Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Absenteeism is a problem all over the world and a solution cannot be easily found. This is also a challenge faced by employers in South Africa. Absenteeism exacerbates the difficulty of health service delivery in many countries where the number of nurses available is insufficient to meet all of the healthcare demands in the health care sector, in this regard South Africa is no exception to this problem. The annual loss to the South African economy caused by absenteeism is between R12 billion and R19.144 billion per year. A combination of factors, namely characteristics of the nurse, the workplace, management, as well as characteristics of the organisation can influence absenteeism. Absenteeism of nurses is on the increase at primary care centres in the Ethekwini municipal district and it has a negative impact on provision of health care services where the study is proposed. It is imperative that sufficient nursing staff be available for duty to provide services to clients. No research on absenteeism has been conducted at these institutions. Therefore, identifying the contributing factors in order to be able to manage it effectively is essential. The aim of this research was to identify factors that contribute to absenteeism of nurses at eight primary care centres in the Ethekwini municipal district of KwaZulu- Natal. A quantitative descriptive exploratory research design was applied for this purpose. The population was all categories of permanently employed nursing staff working at the eight primary care centres. The total population consisted of 689 nurses. Following a pilot study consisting of 10% of the total sample, a research sample was compiled by means of a simple random sampling method and included 30% of all categories of nurses – registered nurses, enrolled nurses and nursing assistants. Hundred and ninety one nurses out of 209 responded to the research study, which sets the response rate at 91%. Data was collected by means of an existing questionnaire. The questionnaire focused on the characteristics of the nurse, manager, work environment and organisation in order to identify factors that contribute to absenteeism of nurses. The data was analysed with the support of a statistician and was expressed as frequencies in tables and histograms. Descriptive statistical analyses, including tests for statistical associations, were performed. Results of this study indicate significant relationships between characteristics of the nurse, the manager, workplace and the organisation. Factors that were identified included stress, staff shortage, work overload, lack of promotion opportunities, lack of child care facilities, lack of appreciation and feedback, bureaucratic leadership styles, inflexible working schedules and lack of a satisfactory reward system. The results further indicate no significant relationship between demographical variables and absenteeism. Recommendations based on the results were offered and recommendations for future research were made. / AFRIKAANSE OPSOMMING: Afwesigheid is ’n probleem dwarsoor die wêreld waarvoor daar nie ’n maklike oplossing gevind kan word nie. Dit is ook ’n uitdaging wat werkgewers in Suid-Afrika in die gesig staar. Afwesigheid vergroot die struikelblok om gesondheidsdienste in menige lande te verskaf waar die aantal beskikbare verpleegsters onvoldoende is vir die gesondheidssorgaanvraag. In hierdie opsig is Suid-Afrika geen uitsondering nie. Die jaarlikse verlies aan inkomste vir die Suid-Afrikaanse ekonomie veroorsaak deur afwesigheid is tussen R12 en R19.144 biljoen per jaar. ’n Kombinasie van faktore, naamlik kenmerke van die vepleegster, die bestuurder, die werkplek, asook kenmerke van die organisasie kan afwesigheid beïnvloed. Afwesigheid van verpleegsters is aan die toeneem by gesondheidssorg gemeenskapsentrums in die Ethekwini-distrik in Kwazulu-Natal en dit het ’n negatiewe impak op die voorsiening van gesondheidssorgdienste waar die studie onderneem is. Dit is noodsaaklik dat voldoende verpleegpersoneel beskikbaar moet wees vir diensverskaffing aan kliënte. Geen navorsing oor afwesigheid is al onderneem by hierdie inrigtings nie. Die identifisering van die faktore wat bydra tot afwesigheid van die werk is essensieel sodat die probleem effektief bestuur kan word. Die doel van hierdie navorsing is om die faktore te identifiseer wat bydra tot die afwesigheid van verpleegsters by agt primêre gesondheidssorg gemeenskapsentrums in die Ethekwini munisipale distrik van KwaZulu-Natal. ’n Kwantitatiewe beskrywende, ondersoekende navorsingsontwerp is toegepas vir hierdie doel. Die populasie het bestaan uit alle kategorieë van permanent aangestelde verpleegpersoneel wat werk by agt primêre gesondheidssorg gemeenskapsentrums. Die totale populasie het bestaan uit 689 verpleegsters. Na ’n loodsprojek van 10% van die totale steekproef, is ’n navorsingssteekproef saamgestel deur middel van ’n eenvoudige ewekansige steekproefmetode wat 30% van alle kategorieë verpleegsters ingesluit het, naamlik geregistreerde verpleegsters, ingeskrewe verpleegsters en verpleegassistente. Honderd een-en-negentig verpleegsters uit 209 het reageer op die navorsingsondersoek wat ‘n responsvlak van 91% daargestel het. Data is ingesamel deur middel van ’n bestaande vraelys. Die vraelys het gefokus op die eienskappe van die verpleegster, die bestuurder, werksomgewing en organisasie ten einde die faktore te identifiseer wat bydrae tot die afwesigheid van verpleegsters. Die data is geanaliseer met die ondersteuning van ’n statistikus en is uitgedruk as frekwensies in tabelle en histogramme en diagramme. Beskrywende statistiese analises, insluitende toetse vir statistiese assosiasies is uitgevoer. Resultate van hierdie studie dui aan dat ‘n beduidende verhouding bestaan tussen die kenmerke van die verpleegster, die bestuurder, werkplek, organisasie en afwesigheid van die werk. Faktore wat geidentifiseer is sluit in stress, personeel tekort, werkoorlading, gebrekkige bevorderingsgeleenthede, afwesigheid van fasiliteite vir die versorging van klein kinders, gebrek aan waardering en terugvoer, burokratiese leierskapstyle, onbuigbare werkskedules en ‘n gebrek aan ‘n bevredigende vergoedingstelsel. Die resultate van hierdie studie dui verder aan dat daar geen verband bestaan tussen demografiese veranderlikes en afwesigheid nie. Aanbevelings ten opsigte van die resultate is gemaak, asook aanbevelings vir toekomstige navorsing.

