The world is facing the highest number of people to have been forced from their homes due to war and conflict. Providing a framework for integrated action is a common societal solution to managing the challenges of integration policy programmes. These programmes are intended to standardise services provided by a diverse set of agencies and areas, and are usually delivered by civil servants and volunteers. The aim of this study was to describe factors, as reported by civil servants and volunteers in a policy programme, that enable or hinder them in helping newly arrived immigrants to establish themselves in Swedish society. The results show that the participants have the prerequisites to enable newly arrived immigrants to make their own choices, strengthen their own motivation and develop their own social networks within their new situation. However, the participants were hindered from influencing the newly arrived immigrants’ housing situation. No consensus was achieved regarding more structural prerequisites such as societal efforts to counteract segregation, or more general community-based welfare solutions. The results support the view that there is a need for a more tailored approach with consideration for each person’s unique living situation.

Good health is a prerequisite for individuals to function in everyday life. The same applies to newly arrived immigrants, where good health is crucial for successful establishment. The aim of this study was to describe stakeholders’ experiences of how newly arrived immigrants’ health affects their opportunities to establish themselves in society. The study had a qualitative design where open-ended questions were analysed following Braun and Clarke’s guidelines for conducting a qualitative thematic analysis. The results consist of three themes: Mental health problems, disabilities, and tormenting concerns about absent family members; A precarious life situation related to housing, education, and income; and Deficiencies in responding to health challenges in organisations and in society. Stakeholders face health problems among newly arrived immigrants that they do not have the right skills to deal with. We argue for the presence of nurses in organisations working with newly arrived immigrants, and that nurses’ competence is necessary to capture their needs.

Sweden, like many other European countries, has received a large number of immigrants in the past few years. To tackle the challenge connected with this, a policy for integration including an establishment programme was adopted by the Swedish Government which speeded up the introduction of newly arrived immigrants into the labour market and social life. The implementation of the programme is performed by various stakeholders in the fields of the labour market, language education and non-governmental organisations.The aim of this study was to investigate challenges and barriers to integration from the perspective of stakeholders’ experiences of encounters with newly arrived immigrants. The study used open-ended data collected in a Delphi project targeting civil servants and volunteers working within the policy establishment programme, and a thematic analysis was conducted. The results indicate that focus on organisational structures, issues concerning resources and competence, and a more holistic approach to new arrivals’ existential situationare key areas to address to move towards successful integration.

The ability to appropriately attend to refugee health needs in the countries that are receiving them is an enormous institutional challenge. The varying practicalities of administering refugee health services can affect a refugee’s mental health outcome during the adjustment period to their new home country. This is a report on a study undertaken to overview Delphi method approaches used to investigate the consensus by experts on the issue of refugees’ social participation in health services. The review was conducted from March to December 2018 by two evaluators utilizing a systematic search strategy in presently available electronic databases. Only Delphi studies concerning forced adult refugee’s social participation in health services were included, while studies that focused on children, minorities, immigrants, migrants, asylum seekers, etc., as well as studies that did not utilize the Delphi technique, were excluded. Ten peer-reviewed articles were included in the final charting of the data. The results show that Delphi approaches regarding refugee social participation have focused on important factors important for providing quality health care, health care priorities, barriers preventing social participation, and research priorities. The experts make clear that bureaucratic procedures, cross-cultural communication and empowerment, be taken into consideration when creating policies, in practice and in research. The conclusion is that by emphasizing the tacit knowledge of experts, the Delphi method can contribute to a deeper understanding of policy priorities and responsive health services.

Primary health prevention regarding social participation for newly arrivedimmigrants is needed to address challenges when responding to the needs of suchimmigrants in their new and vulnerable situation. The aim of this study was to describe socialparticipation as reported by civil servants and volunteers working with newly arrivedimmigrants in Sweden. Open-ended data collected in a Delphi project targeting civil servantsand volunteers working within the policy establishment programme was used. Qualitativecontent analysis was conducted. The findings show that several interacting factors contributeto resources that create perquisites for “going native in the community” and “being part ofeveryday life” as points of perquisites for how civil servants and volunteers elaborate onsocial participation for newly arrived immigrants. A focus on the “here and now” and avoidingmeasures that “put life on hold” are two points of aspects that generate possibilities forpromoting social participation in health services.

Introduction: In a global context of an increasing and aging population, along with environmental changes, nurses play an important role in relieving suffering among vulnerable people and groups in society. Sustainability in nursing contributes to sustainable development through providing an environment that is not detrimental to/protects present and future generations′ opportunities for good health. There is a global shortage of nurses, and it has been shown that, locally, every fifth newly graduated nurse considers leaving their new profession five years after graduation. The aim was to describe how nursing students’ thought about a sustainable professional life as nurses before their graduation.

Materials and Methods: A qualitative design with a written data set was used, and a thematic analysis was performed. One hundred five students (80 women and 25 men) in semester six out of six of the nursing education program participated.

