaction with the care.

The aim of this study was to describe women's experience of living with a colostomy after rectal cancer surgery. Interviews with five women about their experiences were subjected to thematic content analysis. The findings showed that receiving a cancer diagnosis gave rise to thoughts about life and death. For the women to feel comfortable, the information and health-care measures need to focus on supporting them through the entire process, also when the treatment is completed. After the surgery, the women adjusted to living with colostomy and carried on as before the cancer diagnosis, but they constantly worried about leakage or flatulence. The women were happy to have survived the cancer and this realization helped them to accept and have a good life with colostomy. In conclusion, women with colostomy because of rectal surgery need specific rehabilitation and nursing care that focuses on adjustment to temporary or permanent changes in life.

Title. Receiving power through confirmation: the meaning of close relatives for people who have been critically ill Aim. This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit. Background. Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation. Method. A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur. Findings. One major theme was identified, experiencing confirmation, with six sub-themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will-power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them. Conclusion. Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff.