This is a study on the prevalence of refractive errors and patients requiring refractive services at 15 eye clinics in the Amathole, Chris Hani, Joe Gqabi and OR Tambo District Municipalities of the Eastern Cape. This is an area characterised by extreme poverty where the cost of an eye examination and prescription spectacles remains financially unobtainable for most. Optometry services are provided mainly by private optometrists who service the small proportion of the population that can afford them. Adults and children remain house bound or are labelled as dull and unproductive simply because they don’t have access to an eye examination and a pair of spectacles. Purpose The purpose of the study is to identify patients with refractive errors and those requiring refractive services at the 15 eye clinics in the Eastern Cape. Another purpose is to describe the refractive services that are available to patients attending health facilities, where the eye clinics are conducted. Lastly, the purpose is to explore the possibility of nurses providing refractive services independently or under the supervision of optometrists to supplement the lack to refracting and dispensing services. Study Method A quantitative and qualitative non-experimental descriptive design was used. Research involved the analysis of Vision Care’s eye clinic records collected from 15 eye clinics from January 2010-June 2010. Semi-structured interviews were conducted with 30 nurses working at the 15 health facilities where the eye clinics were conducted using purposive sampling. The quantitative data was analysed using excel spreadsheets and graphs and qualitative data was analysed using coding and categorizing methods. Conclusion According to Vision Care’s data of the patients assessed, 19.2 percent had a refractive error and 54 percent of the patients required refractive services. It is estimated that 71.41 percent of the patients had a refractive error according to the optometrist. Although there were some organisations active in the eradication of cataracts, there was little healthcare available in the form of refraction services. xiv Patients needed to travel an average of 63.8kms to access refraction services against the backdrop of poor roads, poverty and unemployment. 28 out of 30 nurses either ‘strongly agreed’ or ‘agreed’ that nurses could be trained to perform refractions and dispense spectacles. 29 out of 30 nurses thought that this would have a positive impact on eye care. Further research is necessary to assess the feasibility of implementing a nurse operated refractive program and whether it should be within their scope of practice to refract and dispense spectacles.

The increased abscondment of Mental Health Care Users from institutions of care, treatment and rehabilitation has prompted the researcher to conduct the study because patients who are not visited do not stand a chance of getting a Leave Of Absence (LOA). Problem: The concern is the danger of assault, murder, rape and other high risk situations the mentally ill individuals and the community are exposed to, which is caused by frequent abscondment of mentally unstable individuals who roam around the community without proper treatment and care. This is caused by failure of the relatives in coming to request patients for leave of absence (LOA). Purpose: The study investigated the effects of mental illness on relationships amongst families with the mentally ill members. The number or frequency of visitations by relatives to the mental health institutions is used by the researcher, to measure the nature of relationships between families and the psychiatric patients related to them. Method: The population comprised families of the mentally ill persons admitted at Cecilia Makiwane mental health units. The sample was collected conveniently as relatives came to visit the mentally ill until the desired number was reached. The designed tool was a questionnaire which was self administered. Data were analysed manually. Tables and graphs are shown in the results. Conclusion and Recommendations: The study revealed that approximately 100% of respondents had a lack of knowledge about mental illness and the mentally ill, in terms of care, treatment and rehabilitation hence they all need assistance in dealing with the mentally ill in the community. Findings also revealed that mental illness causes breakdown in family relationships. Recommendations regarding the enhancement of relationships between families and their mentally ill members are formulated as coping skills in the dissertation. The burden of having to deal with mentally ill person whose illness is not understood can lead the family to a state of confusion and iv not knowing what to anticipate. Lack of resources compounds the problem as the family members are not able to visit the ill member due to lack of funds (Baumann, 2007:637). The families with a mentally ill member usually shoulder the greatest part of the burden of mental illness (Uys and Middleton, 2004:77); unfortunately, lack of resources pose a problem.

The South African Constitution (South Africa, 1996) states that access to healthcare services is a basic human right. The Patients’ Rights Charter (HPCSA, 2008: 6) stipulates that the provision for “special needs in the case of persons living with HIV or AIDS” and palliative care be “affordable and effective”. The need for palliative care in South Africa today continues to increase. Khan and Sayed 2011[2]) found that five years after commencement of anti-retrovirals, twenty five percent of their patients had passed away. This study was performed in the Eastern Cape which is one of the poorest provinces with the second highest HIV prevalence rate. Since 2008, Sophumelela Centre Incorporated has offered palliative care for HIV and AIDS patients in Buffalo City. Some of these patients and their families were interviewed about their experiences in this care centre. The South African Constitution (South Africa, 1996) states that access to healthcare services is a basic human right. The Patients’ Rights Charter (HPCSA, 2008: 6) stipulates that the provision for “special needs in the case of persons living with HIV or AIDS” and palliative care be “affordable and effective”. The need for palliative care in South Africa today continues to increase. Khan and Sayed (2011[2]) found that five years after commencement of anti-retrovirals, twenty five percent of their patients had passed away. This study was performed in the Eastern Cape which is one of the poorest provinces with the second highest HIV prevalence rate. Since 2008, Sophumelela Centre Incorporated has offered palliative care for HIV and AIDS patients in Buffalo City. Some of these patients and their families were interviewed about their experiences in this care centre.

Within the nursing profession, the transition from the student to a graduate nurse is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of a professional journey as a nurse and a member of the multidisciplinary team (Nash, Lemcke & Sacre. 2009:48). This is a period of adjustment, stress, growth and development and the transitional nurse is likely to feel uncomfortable, fearful and may experience feelings of inadequacy. This study was undertaken to explore and describe the experiences of final year nursing students at a public college of nursing in the Eastern Cape regarding their preparedness to become registered nurses, with the aim to identify gaps and make recommendations on strategies to close the gaps. The objectives were to explore and describe the experiences of final year nursing students at the public college of nursing in the Eastern Cape Province with regard to their preparedness to become registered nurses and to recommend strategies to improve the preparation of nursing students for transition to become registered nurses. To answer the research question “What are the experiences of final year nursing students at a public college of nursing in the Eastern Cape Province with regard their preparedness to become registered nurses”, a qualitative, explorative and descriptive design was used as a framework for the study. Data were collected by means of unstructured focus group interviews with a purposively selected sample of 27 final year nursing students at the particular college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Two themes emerged, revealing that participants at the college experienced preparedness and lack of preparedness to assume the role of a professional nurse. This related to certain aspects that had an impact on the preparation of the final year nursing students for practice and included: curriculum-related aspects; clinical teaching and learning support; learning opportunities; interpersonal relationships between lecturers, students and clinical staff; equipment; and library resources. It was concluded that the learning needs of the nursing students were not adequately catered for, leading to lack of preparedness. Through the involvement of nursing students in the evaluation of their learning, shortfalls in both education and practice areas could therefore be detected. Recommendations regarding strategies to be used to promote preparedness of final year nursing students included: continuous feedback on student performance in the form of exit evaluations on the part of students to identify learning needs; writing of progress reports on the part of clinical practice; and the employment of clinical preceptors with clear role specifications between the lecturers, ward sisters and preceptors to avoid role confusion.

The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.

