Signe Gunn Julnes

• Gneist, Juliane; Julnes, Signe Gunn & Mundal, Ingunn Pernille (2026). Avansert klinisk allmennsykepleier i sykehjem : en kvalitativ studie om erfaringer med palliativ omsorg til pasienter med multisykdom. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 22(1), p. 1–18. doi: 10.7557/14.7949. Full text in Research Archive Show summary

  Bakgrunn: Antallet pasienter med multisykdom i palliativ fase har økt i kommunehelsetjenesten. Palliative forløp kan være i måneder og år, og krever kontinuerlig oppfølging, systematisk kartlegging og spesialisert kompetanse. Studien undersøker erfaringer hos avanserte kliniske allmennsykepleiere (AKS) i palliativ omsorg i sykehjem. Metode: Kvalitativ design med semistrukturerte intervjuer av åtte AKS. Malterud’s firetrinns analysemodell for tekstkondensering ble benyttet. Resultat: AKS styrker palliativ omsorg for multisyke pasienter gjennom systematisk kartlegging, personsentrert kommunikasjon og klinisk legemiddelhåndtering, øker kvalitet og trygghet, reduserer sykehusinnleggelser, men påvirkes av organisatoriske barrierer og uklare roller. Konklusjon: AKS-kompetanse styrker helhetlig palliativ omsorg for multisyke pasienter gjennom kartlegging, kommunikasjon og legemiddelhåndtering. Effektiv bruk krever rolleavklaring og organisatorisk støtte, mens manglende systemtilrettelegging begrenser potensialet. Implementering bør fremme tverrfaglig samarbeid og systematisk praksis.

• Dyb-Sandnes, Idun Palma; Julnes, Signe Gunn & Vasset, Frøydis Perny (2025). Coordinating Collaboration Between Hospital Wards and Allocation Office in Municipality-Care Pathways for Patients. Social Sciences & Humanities Open (SSHO). 13(2026)(June ). doi: 10.1016/j.ssaho.2025.102343. Full text in Research Archive Show summary

  This study examines the central role of patients’ pathways are the need for a smooth flow of information during interaction with health services, starting from initial contact. This study aims to explore how hospital nurses and nurse practitioners perceive and manage collaboration between hospital wards and municipal allocation offices, with particular focus on communication tools and coordination processes in patient transitions. This study utilized a qualitative design, conducting focus group interviews with nurses and nurse practitioners working in hospital wards in hospitals in western Norway. The findings of this study reveal that interaction between hospital wards and the municipalities primarily occur through written procedure utilizing e-messenger. This study demonstrates that while most individuals are generally satisfied with interaction, it requires a significant amount of time in everyday work. Furthermore, it is evident that nurse practitioners in hospital wards have not been assigned specific tasks in this area.

• Nilsen, Anita; Eriksen, Siren; Lichtwarck, Bjørn; Hillestad, Adelheid Hummelvoll; Julnes, Signe Gunn & Tretteteig, Signe [Show all 7 contributors for this article] (2024). Treatment and Care for nursing home residents with COVID-19: a qualitative study. Journal of Multidisciplinary Healthcare. 17, p. 2935–2946. doi: 10.2147/JMDH.S467459. Full text in Research Archive Show summary

  Purpose: Coronavirus disease 2019 (COVID-19) placed a significant strain on nursing homes, leading to numerous outbreaks and high mortality rates. This situation created considerable stress and challenges for residents, their physicians and nurses, as well as family caregivers. By understanding these challenges, we can gain new insights and learn valuable lessons. Thus, the purpose of this study is to examine the treatment and care provided to nursing home residents with COVID-19, as experienced by physicians, nurses, and family caregivers. Participants and Methods: This study is a secondary analysis of 35 interviews with physicians, nurses, and family caregivers, each with personal experience caring for nursing home residents diagnosed with COVID-19. The interviews took place from December 2020 to April 2021. We analyzed the transcriptions based on Braun and Clarke’s reflexive thematic analysis model and followed a qualitative descriptive design as outlined by Sandelowski. Findings: The analysis produced three themes: 1) Balancing medical treatment, 2) The need for increased systematic monitoring of vital functions, and 3) Determining the treatment level for nursing home residents. These themes were explored through the unique perspectives of the three participant groups: physicians, nurses, and family caregivers. The findings revealed several challenges related to treatment and care for nursing home residents diagnosed with COVID-19. This applied both to relief of symptoms, monitoring of vital functions, assessment of treatment level and use of advance care planning. Conclusion: Drawing from the experiences of physicians, nurses, and family caregivers, there should be a unified plan at the municipal or national level for competency development in nursing homes to prepare for future crises like pandemics or epidemics. Additionally, the safe engagement of family caregivers and relatives should be given priority.

