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This thesis reports a study which attempted to explore how a group of student nurses perceived their experience of being learners of nursing. In order to obtain the students' accounts of this experience, a qualitative methodological approach has adopted, drawing upon the work of Glaser and Strauss (1967) on the generation of 'grounded theory'. The fieldwork took the form of informal interviews with forty student nurses. Certain predetermined topics provided the overall direction of the fieldwork; the students were encouraged to develop these and to raise any others which they thought to be pertinent to nursing. The interviews were tape recorded and their analysis resulted in the emergence of six conceptual categories which served as a framework for the presentation of the substantive issues raised by the students. Three major themes are taken up from the data, these are: the student experience as a preparation for staff nurse work, the functional interchangeability of the student and the nursing auxiliary and, the concept of medical dominance. This study sheds some light on the process of occupational socialisation in nursing and examines the question of profession and professionalisation in relation to nursing. The concluding discussion moves beyond the data and examines the occupational structure of nursing; this is relevant to the study because the students were preparing to become part of that structure. Moreover the occupational structure has implications for the recruitment of students and the organisation of their training. Four sub-groups within nursing are identified, namely: 'new managers', 'new professionals', 'rank and file' and 'academic professionalisers'. A speculative discourse upon how these groups might articulate with each other, in order to produce an efficient nursing service, is offered and areas for further study are suggested.

The need for nurses to be collaborative and practice-ready upon entering the profession has never been more important than it is today. The Institute of Medicine has identified that teamwork and collaboration should be essential parts of the nursing curriculum to prepare nurses to be ready to manage patient care with a team-based approach. The literature supports the idea that by learning out of silos and bringing students together from all different pre-professional programs, the professional working environment can be mirrored and the processes of collaboration and communication within teams can start. Transition into practice has been studied for decades regarding the “burnout” and “reality shock” that result from the experience. However, no literature has been uncovered that has investigated the nurses’ experiences of transitioning into practice after receiving an interprofessional education. The present study used Merleau-Ponty’s phenomenological perspective and vanManen’s phenomenological research method to illuminate the experiences of nurses transitioning into practice after having IPE. Ten practicing nurses who had received IPE were interviewed about their experiences transitioning into practice. Each participant shared stories about her transition period into professional practice. Through the process of reading and rereading transcripts, four essential themes emerged that shed light on the transition into practice after receiving IPE: (a) Understanding Team Dynamics, (b) Competent and Responsive Communicators, (c) Valuing Team Members, and (d) Recognized Self-Readiness. For this study, the lived experience of nurses who transitioned into practice after receiving an education with an IPE curriculum and practice is one of understanding team dynamics as competent and responsive communicators, valuing team members, and recognizing self-readiness. Interprofessional education does not have to occur only with students in nursing, medicine, or other allied health programs. Being creative with multiple programs at any institution can enrich students’ education by developing their communication and collaboration skills and adding quality and scope to their education experiences while preparing them for the real-world environment.

Chapter one reviews the literatures on psychological studies of aggression, problems of aggression within the Social Services and the National Health Service, and nurse-patient communication. A number of issues are raised which are addressed by the current research. In chapter two nurses' theories about what defuses and what aggravates aggression are explored. It was found that nurses believe that by remaining calm, gentle and firm they will defuse both physical and verbal aggression. In the case of physical aggression they believe it to be aggravated by being authoritarian, demeaning and defensive, while in the case of verbal aggression they believe it to be aggravated by becoming angry or attempting to deflect it. In chapter three nurses' real-life experiences of what defuses and what aggravates physical and verbal aggression are compared with their theories. The nurses' experiences largely support their theories. It was also found that there are very few methods for dealing effectively with physical aggression, while there are a relatively large number of methods for dealing effectively with verbal aggression. Moreover, those nurses who believe themselves to be more capable of dealing with aggression suffer fewer emotional after-effects than those nurses who do not. Chapter four examines individual differences between nurses and relates these differences to their ability to recover from the emotional aftermath of aggression. It was found that nurses who are highly stressed and who bottle-up their feelings of anger suffer emotionally after aggressive incidents. In contrast, nurses who are assertive, extravert and who exercise interpersonal control are not so distressed by aggressive incidents. In chapter five nurses' attributions are related to their ability to select effective methods of dealing with aggression as well as their ability to recover from it emotionally. It was found that those nurses who have a tendency to blame themselves are both emotionally vulnerable and less capable of selecting effective methods of responding to aggression. In addition, a new method of measuring attribution was developed and tested, and was found to be preferable to the usual method of measuring attribution. Chapter six presents the two-day aggression training programme. The training was designed to incorporate the findings of the current research as well as theoretical issues. The training was carefully evaluated with a control group, pre-post measures of both subjective and objective change, and a seven week follow-up. The aggression training group was no different to the control group before training, but was different on all measures after training. It was concluded that the training model has been shown to make a significant difference to objective skills and subjective evaluations, and that the causal influence of some of the findings described in chapters two to five has been demonstrated. Chapter seven summarises the findings of the research, explores their theoretical and practical implications, and suggests directions for future research.

