Introduction

Registered nurses play a critical role in disaster response and patient care during crises. Recent global events underscore the importance of preparedness for disaster response. However, the readiness of registered nurses and their educational preparation vary. In Sweden, this prompted the National Board of Health and Welfare to introduce a new national curriculum for disaster response. This study aimed to assess how education for undergraduate and specialist registered nurses aligns with this curriculum.

Methods

A descriptive cross-sectional study was conducted among universities and university colleges in Sweden offering undergraduate and specialist nursing programs. Surveys were sent to all 25 higher education institutions providing nursing education in November 2023, comprising 29 questions related to the new curriculum.

Results

Findings revealed that half of the respondents had discussed the new curriculum, with 15 reporting some form of learning activities. Traditional lectures were the most commonly used format, and 11 respondents had designated teachers for the subject. Reasons for lacking disaster response education included prioritizing other acute care areas or a limited perspective at the academy.

Discussion

In conclusion, this study suggests that nursing education may not sufficiently prepare registered nurses for disaster response and armed conflicts. Education tends to focus more on acute care rather than taking a broader perspective. As a result, registered nurses may lack the competence and readiness required to effectively respond to disasters.

Introduktion: Sjuksköterskor har en nyckelroll i beredskapen för och vården av patienter under katastrofmedicinska insatser. I Sverige har händelseförloppet de senaste åren, till exempel gängkriminalitet, terrorattentat, covid 19-pandemin och Rysslands fullskaliga invasion av Ukraina ökat uppmärksamheten på sjuksköterskors kompetens att möta olika typer av katastrofer. År 2022 presenterade Socialstyrelsen en rapport där de beskrev detaljerade kunskaps- och färdighetsmål för utbildningar och övningar i katastrofmedicin. Samtidigt visar en nyligen publicerad svensk studie att sjuksköterskestudenter uppfattar sig ha otillräckliga kunskaper i katastrofmedicin.

Syfte: Undersöka i vilken utsträckning sjuksköterskeutbildningarna på grundläggande och avancerad nivå i Sverige bedriver utbildning i katastrofmedicinsk beredskap och civilt försvar.

Metod: En enkät skickades i november 2023 till alla de lärosäten i Sverige som erbjuder grund- och specialistutbildningar för sjuksköterskor (n=25). Enkäten bestod av 29 frågor relaterade till de kunskaps- och färdighetsmål för utbildning och övning i katastrofmedicin som Socialstyrelsen angett ut.

Resultat: 18 av 25 lärosäten besvarade enkäten och förekomst av utbildning var enligt följande:

• Sortering och prioritering av personer på skadeplats (n=16) eller på sjukhus (n=15)

• Sjukvårdens organisation och ledning på skadeplats/ sjukhus (n=15)

• Bedömning och omhändertagande av personer som utsatts för högenergetiskt våld (n=11)

• Principerna för sjukvård under höjd beredskap och krig (n=9)

• Sjukvårdens roll i totalförsvaret (n=5)

• Försvarsmaktens sjukvårdsorganisation och dess funktion vid väpnad konflikt/krig (n=2)

Konklusion: Resultatet tyder på att den utbildning som ges främst fokuserar på akutvård under normalförhållanden. Däremot brister utbildningen när det gäller att förbereda blivande sjuksköterskor på grundläggande och avancerad nivå att möta samt hantera situationer som inryms inom det civila försvaret.

ReferenserSocialstyrelsen. (2022). Nationella utbildnings- och övningsplaner för katastrofmedicinsk beredskap och civilt försvar samt nationell samordning av utbildning och övning. Redovisning av regeringsuppdraget S2021/02922

Robinson et al. (2023) Teaching extent and military service improve undergraduate selfassessed knowledge in disaster medicine: An online survey study among Swedish medical and nursing students. Front. Public Health 11:1161114.

