Patients were recruited from a large University hospital in Norway. The university hospital covers about 10% of the Norwegian population, providing healthcare services for approximately half a million people living in urban and rural municipalities. The patient population is thus heterogenic with respect to ethnicity and socioeconomic factors. All somatic wards having nursing students in acute care clinical studies in autumn 2011 were included in the study. The study sample comprised 14 of 16 medical and surgical somatic wards. Additionally, one rehabilitation ward, one specialized short time unit, one emergency medicine ward, and one cardio-monitoring ward were included.