• Måløy, Elfrid; Aasen-Stensvold, Maria Therese; Vatne, Solfrid & Julnes, Signe Gunn (2023). Intellectual disability nurses’ challenges in medication management in primary health care : a qualitative study. Journal of Intellectual Disabilities. ISSN 1744-6295. 28(2024)(3), p. 854–871. doi: 10.1177/17446295231189368. Full text in Research Archive Show summary

  This study examines how intellectual disability nurses employed in residential living services for persons with intellectual disabilities, in Norway, deal with medication management for these individuals. Using a qualitative study, a total of 18 intellectual disability nurses were interviewed as part of four focus groups. The results demonstrate six main challenges: First, Being alone with the responsibility of medication management - a challenge; Second, The need for further competence development; Third, Teaching and supervising unskilled colleagues in safe medication management; Fourth, Interpreting residents with little or only nonverbal communication; Fifth, The need to act as advocates when residents require hospitalization; Sixth, Deficient systems for medication management on several levels. The findings point to several major flaws in the system of medication management, which necessitates the need for highly qualified intellectual disability nurses. Managers must ensure that there is a secure system to mitigate errors and promote patient safety.

• Julnes, Signe Gunn; Reitan, Laila Solli; Myrvang, Tove; Rønning, Gry & Vatne, Solfrid (2022). Use of rapid response system afferent limb to recognize and respond to deteriorating patients: An action research study. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 43(2023)(1), p. 1–9. doi: 10.1177/20571585221124376. Full text in Research Archive Show summary

  Failure to recognize the deterioration of hospital patients has led to the implementation of a system known as the Rapid Response System. The aim was to explore nurses’ use of the afferent limb of the Rapid Response System to recognize and respond to deteriorating patients. Data were collected via video recordings with observations of 20 registered nurses (RNs) from general wards performing scenarios in a simulation laboratory with focus group interviews. Data were analyzed using systematic text condensation. COREQ were followed. In the first scenario, nurses did not apply ABCDE or ISBAR, and the use of NEWS was insufficient. Completing an education program led to evident improvement in the use of the tools during the second scenario. Nurses initially viewed their new competency as useful, but it was not sustained a year later. Customized education programs and fidelity-scale simulations are suited but not sufficient to change clinical competency without management anchoring.

• Julnes, Signe Gunn; Lichtwarck, Bjørn; Eriksen, Siren; Hillestad, Adelheid Hummelvoll; Nilsen, Anita & Tretteteig, Signe [Show all 7 contributors for this article] (2022). Sykehjemslegers erfaringer med covid-19 : en kvalitativ intervjustudie. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 8(3), p. 1–14. doi: 10.18261/tfo.8.3.12. Full text in Research Archive Show summary

  Beboere med covid-19-sykdom på norske sykehjem hadde høy risiko for alvorlig forløp og død. Hensikten med denne studien var å utforske sykehjemslegers erfaringer med å ivareta behandlingsansvaret for beboere med covid-19 og hvordan de samarbeidet med pårørende og sykepleiere. Denne intervjustudien inkluderte ti sykehjemsleger med erfaring fra covid-19 i sykehjem fra tre av de fire helseregionene i Norge. Vi gjorde en kvalitativ innholdsanalyse av de transkriberte intervjuene. Analysen identifiserte følgende tre hovedfunn: 1) Krevende ansvar for medisinskfaglige vurderinger og avgjørelser, 2) Kommunikasjon og samarbeid med pårørende – viktig og tidkrevende, og 3) Sykepleierne – en viktig samarbeidspartner. Sykehjemslegene opplevde et krevende ansvar og utfordringer med å ivareta multimorbide og skrøpelige beboere under pandemien. Dette illustrerer behovet for gode rutiner samt lokale og nasjonale retningslinjer. Samarbeidet med erfarne og rutinerte sykepleiere ga trygghet. Sykehjemslegenes beskrivelse av følelsesmessige utfordringer under covid-19-pandemien understreker behovet for faste, kollegiale og faglige nettverk. Nøkkelord: kommunehelsetjeneste, pandemi, multisyke, eldre, samarbeid

