Thesis (MHSc--Health Science) -- Auckland University of Technology, 2004. / Also held in print (93 leaves, 30 cm.) in Akoranga Theses Collection (T 618.2 DUN)

Thesis (M.A.) - Carleton University, 2006. / Includes bibliographical references (p. 172-190). Also available in electronic format on the Internet.

Thesis (Ed.D.)--Teachers College, Columbia University, 1975. / Typescript; issued also on microfilm. Sponsor: Marie M. Seedor. Dissertation Committee: Phil C. Lange. Includes bibliographical references (leaves 169-179).

Thesis (M.S.)--Catholic Univ. of America. / Bibliography: p. 61-64.

Thesis (M.S.)--Catholic Univ. of America. / Bibliography: p. 61-64.

Thesis--Columbia University. / Includes bibliographical references (leaves 169-179).

Thesis--Columbia University. / Includes bibliographical references (leaves 169-179).

The qualitative study was designed to study how ethical decision-making realises in difficult care situation in nursing. A hermeneutic phenomenological approach was used. Data collection was done through writing of critical incidents by registered nurses and midwives in two hospitals in Gauteng Province. The critical incident technique was developed by Flanagan (1954:327). Narratives/stories were analysed by: naïve reading, structural analysis and comprehensive understanding (Sorlie 2000:52). The study population was 30 registered nurses and midwives, who held in-charge positions, and have dealt with ethical problems themselves. The methodology was about understanding and interpreting lived experiences in clinical practice about ethically difficult care situations in nursing. Guba's model was used for truth value, which was obtained through human experience as was lived and perceived by narrators, who then described/narrated their stories, this was true of critical incidents. The credibility of the findings depends on accurate documentation of the experience as was narrated, so that the participants would recognise their stories. The participants could not validate the findings due to sensitivity of the critical incidents. Applicability was not relevant, as it was description of a particular experience that could not be generalised. Because of the contextual nature of the study, I could not guarantee consistency, as interpretation is based on shared values, norms and beliefs in a particular profession, and is recognised by readers sharing the same values. Anonymity and confidentiality was maintained to protect the narrators, due to the sensitive nature of the study. Ethical principles and respect for human dignity was adhered to. Permission was granted by the hospital authorities as well as Research Ethics Committee at the University of Pretoria. Limitations of the study have been noted. Interpretation of the findings of realisation of ethical decision making in difficult care situations as well as guidelines for teaching ethics to nursing learners has been done Findings of the study indicate that the context and impact of realisation of ethical decision-making in difficult care situations was different to different narrators and completely dependent on the ethical problem that had to be dealt with and be realised or failed to be achieved. / Dissertation (MCur)--University of Pretoria, 2009. / Nursing Science / unrestricted

ABSTRACT TITLE: What Happens To Advanced Midwives After Their Training? OBJECTIVES: The primary objective of this study was to explore how many Advanced Midwives who graduated between 2000 and 2004 are still working in public sector facilities. The second objective was to determine of those working in the public sector, how many are still ding clinical works in maternity wards. The third objective was to explore the reasons why the Advanced Midwives who left did and where they had gone to followed by the fourth objective which was to explore the reasons why those who stayed back did, the fifth objective was to see whether age, level of facility, rural or urban and province impacted on whether they have remained in the facility and the Sixth objective was to document the recommendations given by the Advanced Midwives on how to keep Advanced Midwives using heir skill in the public sector. STUDY POPULATION: Graduates of Chris Hani Baragwanath nursing college and the University of Johannesburg nursing college for a period of five years 2000 to 2004 METHODS: Following Ethics approval, the two nursing colleges were approached to give the contact details of their graduates between 2000 and 2004. All the advanced Midwives who graduated within these years from the two nursing colleges totaling 320 graduates were communicated with. While some of the advanced midwives whose contact telephone numbers were available were communicated with telephonically, other advanced midwives who had no contact telephone numbers were forwarded the questionnaires by post, including a formal letter containing full explanation of the purpose of the research and the confidentiality of the information they were asked to give. A self addressed envelope was included in the letter to enable those who wished to reply to easily reply without incurring any cost. These questionnaires were completed by the advanced midwives and sent back to the researcher. RESULTS: 69% of the respondents were still working in the public sector while an alarming 31% had moved from the public sector to the private sector. 89% were found to be doing clinical works in the maternity wards while 11% were no longer doing clinical works and found to have either moved to hospital management within the same hospital or moved to ICU and Theater departments. Reasons for Advanced Midwives leaving the public sector facility to the private sector ranged from lack of recognition of Advanced Midwives by the government, lack of scarce skill allowances for doing a one year post basic training in Advanced Midwifery, lack of increment in salary generally, poor working conditions, lack of staff to not being allowed to practice independently and as a result had moved into the private sector where life was a lot better according to them. The reasons why the Advanced Midwives are still working in the public health sector ranged from the fact that the facilities they were working was near their homes, their passion for midwifery, their quest to upgrade themselves to the fact that they have been working as Advanced Midwives for so long. Their were no association between the age, rural/urban and province to whether they have remained in the facilities, with the following P-values (P= 0.135, 0.174 AND 0.779) respectively, however an association was found between the level of facilities the Advanced Midwives worked with whether they have remained in the public facility with P-value (P= 0.001) Therefore Advanced Midwives working in smaller hospitals were more likely to remain in that hospital as against those working in bigger hospitals. The recommendations the advanced midwives had on how to keep Advanced Midwives using their midwifery skills in the public sector ranged from recognizing Advanced Midwives in the public sector, in terms of provision of scarce skill allowances for Advanced Midwives like is the case with the ICU and theater nurses who are paid higher than their counterparts in other departments, increasing their salaries in general, improving their working conditions, increasing the number of staff per midwifery unit, to allowing them practice independently in terms of exploring their expertise without the doctor’s interferences. CONCLUSION: Although many Advanced Midwives had left the public sector to private sector facilities, a good number of them have remained and more so, many have continued using their Advanced Midwifery skills in the maternity wards. Among the Advanced Midwives working in the public sector there are high levels of dissatisfaction, which was reflected in the reasons why they intend to leave. Therefore there is urgent need to address the recommendations given by these Advanced Midwives themselves; by so doing greater number of those who intend to leave the public sector would be compelled to stay back.

No