Thesis (M.S.)--University of Michigan, 1994.

M.Cur. / Quality nursing care is a constitutional right of both patients and clients. This right can only be upheld if nurses are competent. It is unfortunate that this right is often violated by those members of the nursing profession who are expected to uphold it. There is evidence from literature and media reports, which reveal that the competence of nurses is often lacking and therefore leaves much to be desired. ' Reports from the media, literature and other sources prompted the researcher to conduct the study. The purpose of the study was to evaluate the competence of newly qualified nurses from a specific nursing college. To realise the purpose of the study, the researcher conducted a quantitative, non-experimental contextual research. The process of conceptualisation was done in order to clarify the concept of competence within the context of clinical nursing education. It was also important to ~ spell out the concept of competence within the contexts of higher education and training, the SAQA, the SANG, and the nursing college. Research design of the study was done in two phases, namely: the developmental and the evaluation phase. During the developmental phase, the researcher developed an instrument based on Muller's (1999) theoretical framework. Measures were taken to ensure the validity and reliability of the instrument. A manual for the instrument was also developed. A pilot study was also conducted during the developmental phase. The purpose of the evaluation phase was to evaluate the applied competence of newly qualified registered nurses. The target population of the evaluation phase included all thirty-six newly qualified nurses from a specific nursing college.

This study investigated the possibility that registered nurses, working directly with the patient, may hold attitudes towards consumer rights and nursing independence which are different from those in the literature and those of nurse leaders and activists which are reflected in the resolutions on consumer rights passed at the Annual Meeting of the Registered Nurses' Association of British Columbia in 1976. The Pankratz and Pankratz (1974) Attitude Scale, consisting of 47 statements, divided into three clusters: 1) Nursing Autonomy and Advocacy; 2) Patient Rights; and 3) Rejection of Traditional Role Limitations was administered by mail to a random sample of registered nurses who were members of one of the Districts of the Registered Nurses' Association of British Columbia, Canada. The sample was stratified by educational level and 99.1 percent of 425 subjects were contacted by telephone prior to the delivery of the questionnaire. A total of 392 questionnaires (92.23 percent of the complete sample) was returned. Analysis of variance techniques were used to test the difference between the means when the three clusters in the Attitude Scale (Pankratz and Pankratz 1974) were analyzed by the six independent variables—administrative position, working hours, experience, work setting, age and education. Results indicated that nurses in administrative positions, those with advanced education and those who work in educational or community health settings, are more likely to score highly on the Pankratz and Pankratz (1974) Attitude Scale, than are nurses who have not completed a university degree and who work in a hospital setting as staff nurses. The attitudes expressed suggest that nurses are motivated to accept the patient as a participating member of the health care team but they need support to assume the risks associated with a self-image incorporating professional autonomy and interdependence. Conclusions reached were that the mean of the total sample, on all three clusters, was sufficiently high to encourage nurse leaders to provide assertive leadership on the issues of consumer rights in health care, informed access to information by the consumer and nursing autonomy. Such leadership would develop role models of consumer advocacy with which staff nurses could identify. It is suggested that by increasing, wherever practical, the patient's participation in decision making and in his own care, a more professional and more consumer oriented staff nurse role could evolve. / Applied Science, Faculty of / Nursing, School of / Graduate

The recruitment of diverse nurse faculty fosters culturally competent teaching, role modeling of cultural awareness, and mentorship for diverse nursing students. However, with regard to the evolution of New York City’s diversity, the nursing profession has historically failed to parallel the societal transformation. This researcher investigated nursing education’s past in regard to race and ethnicity through the historical case study of one of New York City’s first schools established to educate Black women in nursing arts, namely, the Lincoln School for Nurses of the Bronx, New York. The lack of diversity within nursing is not an issue that developed overnight. Deficiencies of diverse nurse educators have been associated with decreased numbers of enrolled minority students, insufficient percentages of minority nursing staff, and the negative stimuli on healthcare that stemmed from unconscious biases and healthcare disparities. This researcher employed the historical research method and accessed archival materials (both primary and secondary sources) to study the Lincoln School for Nurses. The findings of this study identified the progressive development of African-American nursing students in New York and the pivotal role African American nursing faculty have played in the education of Black nurses. Along with the historical study of the Lincoln School for Nurses, biographical sketches of prominent graduates and leaders (such as Adah B. Samuels Thoms and Ivy Nathan Tinkler) were presented. Furthermore, previous studies of Lincoln School for Nurses’ institution and educational standards, such as the Ethel Johns Report of 1925 and the 1930 study of the school by Isabel M. Stewart and Teachers College, Columbia University, were investigated. The presence of structural racism and discrimination influenced the growth and development of Black nursing faculty in history and, arguably, set the foundation for Blacks in nursing education of present-day. It is vital that researchers examine the origins of this dilemma and provide clarity to the events and experiences that influenced the nursing profession’s current state of diversity, prior to attempting to resolve an issue that took decades to cultivate.

No / This is a summary of See et al.1 Newly registered nurses experience high levels of emotional exhaustion, stress and burnout, with high attrition rates in the first-year post-qualification. The purpose of this review was to consolidate the available evidence on the experiences of newly registered nurses transitioning from the role of student nurse to that of registered nurse.

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Research suggests that individuals in the workplace might have a difficulty sharing their perceptions of risk and challenging unsafe behaviours. This thesis utilises The Theory of Planned Behaviour to examine which factors promote or hinder healthcare workers’ willingness to speak up and confront clinicians’ risky behaviours that could lead to medical error and hence endanger patient safety. The Theory of Planned Behaviour addresses issues surrounding intentions garnered from explicitly measured variables; in addition the thesis further sought to identify attitudes to speaking up using an implicit measure approach, and an approach using a computerbased, scenario-placement, reaction time methodology. Overall, the results of the thesis’s four studies suggest that nurses’ decisions to speak up are influenced by a variety of negative and positive beliefs. These beliefs include the effect speaking up has on the nurse speaking up and the patient; the support and actions of other nurses and medical personnel; and nurses feelings of confidence, knowledge and experience. Nurses also demonstrated a belief that they are more likely to speak up than their peers. Results also suggested that nurses speak up to individuals that they trust and distrust, indicating that trust and distrust are not polar opposites. The findings suggest that if speaking up is to be promoted practitioners need to address nurses’ negative beliefs—this is especially true with regard to fears about speaking up to authority figures. Nurses stated beliefs that they are more likely to speak up than their peers might be a result of presentation-bias or self-bias, if the cause is self-bias then training nurses to be more assertive and challenge risk might be made more difficult by nurses’ collective denial that they have any difficulties speaking up.

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Approved for public release; distribution is unlimited / This thesis examines the implementation elements of the Nurse Internship Program (NIP) at Naval Medical Center San Diego. The NIP provides nurses with no or little nursing experience an opportunity to participate in professional development as United States Navy Nurse Corps officers. The resolution to implement a NIP requires resource allocation decisions and commitment from top leaders in the organization. A review of adult learning and teaching methods is presented as a foundation for the NIP. It emphasizes the Dreyfus sk ill acquisition model adapted to the nursing profession by Benner that depicts the "novice to expert" continuum. Next, an overview of nursing orientation framework as found in the civilian and military healthcare organizations focuses on the program implementation. A discussion of resource allocations made by organizations for a NIP or a nursing orientation program is then presented. Historical accessions data are examined to demonstrate the trend in new nurse appointments to the Navy. The NIP offers po tential benefits to the organization and the nurse interns. Planning, evaluation, and leadership support are important drivers in the NIP framework. Recommendations are presented for further study based on the foundational aspects of this study. / Lieutenant Commander, United States Navy