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Aim The aim of this systematic review was to identify the evidence contributed by qualitative research studies of foreign educated nurses’ work experiences in a new country and to link the results to patient safety competencies. Design A systematic literature review of qualitative studies. Methods Electronic searches in the Ovid MEDLINE, Embase, PsycINFO, Cochrane Library and Cinahl databases and additional manual searches in five scientific journals. A content analysis of 17 qualitative articles was conducted. Results The analysis revealed one main theme: “Being an outsider at work” and two themes: “Cultural dissonance and Unfamiliar nursing practice. Two sub‐themes emerged from the first theme; Loneliness and discrimination” and “Communication barriers”. The second theme was based on the following two sub‐themes: “Handling work‐related stress” and “Role uncertainty and difficulties in decision‐making”. A better prepared and longer orientation period with continual clinical supervision including systematic reflection on practice experiences is needed to support foreign educated nurses in the transition period and strengthen their Patient Safety Competencies. Nurse Managers have an important role in ensuring the inclusion of foreign educated nurses and providing desirable working conditions.

Background Although there is an increasing amount of research on the use of structured behavioural assessment instruments for non-technical skills in a simulation or clinical setting, there is currently little research into how healthcare professionals experience using these instruments. The structured behavioural assessment instrument, Nurse Anaesthetists’ Non-Technical Skills-Norway, has recently been introduced to nurse anaesthesia education as a means of developing and assessing non-technical skills in clinical practice. The aim of this study was therefore to explore the experiences of Norwegian student nurse anaesthetists, their mentors and clinical supervisors on using the instrument in clinical practice. Methods This study has a qualitative descriptive design. Data was collected through semi-structured interviews with four focus groups comprising twelve student nurse anaesthetists and thirteen mentors and clinical supervisors. The interviews were recorded and then transcribed verbatim. Data was analyzed using qualitative content analysis and an inductive approach. Results Six categories were identified that represented the manifest content. One main theme: Forging a path towards clinical excellence was identified representing the latent content, and three themes that described the participants’ experiences with using the instrument: Promotion of excellent non-technical skills: Raising awareness of non-technical skills ensured professional suitability and shaping of a professional identity; internalizing the skills could lead to changes in behaviour. Promotion of cooperative learning: Mentoring was more structured, based on a common language and understanding and clearly defined roles; measurable progress enabled a more reliable and objective evaluation. Promotion of organizational acceptance: A lack of familiarity with the instrument, and challenges with scoring and the terminology impeded acceptance. Conclusion Increased awareness of non-technical skills when using Nurse Anaesthetists’ Non-Technical Skills-Norway contributes to a professionalization of the nurse anaesthetist role and mentoring/learning process in nurse anaesthesia education. Using Nurse Anaesthetists’ Non-Technical Skills-Norway promotes the ideal of clinical excellence, not only as an assessment instrument but also by guiding the student’s learning process. Despite a high level of commitment to using the instrument there is a need to promote further acceptance in the anaesthetic departments.

Aim To explore the experiences of nurses mentoring nursing students who study in an active collaborative learning model in their first clinical placement in nursing homes. Background Clinical nurses play a crucial role in providing a meaningful learning environment when mentoring nursing students. Active collaborative learning models are increasingly being implemented in clinical placements in nursing education and it is important to explore the experiences of mentoring nurses when implementing such models. In our study, a model where one mentor supports a learning cell of two students, again being supported by a team of two persons in joint positions, was explored. Design The study had a qualitative design, interviewing mentors in focus groups about their experiences with mentoring nursing students in a new, collaborative model. Methods Twenty‐seven mentors were interviewed in six focus groups. The data from the interviews were analysed using thematic analysis. Results Two main themes emerged from the analysis: (1) navigating to find the mentor role in a new approach and (2) sharing responsibility for student mentoring. Conclusions Mentors in active, collaborative learning models can experience a shift from emphasis on developing a close relationship with one student to emphasis on supporting a learning cell of two students in organising their learning. When introducing new models to practice learning it is essential to also provide a supportive structure for the mentors. Relevance to Clinical Practice Active collaborative learning models have the potential to provide more clinical placements of high quality. Nurses who mentor students need support. A supportive environment being facilitated by academic–practice collaboration provide a community of practice on mentoring for nurses. Patient or Public Contribution The result of the research was shared and discussed with stakeholders prior to submitting the article for publication.

Aim To illuminate the perceptions of hospital‐based midwives who support women suffering from moderate to severe fear of childbirth during an expected vaginal birth. Design A qualitative descriptive and explorative study. Methods Focus group interviews were conducted with 18 midwives representing four different hospitals in Norway. Results Encountering fear of childbirth evoked the desire to protect and help, although the ability to provide optimal support was dependent on several circumstances, several of which were beyond the midwives̕ control. The main theme “Midwives finding their own strength when encountering the vulnerability of women with fear of childbirth” consisted of two themes: “Being present” and “Being alone.” The midwives described being present as a prerequisite for continuity of care and affirmation. The emphasis on continuity of care could give rise to a sense of loneliness and guilt during and after demanding situations in the birthing room.

Aim To conduct a meta‐study of qualitative empirical research to explore the links between patient safety and fear of childbirth in the maternity care context. The review questions were: How are patient safety and fear of childbirth described? and What are the links between patient safety and fear of childbirth in the maternity care context? Design Meta‐study. Data sources The CINAHL, Cochrane, PubMed, Webb of Science, Proquest and Medline (Ovid) electronic databases were searched for articles published between June 2000‐June 2016. Review methods A meta‐study of qualitative research with a thematic analysis followed by a synthesis. Results Four descriptive themes emerged: “Physical risks associated with giving birth vaginally”; “Control and safety issues”; “Preventing psychological maternal trauma and optimizing foetal well‐being”; and “Fear of the transition to motherhood due to lack of confidence”. The two overarching analytical themes: “Opting for safety” and “An insecure environment breeds fear of childbirth”, represent a deeper understanding and constitute the synthesis of the links between patient safety and fear of childbirth. This meta‐study indicates the need for increased commitment to safe care and professional support to reduce risks and prevent unnecessary harm in maternity care.

