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The suffering patient is thrown into a strange and unfamiliar environment of different technological devices in an Intensive care unit. The intensive room is a place for care and treatment, for rest and recovery, a visiting room, and a working place for the staff. In this context patients and relatives are very vulnerable and are in a need of support. Patients may suffer from unreal experiences, often very traumatic during their stay in ICU and manypatients also suffer from unpleasant memories, and some develop post traumatic stress after their discharge. In order to design optimal rooms in ICU it would be important to identify factors which are meaningful for the patients and relatives. The aim of this study, as part of a larger research project, is to illuminate patients' and relatives' experiences of the physical room, the design and the interior in the ICU. Photographs combined with interviews are used as data collection methods within the ICU-context. Relatives and former patients are asked to photograph different aspects of the room that they remember or associate with a feeling. The pictures were used later during an interview with the informants. In total the researcher meets the informants three times, first time to inform, the second time to take the photos and a third time for the interview. This method gives the researcher opportunity to deepen the understanding and capture aspects of the room that otherwise might have been hidden. The presentation will focus on photography as a research method.

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion ; Paid Open Access

Aim This study illuminates the meaning and purpose of clinical presence in nursing leadership in municipal home care from the first‐line nurse manager's own perspective. Background Being a first‐line nurse manager in the context of home care is demanding due to demographic changes and an ever‐increasing number of elderly suffering from chronic diseases. Leading in this context entails leading from a distance because patients live and receive care in their homes. First‐line nurse managers express the importance of clinical presence. However, there is a paucity of studies from home care of the meaning and purpose of presence. The theory of caritative leadership and the model of caring in nursing leadership served as the starting point for this study. Methods Hermeneutic abductive approach using a purposive sample of three semistructured focus group interviews with 11 first‐line nurse managers in home care in three Nordic countries. Result This study shows that first‐line nurse managers described the meaning and purpose of their clinical presence in home care as safeguarding the patient by taking overall responsibility for care, securing the patients' voices, building and maintaining trustful relations, and securing a sensible economy. Conclusion Our findings indicate that clinical presence serves the purpose of taking the overall responsibility for care and safeguarding the patient. Presence is perceived a necessity to verify staff providing the best possible care. First‐line nurse managers acted metaphorically as a shield to protect patient care, which is the main concern in their leadership. The findings add new knowledge to the significance of caring in nursing leadership and the theory of caritative leadership. Implications for Nursing Management First‐line nurse managers need to be clinically present in order to safeguard the patient and to fulfil their threefold responsibilities for the patient, the staff and the economy. This study might also contribute to the political discussion concerning why nurses has to be first‐line nurse managers and cannot be replaced by economists. ; publishedVersion

Aim: This study illuminates the meaning and purpose of clinical presence in nursing leadership in municipal home care from the first‐line nurse manager's own perspective. Background: Being a first‐line nurse manager in the context of home care is demanding due to demographic changes and an ever‐increasing number of elderly suffering from chronic diseases. Leading in this context entails leading from a distance because patients live and receive care in their homes. First‐line nurse managers express the importance of clinical presence. However, there is a paucity of studies from home care of the meaning and purpose of presence. The theory of caritative leadership and the model of caring in nursing leadership served as the starting point for this study. Methods: Hermeneutic abductive approach using a purposive sample of three semistructured focus group interviews with 11 first‐line nurse managers in home care in three Nordic countries. Result: This study shows that first‐line nurse managers described the meaning and purpose of their clinical presence in home care as safeguarding the patient by taking overall responsibility for care, securing the patients' voices, building and maintaining trustful relations, and securing a sensible economy. Conclusion: Our findings indicate that clinical presence serves the purpose of taking the overall responsibility for care and safeguarding the patient. Presence is perceived a necessity to verify staff providing the best possible care. First‐line nurse managers acted metaphorically as a shield to protect patient care, which is the main concern in their leadership. The findings add new knowledge to the significance of caring in nursing leadership and the theory of caritative leadership. Implications for Nursing Management: First‐line nurse managers need to be clinically present in order to safeguard the patient and to fulfil their threefold responsibilities for the patient, the staff and the economy. This study might also contribute to the political discussion concerning why nurses has to be first‐line nurse managers and cannot be replaced by economists. ; publishedVersion ; Unit Licence Agreement

The aim of this paper was to describe the first person perspective of being a peer midwife and a novice researcher initiating collaborative AR in her own organization to develop knowledge about the first encounters between the labouring woman and her care-givers in a hospital birthing context. It was motivated by the author's longstanding professional clinical experience of observing and hearing parents' stories of vulnerability and fear of childbirth, and how staff's attitudes affected the childbirth experience negatively. Data were collected between 2010 and 2013 and included the researcher's log with reflections from clinical work, as well as interviews, participant observation, and research group communications. A reflective interpretative lifeworld research approach was used to analyze the data. The experience of being a novice insider action researcher (IARr) consisted of three thematic meanings: "the struggle to initiate a clinical insider action research project," "standing alone at the messy front line," and "being a catalytic counterbalance to the prevailing medico technical focus." The comprehensive understanding was "learning how to clinically reflect on and to voice the tacit components of care." The strategy used in undertaking this study was influenced by the philosophies of both midwifery care and AR.