The aim of this study was to determine the knowledge of critical care nurses regarding forensic and liability issues in the critical care environment in order to design an education programme on the topic. A quantitative, descriptive, contextual research design was used and convenience sampling implemented. A survey, using a questionnaire as measuring instrument, was conducted among critical care nurses in selected private hospitals in South Africa. The response rate was 85%. Validity and reliability of the research was ensured. The total average percentage achieved by the group of 171 respondents was 38.46%, which was 21.54% below the set competency indicator of 60%. Only nine respondents achieved a percentage of or above 60%. Results proved that the respondents required intensive training on the topic. The outline of an education programme to address knowledge deficiencies regarding forensic and liability issues in the critical care environment was presented in PowerPoint presentation format. / Dissertation (MCur (Clinical))--University of Pretoria, 2007. / Nursing Science / MCur / unrestricted

Nursing is uniquely demanding work and occupational stress in the nursing profession has been well-documented. Many theories of stress-related disruptions among helping professionals have been proposed. Although these theories differ slightly in their origin of stress, they share similarities in nurses’ response to the patient relationship. Depersonalization, withdrawal, and avoidance all serve to create relational distance between the nurse and the patient. Despite the prevalence of these responses, there are not any theories on the nurses’ process of disengagement from patient relationships. Using Strauss and Corbin’s (1990) grounded theory method, this study explored acute care nurses’ experience of disengagement in patient relationships. The purpose of the study was to develop a mid-range theory of nurses’ process of disengagement from patient relationships as it occurred in acute care. Through purposive and theoretical sampling, 12 acute care nurses participated in open-ended individual interviews. The process of open, axial and selective coding discovered seven categories related to nurses’ experience of disengagement from patient relationships. These categories were emotional experience, behavioural expression, environmental influences, relational distance, professional identity and work spillover. Although these categories were exclusive, conceptual elements were interwoven into more than one category. The categories were interrelated around the core category, ‘Doing and Being’, and the process of nurses’ disengagement from patient relationships was delineated. Participants in the study experienced dissonance when they were unable to act in accordance to their caring beliefs. Conditions in the work environment, such as the lack of time, the culture of productivity and patient characteristics influenced and promoted their process of disengagement. Disengagement was manifested in the nurse-patient relationship by decreased eye contact, increased physical distance and increased task focused behaviour. These behaviours increased relational distance between the nurse and the patient. Nurses’ experience of dissonance had the potential to foster feelings of professional dissatisfaction and alienation from self, leading to increased turnover behaviour and depression. Implications and recommendations for practice and future research are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

“Power” is a concept that has been discussed by nurse scholars and leaders within the nursing literature. The literature surrounding power concurs that power is necessary within the practice of nursing so that nurses are able to support patients and move the profession of nursing forward. There is a scarcity of research, however, regarding nurses’ perception of power within their own practices. Advanced practice nurses (APNs) are in positions in which they apply graduate education, specialized knowledge, and expertise to improve health care outcomes. Therefore, a qualitative study using an interpretive hermeneutic phenomenological approach was undertaken to discover APNs’ lived experience of power within their practices. In-depth, tape-recorded interviews were conducted with eight APNs from a large tertiary care facility. All of the participants agreed to a follow-up interview to review the summary of the study results. van Manen’s (1990) approach was used to analyze the data by subjecting the transcripts to a thematic analysis and reflective process. The overarching theme of the interviews is “building to make a difference” and the APNs’ perceived that this happened by “building on,” building with,” and “building for.” The APNs built on their knowledge and expertise, built with others in relationships and built for the capacity to make a difference. Power was a part of the everyday practices of these APNs and was described as “soft power,” a power that they shared to bring about change for the better. This shared power was reflected back on them resulting in increased power within their practices, a process described by the APNs as power creep.

