Critically ill patients experience overwhelming communication problems; caused by intubation and cognitive, sensory or language deficits that distance the patients from communicating their needs and wants from nurses and loved ones. The purpose of this study was to explore communication patterns and strategies with the aim of implementing intervention strategies for nurse/patient communication in the intensive care units. The American Association of Critical Care Nurses’ Synergy Model for Patient Care was used to guide the study. A mixed method approach using quasi-experimental design combining quantitative and qualitative data collections and analysis was used. Concurrent data collection for quantitative and qualitative data was used. Auditing of patient’s files, protocols, family counselling conference and in-service books and a survey for nurses was used for quantitative data. Qualitative data collection was through interviewing nurses and nurse managers. Lack of documentation and use of other communication strategies were the key findings of the study. In accordance with the model used for the study clinical judgment and moral distress were found to be common among nurses. Lack of collaboration between nurses and other health care workers was also attributed to poor communication with mechanically ventilated patients. Conclusions derived from the study are that nurses need to be supported through informal and formal training on documentation and use of communication methods available / Health Studies / D. Litt. et Phil. (Health Studies)

This study explored and described the impact of the rights and obligations of nurses on the delivery of quality patient care in a clinical setting. Quantitative research approach was utilised. Data was collected using a self-administered questionnaire. The research results revealed that respondents who participated in this study were aware of their rights and obligations, the effects and impact of factors influencing such rights and obligations on patient care. It was established that “patient abandonment” observed when nurses embark on a strike as their constitutionally enshrined right is not due to a lack of insight about their rights and obligations, but on how such rights and obligations are implemented. The researcher recommends that further research be undertaken to explore the causes of nurses embarking on strike actions despite their high level of knowledge concerning the impact of such actions on patient care in a clinical setting / Health Studies / M.A. (Health Studies)

Patients' use of medicines is widely recognised as sub-optimal with a high proportion of patients with a long-term condition not taking their medicines as prescribed. Research and policy guidance emphasise the importance of partnership within the patient-prescriber encounter in enhancing patients' use of medicines. There is however considerable evidence that this is not usually achieved by medical prescribers, limiting the extent to which shared decision-making occurs about prescribed medicines. There is a general assumption that nurse prescribers, who within the United Kingdom have comparable prescribing rights to medical doctors, demonstrate greater abilities in collaborative working with patients leading to an enhanced use of medicines. Research evidence is however limited, particularly in relation to the ways in which patients' use of medicines is discussed and negotiated within the patient-nurse prescriber encounter. This study focused on the management of patients' use of medicines within the patient-nurse prescriber encounter. Seven nurse prescribers, working within a number of clinical specialities in both primary and secondary care settings, were recruited to the study together with their patients who were living with one or more long-term conditions (n=21). Data collection involved the non-participant observation of out-patient consultations to examine the management of patients' use of medicines within the encounter and semi-structured interviews with both patients and prescribers. Discourse analysis was undertaken to examine underpinning assumptions, views and beliefs regarding the management of patients' use of medicines. Asymmetry was evident within the encounters with prescribers controlling the agenda for discussion and interrupting patients' attempts to demonstrate their knowledge. Patient accounts of the moral approach adopted in managing their condition in the context of their everyday lives were also ignored. Biomedical and contrasting moral discourses are examined. An interpretive framework derived from the work of Michel Foucault is used to explain the operation of disciplinary, pastoral and bio-political power within the encounter and the extent to which subjugation of patients' knowledge and resistance were evident. Foucault's concept of technologies of the self is examined to explore its potential application in enhancing patients' medicines use.

M.Cur. / The nursing service manager is accountable for the managerial outputs of the nursing service, being quality nursing care, cost effectiveness and quality nursing staff management. These managerial responsibilities will influence the overall management efficiency of the health delivery system. There is a need for a more scientific basis of staffing in South African critical care units. Various methods are used to determine staffing needs, but the most accurate and acceptable method being used is the patient classification system. The success of a critical care patient classification system is based upon the accurate determination of the ideal nurse-patient ratio. Ideal nursepatient ratio depends on matching the competency of the critical care nurse to the severity of the critical care patient's illness. Internationally and nationally very few guidelines describe the competency requirements that the critical care nurse should have to function effectively in the critical care unit. To maintain a high standard of quality nursing care, the critical care nurse should be assigned to a critical care patient according to her competency level. The aim of this study was to describe a scientific patient classification system for critical care patients according to which workload and nursing requirements can be ascertained. Secondly, to describe guidelines for the competency requirements of a registered critical care nurse assigned to nurse the different categories of critical care patients categorised by the patient classification system as prescribed. The aim of the study is justified by means of an exploratory, descriptive, contextual research design. A critical care patient classification system has been developed and validated by a group of critical care nursing experts using a structured two phase research method. The statistical validity of each item of the critical care patient classification system was determined by means of a content validity index. All the items of the critical care patient classification system were rated as valid and therefore the critical care patient classification system as a whole has been accepted as valid. The reliability of the critical care patient classification system was tested by means of a pilot study in two selected research units. It was determined that the inter-rater reliability was within the 95 per cent confidence interval, that the system could discriminate between different critical care patients and nurse-patient ratios were effectively determined by the system. Critical care nurse competency requirements were identified by critical care nursing experts by means of a focus group interview. The results obtained from the focus group interview were verified by a literature control and peer group review. Guidelines for the competency requirements of the critical care nurse were compiled. The critical care patient classification system developed will equip the critical care manager with a scientific instrument to assign personnel to critical care units. The critical care patient classification system will furthermore assist the critical care unit manager in the daily utilisation of valuable human resources, in that critical care nurses with the appropriate level of expertise can be assigned to each patient, thus facilitating quality critical care nursing.

