Karin Bundgaard

The aim of this study was to explore registered nurses’ experiences of non-nurses being involved in nursing care of hospitalised patients at a Danish university hospital. A total of 16 registered nurses from 12 different inpatient wards where non-nurses were employed (employees without a nursing education) participated in five focus groups. The data were examined using thematic analysis. This article followed the COREQ guidelines. Three themes were generated: (1) balancing support: RNs’ experiences with non-nurses in indirect and direct nursing care; (2) managing complexity: RNs’ experiences with delegating nursing care to non-nurses; and (3) navigating responsibility: RNs’ experiences with coordinating patient care amidst non-nurse involvement. Replacing registered nurses with non-nurses makes delivery of nursing care complex. On the one hand, involving non-nurses in the delivery of indirect nursing care eases nurses’ workloads and releases time to spend with patients. Furthermore, quality of care can be improved if the competencies of the non-nurses’ match patients’ care needs. On the other hand, the involvement of non-nurses in direct nursing care complicates nurses’ delegation practice and causes uncertainty about their nursing role.

Patients with transient ischemic attack (TIA) and minor stroke often struggle with long-term cognitive and psychological difficulties that impact their reintegration into work and leisure activities. The aim of the study was to evaluate the impact of a structured group-based stroke educational (SSGE) programme on patients’ ability to cope with a changed everyday life. Seven semi-structured qualitative interviews were conducted between February and March 2022 and analysed using thematic content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was applied. The analysis uncovered three themes: ‘the existence of remaining challenges’; ‘the significance of support from resource individuals’; and ‘a sense of safety and confidence derived from the educational programme’. This study provides pivotal knowledge of how the SSGE programme supported patients’ long-term ability to navigate challenges after a TIA or minor stroke. The group-based format facilitated crucial exchanges of experience and knowledge with healthcare professionals and peers. However, the necessity for healthcare professionals to initiate post-support groups were underscored, as patients lacked the physical and mental strength to organise these on their own.

Relatives are an important resource to hospitalised patients and hence to nursing. During the COVID-19 pandemic, visiting restriction policies were implemented in healthcare settings globally, unwillingly excluding relatives from visiting the bedsides of their loved ones. The aim of the present study was to explore how the visiting restrictions influenced relatives’ relationships with patients and collaboration with registered nurses at non-pandemic hospital wards. In total, 13 relatives were interviewed. The study was reported following the COREQ guidelines and checklist. Content analysis led to three themes: 1) being excluded from providing care and support; 2) being excluded from conveying person-centred and situational relevant knowledge to registered nurses; and 3) being excluded from assessing the health status of the hospitalised loved one. Together they describe relatives feeling worried and powerless regarding the health of their hospitalised loved one and the performed nursing care. Findings from studies such as this are pivotal to any future national or global health crisis, where visiting restriction policies are implemented.

Nurses are imperative for healthcare systems’ ability to effectively function during pandemics, yet multiple factors may affect their willingness and preparedness to work. The aim of the present cross-sectional survey was to identify factors associated with registered nurses’ (RN) willingness and preparedness to work during the novel coronavirus disease (COVID-19) pandemic. The study was reported following the STROBE guidelines. A total of 358 nurses completed a self-administered online questionnaire. The participants were a part of a COVID-19 task force at a Danish university hospital during spring 2020. The results showed that the majority of RNs felt a professional obligation to engage in clinical work during the pandemic; however, their willingness and preparedness to work were affected by multiple factors, such as being relocated voluntarily, being prepared for the task and feeling safe. This study highlights that these factors are essential for the hospital management and nurse leaders to take responsibility for.

COVID-19 restrictions prevented relatives from visiting and accompanying patients to hospital and required that nurses wore personal protective equipment. These changes affected patients’ relationships with relatives and challenged their ability to connect with nurses. Individual, semi-structured interviews with 15 patients were carried out to explore patients’ experiences of their relationships with relatives and their collaboration with nurses during in- and outpatient contacts in non-COVID-19 hospital wards. The analysis of data was guided by phenomenological hermeneutic frame of reference and the study was reported according to the COREQ checklist. The findings illustrated that patients felt lonely and insecure when separated from relatives, caught between relatives and professionals during information exchange, and experienced the absence of relatives as both beneficial and burdening. Visitor restrictions provided patients with time to heal but prevented provision of informal care. Patients had to take responsibility for maintaining contact with relatives independent of their health condition. COVID-19 restrictions created distance with nurses, which potentially led to insufficient physical and psychosocial care.

This study aims to explore how a changed COVID-19 work environment influences nurses’ clinical decision-making. Data were collected via three focus groups totaling 14 nurses working in COVID-19 pandemic wards at a Danish university hospital. The factors influencing decision-making are described in three themes; navigating in a COVID-19 dominated context, recognizing the importance of collegial fellowship, and the complexities of feeling competent. A strong joint commitment among the nurses to manage critical situations fostered a culture of knowledge-sharing and drawing on colleagues’ competencies in clinical decision-making. It is important for nurse leaders to consider multiple factors when preparing nurses not only to work in changing work environments, but also when nurses are asked to work in environments and specialties that deviate from their usual routines.

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses’ experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.