D.Cur. (Professional Nursing) / The aim of this study was tot describe a model for accompanied self-study in Nursing. Our present time-frame confronts us on a daily basis with the realities of rationalization and financial cutbacks. Amidst these demands, an effective, goal directed philosophy of education is still expected. The challenge of effective education is lodged between on the one hand, the expectations of society and on the other hand, the expectations of the South African Nursing Council. The emphasis in nursing should focus on the development of critical thinkers, who deliver quality nursing. The model is described by means of an exploratory, descriptive, qualitative, theory generative and contextual design for the purpose of accompanied self-study, utilising the hierachial order of research constructs as described by Mouton and Marais (1990). This model is described within the framework of Nursing Theory for the Whole Person (NTWP), reflecting man as a whole person - body, mind and spirit. The theoretical assumptions are derived from NTWP, the constructivistic perspective on learning and teaching, as well as Gravetts' (1993) perspective of teaching as the creation of a context conducive to student learning. The methodological assumptions are based on Botes' research model implying a functional approach to the practice of science. The determinants guiding the study were identified, justified and appropriate research strategies selected. The first step in the model description encompases concept identification and. classification. The survey list of Dickoff, James and Wiedenbach (1968:420), which focuses on the agent, recipient, context, purpose, procedure and dynamics was utilized. The agent in this study was identified as the learning accompanist, and the debate was focused on the shift from lecturing to the management of education. The recipient in this study was the adult as learner who displays specific traits requiring accommodation in the didactic situation. The context of this study is Nursing Science and Nursing. The purpose of this model is to facilitate deep-holistic lifelong learning. The nurse should engage in lifelong learning to render quality nursing care and display critical thinking ability. Two procedures are identified in this model, namely the intentional creation of a context conducive to learning by the learning accompanist as well as the procedure being utilized by the adult as learner, namely accompanied self-study. The underlying dynamics of the model is motivation, as this is a prerequisite for achieving the goal in the model. Focusing on the context of the survey list, a conceptual framework was described, primarily by means of indirect observation and exploring the literature. Accompanied self-study was identified as the main concept in this model. The main theme in this model was an argument for learner-centered education. The other concepts are interrelated and reflect an interdependence in relation to one another. Accompanied self-study was derived from Education, followed by a process of thorough concept analysis resulting in the formulation of a unique definition. During the description of the conceptual framework, deductive logic was utilized to formulate statements during each facet of the survey list. Six sets of statements were formulated with a sum total of thirty one statements on conclusion of the conceptual framework. The model description was derived from these statements with in-depth attention to the structure and process. During the development of this model, it was implemented, and then evaluated by the learners. The model was subsequently evaluated by seven experts and refined. In the following step, guidelines were described by means of deductive and inductive logic, focusing on specific guidelines for the learning accompanist and adult as learner. The unique contribution of the study is the description of accompanied self-study in the context of Nursing Science as a new teaching educational approach based on the constructivistic perspective on learning and teaching as well as the perspective of teaching as the creation of a context conducive to student learning. The purpose of this being the facilitation of deep-holistic lifelong learning, implying the rendering of quality nursing care and the display of critical reasoning by the nurse. The value of this study is embodied in the operationalization of the model which provides positive certainty for the researcher that the model is functional and implementable.

