Nordic Journal of Nursing Research

Norwegian geriatric health care services are in great need of qualified nursing personnel. Recruiting registered nurses to care for the elderly is a challenge for both the Norwegian society as such and for this country's educational institutions. The purpose of this study was to identify factors which make nurses choose geriatric nursing as their professional career. The primary question was What are the characteristics of student nurses who prefer to work with elderly clients? A questionnaire was distributed among 341 students who were in their first, second, or third year of their nursing studies. The students' attitudes to and experiences with elderly people were identified, together with their work preferences. 9,2 % of the students prefer to work with elderly clients. Major traits in these students are: a positive attitude towards elderly people combined with work experience from this group of clients—work experiences these students perceive as more positive than do students who prefer to work with children or adults. Furthermore, many of the students who want to work with elderly clients have more than two years of such clinical work experience prior to entering nurses' training. Student nurses who prefer working with elderly clients also have experienced a more positive attitude towards the elderly in their teachers than the rest of the students do.

The aim of this study was to explore the ethical knowledge nurses possessed and practiced in their interaction with demented patients. A qualitative, descriptive design, with a phenomenological — hermeneutical approach was used. The study was based on moral dilemmas in daily life with six nursing situations presented through narratives. The findings were discussed from an ethical perspective and in particular Kari Martinsen's philosophy of moral practice. Analysis of data followed Kvale's method of qualitative analysis. The findings indicated that nurses emphasised values as respect and the worth of the patient as a human being. The Golden Rule and acting in the patients best interest seemed to be a guide for nursing practice. Autonomy were estimated as important, but often a problematic approach. Interpretations of the behavioural cues of the demented patients, and the caregivers deep knowledge of the patients personal life story were emphasised.

It is typical that students apply to nursing education with idealistic expectations about nursing. During the nursing education, however, students have reported a decrease of motivation because of dissatisfaction with the content of education and difficulties in understanding the relevance of theoretical studies for nursing practice. The contradiction between theoretical and practical studies in nursing education has been the focus of several research projects and discussions, but not from the viewpoint of students' orientation to nursing and the way in which it affects the process of learning to nurse. The concept of orientation is based on theories of cognitive psychology, and it has been defined in activity theory as a process of anticipating, analysing and planning an activity. Orientation is directed by motives and the quality of orientation predicts the quality of learning. The purpose of this research was to describe the social processes involved in nursing students' orientation to nursing at the beginning of their education. The study was conducted qualitatively. The data consisted of essays and interviews of the students' and were analysed using constant comparative analysis. Three different orientations to nursing were found: a caring orientation, a nursing expertise orientation and a life orientation. The orientations differed from each other with regard to the students' caring and nursing experiences, the meaning of nursing for the student, and the expectations applied to a nursing career. The experiences varied from meaningful personal experiences about caring encounters to experiences without any specific meaning for the student's choice of a nursing career. Nursing was defined as altruistic service, an expert profession in health care or an instrument to achieve something, e.g. economic security in life. The students expected the nursing career to promote their personal growth, give possibilities to gain expertise and a professional position in nursing and to achieve personal goals in life. Knowledge of nursing students' orientations to nursing can be used in evaluating how nursing programmes promote students' professional development and the quality of learning nursing. The challenges posed by the students' different orientations to nursing education are discussed.

Research into working life in Finland shows how great changes in society, in combination with changed age structure of the working population, have increased the employees' working load. Because of these changes occupational health services confront new challenges. Internationally OHS in Finland has reached a high level. Simultaneuosly research reports show how the health professionals themselves experience growing work-related stress symptons. The main purpose of the study was to clarify how the occupational health professionals view the changes in their activity, to find out how the professionals in different occupational groups view their working tasks in the future, the collaboration in the oh-team, and the need for new knowledge. In this study a qualitative and naturalistic approach was used in order to undestand, describe and interpret the oh- nurses'and oh-physicians'points of view and their experiences of the phenomenon studied. Data collection was based on open-ended interviews. The data from the interviews were analyzed using qualitative content analysis. The results show how the oh-nurses and oh-physicians consider changes in the activity. Economic depression in society and the need to rationalize workinglife have influenced the problem-areas in oh-activity. The informants experience contradictions between their working goals and the managements' methods of evaluation. They have a clear conception about the main problem-areas in the future. The results also show that the nurses and physicians have different views of the need for new knowledge, mulitidisciplinarity and collaboration in the oh-teams.