Andersson et al. (2024). Are you ready: disaster response in nursing education: a cross‑sectional survey among Swedish universities and university colleges. Discover Health Systems 3:74

Introduktion: I en försämrad global situation blir den civila sjukvårdens beredskap inför väpnade konflikter avgörande. Sjuksköterskor med eller utan specialistutbildning är ofta bland de första att bevittna hot och våld mot sjukvården. Därför är det av yttersta vikt att sjuksköterskor har kunskap om internationell humanitär rätt (IHL) för att fullt ut förstå sina rättigheter och skyldigheter i samband med väpnad konflikt.

Syfte: Undersöka i vilken utsträckning sjuksköterskeutbildningarna på grundläggande och avancerad nivå i Sverige bedriver utbildning i IHL

Metod: En enkät skickades i november 2023 till alla de lärosäten i Sverige som erbjuder grund- och specialistutbildningar för sjuksköterskor (n=25). Enkäten bestod av 9 frågor relaterade till grundläggande kunskaper om IHL.

Resultat: 18 av 25 lärosäten besvarade enkäten och förekomst av utbildning var enligt följande:

• Den civila sjukvårdens beredskap och organisation vid väpnad konflikt/krig (n=4)

• Grundprinciperna som finns i IHL (n=2)

• Relationen mellan IHL och de mänskliga rättigheterna (n=2)

• Vilka skyddade personalkategorier det finns i ett krig enligt IHL (n=2)

• Sjukvården och IHL (n=2)• Vilka skyddssymboler som finns och vad de avser att skydda (n=2)

• Hur krig får föras och vilka vapen som får användas (n=1)

• Konventioner till skydd för krigets offer (n=1)

• Vad som händer när IHL kränks (n=1)

Konklusion: Resultatet tyder på att utbildningen brister när det gäller att förbereda blivande sjuksköterskor på grundläggande och avancerad nivå att förstå sina rättigheter och skyldigheter i samband med väpnad konflikt.

Referenser

Blanchet, K., et al., Have attacks on healthcare become the new normal? a public health call to action for armed conflicts before it is too late. Conflict and health, 2023. 17(1): p. 56.

Sassòli, M. and P.S. Nagler, International humanitarian law: rules, controversies, and solutions to problems arising in warfare. 2019, Cheltenham: Edward Elgar Publishing.

SOU (2022). Hälso- och sjukvårdens beredskap – struktur för ökad förmåga. Slutbetänkande av utredningen om hälso- och sjukvårdens beredskap (2022:6). Regeringskansliet

The growing global instability has increased the demand for healthcare and disaster response skills among registered nurses (RNs). However, research shows that RNs are not sufficiently prepared for disaster situations. Although RNs are responsible for managing injuries during armed conflicts in accordance with International Humanitarian Law (IHL), nursing education lacks specific training in this area. A national survey revealed that only two universities in Sweden offer IHL-related education for nursing students. These findings highlight the urgent need to revise nursing education in Sweden to better prepare RNs for the challenges posed by global crises, including armed conflicts.

Background

It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds.

Methods

This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis.

Results

Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue.

Conclusion

Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service.

Background

It has been suggested that the university environment, to improve students’ health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work.

Methods

This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions.

Results

The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems.

Conclusions

Students’ report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality.

Introduction

Healthcare systems worldwide are facing numerous challenges, such as an aging population, reduced availability of hospital beds, staff reductions and closure of emergency departments (ED). These issues can exacerbate crowding and boarding problems in the ED, negatively impacting patient safety and the work environment. In Sweden a hybrid of prehospital and intrahospital emergency care has been established, referred to in this article as Medical Emergency Team (MET), to meet the increasing demand for emergency care. MET, consisting of physicians and nurses, moving emergency care from EDs to patients’ home. Physicians and nurses may encounter challenges in their healthcare work, such as limited resources for example medical equipment, sampling and examination, in unfamiliar varying home environments. There is a lack of knowledge about how these challenges can influence patient care. Therefore, the aim of this study was to explore the healthcare work of the METs when addressing patients’ emergency care needs in their homes, with a focus on the METs reasoning and actions.