• Julnes, Signe Gunn; Myrvang, Tove; Reitan, Laila Solli; Rønning, Gry & Vatne, Solfrid (2022). Nurse leaders' experiences of professional responsibility towards developing nursing competence in general wards : a qualitative study. Journal of Nursing Management. ISSN 0966-0429. 30(7), p. 2743–2750. doi: 10.1111/jonm.13745. Full text in Research Archive Show summary

  Aim: To explore nurse leaders' experiences of professional responsibility to facilitate nursing competence in general wards. Background: Nurse leaders are responsible for maintaining high levels of competence among nurses to improve patient safety. Methods: Qualitative analysis was conducted between February and April 2019 using semi-structured interview data from 12 nurse leaders in surgical and medical wards at three Norwegian hospitals. Results: Four main themes were identified: struggle to achieve nursing staff competence; focus on operational and budgetary requirements rather than professional development; demands to organize sick leaves and holiday periods; and challenges in facilitating professional development. Conclusion: Nurse leaders felt that their responsibilities were overwhelming and challenging. They witnessed more support for current administrative tasks than for the implementation of professional development. Additionally, unclear work instructions from the employer provided few opportunities to facilitate professional development. Hospital management failed to ensure quality of care and patient safety in general wards by not supporting the strengthening of nurses' professional competence and preventing turnover. Implications for Nursing Management: Management may integrate formal work instructions that clarify nurse leaders' responsibilities as professional developers, allowing nurse leaders to meet their obligation of maintaining adequate professional competence among nursing staff in general wards.

• Tretteteig, Signe; Eriksen, Siren; Hillestad, Adelheid H.; Julnes, Signe Gunn; Lichtwarck, Bjørn & Nilsen, Anita [Show all 7 contributors for this article] (2022). The experience of relatives of nursing home residents with COVID-19 : a qualitative study. Nursing: Research and Reviews. 12, p. 17–27. doi: 10.2147/NRR.S328336. Full text in Research Archive Show summary

  Background: The coronavirus disease 2019 (COVID-19) pandemic had significant consequences for relatives’ opportunities to communicate with and offer care to seriously ill and dying nursing home residents with COVID-19. Residents in nursing homes were urged to protect themselves through social distancing, and visits have been permanently regulated and limited. These restrictions have been challenging, and the limitations have raised many questions and led to difficult choices. The aim of this study was to explore the experiences of relatives of nursing home residents with COVID-19. We investigated the following two research questions: How did relatives of COVID-19 patients in Norwegian nursing homes experience the situation and how did the physical distancing and precepts of infection control affect the relationship between the long-term residents and the relatives?. Methods: The study has a qualitative explorative design with a phenomenological-hermeneutic approach, with individual in-depth interviews used for data collection. The study included ten relatives of nursing home residents with COVID-19. Results: Three main perspectives were identified from the participants’ experiences: (1) the difficult choices; (2) maintaining the relationship; and (3) experiencing support. The relatives experienced ethical dilemmas when weighing the risk of getting COVID-19 if they visited the patient versus the consequences of not visiting their loved one. In this situation, they needed good information and support from health care professionals. Conclusion: To enable relatives of COVID-19 patients to make choices in line with their goals and intrinsic motivations, it is important that staff members possess competence in infection control, updated knowledge about the residents’ situations, and the skills to facilitate a safe and confident dialogue. Trust in the care staff and a feeling of safety are essential for relatives in a stressful situation with difficult choices, while a lack of confidence, routines, and/or dialogue might increase relatives’ feelings of insecurity and stress and make their caring role difficult.

• Hillestad, Adelheid Hummelvoll; Rokstad, Anne Marie Mork; Tretteteig, Signe; Julnes, Signe Gunn; Lichtwarck, Bjørn & Eriksen, Siren (2022). Nurses’ ethical challenges when providing care in nursing homes during the COVID-19 pandemic. Nursing Ethics. ISSN 0969-7330. 30(1), p. 32–45. doi: 10.1177/09697330221105631. Full text in Research Archive Show summary

  Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity anddeath from COVID-19. The social restrictions proved challenging for the residents, their relatives, and thecare staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge abouthow the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethicaldifficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban andrural areas. Ethical considerations: Oral and written information about the study was provided before the participantsgave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) usingmedication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact ondecision-making. Conclusions: The nurses’ethical challenges were intertwined with external factors, such as national andlocal guidelines, and the nurses’own internalized factors, which were connected to their subjective pro-fessionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in aprofessionally sound and safe manner. Keywords: COVID-19, nursing home, nursing, ethical challenges. © The Author(s) 2022, Article Reuse Guidelines: https://doi.org/10.1177/09697330221105631

• Hauge, Kari Johanne Westad; Brask, Ole David; Bachmann, Liv; Bakken, Hege; Bergum, Inger Elisabeth & Grønvik, Cecilie K Utheim [Show all 11 contributors for this article] (2019). Lar praksisveiledere sykepleierstudenter bestå praksisstudier uten oppnådd læringsutbytte? Klinisk Sygepleje. ISSN 0902-2767. 33(1), p. 23–39. doi: 10.18261/issn.1903-2285-2019-01-03. Full text in Research Archive Show summary

  Hensikten med pilotstudien var å vurdere reliabiliteten og validiteten til et nyutviklet spørreskjema om fenomenet bestått på feil grunnlag.

• Bachmann, Liv; Grønvik, Cecilie K Utheim; Hauge, Kari Johanne Westad & Julnes, Signe Gunn (2019). Failing to Fail nursing students among mentors : a confirmatory factor analysis of the Failing to Fail scale. Nursing Open. 6(3), p. 966–973. doi: 10.1002/nop2.276. Full text in Research Archive Show summary

  Aim: The aim was to explore the psychometric properties with respect to the internal consistency reliability of the subject‐specific questionnaire “Failing to Fail.” Design: Cross‐sectional study. Methods: Exploratory factor analysis with varimax rotation. A confirmatory factor analysis was used to examine the factor structure of the “Failing to Fail” scale. The sample included 336 Norwegian nurse mentors. Results: The confirmatory factor analysis confirmed a five‐factor structure of the “Failing to Fail” scale with adequate model fit. The factors were named as: (a) Insufficient mentoring competence; (b) Insufficient support in the working environment; (c) Emotional process dominates the assessment; (d) Insufficient support from the university; and (e) Decision‐making detached from learning outcomes. The scale proved to be feasible to test whether mentors are Failing to Fail nursing students. The confirmatory factor analysis model supported the predictive validity of the “Failing to Fail” scale.

• Julnes, Signe Gunn & Jensen, Kaspara Bugge (2016). Mentors' experience of nursing students' knowledge in clinical practice. Klinisk Sygepleje. ISSN 0902-2767. 30(3), p. 183–195. doi: 10.18261/issn.1903-2285-2016-03-04. Full text in Research Archive Show summary

  Aim: This paper explores how mentors experience nursing students’ knowledge of nursing procedures during their first clinical practice. Method: Four focus group interviews were conducted with 15 mentors working in nursing homes. Data were analysed using a four-step analytical framework of systematic text condensation. Findings: There was a discrepancy in the expectation of the mentors and the actual skills preparedness of the nursing students. Several students struggled with theory–practice integration, basic nursing skills and general competence. The mentors emphasised the role of the evaluation of the students’ level of competence from the skills laboratory, so the students could be provided appropriate individual mentoring of their clinical practice in advance. Conclusion: There was a significant variation in the experiences of the mentors, so this study cannot offer unambiguous solutions and explanations. It is important that central authorities, academia and mentors understand that the transfer of knowledge acquired in one context to another context can be challenging for the students. Keywords: Guidance, mentor, nursing student, clinical practice, skills laboratory

• Hauge, Kari Johanne Westad; Brask, Ole David; Bachmann, Liv; Bergum, Inger Elisabeth; Heggdal, Wenche Mongstad & Inderhaug, Hans [Show all 8 contributors for this article] (2016). Kvalitet i praksisstudier i sykepleier- og vernepleierutdanning. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 12(1), p. 19–33. doi: 10.7557/14.3772. Full text in Research Archive Show summary

  Background: Clinical training in health and social care educations are important in the development of professional competence. Evidence indicates that there are major quality differences in clinical practice in health- and social studies. Purpose: To examine what key players related to clinical practice in nursing and social education believes provides quality. Method: Focus Group Interview where students, supervisor and teachers participated in all groups. Results: Students learning in practice presupposes a knowledge base of the student, a learning environment with adapted responsibilities and coping capabilities, and a relationship with the supervisor who promotes both recognition and needed correction. The supervisor's role can be strengthened through individual competence, clearer support from boss and co-workers, and more emphasis on triangular cooperation with the college. Conclusion: There is a large overlap in the understanding of what in practice is all about quality. The perspectives of the three actors appear primarily as mutually complementary.