The focus of this study was to explore reasons for the failure of student nurses to present themselves for assessment of clinical skills at a public nursing college in the Eastern Cape. The objectives were to explore and describe reasons why these student nurses were not presenting themselves for such assessment of clinical skills; to develop strategies to motivate them to present themselves for clinical skills assessment; and to make recommendations for assessment of clinical skills. The population of the study was the second and the third-year student nurses undergoing a four-year comprehensive diploma course at a public college of nursing in the Eastern Cape. Non-probability convenience sampling was used. The research questions were, firstly, why the student nurses were not presenting themselves for assessment of clinical skills? Secondly, what recommendations could be made to motivate the student nurses to present themselves for clinical skills assessment? A qualitative, explorative, descriptive and contextual research design was used. Focus group interviews with six participants per group were used to collect data. The total number of participants five focus groups was 30 by the time data saturation was reached. Data were collected following the research question, “Why are you not presenting yourselves for clinical skill assessment?” Their responses were recorded using audiotape and notes with the help of an experienced colleague. Data was analysed following Teschʼs method. Findings presented one theme, being the reason for students not presenting themselves for feedback or delaying to do so. Categories indicated that students were afraid and overwhelmed with anxiety; had too much work to do; unpreparedness for learnt skills; equipment and resources; lack of confidence; and busy ward schedules. Subcategories included lecturersʼ attitude; unfamiliarity to lecturers accompanying them; having to study to master a lot of theory; having to prepare for many tests; unavailability of lecturers to mentor them; unavailability of unit professional nurses to guide them; reluctance of patients to be used for practising skills; a tendency not to practise skills; too many students; being used as work force; placement objectives; use of dolls for demonstration; tools used to support learning making reference to obsolete equipment; all skills demonstrated at the same time; lecturers improvising when they are demonstrating some skills, and not being released for practising of skills. The focus of this study was to explore reasons for the failure of student nurses to present themselves for assessment of clinical skills at a public nursing college in the Eastern Cape. The objectives were to explore and describe reasons why these student nurses were not presenting themselves for such assessment of clinical skills; to develop strategies to motivate them to present themselves for clinical skills assessment; and to make recommendations for assessment of clinical skills. The population of the study was the second and the third-year student nurses undergoing a four-year comprehensive diploma course at a public college of nursing in the Eastern Cape. Non-probability convenience sampling was used. The research questions were, firstly, why the student nurses were not presenting themselves for assessment of clinical skills? Secondly, what recommendations could be made to motivate the student nurses to present themselves for clinical skills assessment? A qualitative, explorative, descriptive and contextual research design was used. Focus group interviews with six participants per group were used to collect data. The total number of participants five focus groups was 30 by the time data saturation was reached. Data were collected following the research question, “Why are you not presenting yourselves for clinical skill assessment?” Their responses were recorded using audiotape and notes with the help of an experienced colleague. Data was analysed following Teschʼs method. Findings presented one theme, being the reason for students not presenting themselves for feedback or delaying to do so. Categories indicated that students were afraid and overwhelmed with anxiety; had too much work to do; unpreparedness for learnt skills; equipment and resources; lack of confidence; and busy ward schedules. Subcategories included lecturersʼ attitude; unfamiliarity to lecturers accompanying them; having to study to master a lot of theory; having to prepare for many tests; unavailability of lecturers to mentor them; unavailability of unit professional nurses to guide them; reluctance of patients to be used for practising skills; a tendency not to practise skills; too many students; being used as work force; placement objectives; use of dolls for demonstration; tools used to support learning making reference to obsolete equipment; all skills demonstrated at the same time; lecturers improvising when they are demonstrating some skills, and not being released for practising of skills. The researcher concluded that students had valid reasons for not presenting themselves for assessment of clinical skills but this could be rectified through the involvement of lectures, ward staff as well as students themselves. The researcher recommended that effective communication between the staff in clinical areas and the college is needed. Clinical laboratories needed laboratory managers and had to be well equipped. A revision of the student-lecturer ratio form feed-back on skills is also suggested.The researcher concluded that students had valid reasons for not presenting themselves for assessment of clinical skills but this could be rectified through the involvement of lectures, ward staff as well as students themselves. The researcher recommended that effective communication between the staff in clinical areas and the college is needed. Clinical laboratories needed laboratory managers and had to be well equipped. A revision of the student-lecturer ratio for feed-back on skills is also suggested.

The aim of this study was to investigate whether patients were satisfied with midwifery services rendered at the two Community Health Centres in the Eastern Cape Province.The study sites were Empilweni Gompo and Nontyatyambo Community Health Centres. Descriptive quantitative study design was employed, using a questionnaire with closed and open ended questions as the data collecting tool. Likert Scale was used to measure the following variables: quality care variables to measure level of satisfaction with midwifery services rendered and to determine positive and negative perceptions regarding quality of care received during antenatal, labour and postnatal period. Non-random convenience sampling of sixty pregnant women, thirty from each Community Health Centre, with two or more antenatal subsequent visits and forty postpartum women, twenty from each health facility, six hours after delivery if there were no complications. Out of 60 participants interviewed n=60 (100 percent) agreed that individual counseling and importance of HIV testing was explained.The majority of participants n=53(88 percent) disagreed that they were educated about focused antenatal visits. Out of 60 participants interviewed n=41(68 percent) agreed that delivery plan formed part of their ANC visits and n=18 (30 percent) disagreed. Of the 60 participants interviewed n=11(18 percent) agreed that they were told that they had the right to choose labour companions and n=48 (80 percent) disagreed.Out of 60 participants interviewed n=23 (38 percent) stated that they waited a long period of time without being attended to by midwives. In general, the study revealed high satisfaction level with intrapartum and postnatal care due to functional accessibility of both Community Health Centres. Both health centres delivered normal healthy babies and mothers. However, the participants were dissatisfied with antenatal care rendered at the two facilities. The researcher’s recommendations were based on the closing of gaps that were identified with regard to the implementation of Basic Antenatal Care; birth companions: health education deficiency; community involvement and participation.