Thesis (MCur)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Registered professional nurses are expected to maintain competence. Organisations are employing computer-assisted learning to fulfil this requirement. It was observed that staff experienced challenges such as technical difficulties, insufficient computer literacy, lack of opportunity and access to complete computer-assisted learning activities in a private healthcare organisation. These challenges may have implications for the effective learning and development of registered professional nurses. The aim of the study was to explore the experiences of registered professional nurses in computer-assisted learning at a private healthcare organisation. The research question was: “What are the experiences of registered professional nurses in computer-assisted learning at a private healthcare organisation?” The following objectives were set to:  Explore the experiences of registered professional nurses in computer-assisted learning related to o Organisational support o Human interaction o Programme design o Computer literacy A qualitative approach with a descriptive, exploratory design was applied. A purposive sample of seven (n=7) participants from a population of thirty five (N=35) were recruited. A pre-test was completed. Ethical principles were adhered to. A semi structured interview guide based on the objectives of the study was developed by the researcher and validated by a panel of experts in research methodology and nursing education. Data was collected in the form of individual interviews and a demographic questionnaire by the researcher and one research assistant. Content analysis was applied to analyse the data, with six themes emerging. These were access, opportunity, applied support, programme content and design, social learning and computers. The findings demonstrated that registered professional nurses experienced inadequate access and opportunity to computer-assisted learning activities. The lack of computer literacy and human interaction affected the learning experience of some, but not all participants. Technical problems and disturbances in the learning environment were major contributors to the negative experiences in computer-assisted learning. Positive experiences included the convenience and ease of use of intranet-based computer-assisted learning activities. The conceptual framework of Knowles’ Andragogy supported the findings of the study. Recommendations were to provide intranet access at work and home, internet access at work and also formalised opportunity to complete computer-assisted learning activities. Technical problems should be minimised. Learning environments should be separate from work environments. / AFRIKAANSE OPSOMMING: Daar word van geregistreerde professionele verpleegkundiges verwag om vaardigheid te behou en organisasies wend rekenaar-ondersteunde leer aan om die vereiste te vervul. Dit was waargeneem dat personeel uitdagings ervaar soos tegniese probleme, onvoldoende rekenaargeletterdheid en ’n tekort aan geleentheid en toegang om rekenaar-ondersteunde aktiwiteite te voltooi by ’n privaat gesondheidsorg organisasie. Hierdie uitdagings mag implikasies inhou vir effektiewe leer en ontwikkeling van geregistreerde professionele verpleegkundiges. Die doel van die studie was om die ervaringe van geregistreerde professionele verpleegkundiges in rekenaar-ondersteunde leer, by ’n privaat gesondheidsorg organisasie te ondersoek. Die navorsingsvraag was: “Wat is die ervaringe van geregistreerde profesionele verpleegkundiges in rekenaar-ondersteunde leer by ’n privaat gesondheidsorg organisasie?” Die volgende doelwitte was gestel om:  Die ervaringe van geregistreerde professionele verpleegkundiges in rekenaarondersteunde leer te ondersoek in verband met o Organisasie ondersteuning o Menslike interaksie o Program ontwerp o Rekenaargeletterdheid ’n Kwalitatiewe benadering met ’n beskrywende, ondersoekende ontwerp was toegepas. ’n Steekproefgroep van sewe (n=7) deelnemers is doelbewus geselekteer vanuit ’n populasie van vyf en dertig (N=35). ’n Voortoets is voltooi. Etiese beginsels is nagevolg. ’n Semigestruktureerde onderhoudsgids gebaseer op die doelwitte van die studie is ontwikkel deur die navorser en bekragtig deur ’n paneel deskundiges in navorsingsmetodiek en verpleegonderrig. Data was ingesamel deur middel van individuele onderhoude en ’n demografiese vraelys deur die navorser en een navorsingsassistent. Inhoudsanalise was toegepas om die data te analiseer met ses temas wat na vore gekom het. Hierdie was toegang, geleentheid, toegepaste ondersteuning, program ontwerp en inhoud, sosiale leer en rekenaars. Die bevindinge het daarop gedui dat geregistreerde professionele verpleegkundiges onvoldoende toegang en geleentheid tot rekenaar-ondersteunde leer aktiwiteite ervaar het. Die gebrek aan rekenaargeltterdheid en menslike interaksie het sommige, alhoewel nie alle deelnemers se leerervaring geaffekteer. Tegniese probleme en versteurings in die leeromgewing het hoofsaaklik bygedra tot negatiewe ervarings in rekenaar-ondersteunde leer. Positiewe ervaringe het ingesluit die gerieflikheid en bruikbaarheid van intranetgebaseerde rekenaar-ondersteunde leer aktiwiteite. Die konseptuele raamwerk van Knowles se Andragogie ondersteun die bevindinge van die studie. Aanbevelings is om internet toegang by die werk, intranet toegang tuis en by die werk te voorsien asook formele geleenthede te skep om rekenaar-ondersteunde leer te voltooi. Tegniese probleme behoort tot die minmum beperk te word. Leeromgewings behoort apart te wees van werksomgewings.

