Fredricka Gilje

Transforming Desolation into Consolation: the meaning of being in situations of ethical difficulty in intensive care

The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one’s inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create an ethical work environment and strive for praxis that fosters ‘athomeness’, which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others.

Striving for Purity Shared Understandings in Retired Swedish Care Providers’ Narratives on Nursing Care Around 1950

Caring for the sick has been important throughout all times. Nursing care has been illuminated from various perspectives. The aim of this study was to illuminate nursing care as narrated by 27 retired care providers in northern Sweden. The themes of cleanliness, order, and clear conscience stood out as important in the text. The results are interpreted as pointing to purity. Purity is a complex phenomenon within the cultural context. Some literature states that in the past, physical cleanliness, moral purity, and order were closely interrelated. Nurses were expected to be religious, morally pure persons in clean and perfect uniforms, always prepared to serve and do their duty. Purity is not always readily apparent. It is often revealed through its absence or opposite. Purity and conscience are seldom addressed in contemporary nursing research. More research is needed to further reflect on purity and its significance for nursing care today.

Nurses’ ethical reflections on caring for people with malodorous exuding ulcers

The aim of this study was to illuminate nurses’ reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants’ reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to ‘do good’ and ‘be good’. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to ‘do good’ for patients and ‘be good’ nurses.