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Elmqvist, Carina
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Wallin, K., Hörberg, U., Werkander Harstäde, C., Elmqvist, C. & Bremer, A. (2020). Preceptors’ experiences of student supervision in the emergency medical services: a qualitative interview study. Nurse Education Today, 84, 1-8, Article ID 104223.
Open this publication in new window or tab >>Preceptors’ experiences of student supervision in the emergency medical services: a qualitative interview study
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2020 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, p. 1-8, article id 104223Article in journal (Refereed) Published
Abstract [en]

Background

Clinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research.

Objectives

To describe preceptors' experiences of student supervision in the EMS during clinical placements.

Design

A descriptive qualitative design was used.

Participants and setting

Twenty specialist nurses were recruited among EMS staff from all parts of Sweden.

Methods

Data were collected using individual interviews and analyzed with latent qualitative content analysis.

Findings

EMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse.

Conclusions

Preceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Ambulance nurse, Clinical placement, Emergency medical services, Learning environment, Preceptor, Specialist nurse, Supervision
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-89785 (URN)10.1016/j.nedt.2019.104223 (DOI)000501643800031 ()31726285 (PubMedID)
Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2020-01-10Bibliographically approved
Elmqvist, C. & Almerud Österberg, S. (Eds.). (2019). Akut omhändertagande av trauma: på skadeplats och akutmottagning (2ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Akut omhändertagande av trauma: på skadeplats och akutmottagning
2019 (Swedish)Collection (editor) (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019. p. 205 Edition: 2
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-90951 (URN)9789144127613 (ISBN)
Note

Om boken:

Syftet med denna bok är att beskriva förutsättningarna för att ge ett gott omhändertagande i det initiala skedet efter en skadehändelse. I boken beskrivs de första timmarna från det att larmet om trafikolycka kommer in till alarmeringscentralen och till dess att samtliga drabbade omhändertagits på ett akutsjukhus.

Boken är skriven av sjuksköterskor, läkare och en psykolog med lång klinisk erfarenhet från akut omhändertagande. Personer från SOS Alarm, Polismyndigheten, Värends Räddningstjänst, Länsstyrelsen och Myndigheten för samhällsskydd och beredskap (MSB) medverkar också som författare.

Boken riktar sig främst till sjuksköterskestudenter, studenter vid polisutbildningen samt studerande vid utbildning till del- och heltidsbrandman. Boken kan med fördel även användas i specialistsjuksköterskeutbildningarna inom akutsjukvård samt andra utbildningar och kurser inom akutsjukvårdsområdet.

Available from: 2020-01-16 Created: 2020-01-16 Last updated: 2020-01-16Bibliographically approved
Lederman, J., Löfvenmark, C., Djarv, T., Lindström, V. & Elmqvist, C. (2019). Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians. BMJ Open, 9(9), 1-8, Article ID e030203.
Open this publication in new window or tab >>Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 9, p. 1-8, article id e030203Article in journal (Refereed) Published
Abstract [en]

Objectives To combat overcrowding in emergency departments, ambulance clinicians (ACs) are being encouraged to make on-site assessments regarding patients' need for conveyance to hospital, and this is creating new and challenging demands for ACs. This study aimed to describe ACs' experiences of assessing non-conveyed patients. Design A phenomenological interview study based on a reflective lifeworld research approach. Setting The target area for the study was Stockholm, Sweden, which has a population of approximately 2.3 million inhabitants. In this area, 73 ambulances perform approximately just over 200000 ambulance assignments annually, and approximately 25000 patients are non-conveyed each year. Informants 11 ACs. Methods In-depth open-ended interviews. Results ACs experience uncertainty regarding the accuracy of their assessments of non-conveyed patients. In particular, they fear conducting erroneous assessments that could harm patients. Avoiding hasty decisions is important for conducting safe patient assessments. Several challenging paradoxes were identified that complicate the non-conveyance situation, namely; responsibility, education and feedback paradoxes. The core of the responsibility paradox is that the increased responsibility associated with non-conveyance assessments is not accompanied with appropriate organisational support. Thus, frustration is experienced. The education paradox involves limited and inadequate non-conveyance education. This, in combination with limited support from non-conveyance guidelines, causes the clinical reality to be perceived as challenging and problematic. Finally, the feedback paradox relates to the obstruction of professional development as a result of an absence of learning possibilities after assessments. Additionally, ACs also described loneliness during non-conveyance situations. Conclusions This study suggests that, for ACs, performing non-conveyance assessments means experiencing a paradoxical professional existence. Despite these aggravating paradoxes, however, complex non-conveyance assessments continue to be performed and accompanied with limited organisational support. To create more favourable circumstances and, hopefully, safer assessments, further studies that focus on these paradoxes and non-conveyance are needed.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
ambulance clinicians, emergency medical services, non-conveyance, guidelines, phenomenology
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-90549 (URN)10.1136/bmjopen-2019-030203 (DOI)000497787600257 ()31551383 (PubMedID)
Available from: 2019-12-13 Created: 2019-12-13 Last updated: 2019-12-13Bibliographically approved
Wallin, K., Hörberg, U., Werkander Harstäde, C., Elmqvist, C. & Bremer, A. (2019). Enablers and barriers in ambulance clinical placements – a mentor perspective. In: Presented at Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019: . Paper presented at Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019.
Open this publication in new window or tab >>Enablers and barriers in ambulance clinical placements – a mentor perspective
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2019 (Swedish)In: Presented at Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019, 2019Conference paper, Oral presentation only (Refereed)
Abstract [en]