Thesis (MPA)--Stellenbosch University, 2000. / Full text to be digitised and attached to bibliographic record. / ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective delivery of quality health care. However, turnover of nurses constitutes a major factor in the shortages of staff which are being experienced by the nursing profession in the Republic of South Africa. Shortages of trained nurses with experience, particularly in public sector hospitals, have adverse effects on the provision of efficient and effective quality health care to the consumers of this service. The aim of the study was to provide an understanding of and insight into those inherent problems in the health sector that propel nurses to leave public sector institutions. The overall objective was to investigate and identify some of the factors which exercised an influence on the turnover of registered nurses in public sector hospitals, so as to be able to provide suggestions to hospital managers on the more effective management of human resources, in order to retain nursing personnel. Theresearch was based on a model of nursing turnover which regarded voluntary withdrawal as a process in which feelings of satisfaction with pay, on the one hand, and the opportunity of obtaining alternative jobs in the labour market, on the other, were proposed as the primary causative factors of turnover behaviour. In addition the propositions, made in literature reviewed, that age, tenure, kinship responsibility, general training, education, professionalism, marital status, lintent to stay', job satisfaction, routinization, job autonomy and responsibility, instrumental communication, promotional opportunity, integration, supervisory relationships, distributive justice, work-load, and local kin acted as predictors of turnover, were also investigated. The research was conducted with a sample of 123 nurses in one hospital, Groote Schuur, situated in the Western Cape Province of the Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered) nurses. The data was gathered from respondents by means of a selfadministered questionnaire. In addition, data was gathered by means of semi-structured, open-ended discussions with nursing management. The hypothesised interactions between variables influencing nursing turnover were explored by means of basic statistics, which made it possible to assess the effects of both independent and dependent variables. The results of data analysis provided some support for the proposition contained in the hypothesis. The determinants whose increase produced a greater degree of turnover were firstly, the many jobs available outside the hospital and secondly, professionalism. The determinants whose increase resulted in reductions in turnover were "intent to stay" (which the researcher views as a dimension of commitment), the existence of local kin (kinship responsibilities), participation in making job-related decisions (job autonomy), the receipt of sufficient work-related information (instrumental communication and good supervisory relationships), and tenure. The determinants whose decreaseresulted in increased turnover werepromotional opportunities, distributive justice, pay satisfaction, job satisfaction, integration, opportunity for self-development,age and tenure. Turnover of nurses has serious ramifications for employers, patients, and the nursing profession itself. Effective management of employee turnover is of critical importance to health care providers, employees, and patients. Better control of turnover can improve the quality of patient care, reduce labour costs, and improve employee morale. / AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende omstandigheid ten einde die lewering van effektiewe en doeltreffende gesondheidsorg van gehalte. Nietemin, dra die omset van verpleegkundiges grotendeels by tot die personeeltekort wat tans deur die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan ervare, opgeleide verpleegkundiges, veral in die openbare sektor staatshospitale, het 'n nadelige uitwerking op die voorsiening van effektiewe en doeltreffende gesondheidsorg van gehalte aan die verbruikers van hierdie diens. Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig te probeer kry in, daardie inherente probleme binne die gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van sommige faktore wat die omset van geregistreerde verpleegkundiges in staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan hospitaal bestuurders te kan voorsien ten opsigte van die meer doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud van verpleegpersoneel. Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid, aan die een kant, en geleentheid tot alternatiewe betrekkings in die arbeidsmark, aan die ander, as die primêre veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens is die stellings vanuit die literatuurstudie dat die volgende dien as voorspellers van omset ook ondersoek: ouderdom, ampstermyn of dienstyd, verantwoordelikheid teenoor familie, algemene opleiding, opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly', werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading en plaaslike naasbestaandes. Die navorsing is uitgevoer met gebruik van 'n monster van 123 verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster het geregistreerde verpleegkundiges, senior geregistreerde verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit. Die data is verkry van respondente deur middel van 'n self-toegediende vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote besprekings met van die verpleegbestuur. Die interaksie tussen veranderlikes ten opsigte van verpleegomset wat veronderstel is, is ondersoek deur middel van basiese statistiek, dus kon die uitwerking van afhanklike en onafhanklike veranderlikes bepaal word. Die uitslae van data-ontleding het wel ondersteuning verleen aan die voorstelling soos uiteengesit in die hipotese. Die determinante wie se toename 'n toename in die omsetkoers tot gevolg gehad het was, eerstens, meer werksgeleenthede buite die hospitaal en, tweedens, professionalisme. Die determinante wie se toename tot 'n vermindering in omset bygedra het was 'voorneme om te bly' (wat die navorser as binne die omvang van toewyding beskou), deelname aan werksverwante besluitneming (werks outonomie), die ontvangs van genoegsame werksverwante inligting (bevorderlike kommunikasie en goeie toesighoudende verhoudings), en ampsduur (dienstyd). Die determinante wat tot 'n vermindering in omset lei is bevorderingsgeleenthede, toedelende gereg, salaris bevrediging, geleenthede tot self-ontwikkeling, ouderdom en ampsduur. Die omset van verpleegkundiges het verreikende gevolge vir werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste verminder en die moraal van werknemers verbeter.