• Julnes, Signe Gunn; Grønvik, Cecilie K Utheim; Eines, Trude Fløystad & Ødegård, Atle (2015). Praksisveilederes opplevelse av et nytt veilednings- og vurderingsverktøy for sykepleierstudenter i praksis : en evalueringsstudie. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 11(1), p. 122–136. doi: 10.7557/14.3484. Full text in Research Archive Show summary

  Denne studien har belyst praksisveiledernes evaluering av progresjonsstigen basert på deres opplevelser med progresjonsstigen. Mye tyder på at praksisveilederne opplever progresjonsstigen som et nyttig veilednings- og vurderingsverktøy som viser fagdidaktisk retning i veiledning og vurdering av studentene i deres praksisstudier.

• Grønvik, Cecilie K Utheim; Julnes, Signe Gunn & Ødegård, Atle (2014). En kvalitativ studie av sykepleiestudenters opplevelser av nye læringsaktiviteter i kritisk vurdering av kvantitative forskningsartikler. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 10(2), p. 91–105. doi: 10.7557/14.3325. Full text in Research Archive
• Dahl, Kari; Julnes, Signe Gunn & Vatne, Solfrid (2008). Den glemte anamnesen ... er det samsvar mellom pasientens opplevelse av egen helse og sykepleierens dokumentsjon i den elektroniske pasientjournalen? Norsk tidsskrift for sykepleieforskning. ISSN 1501-4754. 10(4), p. 16–27. Full text in Research Archive Show summary

  Are patients' perspectives of their own health present in the nursing documentation in the electronic patient records? Holistic health care underpins nursing science today. To provide such care, the patient's perspective must be included. In this project we investigated how patients' perspectives of their health are documented in the hospital electronic patient records. In-depth interviews with 12 patients were conducted. The electronic health records were analysed using the concepts, themes, and categories presented in the VIPS model of patient documentation currently used in many Norwegian hospitals. The software program QRS-NS6 (NUD*IST) was used to manage the data. Results indicated that the patients' perceptions of their own health were absent from their electronic health records. Nurses using the VIPS model completed the categories that focused on physical symptoms, diagnoses and treatment. We conclude that the documentation in patients' records may not support a holistic model of health care. To remedy this, nurses need to consider all aspects of health including the patients' own perspectives. Undergraduate nurse training programs have a role in developing student nurses' understanding of how acknowledgement and documentation of patients' perpectives contributes to optimal health care.

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• Vasset, Frøydis Perny & Julnes, Signe Gunn (2024). Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISBN 9788245043914. 270 p. Full text in Research Archive

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• Julnes, Signe Gunn & Vasset, Frøydis Perny (2025). Online collaboration between hospital wards and allocation office in municipality. Full text in Research Archive
• Måløy, Elfrid & Julnes, Signe Gunn (2024). Legemiddelhåndtering, legemiddelbruk og pasientsikkerhet. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 185–199. Full text in Research Archive
• Julnes, Signe Gunn (2024). Helhetlig tilnærming ved opptak av pasientenes helsehistorie. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 110–121. Full text in Research Archive
• Vasset, Frøydis Perny & Julnes, Signe Gunn (2024). Endringsledelse, innovasjon og helselogistikk. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 220–228. Full text in Research Archive
• Julnes, Signe Gunn & Vasset, Frøydis Perny (2024). Innledning. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 16–19. Full text in Research Archive
• Malones, Line Rakvåg; Julnes, Signe Gunn & Vasset, Frøydis Perny (2024). Fra sykepleier til avansert klinisk allmennsykepleier. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 20–32. Full text in Research Archive
• Julnes, Signe Gunn & Vasset, Frøydis Perny (2024). Avansert klinisk allmennsykepleie og rehabilitering i helse- og omsorgstjenesten. In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.), Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten. Fagbokforlaget. ISSN 9788245043914. p. 72–83. Full text in Research Archive
• Vasset, Frøydis Perny & Julnes, Signe Gunn (2023). Praksismodeller for avansert klinisk allmennsykepleier – et essay. Klinisk Sygepleje. ISSN 0902-2767. 37(4), p. 267–272. doi: 10.18261/ks.37.4.5. Full text in Research Archive
• Vasset, Frøydis Perny & Julnes, Signe Gunn (2023). Practice model for nurse practitioners in Norway : a pilot study. Full text in Research Archive
• Vasset, Frøydis Perny & Julnes, Signe Gunn (2023). How do students in the NP programme best acquire clinical competence? Full text in Research Archive
• Julnes, Signe Gunn; Malones, Line Rakvåg & Vasset, Frøydis Perny (2022). «Nei takk!» til avanserte kliniske allmennsykepleiere? Full text in Research Archive
• Julnes, Signe Gunn & Angel, Sanne (2022). The world of night shift : nurses experiences of working in the dark. International Journal of Nursing and Health Care Research. ISSN 2688-9501. 5(4), p. 1–9. doi: 10.29011/2688-9501.101301. Full text in Research Archive Show summary