Background: Acute postoperative pain can develop into chronic pain if not managed well. Nurse anesthetists consider many factors when developing an anesthetic plan to provide optimal postoperative pain management. Multimodal pain management is recommended for managing pain in the perioperative period and this may include administering medications such as intravenous (IV) acetaminophen and IV non-steroidal anti-inflammatory drugs (NSAIDs) to the patients if not contraindicated. Even though these are valuable and daily considerations for nurse anesthetists, there is not a standard of care for addressing postoperative pain management in adult abdominal surgical procedures. Objective: The purpose of the project is to determine the perspectives of nurse anesthetists for developing postoperative pain management in adult patients having abdominal surgical procedures. Design: This is a descriptive study designed to determine if current nurse anesthetist practices are being guided by evidence-based practices and if the findings can be used to develop a standard of care. Participants: Nurse anesthetists from a local Tucson, AZ health care facility Measurements: Nurse anesthetists were interviewed in-person. They were asked six semi-structured questions and the answers were recorded and transcribed into the program NVivo. Each answer was then coded and compared for emerging common themes. Results: Five out of eleven nurse anesthetists participated in this project. Thirty-five themes were discovered and three main categories developed: 1. Nurse anesthetists consider multimodal pain management an integral part of the anesthetic plan. IV acetaminophen and IV NSAIDs are considered for every surgical patient if they are not contraindicated; 2. IV acetaminophen is used more frequently for abdominal procedures compared to IV NSAIDs because of risks for bleeding associated with IV NSAIDs; and 3. Each anesthetic plan is individualized to safely address both the patient and surgical factors. Conclusion: A multi-center study should be considered for a future project to determine if these common themes would be found consistently across health care facilities. Eventually, this information could be used to develop a standard of care for managing postoperative pain in adults having abdominal surgery. Other methods for addressing multimodal pain management such as regional blocks should be considered for future studies as well.

As the baby boomer population continues to age, the number of older adults in the United States continues to rise as well, which has and will continue to result in an ongoing increase in the nursing home population. Challenges in nursing home care include assuring the provision of comprehensive quality care, person centered care, and continuity of care. This DNP project evaluated a comprehensive template for nurse practitioners to use when completing monthly nursing home visits that would help address these challenges. The purpose of this project was to evaluate nurse practitioner satisfaction regarding the effectiveness of the tool in assuring comprehensive, quality and patient centered care when completing monthly nursing home visits. This was accomplished via a descriptive analysis of 10 nurse practitioners providing care in nursing homes. A Likert scale questionnaire was used before and after the nurse practitioners used the tool for a period of two months. All 10 participants agreed or strongly agreed that they would recommend the tool for use by nurse practitioners when completing monthly nursing home visits. Seven of the participants agreed or strongly agreed that the tool helped improve overall quality of the visit. The results demonstrated that the monthly nursing home assessment tool was beneficial in improving the quality of the visits and that there are future implications for use of the tool by not only nurse practitioners who practice in this setting but also for nurse practitioner students and physicians.

D.Cur. / The focus of this study was the mentoring of newly appointed nurse educators in nursing education institutions (NEIs) in South Africa. The mandate of higher education institutions changed due to the transformation of higher education in South Africa. The need for recruiting and retaining nurse educators to meet the demands of teaching and learning became evident. It is important that newly appointed nurse educators (NANEs) be mentored in order to meet higher education demands. The researcher identified the need to develop a model for mentoring newly appointed nurse educators in nursing education institutions in South Africa. The applicable research questions were: What are the mentoring needs of NANEs in NEIs in South Africa? How can the mentoring needs of NANEs in NEIs in South Africa be met? What model could be developed to mentor NANEs in NEIs in South Africa? What guidelines could be formulated for the model to mentor NANEs in NEIs in South Africa? The aim of the study was to develop a model for mentoring NANEs in NEIs in South Africa. The objectives of the study were to: determine and describe the mentoring needs of NANEs in NEIs in South Africa, identify and conceptualise a framework for how the mentoring needs of NANEs in NEIs in South Africa can be met and describe a mentoring model for NANEs in NEIs in South Africa. The design of the study was quantitative, qualitative, descriptive and theory-generating (Walker & Avant, 1995:136). The study was conducted in four phases. A quantitative, qualitative, descriptive and theory-generating research design was conducted using questionnaires, literature triangulation, inductive and deductive strategies (Mouton, 1989:21). Quantitative data was analysed using the statistical package of social sciences (SPSS) and descriptive statistics. An exploratory factor analysis was conducted on data from the empirical phase to identify and analyse central concepts for model development (Burns & Grove, 2001:242). The population of study was newly appointed nurse educators in nursing education institutions in South Africa. Probability and non-probability sampling approaches were used with multi-stage cluster and purposive sampling methods (Burns & Grove, 2001:242). The conceptual framework for the model was based on purpose, context, role-players and their roles in mentoring. The results of the study indicated that 90 (67%) of the participants did not function according to their key performance areas. The participants specified competency development needs. The study confirmed the need for the mentoring model. The assumptions for the model were based on the multi-dimensional, multi-layered (macro, meso and micro), highly interactive and complex (external and internal environment) context. The agent in the study referred to the mentor and a mentee (stakeholders), who are holistic beings functioning at a bio-psycho-social and cultural level. Mentoring is an interactive participative, purposeful dynamic process of relationship-building, development, engagement and reflection. The outcome of mentoring is to empower and build capacity and competency. A critical self-reflective questionnaire was designed and utilised to evaluate the model for its clarity, simplicity, generality, accessibility and importance. The model was presented from the first to the third phase at different international and national conferences and the two promoters, who are experts in management, teaching and ethics in higher education, gave direction to the researcher and added value to the quality of the study. The researcher recommends that a mentoring programme be developed to mentor NANEs in HEIs. The model can be used to improve practice by developing mentoring programmes for use in clinical, management, education and nursing research.