Methods

Using a qualitative multiple case study design, two METs in southwestern Sweden were explored. Data were collected from September 2023 – January 2024 and consist of field notes from participant observations, short interviews and written reflections. A qualitative manifest content analysis with an inductive approach was used as the analysis method.

Result

The result of this study indicates that physicians and nurses face several challenges in their daily work, such as recurring interruptions, miscommunication and faltering teamwork. Some of these problems may arise because physicians and nurses are not accustomed to working together as a team in a different care context. These challenges can lead to stress, which ultimately can expose patients to unnecessary risks.

Conclusion

When launching a new service like METs, which is a hybrid of prehospital and intrahospital emergency care, it is essential to plan and prepare thoroughly to effectively address the challenges and obstacles that may arise. One way to prepare is through team training. Team training can help reduce hierarchical structures by enabling physicians and nurses to feel that they can contribute, collaborate, and take responsibility, leading to a more dynamic and efficient work environment.

Objective

The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.

Design

The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.

Setting

Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. Participants Of 2283 students, 851 (37.3%) participated.

Results

The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.

Conclusions

The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.

Introduction: Ethical competence in professional practice can be considered essential among nurses and nurses in ambulance care encounter ethical dilemmas frequently. To enhance ethical competence among students in the ambulance specialist nursing program, high-fidelity simulation scenarios including ethical dilemmas were introduced as a learning activity. Research aim: The research aim was to investigate the usefulness of high-fidelity simulation in ambulance specialist nurse education to teach ethical reasoning when caring for children. Research design: This study was conducted as a qualitative interview study, complemented with observations and using field notes and qualitative interviews for data collection. Data was analysed using deductive qualitative content analysis based on a care ethical model. Participants and research context: Participants (n = 35) were recruited from an ambulance nurse educational program at a Swedish university. Data was collected after the students took part in two high-fidelity simulations involving children in an ambulance care setting. Ethical considerations: The study has been vetted and approved by the ethical council at the University of Borås, Sweden. The study follows the Helsinki Declaration?s advice on ethical principles. Results: The results showed that most of the students expressed some form of ethical reasoning during the simulation sessions, which were elaborated and reflected upon during the debriefing part of the sessions. The simulation design seemed to have a great impact on the outcome of the student's ethical reasoning, where increased immersion led to deeper emotional engagement among the students which increased awareness of their personal preconceptions. Conclusions: This study aimed to investigate whether high-fidelity simulations could be useful to stimulate ethical reflections and contribute to increased ethical competence among students. In conclusion, a well-designed high-fidelity simulation can be useful as an educational tool to learn and enhance ethical competence among specialist ambulance nursing students.

Abstract: BACKGROUND: Transition programs for newly graduated nurses in hospital settings are reported to provide learning opportunities, strengthening confidence, workplace integration and skills, retention and job satisfaction. Still, our knowledge of long-term effects is scarce and few studies have used control groups. OBJECTIVE: To explore the long-term impact of having attended a transition program on the nurses’ experiences of the first years of practice. More specifically, ideology-infused psychological contract, ethical stress, perceived organizational support, job satisfaction, opportunities for learning, and intention to stay in the nursing profession, were explored as outcome variables. METHODS: A questionnaire survey was carried out among registered nurses from November 2019 to January 2020, with a 54% response rate. The analysis was based on 149 nurses who had attended a transition program, and 72 who had not attended. The nurses had seniority between one and three years. Independent samples t-test were used to investigate differences between the groups. RESULTS: The two groups showed small and non-significant differences in the outcome variables. However, regarding the frequency of ethical value conflicts induced by insufficient resources, as well as experiences of ethical value conflict distress, the group of nurses who had attended a transition program showed statistically significantly higher mean values, although the effect sizes were small. CONCLUSION: Newly graduated nurses need more than transition programs and skills training to progress in their nursing role and develop competence, increase job satisfaction, and reduce stress. Achieving these goals requires a long-term supportive learning environment that is integrated into everyday work.