Results: The analysis resulted in three themes: 1) to have an ethical foundation that guides the individual nurse in protecting the nursing care and developing the nursing care for their patients; 2) to be in a listening, reflexive and supportive workplace enabling a professional nurse to continuously grow and learn and 3) to be a proud professional nurse with integrity, not risking with their own health or personal professional development.

Conclusion: The nursing students describe their thoughts on the requirements for having a sustainable professional life as nurses as having a strong inner ethical compass to help guide, protect and develop the nursing care for the patients. In addition, it requires a workplace with a reflexive and supporting culture. However, the nursing students also put their own health and the opportunities for professional growth at the top of their priorities, and if these conditions are lacking, they will switch to another workplace.

Introduction: A common focus in many studies, in the short-term perspective, is to evaluate students’ workplace learning and its outcome. However, the outcome can be perceived differently depending on when it was evaluated. The aim of this study was to explore student nurses’ learning activities in an acute internal medicine unit and the nurses perceived learning outcome in a long-term perspective.

Material and Methods: Repetitive ethnographic observations were performed in an internal medicine care unit at a teaching hospital in Sweden between 2011 and 2013. Four student nurses and supervisors were repetitively observed. Two years later retrospective interviews were performed with four nurses who had performed workplace learning, as students, in this unit during the observation period. An inductive comparative analysis involving all interviews and observational data was applied.

Results: Three themes were identified: To handle shifting situations – illustrating how student nurses learnt to adapt to shifting situations, to manage stress, to create structure and space for learning and to deal with hierarchies; To build relationships – illustrating how student nurses learnt to collaborate and to interact with patients; To act independently – illustrating how student nurses trained to act independently in the unit, took responsibility, and prioritized in this complex context.

Conclusion: Learning activities in a complex acute medical unit setting were characterized by a high workload and frequent stressful situations, and a demand on students to interact, to take responsibility, and to prioritize. To learn in such a stressful context, have in a long-term perspective, a potential to develop students’ embodied understanding of and in practice, making them more prepared to work and independently apply their nursing expertise in similar contexts as graduated nurses.

OBJECTIVES: Almost all healthcare today is team-based in collaboration over professional borders, and numerous students have work-based learning in such contexts. However, interprofessional learning (IPL) in clinical settings has mostly been systematically explored in specially designed contexts dedicated to interprofessional education (IPE). This study aimed to explore the possibilities for IPL activities, and if or how they occur, in an acute ward context not dedicated to IPE.

DESIGN AND SETTING: Between 2011 and 2013 ethnographic observations were performed of medical and nursing students' interactions and IPL during early clerkship at an acute internal medicine ward in Sweden. Field notes were taken and analysed based on the framework of IPE: learning with, from and about.

PARTICIPANTS: 21 medical, 4 nursing students and 30 supervisors participated.

RESULTS: Learning with-there were no organised IPE activities. Instead, medical and nursing students learnt in parallel. However, students interacted with staff members from other professions. Learning from-interprofessional supervision was frequent. Interprofessional supervision of nursing students by doctors focused on theoretical questions and answers, while interprofessional supervision of medical students by nurses focused on the performance of technical skills. Learning about-students were observed to actively observe interactions between staff and learnt how staff conducted different tasks.

CONCLUSION: This study shows that there were plenty of possibilities for IPL activities, but the potential was not fully utilised or facilitated. Serendipitous IPL activities differed between observed medical and nursing students. Although interprofessional supervision was fairly frequent, students were not learning with, from or about each other over professional borders.

OBJECTIVES: To optimise medical students' early clerkship is a complex task since it is conducted in a context primarily organised to take care of patients. Previous studies have explored medical students' perceptions of facilitation and hindrance of learning. However, the opportunities for medical student to learn within the culture of acute medicine care have not been fully investigated. This study aimed to explore how medical students approach, interact and socialise in an acute internal medicine ward context, and how spaces for learning are created and used in such a culture.

DESIGN AND SETTING: Ethnographic observations were performed of medical students' interactions and learning during early clerkship at an acute internal medicine care ward. Field notes were taken, transcribed and analysed qualitatively. Data analysis was guided by Wenger's theory of communities of practice.

PARTICIPANTS: 21 medical students and 30 supervisors participated.

RESULTS: Two themes were identified: Nervousness and curiosity-students acted nervously and stressed, especially when they could not answer questions. Over time curiosity could evolve. Unexplored opportunities to support students in developing competence to judge and approach more complex patient-related problems were identified. Invited and involved-students were exposed to a huge variation of opportunities to learn, and to interact and to be involved. Short placements seemed to disrupt the learning process. If and how students became involved also depended on supervisors' activities and students' initiatives.

CONCLUSIONS: This study shed light on how an acute internal medicine ward culture can facilitate medical students' possibilities to participate and learn. Medical students' learning situations were characterised by questions and answers rather than challenging dialogues related to the complexity of presented patient cases. Further, students experienced continuous transfers between learning situations where the potential to be involved differed in a wide variety of ways.