Tuija Viking, Maria Skyvell Nilsson and Inga Wernersson
This study aims to investigate how aspects of the sex/gender were scrutinized in a team’s production of clinical guidelines for psychiatric compulsory care and what the…
Abstract
Purpose
This study aims to investigate how aspects of the sex/gender were scrutinized in a team’s production of clinical guidelines for psychiatric compulsory care and what the implications were for the final guidelines and for interprofessional learning.
Design/methodology/approach
The study is a case study, where interviews were conducted and a narrative analysis was used.
Findings
The results reflected how sex/gender arose in a discussion about gender differences when using restraining belts. Furthermore, discussions are presented where profession-specific experiences and knowledge about sex/gender appeared to stimulate interprofessional learning. However, the team’s learning about the complexity of sex/gender resulted in guidelines that emphasized aspects of power and focused on the individual patient. Thus, discussions leading to analysis and learning related to gender paradoxically produced guidelines that were gender-neutral.
Originality/value
The study highlights the potential interprofessional learning in discussions of sex/gender and its complex relation in medicine.
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Mia Björk, Annika Eklund, Maria Skyvell Nilsson and Viola Nyman
The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.
Abstract
Purpose
The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.
Design/methodology/approach
The study was conducted as a bottom-up improvement project at a hospital ward in western Sweden. An insider action research (IAR) approach was used during the project. The theoretical framework for this project was based on the Cultural-Historical Activity Theory (CHAT). Data were collected between 2019 and 2021.
Findings
The findings showed that unclear professional boundaries and limited resources challenged and hindered interprofessional collaboration. The project group had to reorganize its daily work to adjust to the different disciplines’ legal responsibilities in relation to the patients’ recovery process. To safely discharge patients, the professionals needed to talk about each other’s professional responsibilities, professional boundaries and ethical codes.
Originality/value
The IAR project revealed that revising the daily team-round routine improved the status of assistant nurses and encouraged physicians to consider input from all professions during the patients’ recovery process. However, the new approach faced resistance from clinic leadership, who believed it could prolong patients’ stays in the ward. The findings underscore the challenges of modifying hierarchical structures and social orders within hospital settings.
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Annika Eklund and Maria Skyvell Nilsson
While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in…
Abstract
Purpose
While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.
Design/methodology/approach
An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.
Findings
The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.
Originality/value
This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.
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Christian Gadolin, Maria Skyvell Nilsson, Axel Ros and Marianne Törner
The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations.
Abstract
Purpose
The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations.
Design/methodology/approach
A qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care.
Findings
The nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college. The preconditions affecting the nurses’ perceptions of organizational support were supportive structuring and structures at work, as well as individual recognition and professional acknowledgement.
Originality/value
Previous studies of POS have mostly had a quantitative outset. In this paper, context-specific preconditions for nurses' POS are described in depth, enabled by the qualitative approach of the study. The findings may be used to guide healthcare organizations and managers aiming to foster nurses' POS, and thereby, benefit nurses' well-being and retention, as well as healthcare quality and efficiency.