Purpose: New mothers may question the nature of their motherly love after the birth. Most mothers find that feelings of affection come within a week from birth. However, some mothers are still struggling with this after many months. Many studies place strong emphasis on the importance of maternal affection for the development of the child. Few studies look into mothers' experiences when maternal affection or love remains a struggle. Method:We present an interpretative synthesis based on a systematic analysis of five qualitative studies that report findings related to mothers' stated inability to exhibit maternal affection. Result:In answer to our question \"what characterizes the experiences of women who struggle with, or are unable to exhibit, maternal affection after birth\", we identified the uncertainty involved in imagining the unborn child, birth and maternal future, birth as a disillusionment, and the ensuing process of decreasing agency and increasing alienation. Especially a traumatic birth may lead to disillusionment. Conclusion: Health care workers and research can support a mother's positive resolution of her struggle by promoting realistic and more open expectations for maternal affection as well as her sense of agency and ownership during birth and the early mother-child relationship.

Introduction Nurses educated in the European Union and European Economic Area are automatically given professional authorization to work in all member states, facilitating workforce mobility between countries. Along with many other European countries, Norway faces nursing shortages in healthcare. European Foreign Educated Nurses are often recruited to work in Norway by agencies or apply for work themselves. Aims To explore the experiences Foreign Educated Nurses from European Union and European Economic Area had with their preparation and orientation programs and their first year of work in Norwegian elderly care institutions Methods The study followed a qualitative explorative design. Nine open, dialogue-based, semi-structured interviews were conducted with Foreign Educated Nurses from Poland, Lithuania, Latvia, Iceland, and Spain. Data were analyzed using qualitative content analysis. Findings One main theme, struggling to adjust to professional competence standards, and four subthemes emerged from our data (1) deficiencies in preparation and orientation by recruitment agencies and institutions, (2) language skills and communication challenges at work, (3) cultural differences in the nursing role in clinical practice, and (4) social interactions at work. Conclusion More comprehensive preparation and orientation programs regarding language skills and local healthcare systems are needed. Foreign Educated Nurses make important contributions to the Norwegian healthcare work force, but the challenges brought to light in this study negatively affected their work conditions and can possibly threaten patient safety. More research is suggested to address the lack of collaboration between agencies, healthcare institutions, and other stakeholders in establishing professional standards and appropriate support for Foreign Educated Nurses from European Union and European Economic Area.

Resilience is a term commonly used to describe the ability to turn adversity into opportunities and learn from demanding situations. There seems to be a need to identify support strategies for developing resilience among nursing students in order to strengthen their professional practice. The aim of this review was to synthesize qualitative research exploring how resilience can be developed in nursing students. The review question was: How can nurse educators support students’ development of resilience? Relevant publications were identified by systematic data searches in May 2017 in the following electronic databases: MEDLINE, CINAHL, Scopus, Embase, PubMed, PsycInfo, Webb of Science, ProQuest, Academic and Eric. Eight qualitative research studies in English that explored resilience in the context of nursing education were included. Five descriptive themes emerged: Demonstrating caring relationships, Recognizing resources and power, Acknowledging uncertainty, Reframing burdensome experiences and Adjusting frames for learning. In addition, two overarching analytic themes emerged: An educational culture of trustworthiness and Readiness to care. In conclusion, a learning culture characterized by trustworthiness appears to be a catalyst for developing resilience in nursing students. A variety of support strategies in nursing education contribute to resilience in nursing students, thus influencing their readiness to care. •Research on how to develop resilience in nursing students is scarce.•Resilience contributes to nursing students' readiness to care.•An educational learning culture of trustworthiness promotes the development of resilience.•Nurse educators can support the development of their students' resilience.

In this study, we aim to understand midwife leaders’ perspectives on continuing professional education among midwives in their work unit. We used a phenomenological perspective and method in the process of interviewing the participants and analyzing the data. Five midwife leaders who worked in large maternity wards and had considerable experience as managers were recruited. Results revealed three essential constituents: (a) constraints and the individualization of continuing professional education, (b) normal and at-risk births: fluid boundaries and moving targets, and (c) a personal approach: dimensions of control and trust-driven leadership. We discuss these findings in relation to current research and perspectives on how professional cultures and leadership impact continuing professional education and knowledge management, revealing possible implications to further promote professional development in public health organizations. We conclude that midwife leaders’ views on continuing professional education as practical skills training may hinder professional communication and knowledge development in maternity care.

The aim of the study was to explore the maternal health coping strategies of migrant women in Norway. The ethnic and cultural background of the Norwegian population have become increasingly diverse. A challenge in practice is to adjust maternal health services to migrant women’s specific needs. Previous studies have revealed that migrant women have difficulty achieving safe pregnancies and childbirths. Data were obtained by means of 17 semistructured interviews with women from South America, Europe, the Middle East, Asia, and Africa. Qualitative content analysis was employed. One overall theme is as follows: keeping original traditions while at the same time being willing to integrate into Norwegian society, and four themes emerged as follows: balancing their sense of belongingness; seeking information and support from healthcare professionals; being open to new opportunities and focusing on feeling safe in the new country. The results were interpreted in the light of Bronfenbrenner’s ecological model. To provide quality care, healthcare professionals should focus on the development of migrant women’s capabilities. Adaptation of maternal health services for culturally diverse migrant women also requires a culturally sensitive approach on the part of healthcare professionals.