  Working at nights as a nurse seems to become ever busier due to an increasing level of duties and stressful working conditions. The aim of the study is to explore nurses’ experience of living and working through the night time. Data were collected through interviews with 19 nurses. The analysis was based on a phenomenological method. The nurses establishing a good link between the evening and the day shift; facilitating rest and sleep; being tired but ready for the unexpected; relieving pain, frustration and sombre thoughts; needing an ally to avoid feeling alone and vulnerable; and coping with unforeseen acute situations. Nurses experience a stressful work and struggle against fatigue and a need for prolonged alertness caused anxiety and fear of making patient care errors. The nurses rely on close collaboration to increase their ability to handle difficult situations. Keywords: hospital, night shift nurses, patient safety, phenomenology, workforce

• Julnes, Signe Gunn; Malones, Line Rakvåg & Vasset, Frøydis Perny (2022). «Nei takk!» til avanserte kliniske allmennsykepleiere? p. 9–9. Full text in Research Archive
• Julnes, Signe Gunn; Orøy, Aud Jorun & Hovde, Katharina (2021). Nytt tilbud på Høgskolen fra neste høst: – Skal imøtekomme økte kompetansekrav. [Journal]. Romsdals Budstikke. Full text in Research Archive
• Myrvang, Tove; Julnes, Signe Gunn; Rønning, Gry & Reitan, Laila Solli (2019). Sykepleiernes utvikling av klinisk kompetanse i bruk av observasjons- og vurderingsverktøy til pasienter med tidlig forverring på sengepost. Full text in Research Archive Show summary

  Bakgrunn: Sykepleiere som jobber på sengepost i sykehus i dag møter pasienter med høy risiko for klinisk forverring. Design: Aksjonsforskning Deltakende observasjon og observasjon via video under to scenario i simuleringsenhet med påfølgende fokusgruppeintervju. Fokusgruppeintervju etter ett år. Antall deltagere: 20 Analyse:Tematisk analyse. Godkjent av NSD. Foreløpige funn av forskningsprosjektet: Før opplæring Sykepleierne opplever det lite aktuelt å bruke ABCDE tilnærming på sengepost. Sykepleierne viser usystematiske observasjoner og forsinket oppdagelse av tidlig forverring. NEWS skåringsverktøy er implementert, men anvendes i varierende grad. Sykepleierne skårer ulikt på samme scenario. ISBAR anvendes ikke i kommunikasjon mellom helsepersonell. Sykepleierne er vant til at legen tar ut essensen av formidlet pasientdata. De skiller mellom erfarne og uerfarne leger i formidling av pasientdata. Etter opplæring Økt bevisstgjøring i å anvende felles systematikk av ABCDE tilnærming etter opplæring. Økt oppdagelse av tidlig forverring og redusert forsinkelse. NEWS brukes aktivt og det dokumenteres mer korrekt skåring. ISBAR økt struktur og kvalitet i formidling av pasientdata mellom helsepersonell. Foreløpig konklusjon Misforhold mellom endret pasientbilde og sykepleierens kliniske kompetanse. Etter opplæringsprogrammet viser sykepleierne økt forståelse i anvendelse av de kliniske verktøyene både i systematikk og struktur. Vår aksjonsforskning viser at samarbeid om en tilpasset opplæringspakke, med bruk av simulering, kan være av betydning for å oppdage tidlig forverring.