Dissertation submitted in partial compliance with the requirements for the Master's Degree of Technology: Nursing, Technikon Natal, 2002. / The Integrated Management of Childhood Illness (IMCI) is an approach that aims to reduce the mortality and morbidity in children under the age of five years. When this programme was initiated, the conditions targeted were acute respiratory infections, diarrhoea, fevers associated with malaria and measles and malnutrition. As a result of the HIV pandemic in South Africa, the identification of children who are symptomatic of HIV infection was included. This study evaluates the use of the HIV portion of the IMCI algorithm by nurses in selected, public sector, primary health clinics in KwaZulu Natal. IMCI nurses were observed as they used the IMCI approach while consulting with sick children. Data was collected in relation to the accuracy with which the nurses used the algorithm and the extent to which the HIV portion of the algorithm was used to guide their management decisions when consulting with the children. Seventy-two observations were undertaken. In-depth interview were conducted with 13 IMCI nurses to establish factors that influenced the use of the HIV portion of the algorithm. The study showed a poor level of accuracy when using the HIV portion of the algorithm. In addition, as a result of poor accuracy when using the algorithm to assess and classify for symptomatic HIV infection, it appeared that nurses were not using the HIV portion of the algorithm to guide management decisions regarding children who were possibly symptomatic of HIV infection. I A general poor level of knowledge about HIV infection was identified which the researcher felt could be one of the factors influencing the use of the HIV portion of the algorithm. Death anxiety, low level of counselling skills and burnout also seemed to play some role in the use of the HIV portion of the algorithm.Recommendations were made to adapt future training of IMCI nurses and include an HIV training course and a course on growth monitoring of children in this age group. Further recommendations to continually evaluate the practice of nurses were made. Future areas for research were suggested. / M

