Aim: The aim of the study was to describe nurses' conception of reflection in their working situation.
Background: To be a municipal night duty registered nurse in Sweden means to shoulder nursing care responsibility for numerous units with older people in need of care. Two night nurses share nursing care responsibility for up to 1300 people. In nursing research, reflection is an often-mentioned phenomenon discussed with advantages and benefits within the 'traditional fields' of nursing (hospital context). A question to ask is, how do night nurses having an untraditional amount of nursing care responsibility conceptualise and experience reflection in their working situation?
Design: A phenomenographic methodology was used.
Methods: Data were collected by interviewing all nurses (n = 7) in a medium-sized municipality bordering a metropolitan area of Sweden. Results. The nurses' conceptions of reflection are categorised as 'Field of applications' (an instrument for interpreting, a strategy for handling the working situation and an approach to learning) and 'Field of prerequisites' (presence facilitates reflection; flexibility implies reflection; courage in thought and activity increases reflection).
Conclusion: The findings reveal that reflection in the nurses' working situation is more than an instrument for learning, understanding and encouragement for change and improvement. Reflection is conceptualised as an instrument for interpreting nursing care situations, which requires courage and is facilitated by presence and flexibility. Reflection is also conceptualised as an approach to handling, managing and coping with a sometimes impossible working situation that includes nursing responsibility for hundreds of older people and can sometimes entail difficulties and stress.
Relevance to clinical practice: The findings showed that reflection has a broader use than had earlier been described. Deliberate use of reflection could mean improved nursing practice. This guides nursing managers to pay attention to the phenomenon as an instrument for nursing care improvement.