D.Litt. et Phil. / In an examination of the training of nurses in Swaziland from 1927 – 2007, this study argues that the actions of the Church of the Nazarene (CON) and the state, as well as local conceptions of gender, contributed to the introduction and advancement of training of young Swazi women as nurses at the Ainsworth Dickson Nurses’ Home. Aiming at opening a medical mission at Bremersdorp in the Manzini District in Swaziland in 1925, the CON entered into an agreement with the British Colonial government, whereby the latter provided the CON with a piece of land on which to establish the first hospital in Swaziland, which it would staff with a British physician and white nurses. This agreement began an enduring relationship between the CON and the Swaziland government, which saw not only the establishment of the Raleigh Fitkin Memorial Hospital (RFM) but also the inauguration of nursing training in 1927. This study argues that the endurance of this training programme was largely dependent on the government’s financial support and on the provision of medical workers by the CON. From the 1930 onwards, the government not only paid salaries for the teaching staff, but also provided funding for nursing students. Following the example of Florence Nightingale, the CON and the Swazi government agreed, in the 1930s, to train only Swazi girls as nurses on the job, using the RFM as the teaching hospital. This agreement proved very suitable to the Swazi context, where cultural understandings precluded the training of boys as nurses, yet, from the beginning, marking the training of nurses in terms of gender...

The problem this study addresses is the need for nurses to adhere to guidelines on pressure ulcer prevention and treatment, so patients best possible health outcomes. This study created and utilized a new tool to assess nurses’ training, attitudes, knowledge, and skill/ability for adhering to practice guidelines of the National Pressure Ulcer Advisory Panel. The study sought to identity significant predictors of Personal Knowledge Rating Scale (TPKRS-101) and Personal Skill/Ability Rating Scale (TPS/ARS-101). The online study’s convenience sample of nurses (n=190) was 80.5% (n=153) female, 59.5% (n=113) Black, and 18.4% (n=35) Asian—with mean age of 40.27 years (min 23, max 73, SD=10.95). Some 53.2% (n=101) were not born in the US, while 16.8% (n=32) were from Ghana, 7.9% (n=15) from Jamaica, and 7.4% (n=14) from Philippines. Annual household income mean was $50,000 to $99,999 (mean=4.43, category 4, min=2, max=10, SD=1.00). Mean years working in nursing was 8-10 years (mean=4.34, category 4, min=1, max=9, SD=2.14). Nurses rated themselves “good” for performing pressure ulcer care tasks, as follows: (a) Nursing Training Rating Scale (TNRS-101) with global mean of 4.11 (SD=0.60, min= 1.94, max=5.00), or good; (b) Personal Knowledge Rating Scale (TPKRS-101) with global mean of 4.15 (SD=0.57, min=2.79, max=5.00), or good; and, (c) Personal Skill/Ability Rating Scale (TPS/ARS-101) with global mean of 4.13 (SD=0.62, min=2.56, max=5.00), or good. Higher Personal Knowledge Rating Scale (TPKRS-101) scores were significantly predicted by: more positive Attitudes Regarding Practice Guidelines-Relevance Scale (ARPG-R-5) (b = .067, SEB = .029, p = .022); and, higher level of Social Desirability (13 items) (b = .030, SEB = .013, p =.023). For this regression model, R2=.063, and AdjR2=.053, meaning that 5.3% of the variance was explained by model. Personal Skill/Ability Rating Scale (TPS/ARS-101) scores were significantly predicted by: higher level of Social Desirability (13 items) (b = .051, SEB = .014, p = .000). For this regression model, R2=.064, and AdjR2=.059, meaning that 5.9% of the variance was explained by model. Finally, the quantitative data were augmented by qualitative findings for barriers nurses experience to pressure ulcer prevention and treatment, as follows: Category I-External Barriers; and, Category II-Internal Barriers.

