Clinical nursing practice is on the cusp of significant and unrelenting change amid globalization, austerity measures and technological advancements as the world moves out of the industrial age into the knowledge age. With advances in technology, theory and research, the potential changes to future nursing practice are unlimited. Understanding the process nurses undertake to change their practice in light of these predicted trends is critical if outcomes for patients are to be safe and effective. Yet, there was a paucity of published research that investigate the process of nursing practice change. Thus, the purpose of this study was to describe the process registered nurses undertake to change their clinical practice. The study used an interpretive description methodology and involved interviewing 15 registered nurses with various backgrounds and experience in Doha, Qatar. Data were analyzed using constant comparison methods, simultaneous data collection and analysis, and intensive memoing. The findings revealed an overall theme of asing the dis-ease’, in addition to three sub-themes: disruption, actioning and stabilizing. The study provide simportant insights into how nurses change their clinical practice. A significant contribution of this study is the role of the individual in changing nursing practice. / Graduate / 2020-06-03

The thesis named "Current practice and possible ways of implementing clinical supervision in nursing" is the first doctoral dissertation establishing the concept of supervision in the Czech nursing environment. Itscentralresearch questionis as follows: How do nurses and university educators in nursing construct, interpret and practically apply theconcept ofclinical supervision and the supervisor's role in the context of nursing education at specific institutions of tertiary education and clinical nursing practice in the Czech Republic? The author draws on international theoretical literature and local empiricalevidence.Her qualitative research took the form of 26 semi-structured interviews with academic nursingeducators from the entire Czech Republic. In justified cases those are supplemented with qualitative data obtained through the study of legislative, policy and strategic documents in nursing and health care, including publicly available information and sources on clinical supervision, in order torefine the resulting picture of her interpretation of current clinical supervision practice in Czech nursing. A shift to the constructivist paradigm enabled one to conceive the term "clinical supervision" mainly in relation to learning, training and professional development of supervisees, also in the context of transformation of education and supervision not only of nurses but also of supervisors themselves in the Czech Republic. The author also focuses on the philosophical and theoretical foundations of clinical supervision and application of the postmodern approach in egalitarian clinical supervision. The empirical part of this dissertation is based on the qualitative research conducted. The author gradually presents her results as individual categoriesand relations between them that ensued from the analysed data in the process of open coding. The author draws a link between the category of implementation of clinical supervision in the context of nurses' professional education andexternal conditions, the environment and a broader professional and social-cultural context. Clinical supervision in nursing is constructed mainly as a unidisciplinaryconcept and a part of the nursing profession. The university nursing educatoris typically constructed as a role professional, but there is also an ongoing process ofdiversification, stratification, profiling and professionalization of non-academic nursing educators. Based on a content analysis of documents and post-modern philosophical-theoretical foundations and strategies of legitimizingclinical supervision, the author views the concept of clinical supervision in nursing as socially constructedand discursively legitimated. The author also defines the limitations of her research that arise from the choice of a qualitative research design. In the conclusion she outlines some future trends of clinical supervision in particular educational institutions that can be interesting and inspiring not only for supervisors but also for teachers of supervision themselves. Based on the results of her empirical analysis the author emphasises the need to integrate the theory and practice of education, clinical supervision and nursing. A comprehensive structure and methodology of system-wide implementation of clinical supervision, based on the situation of clinical nursing practice and supervision needs in the Czech Republic,should in future formthe basis of innovation of existing university programmes in nursing and approaches to the education and training of supervisors, as well as the subject of new research in clinical supervision.