• Julnes, Signe Gunn; Heiene, Mait & Brunvoll, Bjørn (2019). Håper solfilm vil hjelpe. [Journal]. Romsdals Budstikke. Full text in Research Archive
• Hauge, Kari Johanne Westad; Brask, Ole David; Grønvik, Cecilie K Utheim; Julnes, Signe Gunn; Bachmann, Liv & Bakken, Hege [Show all 12 contributors for this article] (2017). Unngår praksisveiledere å stryke sykepleierstudenter i praksisstudier? Full text in Research Archive
• Brask, Ole David; Ulvund, Ingeborg; Hauge, Kari Johanne Westad; Grønvik, Cecilie K Utheim; Heggdal, Wenche Mongstad & Inderhaug, Hans [Show all 12 contributors for this article] (2017). Praksisveiledere i sykepleiepraksis: Slippes studenter igjennom,som burde ha strøket? Full text in Research Archive
• Orøy, Aud Jorun & Julnes, Signe Gunn (2016). Avansert klinisk sykepleierolle i kommunehelsetjenesten. p. 39–39. Full text in Research Archive
• Brask, Ole David; Heggdal, Wenche Mongstad; Inderhaug, Hans; Hauge, Kari Johanne Westad; Bachmann, Liv & Bergum, Inger Elisabeth [Show all 8 contributors for this article] (2015). Kvalitet i praksisstudier ved sykepleier- og vernepleierutdanning. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2014). God sykepleie i dag er ikke nødvendigvis god sykepleie i fremtiden. 172(220), p. 31–31. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2014). God sykepleie i dag er ikke nødvendigvis god sykepleie i fremtiden. 105(226). Full text in Research Archive
• Julnes, Signe Gunn (2014). Nursing students communication skills to patients with intellectual disability. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2013). Erfaringer med læringsaktiviteter i kvantitativ metode for bachelorstudenter i sykepleie. Full text in Research Archive
• Julnes, Signe Gunn & Balandin, Susan (2012). Communication in hospital : implications of training, collaboration, policy and practice. Full text in Research Archive
• Julnes, Signe Gunn; Grønvik, Cecilie K Utheim & Eines, Trude Fløystad (2012). Praksisveiledernes erfaringer med progresjonsstigen som et pedagogiske verktøy i veiledning av sykepleiestudenter. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2012). Sykepleiestudenters erfaringer med læringsaktiviteter i kvantitativ metode. Full text in Research Archive
• Grønvik, Cecilie K Utheim; Julnes, Signe Gunn & Ødegård, Atle (2012). En kvalitativ evalueringsstudie av sykepleiestudenters erfaringer med læringsaktiviteter i kvantitativ metode. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2012). Sykepleiestudenters erfaringer med læringsaktiviteter i kvantitativ metode. Full text in Research Archive
• Julnes, Signe Gunn; Grønvik, Cecilie K Utheim & Eines, Trude Fløystad (2012). Progresjonsstiger i klinisk praksis – utgjør det en forskjell? Full text in Research Archive
• Grønvik, Cecilie K Utheim; Julnes, Signe Gunn & Ødegård, Atle (2012). Sykepleiestudenters erfaringer med læringsaktiviteter i kvantitativ metode. Full text in Research Archive
• Julnes, Signe Gunn & Balandin, Susan (2012). Sykepleiernes erfaringer med personer med psykisk utviklingshemming/funksjonshemming med liten eller ingen verbal kommunikasjon. Full text in Research Archive
• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2010). Sykepleiestudenters erfaringer med læringsaktiviteter i kvantitativ metode. Full text in Research Archive
• Julnes, Signe Gunn; Balandin, Susan & Molka-Danielsen, Judith (2010). Fritidsaktiviteter i den virkelige og den virtuelle verden. Full text in Research Archive
• Julnes, Signe Gunn; Balandin, Susan & Molka-Danielsen, Judith (2010). An exploration of leisure activities in real and virtual worlds. Full text in Research Archive
• Balandin, Susan; Julnes, Signe Gunn & Molka-Danielsen, Judith (2010). A model for exploring the use of virtual worlds by people with lifelong disability. In ISAAC, Spain (Eds.), ISAAC 2010 : Final Program. International Society For Augmentative And Alternative Communication - ISAAC. p. 258–258. Full text in Research Archive Show summary

  Although virtual environments have been used to promote skills for independence, and improve cognitive performance for people with intellectual disability, few programs have aimed at improving the social skills of people with lifelong disability including people who use AAC. The evidence of the benefits of virtual worlds for building friendships and providing meaningful activity for people with lifelong disability is anecdotal. Adults with cerebral palsy have noted that in a virtual world they can choose whether to disclose their disability or not but the impact of this is unknown. Research is required to reveal the opportunities virtual worlds offer for people who use AAC. In this poster we will present a model for addressing the gap in the evidence of how virtual worlds can be used in promoting social inclusion and providing enjoyable activities for people with a disability who use AAC.

