Aim: To explore how nurses during their early working life learn to provide high-quality care in relation to organisational prerequisites in a hospital setting.
Background: When nurses enter employment in contemporary hospital settings, they face multiple learning challenges. Organisational prerequisites that have been identified to affect their ability to learn to provide high-quality care are related to staffing turnovers, large patient groups and a lack of experienced staff to support their learning.
Design: Qualitative.
Methods: The study was conducted between 2018 and 2019 at a medium-sized hospital in Sweden. Data from interviews with 10 nurses with fewer than two years' work experience were subjected to qualitative content analysis.
Results: The results describe the nurses' learning during their early working life in two categories: Performing tasks in relation to organisational prerequisites and Making use of clinical experiences to grasp the complexity of nursing care. The first theme reflected a learning process that was initially characterised by seeking confirmation and instructions from colleagues of how to act safely and by balancing the demands of time efficiency and sustaining patient safety. The second theme reflected that, after addressing organisational prerequisites, the nurses tried to understand and make use of clinical experiences to grasp the complexity of nursing care by encountering and processing clinical patient situations.
Conclusions: The results of this study revealed that nurses' learning during early working life seemed to be primarily directed towards handling tasks, with sometimes limited opportunities to grasp the complexity of nursing care. Their learning depended largely on their own initiative and motivation and was strongly influenced by organisational prerequisites. The limited availability of experienced nurse colleagues and lack of time devoted for reflection needs to be dealt with to support nurses' learning.
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http://dx.doi.org/10.1016/j.nepr.2022.103506 | DOI Listing |
BMC Med Inform Decis Mak
March 2025
Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
Background: Shared decision-making (SDM) is the gold standard for patient-clinician interaction, yet many patients are not actively involved in medical consultations and hesitate to engage in decisions on their health. Despite considerable efforts to improve implementation, research on barriers to SDM within the patient-clinician relationship and interaction is scant. To identify potential barriers to urological patients' participation in decision-making, we developed two novel scales assessing power asymmetry (PA-ME) and embarrassment in medical encounters (EmMed).
View Article and Find Full Text PDFHealth Res Policy Syst
March 2025
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Background: The medical research community widely endorses the importance of ensuring that research outputs are relevant and accessible to knowledge users, as well as the value of engaging the latter in the conduct of research to achieve these goals. However, it appears these principles are reflected in actual medical research practices to a limited extent. To better understand this dissonance, we conducted a qualitative investigation into the perspectives of key stakeholders on bridging the knowledge-to-action gap and patient and public engagement.
View Article and Find Full Text PDFBMJ Open
March 2025
Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
Objectives: This study aimed to explore how emergency department (ED) organisations and clinicians adapted to altered prerequisites during the first wave of the COVID-19 pandemic, the processes involved and the consequences. In addition, we examined how the ordinary state affected resilient performance during this period.
Design: This qualitative study involved inductive thematic analysis of semi-structured interviews and narratives.
Spine J
March 2025
Division of Spine Surgery, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA.
Background Context: Physical therapy is often utilized as a nonoperative modality for the treatment of lumbar stenosis, oftentimes a prerequisite for insurance approval for surgery.
Purpose: The goal of our study was to evaluate the relative cost-effectiveness of physical therapy as compared to a hospital-based or inpatient single-level lumbar laminectomy from the outset for lumbar stenosis.
Study Design/setting: Cost-effectiveness analysis, Markov model simulation PATIENT SAMPLE: We developed a Markov model to analyze the baseline case: a 55-year-old patient with symptomatic lumbar stenosis undergoing physical therapy versus lumbar laminectomy from outset.
Ann N Y Acad Sci
March 2025
Institute of Gene Biology, Russian Academy of Sciences, Moscow, Russia.
During zygotic genome activation (ZGA) and early development, hierarchical levels of chromatin structure undergo remarkable perturbations: changes in the nuclear-to-cytoplasmic ratio of various components; changes in chromatin accessibility; histone exchange; and the formation of 3D structures such as loops, topologically associated domains, and compartments. Here, we review the peculiarities, variability, and emergence of the chromatin structural features during ZGA in different organisms. Focusing on newly found structures called fountains, we describe the prerequisites for cohesin loading on DNA and possible mechanisms of genome organization in early development.
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