Anestesisjuksköterskans arbete är medicintekniskt avancerat. I sitt arbete utsätts hon ständigt för nya situationer där hon får handskas med svåra etiska problem. Anestesisjuksköterskan ska se till att tillgodose patientens behov i olika tillstånd vilket kräver goda kunskaper inom sitt yrkesområde. Anestesisjuksköterskan träffar patienten under förhållandevis korta stunder. Syftet med studien är att belysa anestesisjuksköterskans upplevelser av att delta vid akut omhändertagande av patienter utanför operationssalens kontext. Tidigare forskning inom detta område är sparsamt. Studien är kvalitativ och datainsamlingen genomfördes med semistrukturerade intervjuer.  Under intervjuprocessen fick anestesisjuksköterskorna som intervjuades svara enskilt på öppna intervjufrågor. Fyra stycken anestesisjuksköterskor deltog i studien. Anestesisjuksköterskorna som deltog i studien är anställda på en operationsavdelning på ett sjukhus i Västsverige. I analysen framkom det en huvudkategori och två kategorier med sex stycken tillhörande subkategorier. Kategorierna är: ”anestesisköterskans upplevda positiva känslor” och ”anestesisjuksköterskans upplevda negativa känslor”. Resultatet visar att anestesisjuksköterskorna upplevde att  det  är tryggare  att  arbeta  på operationsavdelningen i förhållande mot att arbeta i annan kontext så som traumarum förlossningsavdelning eller liknande. Upplevelsen av att arbeta utanför operationssalen varierade. Informanternas erfarenhet av att arbeta under ett akut omhändertagande på olika platser på sjukhuset är att de känner sig trygga i sin arbetsroll förutsatt att det finns en erfaren, trygg och tydlig anestesiolog med som bestämmer om vad som ska göras under ett akut omhändertagande. Det upplevdes tryggare att arbeta på operationsavdelningen än i en annan miljö. På operationsavdelningen finns det gott om folk att ta hjälp av om det skulle behövas och det upplevdes även tryggt att veta vart alla sakerna finns. Utanför operationsavdelningen känner sig informanterna otrygga då det inte vet om akutvagnar är påfyllda eller om de kan få samma service av sina medarbetare på den ”nya” avdelningen.

