Background Nurses encounter many ethical dilemmas in their practice. The ability to make good ethical decisions is a necessary competence in healthcare professions. International studies call for development and research on various methods to teach healthcare professionals ethics. This article describes an approach for learning how to be aware of and discover ethical dilemmas. By applying experienced narratives from healthcare practice and using question guidelines from a structured ethical model, nursing students learn to discover and find possible solutions for ethical problem in their practice. Aim The aim of this study was to describe second‐ and third‐year nursing students’ experiences by using structured ethical reflection as an approach to increase ethical awareness and deal with ethical decisions. Design This study has a descriptive exploratory design. A three‐day ethics seminar was carried out to help students learn how to recognize and explore ethical dilemmas in their practice. Materials and Methods The data are collected from questionnaires used to evaluate the ethics seminar where 52 nursing students participated. The questionnaire contained open‐ended and closed questions and was analysed using Braun and Clarke’s reflexive thematic analysis. The empirical data were collected by 52 nursing students answering an evaluation questionnaire after the ethics seminar. Findings Four themes were developed: Becoming aware of ethical dilemmas, Learning ethics by discussing knowledge and experiences with other students, Increased curiosity about ethics as a subject and Understanding the importance of critical ethical reflection work in clinical practice. Discussion The process of learning how to understand the ethical principles in real‐life nursing context continues progressing through the bachelor’s program. Using group discussions and discussing examples of ethical dilemmas from practice help the students to a more comprehensive reflection process. Conclusion The nursing students experienced video lessons, group discussions and the use of a structured reflection model as a valuable approach in learning to recognize ethical dilemmas and how to deal with real‐life ethical dilemmas.

<span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-language: NO-BOK; mso-ansi-language: NO-BOK; mso-bidi-language: AR-SA;"><em>Artikkelen handler om hvorvidt, og p&aring; hvilken m&aring;te refleksjonsgrupper med sykepleierstudenter og sykepleiel&aelig;rer i spesialisthelsetjenesten er virksomme i opp&oslash;ving til &aring; bli en kyndig sykepleier. Studentenes ukentlige refleksjonsm&oslash;ter i l&oslash;pet av deres medisinske praksisperiode er blitt til i l&oslash;pet av et pedagogisk aksjonsforskningsprosjekt (2006 &ndash; 2009), kalt &rdquo;N&aring;r praksisfelt og skole flyter sammen&rdquo;. Studentevalueringer og loggdata viste at refleksjonsgruppene var viktige for studentenes l&aelig;ring, men sa lite om p&aring; hvilken m&aring;te. Dette ble utforsket gjennom et fokusgruppeintervju med 8 studenter. Det utkrystalliserte seg fem </em><a name="OLE_LINK2"></a><a name="OLE_LINK1"><span style="mso-bookmark: OLE_LINK2;"><em>tema: &Aring; utvikle kunnskap, Erfaringsl&aelig;ring, Anerkjennelse av egen s&aring;rbarhet, &Aring; opp&oslash;ve faglig skj&oslash;nn og </em></span></a><em>&Aring; v&aelig;re i bevegelse mot profesjonell yrkesut&oslash;velse. I en sammenfattende tyding fremkom Dannelse som et overordnet tema. Refleksjonsrommet dr&oslash;ftes som en dannelsesarena, en &rdquo;refleksjonsoase&rdquo;, hvor studentene erfarer at de f&aring;r et personlig og reflektert forhold til kunnskapene de erverver seg. Kunnskaper og dannelse vil da sammen, og i vekselvirkning med hverandre, hjelpe dem mot en bedre yrkesut&oslash;velse. </em></span>

Background:In Norway, as in many other countries, more people receive health and care services in their homes than before. Home care professionals provide care and support to people with a range of health and care needs. Older home care service users are sometimes referred to as 'frail', but the terms 'frail' and 'frailty' have different meanings in different contexts, and little is known about the meaning ascribed to the terms in the context of home care services. Home care services are crucial for many older persons who have health challenges, and how home care professionals conceptualise frailty might shape clinical encounters. Objectives:The purpose of this study is to explore how home care professionals conceptualised frailty in the context of home care. Methods:We conducted four focus group discussions with 14 home care professionals who worked in municipal home care in northern Norway and analysed the data using thematic analysis.Results: Our analysis resulted in five themes: '"Frail" -a term which is too imprecise to be useful', 'Frailty as a consequence of ageing', 'Frailty as lack of engagement and possibilities for engagement', 'Frailty as a contextual phenomenon' and 'Frailty as potentially affected by care'. The home care professionals conceptualised frailty as an individual trait but also as resulting from the interplay between individual and environmental factors. Moreover, their conceptualisations of frailty represented a continuum between frailty as related to prevention and management ('cure') and frailty as related to ageing as natural decline ('care'). Conclusion:The home care professionals conceptualised frailty diversely, as moving along a continuum between cure and care. Diverse conceptualisations of frailty might be necessary if nurses are to meet the changing and varying care needs of older persons who live in their own homes and need health and care services.

The encounter between divergent institutional logics may be challenging for nurses, since they must balance different expectations in their daily institutional work. These challenges increase when new reforms are introduced. Our research question is: How do actors linked to a palliative care unit experience the consequences of the Coordination reform in their daily performance of care work? Our study is based on a qualitative study in a palliative care unit in a nursing home where we interviewed patients, their relatives, and nurses/department leaders. Our findings show that by downgrading the professional logic because of the Coordination reform, the focus is on efficiency and budget instead of proper healthcare. This is not satisfactory for any of the actors in our study. We contribute to the research on the reforming of the healthcare sector by focusing on how different actors experienced day-to-day activities in a context where different institutional logics were involved.

The importance of the story to promote hope and life courage in the face of serious illnessIn connection with my PhD (Mæhre, 2017), I conducted qualitative interviews with five critically ill patients in an enhanced ward of a nursing home, based on the Coordination Reform. The purpose of the interviews was to increase understanding of patient experiences of the ward, and their perceived challenges and needs for assistance. The research method was a hermeneutic-phenomenological approach. The essay is based on one of the patient interviews, which has been rewritten as a narrative. This narrative emphasizes how the patient has fought against her illness, and her need to be seen as herself as a person and not understood in terms of a diagnosis. The illness narrative becomes part of her life story. The article highlights opportunities for narratives in the face of serious illness. The narrative reveals how a changed life situation, despite severe illness, can add courage and joy to life, but also how it can lead to hopelessness, doubt, and uncertainty.