The subject of this study was to describe how home-based care to terminally ill cancer patients was established in a rural setting. A central question was what kind of qualifications among the caregivers was available and how the service was organized. The study was performed as interviewes of twelve nurses. The results show that the nurses mostly are working alone in a difficult and challenging field. The care is not organized as a multidisiplinary teamwork. The nurses can call for the GP doctor when it is needed, which mainly is for ordination of painmedications. In the nurses opinion, the doctors found little interest in the patients. Their knowledge about pain and controll of symptoms is very often poor. Very often, it is the nurses who diagnose the patients pain or other symptoms and suggest the medication. Additionally, more emphasis are needed on education related to pain management and the use of available guidelines on management of pain related to cancer. The conclusion emphasises two factors: Satisfactory terminal home care can be achieved, but it presupposes effective support and symptom control. The second factor is that the terminal home care should be organised in teams.

Nowadays it is possible for sick and dying patients to be cared for at home. In some parts of the country up to 90% of registered patient die at home. In the country as a whole 85% of all patients that die, do this in a hospital or some other institution. If the home care is connected to a hospital, resources are available all around the clock. Home care saves days of hospital treatment that otherwise should be necessary. When a patient is treated in the home great responsibility is layed on the relatives that carry out the main part of the care. In the literature the importance of being well informed in order to be able to cope with stress is emphasised. Stress develops in situations where we are feeling insufficient. If we understand what is happening and can foresee what is coming next it will be much easier to cope whit the situation. The objective of the study was to investigate if and to what extent relatives of patients in home care were given information and education. The results presented obtained by interviewing relatives and personnel around the families about their feelings and experiences in connection whit the home care. It was shown that information and education in an organised way occurred to a small degree or not at all. Therefore the report concentrates on the general situation for home care. The relatives agreed that availability and respect for integrity were fundamental in this connection.

Teachers at the School of Nursing, Centre for Haelth Care Education in Greenland often experience low verbal activity in the classrooms. Only few students participate avtively an spontaneously in discussions. This article seeks to describe a study aiming at analysing the reasons for the low activity and the possible pedagogical factors that could contribute to a higher activity. The study combines questionnaire data, classroomobservations and focus-group-interviews. The study shows that three kinds of factors influence the verbal activity: cultural, linguistic and pedagogical factors. In accordance with the litterature on Greenlandic and Inuit culture, the study indicates that showing authorities (including teachers) respect by keeping quiet, not criticizing others and avoiding making a point of stating ones opinion are cultural elements. The linguistic factors influencing the verbal activity have to do with the bilingual conditions of higher education in Greenland. At the school of nursing, most of the students speaks Greenlandic as their native mother tongue whereas the majority of the teachers speaks Danish and no Greenlandic. The combination of the cultural factors and the linguistic factors generates a need for specific pedagogical initiatives; most important seems to be the creation of a basic feeling of security when students are asked to speak up in the classroom. There is a need for situations where the student can practice explaining things and share his or her opinion with fellow students.

The Department of Nursing, Malmö University, reports from the fifth year of a six year long health care project in Estonia. The aim of the project, that among others have support from the Swedish East-European Committé for Health Care, is to enhance the Estonian nurses', nurseteacher's and nursestudent's possibilities to knowledge exchange in order to promote the development of the health care sector in Estonia. The specific aim of this article is to describe how the VIPS-model for documentation can support the development of the nursing profession in Estonia.