Registered nurses entering a Nurse Prescriber programme participated in a mixed methods case study to explore the extent of their bioscience knowledge and the confidence with which that knowledge was held. Forty two Nurse Prescriber students, aged 26 – 55 years, from a range of job roles were recruited. Using questionnaires and interviews, both quantitative and qualitative data were obtained. An examination of the Nurse Prescribers’ views of pre-registration nursing demonstrated that the knowledge gained had been related to practice but had been both superficial and lacking in breadth. The bioscience in pre-registration programmes had not sufficiently prepared the participants for their roles as registered nurses. The importance of experiences gained as a registered nurse in the practice setting in the learning of bioscience was strongly emphasised. Participants reported greater learning of bioscience by informal methods such as work experience, use of books and the Internet and discussion with colleagues than from experiences in the classroom. Interviewees placed particularly strong emphasis on the importance of learning from medical colleagues. The role of post-registration programmes emerged as important in learning bioscience because it related to the job role. Post-registration courses also emerged as significant in giving confidence to the registered nurse. Confidence increased not just in terms of the knowledge held, but also in terms of nurses’ ability to communicate with patients, relatives, and doctors, their ability to understand nursing skills, and their willingness to admit when something was not known.

Class of 2009 Abstract / OBJECTIVES: The purpose of this study is to describe clinical pharmacist services in a nurse practitioner (NP) run clinic and how clinical pharmacists might influence prescribing. METHODS: The description of the clinical pharmacist services is based on a 12-week experience of a clinical pharmacist and senior student pharmacist working with the nurse practitioner and nurse practitioner students. A questionaire was developed and consisted of items relating to the nurse practitioners ability to identify possible interactions of OTC medications, herbals and prescription medications. In addition, the questionnare assessed the comfort level of NP’s taking a prescription medication history, checking a patient’s prescription formulary, and selecting appropriate medication therapies. The questionaire uses a retrospective pretest format and was tested as a method of collecting data on how a pharmacist influenced NP prescribing. The site selected for this study was the Arizona State University Center for Healthcare Innovation (ASU Center) located in the heart of Downtown Phoenix (3rd Ave and Van Buren). RESULTS: Only one nurse practitioner worked at the ASU Center. The facility is new to the neighborhood and does not see many patients. The nurse practitioner partner in this project responded that working with a clinical pharmacist on a regular basis, with more patients would definitely help her hone skills necessary to identify interactions and prescribe according to a patients formulary. CONCLUSIONS: Pharmacists provide value-added services in an ambulatory care clinic run by nurse practitioners and provide valuable education and consultation on drug interactions. Pharmacist influence can be measured successfully to using a questionnaire in a retrospective pretest-posttest study design.

Stress is well known to go hand in hand with registered nurses and the nursing field. The aim was to examine stress related coping strategies experienced and used by registered nurses from different countries all over the world. This qualitative study was done by analyzing the results from 10 different articles. The findings showed that there was multiple coping strategies that is being used by nurses to cope with the stress they experience at work. Some of the coping strategies were done after work; For instance, different physical activities including yoga and sports. Other coping strategies that were found are more work related. For example, the importance of knowing yourself in your nursing role, knowing your limits, and the importance of having a good relationship with your colleagues. Employers can use these strategies on a daily basis both and registered nurses to cope with work related stress.

The purpose of this study was to explore the need for school nurses in the Saudi school system and to explore the current role of nurses in school health education and health promotion in Saudi Arabia. The study used a qualitative approach that was guided by implementation literature. Fifteen participants (8 nursing students; 4 nursing faculty members; 3 nurses) answered open-ended questions and participated in semi-structured interviews. From the findings, three themes emerged to identify the current role of nurses in Saudi Arabian school: “Health educator”, “Health promoter”, and “Liaison with community”. Four themes were identified based on the potential role of nurses in Saudi Arabian schools: “Leadership role”, “Care provider role”, “Educator role”, and “Liaison with community”. Five themes were identified based on facilitators and barriers to providing health and physical education in Saudi schools: “University and college level support”, “School health services”, “Governmental support”, “Lack of cultural approval”, and “Demand for nurses exceeds supply”. This study contributes to our understanding of what are the current and potential roles of nurses in Saudi Arabian schools, are nursing students currently prepared to provide health education and promotion to school staff and students, and what facilitators and barriers exist for nursing to provide health education and promotion in Saudi schools. This information can contribute to decision-making processes, formulation of necessary legislation, and government measures towards the implementation of school nursing and physical education, particularly in girls’ schools in Saudi Arabia, so as to maximize health and wellness in the Saudi community. / Graduate / 0680,0523,0714 / hebah.alqallaf@gmail.com