The purpose of this study was to explore and describe the experiences of nursing students learning in a tertiary institution in East London in the Province of the Eastern Cape. Reviewed literature has revealed that the transition from high school to university is a major concern globally and that students start tertiary education with a number of pre-existing problems which influence their experience of learning and their academic performance. A qualitative, contextual approach and phenomenology design was seen as most appropriate to guide this research process in this study. Purposive, non-probability sampling was used to select the 12 participants. The participants included nursing students from the University of Fort Hare in East London in the Eastern Cape Province who are enrolled in the course leading to registration as a Nurse (General, Psychiatry and Community) and Midwifery. A pilot study was conducted at the University of Fort Hare involving respondents with similar characteristics to the study population.

The general Australian workforce is becoming increasingly reliant on agency staff due to the diminishing of full-time jobs and the rise in part-time jobs since the recession of 1991-1992. This pattern is also seen in Western countries such as America and the United Kingdom (Peerson et al., 2002:505). The excessive costs of health service adopting a 100% staffing model has created the use of agency nursing to help meet fluctuating and unpredictable health care demands in Australia and overseas; agency staff are used to meet the shortfalls in staff-patient ratios (Peerson et al., 2002:505). Hurst & Smith (2011:287) agree that agency nurse staffing form a large part of the health service in the UK and state that this was unlikely to change because of recruitment and retention problems, high absenteeism, and staff wanting to work casually. In their study, they identified three types of agency nurses: A bank nurse – the hospital’s own employees or those supplied by NHS Professionals, who work when required, usually at short notice; agency nurses provided by commercial organisations, who are equally flexible but less familiar with the ward patients and procedures; and permanent ward staff working paid overtime. In South Africa, this also remains a problem in public and private institutions. The World Health Organization (WHO) states that the minimum ratio for nurses to population is 200:100 000 or 500 people per nurse. According to South African Nursing Council statistics of nursing manpower as at the end of 2008, South Africa has 437 nurses for every 100 000 people. This assumed that all nurses registered with SANC are working in South Africa at the time. Therefore, if the assumed number of staff not working in South Africa is subtracted, the ratio can increase to between 600 and 678 people per nurse (WHO, 2006). Joubert (2009:2) shows that a shortage of nurses contributes to deaths in hospitals in South Africa that would otherwise have been avoidable. The use of agency staff is becoming an appropriate means of providing cost-effectiveness and flexibility to staffing needs.

Clinical experience has always been an important part of nursing education. Nursing colleges require students to be placed in clinical areas in order to acquire new knowledge and skills. The purpose of the study was to explore and describe the clinical experiences during their clinical placement of the third-year student nurses at a public college in the Eastern Cape. The objectives of this study were: to explore and describe the experiences of the third-year student of a public nursing college in the Eastern Cape, and to describe strategies for the improvement of student learning during clinical practice. A qualitative, explorative and descriptive research design was used to describe the clinical experiences of these student nurses and the strategies for the improvement of student learning during clinical practice. Data were collected from focus group interviews, using a purposive and convenience sample from one college campus in the Eastern Cape. Tesch’s method of data analysis (in Creswell, 2003) was used to analyse data. Trustworthiness was ensured in this research by using Guba’s model (in Lincoln & Guba, 1985) of qualitative research. Ethical approval was obtained from the University of Fort Hare Research Ethics Committee, the Department of Health, Eastern Cape, the Head of the Nursing College, the Campus Head and the participants and ethical consideration was ensured throughout the research process. Themes and sub-themes emerged from data collected about the clinical experiences of the nurses. The study brought to light the experiences of third-year student nurses during allocation to clinical areas. The findings from this study revealed the need for proper clinical accompaniment by college staff to ensure that clinical learning is taking place. Strategies to improve learning in the clinical areas are described. and recommendations for nursing education and nursing practice are made. If this is applied, it will help the student nurses to be better professionals.