Background: The importance of clinical placements for nursing students to be able to integrate theory and practice and develop clinical competence are described in literature. Recent research in the Swedish prehospital context has shown that there possibly are differences in the preparations among ambulance nursing students before entering their clinical placements in accordance with studies in other countries. Studies have also highlighted difficulties in creating a good learning environment in the context of prehospital emergency care. The role of the mentor in supporting these students during clinical placements via an individualized mentorship model has proven to be of most importance. At the same time the role of the mentor is described as demanding, undefined and lacking support from both universities and ambulance services. In the Swedish educational system, the voice of the mentor is missing in research in order to develop and enhance the learning environment during clinical placements.

Purpose: To describe mentors ‘experiences of enablers and barriers for supervision during ambulance clinical placements.

Methods: Individual interviews were conducted with 20 mentors from 10 ambulance districts from all parts of Sweden. The interviews were analysed according to qualitative content analysis.

Results/Conclusions: Preliminary findings indicates that the mentors need specific competence, further education and improved support from universities and ambulances services to feel competent and safe. They are forced to adjust their learning strategies to the unique context of prehospital emergency care and are constantly drawn between responsibilities towards the patient and the student. The role and the assignment are unclear and they are in need of support and structure. The competence and attitudes of the team colleague are of high importance for the mentors’ perceived support.

Keywords
Handledare, Erfarenheter, Ambulanssjukvård, Ambulanssjuksköterska, Intervju
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-82021 (URN)
Conference
Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019
Available from: 2019-04-17 Created: 2019-04-17 Last updated: 2019-11-19Bibliographically approved
Elmqvist, C. & Almerud Österberg, S. (2019). Introduktion (2ed.). In: Carina Elmqvist & Sofia Almerud Österberg (Ed.), Akut omhändertagande av trauma: på skadeplats och akutmottagning (pp. 17-22). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Introduktion
2019 (Swedish)In: Akut omhändertagande av trauma: på skadeplats och akutmottagning / [ed] Carina Elmqvist & Sofia Almerud Österberg, Lund: Studentlitteratur AB, 2019, 2, p. 17-22Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 2
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-90948 (URN)9789144127613 (ISBN)
Available from: 2020-01-16 Created: 2020-01-16 Last updated: 2020-01-16Bibliographically approved
Elmqvist, C. & Johansson, C. (2019). Kliniskt träningscentrum: En miljö som främjar ett reflekterat lärande (2ed.). In: Mia Berglund & Margaretha Ekebergh (Ed.), Reflektion i lärande och vård: en utmaning för sjuksköterskan (pp. 151-170). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Kliniskt träningscentrum: En miljö som främjar ett reflekterat lärande
2019 (Swedish)In: Reflektion i lärande och vård: en utmaning för sjuksköterskan / [ed] Mia Berglund & Margaretha Ekebergh, Lund: Studentlitteratur AB, 2019, 2, p. 151-170Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 2
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-90972 (URN)9789144131979 (ISBN)
Available from: 2020-01-16 Created: 2020-01-16 Last updated: 2020-01-16Bibliographically approved
Nord-Ljungquist, H., Engström, Å., Fridlund, B. & Elmqvist, C. (2019). Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background In a rural environment where distances and access to ambulance resources in people's immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called 'While Waiting for the Ambulance' (WWFA). Knowledge is limited about the experience from a caller's perspective when a person has a life-threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved. Aim The aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective. Method A descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in-depth interviews with eight callers. Results An emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm. Conclusion A double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ambulance staff, caller, CPR, emergency medical dispatcher, emergency situation, firefighters, first aid, reflective lifeworld research, responder, rural environment
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-89970 (URN)10.1111/scs.12767 (DOI)000492266600001 ()31614024 (PubMedID)
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-08
Holmberg, P., Nilsson, J., Elmqvist, C. & Lindqvist, G. (2019). Nurses' encounters with children as next of kin to parents with a cancer diagnosis on oncology wards. Nordic journal of nursing research, 1-8
Open this publication in new window or tab >>Nurses' encounters with children as next of kin to parents with a cancer diagnosis on oncology wards
2019 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, p. 1-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

