Table 5 Example of qualitative content analysis process

Every other Tuesday we have simulation. Two of the nurses get a case, and then they are going to do the whole chain if they have to call a physician or if they have to call intensive care. It's very educational. Not everyone thinks it's great fun, but they're getting better and better

Fixed day for simulation training, educational even if some thinks is unpleasant

Fixed day for simulation, deciding who is attending

Arrange simulation training as part of competence development

Facilitate simulation/practice-based learning

Building competence in the teams

It is difficult and there are a lot of considerations to be done. Putting together the team that you think works well or this doesn't work, right? So, I feel a lot of times that I spend an enormous amount of time on distribution team members. Because I kind of distribute to the evening shift and to the night shift and do a rough distribution of the morning shift the next day. And then you often put a couple of positions open and so that you redistribute, because a lot can happen during the evening and nightshifts

Difficult to disperse employees to the teams considering multiple factors. And the workload situation changes during the different shifts. Time-consuming activity

Multiple factors to consider when putting together the teams, considering what will work well and what will not

Considering multiple factors when composing the teams. Time-consuming and ongoing task

Risk based staffing

Balancing competence, workload, risk, and staff needs

A low functioning team is if you as a person is somewhat rigid, and don’t want to change or adjust to the ward’s needs. Or not wanting to help out, because we are dependent on that. Otherwise, it will not work

The ward is dependent on employees who are willing to help each other and adjust to requests

Dependent on flexible co-workers adjusting to the wards needs

Dependent on workers to be a good colleague and build relationships

Collegial support and flexibility

Relational leadership

Evening shifts were reported very busy, and our software also confirmed that the income of patient was at its peak in early afternoon, and so we altered one of the day shifts to a middle shift to match the staff amount with patient amount. This was a new shift with working hours from 11 am. to 18 pm. It has been a success

Busy evening shift due to high income of patient in early afternoon led to altering the shift plan and creating a new role/working hour to match the staff amount with the patient amount

Busy evenings shift due to high income of patient led to change in work schedule for better match of patients and staff

Busy evening shifts led to changing the shift plan in to staff in line with the number of patients

Changing the working schedule to match the needs of the workplace

Situational understanding of work practice needs