The ways specialist nursing students understand the work in the ambulance service - a national Swedish phenomenographic study

Wallin, Kim; Bremer, Anders; Fridlund, Bengt; Hörberg, Ulrica; Harstäde, Carina Werkander

doi:10.1080/17482631.2022.2099023

Cited by 5 publications

(5 citation statements)

References 44 publications

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“…In the present study, the distribution in the participating region was 78.5% specialist trained nurses (dominated by SANs), 15.5% RNs, and 6% EMTs. The total number of employed ACs was 148 [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Caring for older patients with reduced decision-making capacity: a deductive exploratory study of ambulance clinicians’ ethical competence

2023

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Background As more people are living longer, they become frail and are affected by multi-morbidity, resulting in increased demands from the ambulance service. Being vulnerable, older patients may have reduced decision-making capacity, despite still wanting to be involved in decision-making about their care. Their needs may be complex and difficult to assess, and do not always correspond with ambulance assessment protocols. When needing an ambulance, older patients encounter ambulance clinicians who are under high workloads and primarily consider themselves as emergency medical care providers. This situates them in the struggle between differing expectations, and ethical conflicts may arise. To resolve these, providing ethical care, focussing on interpersonal relationships and using ethical competence is needed. However, it is not known whether ambulance clinicians possess the ethical competence required to provide ethical care. Thus, the aim of this study was to deductively explore their ethical competence when caring for older patients with reduced decision-making ability. Methods A qualitative deductive and exploratory design was used to analyse dyadic interviews with ambulance clinicians. A literature review, defining ethical competence as comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action and ethical behaviour, was used as a structured categorization matrix for the analysis. Results Ambulance clinicians possess ethical competence in terms of their ethical knowledge, highlighting the need for establishing an interpersonal relationship with the older patients. To establish this, they use ethical sensitivity to interpret the patients’ needs. Doing this, they are aware of their ethical behaviour, signifying how they must act respectfully and provide the necessary time for listening and interacting. Conclusions Ambulance clinicians fail to see their gut feeling as a professional ethical competence, which might hinder them from reacting to unethical ways of working. Further, they lack ethical reflection regarding the benefits and disadvantages of paternalism, which reduces their ability to perform ethical decision-making. Moreover, their ethical knowledge is hampered by an ageist approach to older patients, which also has consequences for their ethical action. Finally, ambulance clinicians show deficiencies regarding their ethical reflections, as they reflect merely on their own actions, rather than on their values.

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Section: Methodsmentioning

confidence: 99%

Caring for older patients with reduced decision-making capacity: a deductive exploratory study of ambulance clinicians’ ethical competence

2023

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Section: Some Appli C Ati On S Of Phenomenog R Aphy In Nur S Ingmentioning

confidence: 99%

“…The authors uncovered five different ways of understanding work: medical, practical, patient-oriented, commanding and comprehensive roles (Wallin et al, 2022). These diverse descriptions can offer support to curriculum design and development of expertise.…”

Section: Some Appli C Ati On S Of Phenomenog R Aphy In Nur S Ingmentioning

confidence: 99%

“…Further to the above, some studies were identified in the domain of nursing education. A phenomenographic study examined the ways that specialist ambulance nursing students understood their work in the Swedish Ambulance Service (Wallin et al, 2022). The authors uncovered five different ways of understanding work: medical, practical, patient‐oriented, commanding and comprehensive roles (Wallin et al, 2022).…”

Section: Some Applications Of Phenomenography In Nursingmentioning

confidence: 99%

“…A phenomenographic study examined the ways that specialist ambulance nursing students understood their work in the Swedish Ambulance Service (Wallin et al, 2022). The authors uncovered five different ways of understanding work: medical, practical, patient‐oriented, commanding and comprehensive roles (Wallin et al, 2022). These diverse descriptions can offer support to curriculum design and development of expertise.…”

Section: Some Applications Of Phenomenography In Nursingmentioning

confidence: 99%

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Phenomenography: An emerging qualitative research design for nursing

Bayuo,

Aziato,

Wong

et al. 2023

Journal of Advanced Nursing

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BackgroundPhenomenography emerged from pedagogy to examine the qualitatively different ways that individuals experience and perceive the same phenomenon. Despite its uniqueness, the uptake of phenomenography in nursing research is still limited. Potentially, this may be related to confusion regarding what the design is about, its philosophical underpinnings and how distinct it is from other qualitative designs.ObjectivesTo offer a better understanding of phenomenography by comparing it with other established qualitative research designs, examining its theoretical foundations, highlighting some studies that have employed the approach in nursing and offering methodological guidance to improve its uptake in nursing.DesignDiscussion paper.FindingsCompared to the traditional qualitative designs employed in nursing, phenomenography has been utilized in fewer studies. The ontological, epistemological and methodological basis of phenomenography highlights it as a distinct design. The strength of phenomenography lies in its emphasis on understanding the collective variations between participants and presenting these holistically as an ‘outcome space’.DiscussionPhenomenography is a distinct qualitative research approach that presents a unique opportunity for nursing to further its use. Issues regarding bracketing, the inclusion of phenomenography studies in qualitative meta‐synthesis and employing a hermeneutic approach to phenomenography are avenues for further work in nursing.Patient and Public ContributionNo patient or public contribution.

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Taking or creating control: A qualitative study of uncertainty among novice nurses in ambulance care

Hörberg

Wälivaara

Wihlborg

2023

International Emergency Nursing

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The ways specialist nursing students understand the work in the ambulance service - a national Swedish phenomenographic study

Cited by 5 publications

References 44 publications

Caring for older patients with reduced decision-making capacity: a deductive exploratory study of ambulance clinicians’ ethical competence

Caring for older patients with reduced decision-making capacity: a deductive exploratory study of ambulance clinicians’ ethical competence

Phenomenography: An emerging qualitative research design for nursing

Taking or creating control: A qualitative study of uncertainty among novice nurses in ambulance care

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