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Att vårda svårt sjuka eller skadade prehospitalt på landsbygden: Sjuksköterskors upplevelser och erfarenheter
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
2020 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Introduktion: Den senaste tidens medicinska utveckling har medfört en centralisering av akutmottagningar och sjukhus med specialistsjukvård. Det betyder fler och längre ambulanstransporter som i sin tur ställer högre krav på den prehospitala personalen. Sverige är överlag ett glest befolkat land och för den svårt sjuke eller skadade patienten kan tiden in till sjukhus vara livsavgörande.

Syfte: Att undersöka sjuksköterskors upplevelser och erfarenheter av att vårda svårt sjuka eller skadade patienter prehospitalt på landsbygden.

Metod: Data insamlades genom en webbaserad enkät besvarad av 21 deltagare från nio stationer belägna på landsbygden i mellersta Sverige. Materialet analyserades med kvalitativ innehållsanalys.

Resultat: Analysprocessen resulterade i fem huvudkategorier: vikten av förberedelser och planering under framkörning till patient, vikten av god handlingsberedskap under transport med patient, känsla av ensamhet och maktlöshet att arbeta på landsbygden, möjligheten att utvärdera given behandling och ge god omvårdnad under transport samt vikten av att extra resurser finns att tillgå. Arbetet på landsbygden kan upplevas ensamt och det är värdefullt att kunna diskutera medicinska beslut med en annan sjuksköterska eller medicinskt bakre stöd.

Konklusion:  Arbete på landsbygden medför längre transporter in till sjukhus och det är viktigt med en god planering och en god handlingsberedskap både i behandlingen av patienten samt vid behov av extra resurser. Arbetet kan medföra både en känsla av ensamhet och maktlöshet samt en känsla av glädje. Längre transporter ger möjlighet till god omvårdnad och utvärdering av given behandling. Att arbeta på stationer belägna på landsbygden kan vara både utmanande och utvecklande, och att ha några års erfarenhet av ambulanssjukvård innan man börjar på landsbygden anses positivt. 

Abstract [en]

Introduction: The recent medical development have led to a centralization of emergency rooms and hospitals with specialist care. This means more and longer ambulance transports, which in turn leads to higher demands on the prehospital staff. Sweden is a generally sparsely populated country, for the severely ill or injured patient, the time to reach the hospital can be crucial for life or death.

Aim: To examine the experiences of prehospital nurses when they nurse and cherish severely ill or badly wounded patients out of hospital in rural areas.

Method: A web-based survey was conducted and 21 prehospital nurses working in rural areas in two regions in the middle of Sweden participated. The material was analyzed with qualitative content analysis.

Result: The analysis process resulted in five main categories: the importance of preparation and planning before arriving to patient, the importance of good preparedness during transport with a patient,  feelings of loneliness and powerlessness, the opportunity to evaluate the given treatment and provide good nursing care during transport and the importance of additional resources being available. Working in rural areas can be experienced with a feeling of loneliness and it is valuable to be able to discuss medical decisions with another nurse or medical support.

Conclusion: Rural work entails longer transport to hospitals and it is important to have good planning and good preparedness both in the treatment of the patient and when needed extra resources. The work can bring both a feeling of loneliness and powerlessness as well as a feeling of joy. Longer transports provides the opportunity for good nursing and evaluation of given treatment. Working at stations located in rural areas can be both challenging and evolving and having a few years of experience in ambulance care before starting working in rural areas is considered positive.

Place, publisher, year, edition, pages
2020. , p. 24
Keywords [en]
Out of hospital care, rural areas, nursing, experiences, critical illness
Keywords [sv]
Ambulanssjukvård, glesbygd, omvårdnad, upplevelser, kritiska tillstånd
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:kau:diva-77203OAI: oai:DiVA.org:kau-77203DiVA, id: diva2:1413339
Subject / course
Emergency Care Specialist Nursing, Prehospital Nursing, Graduate Diploma*
Educational program
Study Programme for Specialist Nursing in Prehospital Nursing (60 ECTS credits)
Supervisors
Examiners
Available from: 2020-03-10 Created: 2020-03-10 Last updated: 2020-03-10Bibliographically approved

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