Purposes/Aims: This study described the unique relationships that develop while providing cancer care to American Indian (AI) populations and the underlying meaning that nurses ascribed to these experiences. Rationale/Conceptual Basis/Background: The establishment of caring relationships in order to provide high quality cancer care is particularly challenging for nurses who engage with ethnic minority populations as they contend with cultural and contextual influences different from those found in the majority population. AIs represent an Indigenous minority group in the U.S. facing a considerable cancer care inequity. Nurses who care for AI patients frequently encounter population-specific issues that impact the caring dynamic, yet their experiences and the meaning they ascribe to them are largely unknown. Methods: This was an interpretive phenomenological study with iterative data collection and analysis. Nine cancer care nurses with a minimum of three years of experience working with AI patients participated by engaging in 2-3 exploratory, open-ended, reflective interviews over a period of 9 months. Thematic reduction was completed to explicate the fundamental structures of nurse-patient relationships during cancer care. Phenomenological and hermeneutical reflective writing resulted in linguistic transformation illuminating the essential meaning for nurses within this patient-nurse phenomenon. Results: Findings include individually-situated wholistic descriptions capturing the existential experiences of each of the participants. Reduction of individually-situated themes into seven shared meta-themes included From Task to Connection; Unnerving Messaging; We Are One; the Freedom of Unconditional Acceptance; Attuning and Opening; Atoning for the Past, One Moment at a Time; and Humanizing the Inhumane. Themes were explicated in a comprehensive general structural description followed by the reconstitution of the data and self-reflection into a deeply introspective essential description, suggesting that the meaning of the AI patient-cancer care nurse relationship was expressed in contradictory yet simultaneous patterns of joy and sorrow; ease and difficulty; obligation and vocation. From one moment to the next, nurses sought synchronicity with their patient as they danced to a life rhythm that revealed and concealed; enabled and limited; connected and separated. Being in relationship provided nurses great purpose within the universal human context of caring. Implications: Results contribute to the development of interventions designed to improve both the AI cancer care experience and the support and training of the nurses who serve this population. Refinement of our praxis will result in improved outcomes for both nurses and AI patients, reflecting the inseparability of the two entities within the cancer care relationship. The complimentary and mutually dependent nature of the patient-nurse relationship implies that strengthening and improving support for one entity may in turn positively impact the other. Further research into the AI patient’s perspective of their relationships with cancer care nurses is called for.

The purpose of this study is to identify predictors of psychological empowerment among nurse aides in nursing homes. Five structural factors (information exchange, decentralization of resources, co-worker support, supervisor support, and availability of training) and four control factors (age, sex, level of education, and race) are analyzed using multivariate linear regression to examine their effects on psychological empowerment. Two of the five structural factors, decentralization of resources and supervisor support, are shown to positively influence psychological empowerment. Nursing home managers can consider developing and implementing procedures that decentralize resources and demonstrate supervisor support in order to increase psychological empowerment. Based on the findings of this study theory and practice might benefit from additional study of decentralization of resources and supervisor support.

