There is an abundance of historical and anecdotal material relating to the experiences of the Australian soldier during World War 1. These soldiers were conscious both during and after the war that their contribution was important and that it was recognised as such by Australian society at large. Conversely there is an almost total absence of historical or anecdotal material about the role of the Australian nurse who served during this same conflict. Whether these nurses had the same degree of consciousness, either during or after the war, that their contributions were valued or seen as important by Australian society remains, largely, unknown. This thesis attempts to redress, in part, this absence by telling the story of a nurse, Jessie Tomlins, who served in the Australian Army Nursing Service during this period. At the same time specific aspects of the historical events surrounding World War One will be explored. Jessie Tomlins served, first as a Staff Nurse and later as a Sister, in the 14th Australian General Hospital in Egypt during 1916. At the same time her brother, Fred Tomlins, was already serving in the 1st Australian Light Horse Regiment and spent the entire four years of World War 1 in Palestine and Egypt. At the end of 1916 their younger brother, Will Tomlins, also joined the Army and became a member of the Anzac Mounted Division. The letters, postcards and photographs that Jessie, Fred and Will sent home to their mother and family, as well as Fred's fourteen diaries, form the foundation of this thesis. This thesis provides a meaningful snapshot of one woman from rural Australia who completed her nurse training during the war and then served her country during one of the most brutal periods of humankind. Her own words clearly tell the story of her war time experiences whilst, at the same time, conveying her expectations, prior to, during and after, this event. The development of the Australian Army Nursing Service, as it affected Jessie, over this period is also considered. It will be demonstrated that whilst ordinary men, soldiers, were at the military front line so too were ordinary women, nurses. The thesis will provide support for the contention that the contribution of Australian nurses in World War One, especially that of the ordinary nurse caring for the ordinary soldier, has been poorly recorded and as a result remains under-valued.

As the capacity for saving smaller and smaller infants increases, the ethical dilemmas experienced by neonatal nurses who care for the smallest and most fragile of human beings will also increase. The current approaches to the resuscitation and management of extremely premature infants (24 weeks gestation and less) has resulted in the survival of infants with far less than optimal outcome. Neonatal nurses have begun to question saving the lives of extremely premature infants just because the technology exists to do so. This study explores the ethical issues faced by neonatal nurses caring for infants of 24 weeks gestation and less. The research question arose out of the need for neonatal nurses to articulate the ethical issues that they face in clinical practice when caring for extremely premature infants. The study design takes a dual approach to the research question, namely, a survey questionnaire and a qualitative analysis informed by phenomenology. Given the complexities of the issues within the topic, this combination of methods was deemed to be the most appropriate in gaining a convincing and authentic result. The results of this research are not generalisable to the experience of other nurses, or nurses caring for other groups of premature infants. In the first stage of the study neonatal nurses, members of the Australian Association of Neonatal Nurses (ANNA), were surveyed using a self-completion questionnaire. Then, in the qualitative component of this study fourteen (14) interviews with neonatal nurses were undertaken. These were either single or focus group interviews. In all, twenty four neonatal nurses from the state of New South Wales (NSW) and the Australian Capital Territory (ACT) were interviewed about their experiences of caring for infants of 24 weeks gestation and less. The questions asked during the interviews were based on findings from the questionnaire. The interview data was analysed using a qualitative approach informed by interpretative phenomenology. The qualitative analysis revealed that the ethical dilemmas faced by the nurses existed within four themes. The four themes are: • It’s all about this baby • Having a voice • Dealing with awfulness • Reflecting on the outcome. The qualitative description as given in the four themes reveals structures and meanings about what it is to be the neonatal nurse who experiences ethical dilemmas when caring for extremely premature infants. The study and its findings are a written account of the experiences of neonatal nurses and their ethical dilemmas in caring for infants of 24 weeks gestation and less. The meanings within the nurses’ experiences are offered and the final phenomenological description, Balancing hope with reality, is given. Hope has a buffering effect on the nurses. The nurses inspire and instil hope in themselves and a baby’s parents until the reality of a poor outcome dawns. Each time an extremely premature baby is born the nurses are hopeful for a good outcome, but the reality is that they have experienced many instances in which babies die or have a poor outcome. The neonatal nurses, affected by their experiences of ethical distress, attempted to find a pathway to achieve a balance between their emotions and caring for the baby. In doing so the nurses were able to remain productive the neonatal intensive care unit, and give high quality care to the baby and compassion to the parents. This study makes an important contribution to neonatal nursing knowledge and practice by exploring the ethical dilemmas and complexities associated with extremely premature infants. This study also makes a unique contribution to the body of literature on ethical dilemmas experienced by neonatal nurses.