• Julnes, Signe Gunn (2010). Ut av ensomheten med Second Life? p. 35–35. Full text in Research Archive
• Julnes, Signe Gunn; Balandin, Susan & Molka-Danielsen, Judith Ann (2010). An exploration of leisure activities in real and virtual worlds. JARID: Journal of applied research in intellectual disabilities. ISSN 1360-2322. 23(5), p. 509–509. Full text in Research Archive Show summary

  AIM: To identify what leisure activities people with life-long disabilities might like to do in both real and virtual worlds. METHOD: Three focus groups were conducted with adults aged 18-35 years with a range of lifelong disabilities. Participants were recruited through local disability services on the west coast of Norway. Participants were asked what leisure activities they currently did, what they would like to do and what activities they might like to do in a virtual world. You-tube videos were used to provide information on activities in a virtual world. Data were analysed using a contestant comparative analysis of topics and themes within and across groups. RESULTS: Participants had little knowledge or understanding of the leisure opportunities that virtual worlds afford. Preliminary analysis indicated that participants are interested in going in to a virtual world but note that they will require much support. They were interested in a range of activities both disability specific and others available to all community members. CONCLUSION: Leisure activities are important for social interaction and inclusion. Virtual worlds may offer a new opportunity for people with disability to be involved in activities that would not be available in the real world. It is not clear if these activities will lead to social interaction and inclusion in a virtual community.

• Balandin, Susan; Julnes, Signe Gunn & Molka-Danielsen, Judith Ann (2010). A model for exploring the use of virtual worlds by people with lifelong disability. Full text in Research Archive
• Julnes, Signe Gunn; Grønvik, Cecilie K Utheim & Eines, Trude Fløystad (2015). Implementering av nasjonalt kvalifikasjonsrammeverk for høyere utdanning i et nytt veilednings- og vurderingsdokument i praksis for sykepleierstudenter. Møreforsking. ISSN 9788278302477. Full text in Research Archive Show summary

  Nasjonalt kvalifikasjonsrammeverk for høyere utdanning ble implementert i et nytt veilednings- og vurderingsverktøy kalt «progresjonsstigen» i praksisstudiene for sykepleierstudenter i andre studieår ved høgskolen i Molde i 2010. Praksisveiledere i spesialist- og kommunehelsetjenesten evaluerte det nye veilednings- og vurderingsverktøyet ved å delta i fokusgruppeintervju. De tre første trinnene i Kirkpatrick`s evalueringsmodell ble benyttet som mal i evalueringen. Hensikten med evalueringen var å undersøke om praksisveilederne aktivt anvendte det nye veilednings- og vurderingsverktøyet i veiledning og vurdering av studentene. Studiens funn viste at praksis­veilederne opplevde progresjonsstigen som sykepleiefaglig, retningsgivende og nyttig i veiledning og vurdering av studentene for å nå det aktuelle nivå av forventet læringsutbytte.

• Grønvik, Cecilie K Utheim & Julnes, Signe Gunn (2015). Innovative læringsaktiviteter bidro til at sykepleiestudenter opplevde læringsutbytte i kvantitativ metode. Møreforsking. Full text in Research Archive Show summary

  Sykepleierutdanningen skal bidra til at nyutdannede sykepleiere har kompetanse til å lese og anvende forskning. Krav om implementering av Nasjonalt kvalifikasjonsrammeverk i bachelorutdanning bidro til utvikling av et nytt undervisningsopplegg i kvantitativ metode og kritisk vurdering av kvantitativ forskning ved Høgskolen i Molde. Hensikten med rapporten er å belyse det nye undervisningsopplegget og beskrive hvordan sykepleiestudenter opplevde de nye læringsaktivitetene.

• Julnes, Signe Gunn (2005). Hjertesviktpasientens erfaring med informasjon, kunnskap og etterlevelse og deres helserelaterte livskvalitet. S. G. Julnes. Full text in Research Archive Show summary

  Hovedoppgave i helsevitenskap - Norges teknisk-naturvitenskapelige universitet

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