BackgroundRegistered nurses lead the nursing care close to older adults in municipal home healthcare. There is a globally increasing number of older adults and a rising demand for healthcare. The trend is shifting toward care being provided in older adults' homes. Therefore, strengthening registered nurses' leadership in nursing is important and there is a need for increased knowledge about their leadership close to older adults in home healthcare. The aim was to explore registered nurses' experiences of their leadership close to older adults in municipal home healthcare.MethodsAn explorative qualitative design with an inductive approach was applied. Focus groups were conducted with registered nurses (n = 14), and data were analyzed using qualitative content analysis.ResultsThe registered nurses struggled against organizational preconditions in their leadership close to older adults in municipal home healthcare. They experienced their leadership as focusing on the older adult, trying to create a sense of security, creating trustful relationships, and managing organizational challenges.ConclusionsRegistered nurses want to lead but struggle to compensate for deficiencies in organizational preconditions. There is a need to facilitate registered nurses' leadership. Leadership development must be systemic, extending beyond the individual registered nurse, to include municipal governance, healthcare organizations, and nursing education programs.

Peer learning supports bachelor nursing students’ professional development, yet its usefulness across clinical contexts and educational levels remains underexplored. This cross-sectional survey study used quantitative and qualitative data (n = 1264; 50.3% response rate) collected between May 2020 and June 2022 to examine bachelor nursing students’ perceptions of their learning environment and professional development, during different clinical placements and educational levels, when supervised within peer learning. Reporting followed STROBE and COREQ guidelines. Most students reported that peer learning significantly enhanced learning (67.7%), professional development (65.7%), autonomy (59.1%) and understanding of the nursing process (57.5%). Students favoured regular changes of peers. Peer learning environments were scored significantly higher than traditional one-to-one supervision. However, peer learning benefits appear to decline in later semesters and at certain clinical settings. Structured reflection based on the profession's role and function, as well as context-sensitive implementation, may enhance the relevance of peer learning for more advanced students.

Background/Objectives: There is a rising global demand to educate independent and reflective nurses capable of addressing the evolving needs of healthcare systems and diverse populations. The Indonesian Nursing Act solidifies the professional status of nurses, although challenges persist including discrepancies between practice and educational standards. There is a need to increase the competence of Indonesian nurse educators and their ability to facilitate learning that can strengthen the nursing programs' quality and improve the nurses' ability to address various health issues in the population. The aim of the study was to describe the nurse educators' experiences with developing student-active methods in nursing education in Indonesia. Methods: This study is part of an Erasmus+ project: Capacity Building in Nursing Education in Indonesia (CABNEI). A three-year educational program for nursing educators in Indonesia was developed. The current study used a qualitative, descriptive design with a questionnaire containing four open-ended questions focusing on the educators' experiences with developing student-active methods and conditions affecting this process. Data were collected between January and November 2022 and analyzed using qualitative content analysis. Results: A total of 32 educators from two universities and two nursing schools in Indonesia participated. The analysis revealed the theme "A change of pedagogical approaches to nursing students' learning" with three categories: "Setting the stage for pedagogical development in the nursing education", "From correction to reflection", and "Factors affecting the educators' learning process". Conclusions: The nursing educators' experiences with developing student-active methods in Indonesia were positive. They reported incorporating additional pedagogical tools into their teaching methods and nursing programs. Management is vital in facilitating active-learning strategies. It is important to foster collaborative opportunities for educators and enhance their pedagogical skills to meet the healthcare system's evolving needs and society's demands for sustainable nursing expertise.