Background Every year around 350 children in Sweden become ill in some form of cancer, which also is the most common cause of death for children up to 14 years. The nurse has an important function in conveying safety and hope to these severely ill children and their families. Caring for children with cancer can be difficult and challenging. Method and Aim A literature study based on qualitative research with the aim of describe the nurse's experiences of caring for children with cancer was performed. Results The result was based on nine qualitative articles that, after analysis according to Friberg, resulted in three main themes; Become a part of the family, Emotional stress and Be professional, built on seven subthemes. The result showed that being a nurse caring for children with cancer was both mentally and physically exhausting. Strong relationships were formed between the nurse, the children and their families, and the nurse provided important support. Caring for children with cancer caused the nurse to experience several different emotions that affected both private life and working life. Emotions had to be handled with the help of support. Conclusion Caring for children with cancer is giving the nurse several strong feelings, both positive and negative. Strong relationships between the nurse, the children and their family can increase these feelings. To as a nurse every day meet these children with cancer is very demanding and support of different kinds are therefore necessary. / Varje år insjuknar ca 350 barn i Sverige i någon form av cancer som också är den vanligaste dödsorsaken för barn upp till 14 års ålder. Hjärntumörer och leukemi är de vanligaste cancerformerna hos barn under 10 år. Hos barn över 10 år är lymfom och melanom vanligast. Vanligt förekommande symtom är feber, trötthet och minskad aptit. Cytostatikabehandling, strålbehandling och operation är de behandlingar som används vid barncancer. Sjuksköterskan är omvårdnadsansvarig och har en viktig funktion i att ge stöd samt förmedla trygghet och hopp till barnen. Arbetet med barn med cancer kan vara svårt och utmanande. Syftet med denna litteraturstudie var att belysa sjuksköterskans erfarenheter av att vårda barn med cancer. Metoden som valdes var därför en litteraturstudie med grund i kvalitativ forskning. Resultatet baserades på nio kvalitativa artiklar som efter analys resulterade i tre teman och sju subteman. Första temat Bli en del av familjen beskriver de nära relationer som bildas mellan sjuksköterskan, barnen och deras familjer samt funktioner i att ge stöd åt barn med cancer. Andra temat, Emotionella påfrestningar, handlar om de känslor sjuksköterskan upplever i arbetet, sjuksköterskans upplevelse av att känna sig otillräcklig i omvårdnaden samt hur arbetet påverkar sjuksköterskans privatliv. Tredje temat, Vara professionell beskriver sjuksköterskans svårigheter att hantera känslorna samt sjuksköterskans upplevelse av bland annat stress, press och kunskapskrav. Litteraturstudiens diskussion fokuserade på de starka relationerna, de upplevda känslorna samt sjuksköterskans behov av stöd. Slutsatser som kan dras av denna litteraturstudie är att som sjuksköterska vårda barn med cancer på många sätt är ett krävande arbete och sjuksköterskan påverkas både emotionellt, psykiskt och fysiskt. Stöd är därför nödvändigt. För att vården ska kunna utvecklas och bli än bättre i framtiden finns behov av ytterligare forskning om sjuksköterskans upplevelse av att få stöd samt vilka former av stöd som behövs.

This is the first primary care dermatology reference written by and for nurses. It focuses on approximately 60 skin conditions that are commonly seen in primary care settings and provides unique decision trees to assist in accurate diagnosis. Organized for quick access, the book presents conditions alphabetically and includes evidence-based treatment and management strategies along with full-color photos taken during actual office visits. Dermatologic diagnostics cover skin assessment, specimen collection procedures, and use of mechanical devices, along with relevant evidence-based topical, systemic, and surgical treatment options. The resource provides an overview of dermatology basics including skin anatomy and physiology and skin terminology. Illustrations, graphs, and skin terminology help to accurately document descriptions of rashes, lesions, and diseases during diagnostic evaluations. The book also defines risk factors in relation to skin conditions and diseases and delineates conditions common to specific populations. A broad range of management strategies is presented along with alerts for when expert follow-up is indicated. To promote rapid identification of skin conditions, each is presented in a consistent organization that includes overview, epidemiology, pathology/histology, clinical presentation, differential diagnosis, treatment/management, special considerations and appropriate referrals, and patient education. The Clinical Pearls feature captures the authors" expertise. Additional photos are available from the website as a digital photo archive. Key Features: Focuses on approximately 60 common dermatological conditions with high-quality, full-color photos Presents four unique decision trees to foster accurate diagnosis and clinical decision making Delivers evidence-based protocols for diagnosis, treatment, and management Uses a consistent format to promote quick access to information Written by advanced-degree nurse practitioners with nurses" informational needs in mind / https://dc.etsu.edu/etsu_books/1221/thumbnail.jpg

Magister Curationis - MCur / Cardiopulmonary resuscitation (CPR) is a core emergency skill in which all nurses need to be proficient to save the lives of patients. It is important for nurses working in psychiatric hospitals to administer CPR correctly should the need arise. However, they rarely perform CPR as the patients they care for are generally not physical ill, unlike patients admitted in general hospitals. Given the paucity of literature on CPR in psychiatric hospitals, this study aimed at investigating the attitudes towards CPR and the CPR competency of nurses working at a hospital for intellectually disabled people in the Western Cape, South Africa