Påfrestande situationer och bemästrandets konst : en fenomenologisk studie av sjuksköterskor i äldrevården

Sammanfattning: The aim of this study is to describe situations that nurses experience as strenuous in their work with elders in institutional environment. The study focuses on the content and structure of the situations, meanings the nurses put in the situations and how they manage to handle the situations.The approach was to have a phenomenological perspective and a theoretical frame of reference in the CPT model  (CognitivePhenomenological-Transactional view) from Lazarus and Manet as well as inAntonovsky's discussion about the importance of general resistance resources against stressful events.The study is based on observations and interviews with five nurses working in three different institutions and in five different wards.The thesis states that factors in the work organisation such as lack of a common caring philosophy, ignorance of the nurses' role and function, communication problems with other organisations, imbalance between demands and resources are experienced as strenuous. Situations with pain and pain relieving, constant shouting from patients and  severe confusion were pointed out as particularly stressful in the interaction with patients.The nurses use a number of strategies in order to handle these strains, such as seeking social support, planned problemsolving, positive reappraisal and sometimes distancing. From an immediate perspective these strategi.es were efficient and the nurses were satisfied with their work.