<p>Aim: The aim was to describe adult patients quality of life after cardiac arrest and resuscitation with CPR. Method: A literature overview based on eight scientific articles and one master thesis. Results: The result is presented in three categories, physical, psychological and social quality of life. Sleeping disorders, fatigue and low energy level affected the physical quality of life in a negative way. The psychological quality of life was often impaired the first time after the cardiac arrest, to be improved over time. Number of patients described a will to change their life, to put priorities straight and live for the moment. The social quality of life was affected by several factors such as social isolation, work disability and impaired social network. Several patients had to move to sheltered accommodation and many more patients was relaying on others to manage their activity of daily living (ADL). Other patients described no change regarding their social quality of life. Conclusion: The results showed that very few people survived a cardiac arrest, but once survival was achieved, a fairly good quality of life could be expected. Several of the studies also showed that patients can have a good quality of life despite physical, psychological and social dysfunction.</p>

Teenage pregnancy is a global public health problem, which results in inevitable interruptions in their education. In some instances, dropping out of school is temporary, but some of teenagers do not return to school. The dual responsibility of parenting and school work often results in poor scholastic performance, adding to the burden of a limited education and scarce employment opportunities. Since 2004, schools in Soshanguve have been requesting urgent preventive interventions regarding teenage pregnancy, which prompted the need for this study. The aim of the study was to determine the pattern of relationships, perceptions and the socio-cultural environments of pregnant teenagers in Soshanguve. A qualitative exploratory, descriptive and contextual design was used for the study. Participants comprised teenagers from Soshanguve secondary schools, who visited the clinic for ante-natal or post-natal care. A purposive sampling method was used and the sample size was determined by saturation. Semi-structured interviews were conducted with 30 participants. Tesch’s approach, using open coding and a template analysis system, was utilised for data analysis. Teenagers lacked information about menarche and menstruation, leaving them unprepared for their pregnancies. Participants did not realise the consequences of their love and sex relationships. Circumstances around their lives and the socio-cultural environments contributed to their pregnancies, resulting in teenagers showing regret, shame, denial and some accepting their pregnancies. Communication about sexuality was lacking and teenagers had no risk perceptions teenage pregnancy is urgently needed.

Cervical cancer is a global health problem and the most common cancer in women living in sub- Saharan Africa (SSA). Various barriers to cervical screening have been identified. These include cytology based screening. Cervical screening by means of visual inspection with 3% to 5% acetic acid (VIA) can be implemented in a wide range of settings as no laboratory processing is required. This study was a pilot study to determine the knowledge of women, employed by one institution in Tshwane, regarding cervical cancer, whether VIA screening would be acceptable, what the results of such screening would be as well as the practical lessons that could be learnt to improve the screening process. The research study was an exploratory, descriptive and contextual survey. The sampling method was convenient (n=31). Data were gathered by means of self-reports using structured interviews. The results of the screening were documented on a clinical record. The study provides evidence that VIA screening was acceptable to women. However the knowledge of women, despite having a higher level of education, was low. Although one of the participants was VIA positive, none was VIA positive/invasive cancer. Lessons learnt included that the number of women that could be screened in a given time should not be overestimated and that clinical breast examinations should be offered concurrently with cervical screening campaigns.

<p>Accurate and safe medication administration is an important aspect in the everyday care of the hospitalized patient. Patients put their trust and safety into the hands of those providing care and expect that care is provided in a safe and efficient manner. Nurses strive to provide high quality error free, patient care. With adult patients, medication administration accounts for 26% to 32% of hospital medication errors (Koppel, Wetterneck, Telles, &amp; Karsh, 2008). Only 2% of administration errors are corrected before reaching the patient (Dwibedi, et al., 2011). Literature supports that knowledge based medication administration programs reduce medication administration errors (Fowler, Sohler, &amp; Zarillo, 2009). The research question proposed was: What are the perceptions and beliefs of nurses using Knowledge Based Medication Administration (KBMA) bar code scanning processes in regards to patient safety? The design was a quantitative, descriptive study, using a convenience sample. The study site was west-central Illinois hospital. Data were collected and analyzed related to the perceptions and beliefs of the staff nurses using KBMA in regards to patient safety during medication administration processes. Staff nurses were surveyed using a Likert-like scale. Participants accessed the survey via My Netlearning which linked to Survey Monkey. Participation was voluntary and responses were anonymous. Future implications for quality improvement and education are considered. </p>

<p>The operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority. </p><p> The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR. </p><p> The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the </p><p> positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR. </p><p> The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses. </p>

