Background: Moral distress is an increasing concern among nurses in their workplace. Previous research has suggested that moral distress is associated with ethical climate and job dissatisfaction. Economic restraints in the organization have led to loss of nurses from the workplace. Aim: To examine nurses experience of moral distress and their causes. Method: The study was a literature review. Twelve articles were used in the study.

The aim of the present literature study was to describe the significant factors contributing to the development of moral distress and the consequences of moral distress can lead to in the nurse profession. A literature search was performed in the databases Medline through PubMed and Academic Search Elite on the basis of in advanced defined criterions. A total of 19 articles was reviewed and included in the study. The main result revealed that nurses experience moral distress and that it is frequent within the nurse profession. The findings revealed that there seem to be several significant factors in the development of moral distress, such as providing life-sustaining care, competing loyalties, conflicts with the physician, communication barriers, emotional barriers, cultural barriers, regulation and rules and working environment that gives the nurse difficult or unsolved ethical dilemmas.

Background: Children frequently exhibit high levels of distress while undergoing routine blood sampling or injections. If the child is not treated with appropriate care, the feelings of distress may increase over time and result in needle-phobia. Objective: The purpose of this study was to describe nurses´ possibilities to relieve distress in children undergoing needle sticks. Method: A systematic literature review was conducted through database search and screening of reference lists. Ten research articles with a quantitative approach were included, coded for quality and then analyzed.

Intensivvårdssjuksköterskor uttrycker upplevelser av moralisk stress i det dagliga arbetet och detta kan leda till utbrändhet eller behov av att byta yrke då de inte lyckas bemästra sin situation. Studiens syfte var att kartlägga moralisk stress hos intensivvårdssjuksköterskor med hjälp av Moral Distress Scale(MDS). Studien utfördes med en deskreptiv metod av tvärsnittsdesign där 45 sjusköterskor med intensivvårdsutbildning i västsverige tillfrågades att vid ett tillfälle besvara en enkät med en validerad svensköversatt MDS. Resultatet påvisade att det finns signifikant höga nivåer av moralisk stress hos intensivvårdssjuksköterskor yngre än 45 år(p=0,044) och även i gruppen med kandidat/-magisterexamen(p=0,003). De högsta nivåerna av moralisk stress kunde uppmätas när intensivvårdssjuksköterskorna ställdes inför situationer där de upplevde att ingen var beredd att fatta beslut om att avsluta livsuppehållande behandling.

Early extubation of cardiac surgery patients has become increasingly important. The assessment of the patient before an early extubation is crucial and the intensive care nurses (ICU nurses) in this estimation is there for very important.The aim of this study was to examine critical care nurses' knowledge of early extubation, and what view ICU nurse has about factors that affect the time to extubation of cardiac surgery patients.A quantitative approach with descriptive and comparative design was used. Selection was all ICU nurses at a thoracic intensive care unit who were clinically active in patient care.The study showed that ICU nurses had good knowledge of why an early extubation was essential. However, the knowledge about the unit?s extubation criteria was low.

ABSTRACTAim. To describe intensive care nurses´ experiences of caring for patients with postoperative delirium after heart surgery.Background. Delirium is a common condition after heart surgery. Previous research has focused more on pathophysiology, incidence, etiology, prevention, detection and management, and less on how nurses caring for patients with delirium experience it.Design. A qualitative interview study.Method.

Aim: The aim of this study was to describe intensive care nurses? experiences communicating with patients during mechanical ventilation.Methods/design: A qualitative interview study. Interviews where analyzed using descriptive content analysisSetting: Nine intensive care nurses from two different intensive care units were interviewed using a semi structured interview guide.Background: Past research has shown that patients during mechanical ventilation in the intensive care unit, feel very vulnerable and the helplessness of being unable to speak. These patients feels that they are completely dependent on the nurses and their competence. It has been shown to be very important that the patient feels included, acknowledged and respected.Results: The analyzed data resulted in a theme; through communication strive to preserve patients´ dignity and three main categories; create relationship to the patient, minimize patients´ vulnerability and don´t give up.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Aim: The aim of this study was to describe intensive care nurses? experiences communicating with patients during mechanical ventilation.Methods/design: A qualitative interview study. Interviews where analyzed using descriptive content analysisSetting: Nine intensive care nurses from two different intensive care units were interviewed using a semi structured interview guide.Background: Past research has shown that patients during mechanical ventilation in the intensive care unit, feel very vulnerable and the helplessness of being unable to speak. These patients feels that they are completely dependent on the nurses and their competence. It has been shown to be very important that the patient feels included, acknowledged and respected.Results: The analyzed data resulted in a theme; through communication strive to preserve patients´ dignity and three main categories; create relationship to the patient, minimize patients´ vulnerability and don´t give up.

Background: The abortion issue raises many ethical, moral and religious aspectsand is therefore well debated worldwide. In the care for an abortion seeking woman, it isimportant that the nurse find a balance between her and the woman's moral opinions aboutabortion in the quest to achieve good care.Aim: The aim of this study was to describe nurses? experiences of caring for womenundergoing abortion.Methods: Literature review based on ten original articles.Results: Literature review's results highlights two key themes: nurse?s experience of anemotional roller coaster as well as difficulties and challenging experiences at work inabortion care. These two themes consists of three subthemes: to get support in the workthrough to vent thoughts and feelings, how strain and stress affects the nurse's work and as anurse learn to accept the woman?s choice.Discussions: Within abortion care nurses find it difficult dealing with theemotional roller coaster that can occur while they strive to maintain an ethical andprofessional approach.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

HIV/AIDS is a chronic disease that has increased and will continue to increase. Most health care workers will one way or another come into contact with it. The purpose of this literature review was to describe factors contributing to nurses' attitudes towards patients with HIV/AIDS. Sixteen articles were analyzed and quality assessed. The results revealed gaps in knowledge among nurses.

In the care for the critically ill patient the next of kin is of great importance. Their support, love and care for the patient, increases the wellbeing and makes a connection to the patient?s normal lifeworld. For the next of kin to be able to be that support the next of kin needs to be helped to maintain the basic need of for example their sleep, food, hygiene and psychosocial support. The critical care nurse must see to the patient?s whole lifeworld which includes their next of kin.The aim of the study was to identify the resources available for the next of kin in intensive care units in Sweden.

ObjectiveThe aim of this study was to explore nurses' experiences of informing relatives to critically ill patients in the intensive care unit (ICU).MethodThe study was descriptive with a qualitative approach. Nine nurses were interviewed. The study took place in a university hospital in the midst of Sweden. An interview guide was used, designed in consensus with the study questions. Data was analyzed via qualitative content analysis.FindingsMeeting and preparing relatives at the arrival at the ICU seemed valuable and led to safety and participation among relatives.