Several issues have impacted on district nursing practice and education within the UK, which can be conceptualised within four main areas: national policy; local organisational structures and practice; professional and disciplinary theory; and practice of individuals (Bergen and While 2005). However, there has been a lack of direction in district nursing in recent years within the UK, with a decline in the number of district nurses being educated (Queen’s Nursing Institute 2014a) and the educational standards supporting district nurse education being over 20 years out of date (Nursing and Midwifery Council 2001). In addition to this, the standards of education for pre-registration nursing (Nursing and Midwifery Council 2010) have supported a graduate workforce with an increasing focus on nursing in the community. This was identified as a consideration for me as an educator when examining the future educational requirements of nurses beyond the point of registration in the community, and became the focus of this study. Knowing in practice is a key concept within this thesis, that is, the particular awareness that underpins the being and doing of a district nurse in practice (Chinn and Kramer 2008). This study explores the unique knowing of district nursing in practice, and how this professional knowing is developed. Understanding the knowing of district nurses and how this is developed will contribute to future educational frameworks and ways of supporting professional development within community nursing practice. A question that is often asked is what makes district nurse knowing different from nursing in inpatient settings, and this emerges in this thesis. A qualitative study using an interpretative approach within a case study design was adopted using three Health Boards within Scotland as the cases. Within each Health Board area, interviews were undertaken with key informants and also, group interviews with district nurses were undertaken using photo elicitation as a focussing exercise. The data were analysed using framework analysis (Spencer et al. 2003). This approach illuminated a depth and breadth of knowing in district nurse practice and how this knowing is developed. The study findings depict the complexity of knowing in district nursing, acknowledging the advancing role of district nursing practice, where the context of care is an essential consideration. The unique knowing can be described as a landscape that the district nurse must travel: crossing a variety of socio-economic areas; entering the private space of individuals, and the public space of communities; as well as acknowledging professional practice; navigating the policy agenda while maintaining clinical person-centred care; and leading others across the terrain of interprofessional working. The unique knowing in practice that characterises the expertise of district nurses is a matrix of elements that incorporates different aspects of knowing that contribute to leadership, as suggested by Jackson et al. (2009). The participants in this study recognised that due to the complexity of the district nurse role, and its continuing advancements, that district nurse education needs to move to a Master's level preparation and it needs to continue to be supported by a suitably qualified practice teacher. Furthermore, the findings within this study demonstrate that the development of the unique knowing in district nurses does not happen in isolation and it is very complex. It consists of networks, conversations, engagement with policy, understanding of professional contexts, adhering to organisational boundaries, and interaction with complex and challenging situations. Theory and practice are mutually dependent on each other; change is inevitable and is unpredictable; and practices change by having experiences, therefore change is integral to practice. Consequently, it was concluded that the interdependent elements, which interact, develop the unique knowing of district nurses in practice. Finally this thesis makes recommendations and discusses future implications for policy, practice and research.

En av de största utmaningarna, inom folkhälsan, under 2000-talet beskrivs vara, övervikt och fetma hos barn. Sen år 1990 är ökningen alarmerande och detta främst i låg- och medelinkomstländerna. I Sverige har det främst varit en ökning av övervikt och fetma bland barn i en mer utsatt socioekonomisk bakgrund. Familjen och de levnadsvanor som följer barnet i uppväxten beskrivs vara avgörande, för om barnet utvecklar övervikt eller fetma. Sjuksköterskor har goda möjligheter, att komma i kontakt med hela familjen för att rådgöra samt stötta. Syftet med studien är att beskriva sjuksköterskors erfarenheter av att möta barn med övervikt samt deras familjer. En litteraturstudie genomfördes. Elva vetenskapliga artiklar, varav 9 med kvalitativ forskningsansats och 2 med kvantitativ forskningsansats, granskades och analyserades. Fyra teman och nio subteman identifierades. Resultatet visar att yrkesverksamma sjuksköterskor möter svårigheter, till dessa hör att övervikt tolereras och accepteras på ett annat sätt än tidigare, liksom livsstilsförändringar som innebär att vi idag är mer stillasittande. De ansåg sig väl positionerade för att ta hand om barnen med övervikt och fetma, men upplevde en osäkerhet för samtalet kring och med barnet, samt dess familj. Bristande riktlinjer på arbetsplatsen bidrog till färre antal samtal, med berörda föräldrar. Sjuksköterskorna upplevde en osäkerhet i den egna professionen, där mer utbildning önskades, dels i hur kommunikationen med barn och deras föräldrar kunde förbättras men även i ämnet övervikt. För att öka tryggheten hos sjuksköterskorna behövs tydlig arbetsbeskrivning och riktlinjer, mer utbildning, främst i kommunikation med barn och familj, men även ett förbättrat samarbete med andra yrkeskategorier.