BackgroundRegistered nurses lead the nursing care close to older adults in home healthcare. It is expected that there will be an increased need for home healthcare. In addition, more advanced care is now being performed in home healthcare, leading to increased demands for registered nurses. Therefore, the aims of this study are to explore and compare registered nurses' perceptions of their leadership close to older adults in municipal home healthcare, as well as to correlate their perceptions with age and work experience.MethodsThis study is a part of a larger web-based questionnaire survey, with a non-experimental and cross-sectional design. Descriptive and analytical statistics were used. A total of n = 71 registered nurses leading close to older adults participated, in seven municipalities in two geographic areas in Sweden.ResultsThe registered nurses perceived their ability as leaders close to older adults as high. The registered nurses had neither low or high trust in care staff's competence. They perceived to have space and access neither in a low or high degree in their work to develop sufficient competence in leadership and having nursing responsibility on an organisational level. Registered nurses' perceptions of their leadership differed depending on whether they had a specialist education or not; those with specialist education perceived to a higher degree that they could apply their professional experience in their work; interact with the older adult and their next of kin; assess individual needs and based on a holistic view of the older adult, create good relationships with the older adults' next of kin.ConclusionsRegistered nurses' specialist education may strengthen their leadership in home healthcare. Further research is needed to gain new knowledge of registered nurses' leadership in home healthcare, as well as care staff's' experiences of registered nurses' leadership in municipal home healthcare.

Numerous countries in the world have chosen to allow district nurses to prescribe drugs to streamline the primary care process. This qualitative, systematic literature study aimed to examine district nurses’ experience of prescribing within primary care. The search followed the PRISMA-P search strategy, and the quality assessment of the nine articles was completed using the review template for assessing studies with qualitative methodology, using GRADE CERQual. The databases CINAHL, Pubmed, PsycINFO, and Scopus were used. The result shows that district nurses experience prescribing as crucial for being able to meet patient needs through holistic and person-centered care. Being able to sufficiently and efficiently meet patient needs contributed to increased job satisfaction and professional pride in district nurses. However, district nurses need more collegial support and training in prescribing. The additional burden that the ability to prescribe poses needs to be addressed to prevent limitations in the prescription rights of district nurses. Through an extended prescription right, district nurses can contribute to a more efficient care system that can meet future demand for healthcare services in primary care. 

Aim To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. Background Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. Methods An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. Results One theme emerged: 'Clarity and security in one's own nursing role despite facing challenges that hinder professional development' and three categories: 'Independency due to one's own efforts and experience', 'Well-functioning teamwork' and 'Challenges in the work situation'. Conclusion After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. Implication for Nursing Management Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.

The medical nature of esthetic treatments is confusing, as the boundaries between medicine and beauty are unclear. A person's autonomous decision is an indicator for esthetic treatments that will improve their self-image, self-esteem and appearance to others. Robust ethical consideration is therefore necessary for the medical esthetician in each meeting with the client. This study aimed to describe medical estheticians' perceptions of ethics and esthetics in injection treatments with Botox and Filler. The results are described in Understanding what different clients desire, Reaching a mutual understanding of expectations and possibilities and Taking responsibility for beauty.

Aims and objectives: To explore newly graduated registered nurses' experiences and how they manage complex patient situations.Background: Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages.Design: Qualitative study design.Methods: Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used.Results: The analysis resulted in the overarching theme "Not being sufficiently prepared and supported to meet responsibilities and demands." The theme included three categories: "Responsibility is not in proportion to competence," "Lack of medical competence and experience complicates patient safety" and "Strives for control to manage and organise nursing care."Conclusion: The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised.Relevance to practice: Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.

Background: Caring for patients in the end-of-life is an emotionally and physically challenging task. Therefore, undergraduate nursing students (UNS) need opportunities to learn to care for the dying patient. This study aimed to describe UNS' experiences of caring for patients at end-of-life. Methods: Interviews with 16 UNS in their last semester of nursing education were conducted. Data were analyzed with a phenomenological approach. Results: The UNS created a professional relationship with the dying patient. It meant that when the patient was unable to speak for themselves, the UNS could still meet his/her wishes and needs. The UNS believed they could take responsibility for the patient who was no longer able to take responsibility for themselves. Meeting with the patient's family could be experienced with anxiousness but was dependent on the personal chemistry between the patient's family and the UNS. Conclusion: The UNS creates a relationship with the patient and their family. To be knowledgeable about the patient's physical and psychosocial needs means that the UNS can support the patient in the end-of-life phase. Being close to the patient and the family results in an intensity of emotions in the care situation. The UNS can receive support from their colleagues during processing their emotions and creating an experience from their encounters with patients in end-of-life care.