It is a challenge for registered nurses (RNs) to meet children and young people who have a parent diagnosed with cancer. These children often suffer from shock, anxiety, outrage, fear and stress. Recent studies indicate that when next of kin have a professional person to talk to, their wellbeing increases. Moreover, when these children are involved in their parent’s care they also begin to trust the nurse caring for their parent. However, there is little known of how nurses respond to a child’s needs. Thus, aim of this study was to describe RNs’ experiences of encounters with children as next of kin to a parent diagnosed with cancer. A qualitative descriptive study based on semi-structured group interviews, with a latent content analysis was carried out. One theme, ‘sense of security’ including three categories ‘balanced meeting’, ‘de-dramatize healthcare’ and ‘learn from one another’ was identified. Beyond the categories, there are six sub-categories: ‘sense of insecurity’, ‘caring approach’, ‘providing information’, ‘participation’, ‘processing and follow-up’ and ‘increased knowledge’. The findings of this study highlight the importance of strengthening the RN's ability to create a caring relationship with children as next of kin.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Children as next of kin, Encounter, Experience, Parent with cancer, Registered nurses
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-89063 (URN)10.1177/2057158519868437 (DOI)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2019-11-26
Albinsson, G., Elmqvist, C. & Hörberg, U. (2019). Nursing students’ and lecturers’ experiences of learning at a university-based nursing student–run health clinic. Reflective Practice, 20(4), 423-436
Open this publication in new window or tab >>Nursing students’ and lecturers’ experiences of learning at a university-based nursing student–run health clinic
2019 (English)In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 20, no 4, p. 423-436Article in journal (Refereed) Published
Abstract [en]

This article aims to describe the phenomenon of learning at a university-based nursing student–run health clinic, as experienced by student nurses and lecturers. The study is based on a reflective lifeworld research approach founded on continental philosophy. Eight group interviews were conducted with 38 student nurses and 5 lecturers. The data were explored and analysed for meaning. The results show that learning is supported by a permissive learning environment that builds on both individual and common learning as well as equal relationships within the student group, in relation to the visitors at the health clinic and, to a certain extent, in relation to the lecturers. The most significant finding is that reflective, development-oriented learning takes place when the students, supported by each other and their lecturers, reflect on how to relate to problems and situations. A situation-based learning approach is thus shown to create the prerequisites for lecturers being nearby, reflective dialogue partners but also supervisors in situations where the students ask for support and guidance.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Nursing students, Lecturers, Lifeworld-led learning, Health clinic, Health support, Refective talks, Intertwining of theory and practice
National Category
Nursing Educational Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-86635 (URN)10.1080/14623943.2019.1638242 (DOI)000475073200001 ()
Available from: 2019-07-11 Created: 2019-07-11 Last updated: 2019-09-23Bibliographically approved
Frank, C. & Elmqvist, C. (2019). Staff strategies for dealing with care situations at an emergency department. Scandinavian Journal of Caring Sciences, 1-7
Open this publication in new window or tab >>Staff strategies for dealing with care situations at an emergency department
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, p. 1-7Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction Overcrowding is a common international problem at Emergency Departments often due to those patients get recommendations or referrals from other health professionals to seek care at the emergency department. Crowding brings with it an amount of adverse consequences for both patients and staff, and knowledge about staff's strategies of dealing with this caring situation is limited. Aim The aim of the present study was thus to describe staffs' strategies to deal with the caring situations at an emergency department. Method Secondary analysis has been made of 18 qualitative interviews grounded in a lifeworld perspective. The interviews were analysed by qualitative content analysis. Findings The results showed that the staff at the ED worked in twofold directions using both proactive and reactive strategies in order to deal with the care situation when caring for patients at ED. The proactive strategy is optimising conditions, controlling patient flow and being boundary. The reactive strategy is about customising the conversation and holding an open approach. Conclusion In conclusion, the proactive strategy is to make what you decided for unseen circumstances. The reactive strategy is then about less anticipation of the encounter, waiting for the patient to act and react to it. Implication The result can have implications with respect to developing and improving care at crowded Emergency departments. Knowledge about strategies creates a fundament for developing visible sustainable structure for patient flow in making work patient safety for patients, staff and organisation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
emergency department, lifeworld, staff perspective, secondary analysis, strategies, content analysis
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-90850 (URN)10.1111/scs.12812 (DOI)000503692400001 ()31865626 (PubMedID)
Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-01-16
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