M.Cur. / Caring is a natural capacity. This simply means that human beings care because they are human. It is a reciprocal process. It never takes place in a vacuum as the one caring must do it out of love, and respect for another human being and it must be done with the utmost gentleness, tolerance and consideration. In the nursing profession it is done to people who are in most instances vulnerable and in need of care. This therefore, dictates that the one caring must have appropriate values and act them out consistently. In the case of nurses, a set of appropriate professional values is needed to serve as a framework from which they can base their decisions and actions. These professional values must be such that they should facilitate caring in the product of the nursing education system. Scholars are in support of one another that as much as caring is a natural phenomenon, this must be taught and nurtured. Much has been said about the decaying moral fibre of the South African society. The nursing profession also does not escape this scourge. The Department Education recommended that a working group be formed to look at and work on 'values education to teach new values to the generation to come'. The ANC through its Ethical Transformation called for a moral renewal of the society. The nursing education system called for a caring campaign. The aim of this study was to describe guidelines to facilitate internalisation of professional values in student nurses to make them caring professionals. To realise this goal, the researcher undertook a quantitative and qualitative, descriptive, exploratory and contextual approach. The design was conducted in four (4) phases. Data was collected from the nurse educators through focus group interviews and from the student nurses by means of naive sketches. In phase 1 of the design, the groups were separately asked to describe their perceptions about which professional values they regarded as important for nursing. They were further more asked to describe how these professional values should be taught to student nurses in order to make them caring practitioners. Conceptualisation was undertaken in phase 2. Phase 3 focussed on document analysis to evaluate if the identified professional values and teaching strategies were reflected in the college curriculum. Guidelines were described in the last phase. These was to be used by the nurse educators and student nurses to facilitate caring in the practitioners of nursing The results of the study indicated that the groups identified appropriate professional values as well as teaching strategies to be used to facilitate caring. The documents that have been evaluated indicated and supported this. Some of the professional values as well as teaching strategies were indeed reflected in the college curriculum. The only problem that was noted was that the evaluation done in the college did not seem to support if these professional values are taught, or if the teaching strategies were indeed used. The tests and examination papers evaluated seem not support this. It also became clear that nurse educators needed to be moral agents or become role models to their students in this regard. From the guidelines it was highlighted that the values identified must form part of the college curriculum and be displayed on the college walls to be seen by all. The following guidelines were spelled out. Educators must periodically receive in service training on those teaching strategies that facilitate caring. It came out clearly that the quality assurance team must place values education high on their list of priorities. A concerted effort must be engaged in by all the stakeholders to ensure that both the formative and summative evaluations conducted in the nursing college reflect inclusion of identified professional values. Emphasis must be placed on the affective domain as it has been noted that teaching and evaluation in this domain are difficult to implement. The recommendations that emanated from the study are based on the findings that although values and teaching strategies were reflected in the college curriculum they did not seem to be appropriately taught and evaluated. It was, therefore, recommended that the guidelines described in the study be implemented. The researcher further recommended that the caring attitudes of nurse educators be explored, as they are the primary socialising agents.

M.Cur. / The revision of education legislation in South-Africa has brought about a changed approach in teaching which requires that students' background knowledge and frame of reference be accommodated in courses. Adult learners registering for post-basic courses at tertiary education institutions already possess acquired knowledge and experience, and have certain preferences in teaching and learning methods. They have also developed a personal interest in their vocational fields. Moreover, they are able to assume responsibility for their own learning, and they desire to become involved in the planning of their teaching. The principle of active involvement of adult learners in their learning, as well as the structuring of own knowledge, is endorsed by the literature as being the most effective approach to learning. Guidance by learning facilitators must take this into account. It appears that the active involvement of adult learners in the drawing up an agreement between learner and learning facilitator can offer a possible solution. The aim of the study was to formulate guidelines for framing an individualised learning-teaching agreement between adult learners and learning facilitators for the completion of a selected module in Community Health Nursing or Occupational Health at a residential Technikon. A contextual, qualitative, exploratory and descriptive research design was selected, in which an inductive strategy was followed. The study had three phases. During the first phase, focus-group interviews were conducted to explore adult learners' views of teaching, learning and a possibile agreement. The analysed data were summarised in a table of 37 consolidated statements. During the second phase, a literature study was carried out by using the main categories of the data of Phase 1 as a point of departure. A second table of 42 consolidated statements was drawn up. After completion of this phase, the main categories were represented in a conceptual framework. The data from the first two phases were consolidated and by logical inferences 11 guidelines were formulated, as well as the rationale and operationalision of each, for drawing up a teaching-learning agreement. These guidelines were validated during a critical discussion with fellow learning facilitators. The guidelines direct the learning facilitator and adult learner in jointly drawing up an individualised teaching-learning agreement, according to which the needs of the adult learner and the vocational requirements of the educational institution and occupational councils can be reconciled in order to ensure that effective learning and vocational preparation can eventually be achieved.

M.Cur. / The attitude, insight and contribution of a group of unit managers into student nurse education, as well as the problems related to this function, was explored in an exploratory descriptive survey in contextual relation. The target population was confined to hospitals affilliated to the Western Transvaal Nursing College. The attitude of unit managers was found to be positive towards their training function although a lack of insight regarding the program content and training policy regarding the new comprehensive four year course was illustrated. A lack of collaboration between the college and unit managers was also evident, regarding standards and student evaluation. The main recommendations include the design and implementation of inservice education programmes and improved liason between teaching and unit personnel including differentiation of the student-teaching function for unit managers.