Quantitative, descriptive research was conducted to determine which factors contribute to absenteeism among nurses. A structured self-administered questionnaire was administered to the entire population of nurses who worked at a district hospital in the Limpopo Province. Statistical data analysis, involving factor analysis, frequencies and Chi-squares was performed. The findings revealed that various factors related to the characteristics of the nurse, characteristics of the manager, characteristics of the work and characteristics of the organisation contribute to absenteeism. Professional nurses and sub-professional nurses, as well as nurses younger than 40 and nurses who are 40 years and older, appeared to disagree on the extent to which various factors contribute to absenteeism in the workplace. This study was aimed at assisting organisations and managers in reducing absenteeism in the workplace, and by doing so, improving the quality of care. / Health Studies / MA (HEALTH STUDIES)

The purpose of the study was to explore and describe the professional nurse's perception of working in remote rural clinics in Limpopo Province. The research design was qualitative, exploratory, descriptive and contextual. The research population was the professional nurses working in remote rural clinics in Limpopo Province. Purposive sampling was used and data collected by means of tape-recorded in-depth semi-structured individual interviews. The study revealed that the professional nurses perceived working in the remote rural clinics both positively and negatively and had concerns. / Health Studies / M.A. (Health Studies)

As a clinic supervisor overseeing a cluster of clinics in the Nelson Mandela Bay Health District (NMBHD), the researcher observed a number of problems with the implementation of the re-engineering of the primary health care (RPHC) programme. The problems observed include inadequate supervision of RPHC staff, poor communication and conflict between clinic and RPHC staff, failure to filter RPHC statistics into clinic statistics and the incorrect management of patients by RPHC staff. Therefore, the purpose of this study is to explore and describe the experiences of professional nurses regarding the implementation of the RPHC programme in the NMBHD and to make recommendations the district manager could use to address the research findings. The study used a qualitative, exploratory, descriptive and contextual design. The research population consisted of professional nurses who are implementing the RPHC programme in the NMBHD, and the sampling technique was a non-probability, purposive technique for the selection of the research sample. Semi-structured interviews were used to collect the data and Tesch’s model respectively. The researcher adhered to ethical considerations throughout the study and ensured trustworthiness of the data by using the criteria of credibility, transferability, dependability and conformability. Three themes were identified; namely; the professional nurses expression of their concerns regarding poor working conditions; issues regarding the community health workers and their positive experiences associated with the RPHC programme. The study concludes with recommendations made to the District manager with regard to nursing practice, as well as recommendations to nursing education and research.

Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.

Tuberculosis (TB) has re-emerged as a major worldwide public health challenge in the last decade with an increasing incidence amongst children. The diagnosis of TB in children is difficult as the presentation is not always classical and available diagnostic modalities are imperfect. Diagnosis is, especially complex in developing countries where resources and access to sophisticated diagnostic facilities are limited. Thus practical score charts combining a number of complementary clinical characteristics with affordable special investigations have been developed to aid diagnosis. The new South African primary health care (PHC) nurse-driven system demands that first line nurses be equipped to suspect, diagnose, confirm the diagnosis and treat children with TB. Very little is known about the ability of PHC nurses to diagnose TB in children. In Mpumalanga province relatively low rates of notified paediatric TB prompted an investigation to determine the ability of local PHC nurses to diagnose TB in children and explore whether the PHC setting allowed this. Within method triangulation was used in this quantitative descriptive study by combining a self-completed knowledge survey with clinic visits to audit records and assess access to diagnostic aids and tests. Important deficiencies in knowledge and limited access to certain diagnostic modalities found in this study must be addressed if appropriate management of TB in children is to be assured. / Health Studies / M. A. (Public Health)

The study explored professional nurses' experience of working in a remote rural hospital in the Eastern Cape Province. A qualitative phenomenological design was used and the study was conducted in a remote rural hospital in region `D'. Eight professional nurses were selected non-randomly from a population of professional nurses who had been working in the hospital for more than one year. Purposive sampling was used to select the participants and semi-structured phenomenological interviews were conducted to collect data. Colaizzi's eight-step method was used for data analysis. The themes that emerged from the data analysis were shortage of human and material resources, poor access, communication problems and lack of safety and insecurity. The study found that the professional nurses at the remote rural hospital experience many obstacles to quality service delivery. / Health Studies / M.A. (Health Studies)