M.Cur. (Psychiatric Nursing) / The psychiatric nurse, as a member of the multiprofessional mental health team, utilises a goal directed approach to assist the psychiatric patient to mobilise resources to promote, restore and maintain his mental health as an integral part of his quest for wholeness. This goal directed approach is the nursing process which comprises assessment, planning, implementing and evaluation. All four steps of the nursing process and the nurse's interaction wi th the patient are dependent upon therapeutic communication between the nurse and the patient to elicit the necessary information so as to be able to formulate the nursing diagnosis, nursing actions and the patients' outcomes. Therapeutic communication remains important as the core of all nurse-patient interactions. Lack of therapeutic communication with the patient can cause conflict in the patient's internal and external environments since he will be unable to communicate his needs and problems and this will delay the mental health promotion, restoration and maintenance phases. Currently much attention is paid to the pharmacological treatment of the patient as more and more sophisticated psychotropic drugs are produced, and yet the other aspect of the patient's treatment which is equally important is neglected, namely his communication during hospitalisation, especially with the psychiatric nurse as she is the person in direct contact with him and should spend most of her time interacting with him.

M.Cur. / Please refer to full text to view abstract

This project addressed the continuing education needs of nursing staff and other health care professionals for delivering competent and compassionate palliative or end of life care. The scope of the project included, writing a grant application, training and certification by the end of life Nursing Education Consortium and implementing an education program for staff at the Loma Linda Veterans Affairs medical center.

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Caring for terminally ill cancer patients is considered stressful and heartbreaking. Oncology nurses often consider leaving the nursing profession because of the high levels of stress experienced by these health care professionals. The aim of this study was to investigate the experiences and the practices of nurses who care for terminally ill cancer patients in the Pietersburg Provincial Hospital in the Capricorn District of the Limpopo Province. The objectives of this study were to explore and describe the experiences and practices of nurses who care for terminally ill cancer patients and further to describe the relationship between certain demographic variables and nurses’ experiences of death. An additional objective was to develop recommendations and strategies that might assist management of the Pietersburg Provincial Hospital with the development of appropriate skills and the implementation of emotional support that could assist nurses who care for dying cancer patients in the oncology wards. The study followed a phenomenological, descriptive, exploratory and contextual research design, which assisted the researcher to describe and explore the experience and practices of nurses caring for terminally ill cancer patients. Semi-structured interview method was used to collect data, making use of an interview guide, was used because it is a more free-flowing approach, with its structure being limited only by focusing on the research. Field notes were captured during the data collection session by the researcher. A voice recorder was used to capture all the interview sessions. The initial data analysis started with the researcher listening to the recordings and transcribing verbatim all statements made by the participants. Tesch’s open coding data analysis method was used by following the proposed eight steps to analyse qualitative data as outlined in Creswell (2013). Ethical standards as set in Babbie (2013) were adhered to by the researcher. The researcher requested permission to conduct the study from the Limpopo Department of Health Ethics Research Committee and informed consent was obtained from the participants before collecting data. Privacy of the participants was ensured as participants were never called by their names. In the study participants shared different views with respect to caring for dying cancer patients. Some participants regarded caring for cancer patients as stressful and heartbreaking. Other oncology nurses blamed the management for not providing them with courses to assist them with caring for dying cancer patient, nor providing debriefing sessions for them. On the other hand, some oncology nurses believed that relocating to other wards was a better solution. The participants suggested the following improvements for caring for dying cancer patients; oncology nurses should be offered short courses to assist them with the challenges that they come across with regard to caring for dying cancer patients. Oncology nurses need support from the management and colleagues in order to cope with the workload. Oncology nurses need psychological assistance to help them with the psychological stressors they experience. Family members and patients need health education on how to deal anticipatory grief. / University of Limpopo

Registered nurses are exposed to the risk of Human Immunodeficiency Virus (HIV) infection and contracting the Acquired Immunodeficiency Syndrome (AIDS). Qualitative phenomenological research was conducted to explore registered nurses' experiences of working in such a high-risk environment and how their experiences influence the therapeutic relationship. A sample of registered nurses who care for HIV-infected persons or persons who suffer from AIDS was purposefully selected. Focus group interviews were conducted. Qualitative data analysis was performed. Frankl's theory of meaning of life served as a theoretical foundation for interpreting the research findings. The research results revealed that registered nurses experience existential frustration due to the intentional and unintentional risks that they are exposed to. This negatively impacts upon their ability to maintain a healthy therapeutic relationship with patients. However, evidence was obtained indicating that some factors support their quest for finding meaning in life in the workplace. / Health Studies / M.A. (Health Studies)

A quantitative research design for a descriptive and contextual study to determine the critical care nurses knowledge and data preferences regarding the central venous and pulmonary artery catheters management and decision making after coronary arte.y bypass graft operations and the utmzation period of the pulmonary artery catheter after coronary artery bypass graft operations. The data was collected through a questionnaire completed by critical care nurses and retrospective analysis of patient records through a structured checklist. Data analysis indicated the following: critical care nurses have a knowledge deficit in the management of the central venous and pulmonary artery catheters and felt more competent and confident in the central venous measurements. The utilization period of the pulmonary artery catheter was 48% compared to the 100% of the central venous catheter. / Advanced Nursing Science / M.A. (Advanced Nursing Science)