<p> The purpose of this study is to assess the attitudes towards individuals with mental illness among the healthcare providers of a long-term care facility. It takes a quantitative, non-experimental, cross-sectional, descriptive approach to view relationships. Minimal research exists in this subject matter, and literature reviews suggest that negative attitudes toward mental illness exist among healthcare providers (Ahmead et al., 2010; Aydin et al., 2003; Bjorkman et al., 2008; Rao et al., 2008; Reed &amp; Fitzgerald, 2005; Ucok, 2008; Ross &amp; Goldner, 2009; Smith et al., 2011; Zolnierek &amp; Clingerman, 2012). The Community Attitudes toward the Mentally Ill (CAMI) questionnaire was given to a sample of 51 long-term care employees. Data was analyzed by using the IBM Statistical Package for the Social Sciences (SPSS) version 20.0, focusing on significant results concerning t-test, chi-square, and correlations in order to answer the research questions. Findings suggest a majority of the employee's attitudes in this long-term care facility were nonauthoritarian, nonsocial restrictive, and nonbenevolent. While there was no significant empirical support for differences in attitudes among RNs, LPNs, and CNAs, certain questions on the CAMI did provide significant results. Related to this there was also no empirical evidence for differences among the attitudes of departments, except when individual analysis of each question was complete. Correlational analysis showed relationships between various variables: education and seeking treatment for oneself, race and previous work experience, department and previous work experience, authoritarian views and gender, authoritarian views and education, nonsocial restrictive view and age, community mental health ideology and age, and community mental health ideology and department. Implications on future research and a discussion of recommendations to further decrease stigma in the long-term care environment are completed.</p>

<p> Nurse educators in baccalaureate nursing programs have the daunting task of preparing nursing students to be safe and competent practitioners that provide quality, patient-centered care in a reasonably short duration of time. Advances in current technology have created opportunities for new and innovative teaching strategies in healthcare to meet this challenge. The use of high-fidelity simulation is one technology that is beginning to emerge and be integrated into the nursing curriculum. This study featured a health and environmental safety assessment simulation designed to orient and prepare novice nursing students with competencies to perform a head-to-toe assessment on a patient in a clinical setting. The quantitative study featured a convenience sample of sophomore-level nursing students from a rural Midwestern, private, not-for profit, four-year baccalaureate program. The purpose of the research study was to identify the impact of the health and safety assessment simulation on student anxiety level, satisfaction, and self-confidence. Participants completed a demographic questionnaire, the State-Trait Anxiety Inventory Scale for Adults, and the Student Satisfaction and Self-Confidence in Learning Scale. Student anxiety was measured using a pretest-posttest (repeated measures) design. Student satisfaction and self-confidence was collected at the conclusion of the simulation experience. Simulation debriefing revealed positive remarks from students about the simulation experience but were not evaluated for themes. Results were analyzed using SPSS, Version 20 using descriptive statistics, paired <i>t-tests,</i> and Pearson's Correlation Coefficient. Results of this study support the use of high-fidelity simulation with simulators as an effective teaching strategy to decrease anxiety and increase student nurse self-confidence while performing a health and safety assessment on a patient.</p>

<p>The use of high fidelity simulation to educate health care professionals is becoming more common, especially in nursing education. This innovative teaching method bridges the knowledge gaps that are often present in nursing students related to limited clinical experiences and the transition of healthcare to the community setting. In addition, there are limited opportunities to practice in specialty clinical experiences such as pediatrics. This is particularly the case with pediatric immunizations. However, accrediting boards for colleges and future employers expect students to be able to function in these specialty roles despite the lack of clinical opportunities. Therefore, a pediatric immunization and parent education simulation was designed to address this knowledge gap and evaluate student anxiety, knowledge acquisition, satisfaction, and self-confidence with this innovative teaching method. The sample consisted of 21 senior nursing students enrolled in a community health nursing course in a rural baccalaureate nursing program in Illinois. The study design was a one-group, pre-test, post-test repeated measures design guided by Jeffries&rsquo; Nursing Education Simulation Framework. Participants completed a researcher designed demographic questionnaire, the State-Trait Anxiety Inventory Scale for Adults (STAI), a researcher-designed knowledge test, and the Student Satisfaction and Self-Confidence in Learning scale. Results were analyzed with SPSS, Version 20 using descriptive statistics, paired <i>t-tests</i>, and Pearson&rsquo;s Correlation Coefficient. The study results demonstrated that high fidelity simulation was an effective teaching modality that decreased students&rsquo; anxiety, enhanced their knowledge, and increased their self-confidence with administering pediatric immunizations and providing parent education. </p>