D.Cur. / Lifecare, like any other corporate business, in the current environment, has to change all the time. Companies need new customers, innovative products, expanded market and cutting edge technologies. The Company has the potential to shape the behaviour, reinforce common beliefs, and encourage members to apply their efforts to accomplish important Company objectives of providing care for chronic mentally ill patients. The psychiatric nurses are therefore an essential requirement for the success of the Company in a competitive environment. On the other side, psychiatric nurses face the difficult task of confronting the challenges involved in the nature of care required among chronic psychiatric patients. Whilst striving for quality patient care, they find themselves faced with some breakdowns within the environment in which they are interacting, resulting in their resorting to negative media publicity. This type of publicity can lead to damaging the Company’s reputation and can retard the Company’s growth strategy, which the psychiatric nurses might not seem to understand. There was also high staff turnover which hampered quality patient care. This could also affect the Company in terms of what affects the competitiveness of the quality care which the Company aims to deliver. The researcher believes that for clinical care to take place, psychiatric nurses need to be in sound mental health and understand the dynamics within the Company in order to deal with it in an effective way. The following research questions posed were addressed in this research: • What are the psychiatric nurses’ experiences whilst being employed by the Company? • In what way can the formulation of the model be of assistance in the promotion of the psychiatric nurses’ mental health as an integral part of health? The research objectives were: • To explore and describe the experiences of the psychiatric nurses whilst employed by Lifecare.• To use the results to generate the concepts for the model that would serve as a framework for the psychiatric nursing specialist to facilitate the implementation of guidelines that would assist the psychiatric nurses to be in a sound mental state. • To describe the guidelines that would serve as a framework for operationalising the model in nursing education, psychiatric nursing practice and nursing research. Methods to ensure trustworthiness were ensured throughout this research. Ethical consideration as outlined in the Position Statements published by the Democratic Nursing Association of South Africa (1998: 2-21), was adopted. The researcher utilized the assumptions of the Theory for Health Promotion in Nursing in this research. This theory focuses on the whole person, that is, the mind, body and spirit as well as on the parameters of nursing and the beliefs about the person, health, illness and nursing. The emphasis in this theory is on mental health promotion of the psychiatric nurses within the Company. This research consisted of three stages as follows: In stage one a qualitative design was used to explore and describe the psychiatric nurses’ inner world experiences of the Company’s culture. Indepth semi-structured interviews were utilized to obtain data from these psychiatric nurses. These interviews were conducted by an independent interviewer, and were audio-taped. These were transcribed and were analysed by the researcher. Tesch (1990) in Cresswell (1994: 154) outlined eight steps, which are referred to as decontextualisation and contextualisation, which were adopted in analyzing the results. A description of the results was given. This was followed by literature control which highlighted the similarities to and contributions to this research. Themes that emerged highlighted the experiences that the psychiatric nurses had of the Company culture which affected their mental health. In stage two the research design and theory generation was employed to formulate a model which could be used in nursing education, nursing research and nursing practice. The model formulated was based on the resultsobtained on the inner world experiences of psychiatric nurses. A combination of stages of theory generation by Chinn and Kramer (1991:79-104) and Dickoff, James and Wiedenbach (1968: 431-434) were employed by the researcher to identify the central concepts that guided the identification of the main theme. A tentative model was formulated and was submitted to the independent experts for consultations and clarification. The model was named and presented in its final form to the independent experts. In stage three the researcher formulated the guidelines for operationalising the implementation of the model in clinical practice, nursing education and recommendations were made for further research.

M.Cur. / Currently an increasing awareness of human rights exists in South Africa, which can be ascribed to fundamental human rights being spelt out in the Constitution of the Republic of South Africa, 1993 (Act number 200 of 1993). Events such as strikes by nurses presently focus the attention on human rights in health care. Incompatibility between the rights of the nurse and those of the patient leads to conflict. However, rights should not be perceived in isolation and, of necessity, they entail explicit or implied responsibilities ...