Descriptive surveys were employed to investigate the competencies of newly qualified nurses (NQNs) as viewed by senior professional nurses (SPNs). The study used questionnaires for collecting data. Questionnaires were delivered by the researcher and also collected by the researcher after completion. SPNs working at thirteen hospitals, that is, six in the former Gazankulu, three in the fonner Venda, and four in the form.er Lebowa health services (falling within the Northern Province of the RSA since April 1994) constituted the subjects of this study. Scientific sampling techniques were not employed as the total population of 396 SPNs was studied. This study obtained responses from 259 SPNs. Findings indicated that specific cognitive, affective and psychomotor competencies were expected ofNQNs upon entering the work setting, as perceived by SPNs. NQNs were perceived to be competent in performing numerous, but not all, clinical competencies which were outlined in the four groups' questionnaires. Application of stages of the nursing process (problem solving and clinical judgement), research, management and administration of a clinical unit, nursing ethics and critical care were perceived by the SPNs to be the central focus ofNQNs' incompetency in all four clinical nursing units, namely community, psychiatric, midwifery and general units. Nevertheless, SPNs were aware that they should provide guidance and support to NQNs. An attempt to elicit SPNs' views on the competencies NQNs should have in the practical situation, could benefit NQNs at grassroots level. Such information could provide curriculum developers with realistic input which would assist in the delineation and refinement of the professional competencies expected of nurses trained in the comprehensive course leading to registration as a nurse (general, psychiatric, and community) and midwife. The identified competencies could improve the quality of care and the nursing standards if they could be mastered by NQNs in the health services included in this research. On the basis of these research findings, the expected competencies, which were perceived by the SPNs to be incompetently performed by NQNs, were used to compile an orientation list of competencies to be mastered by NQNs in their first professional position (Annexure D). / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)

The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)

Submitted in fulfilment of requirements for the Degree of Masters in Technology: Nursing, Durban University of Technology, 2013. / Introduction : Empirical research pertaining to spirituality has grown in the Western context, with a myriad studies, that have documented the salience of spirituality to health and wellbeing in relation to a range of issues such as HIV/AIDS, cancer and heart disease (Koenig et al. 2001:1189). It is against this backdrop that nursing scholars have begun to research the role of spirituality and spiritual care in nursing practice, in the Euro-American context. In South Africa research in this field is sparse, hence prompting the need for the current study. Problem statement : There is a huge gap in the South African nursing literature on spirituality and spiritual care, grounding the need for research in this area. Internationally however studies have grown focussing on the views of practitioners and faculty with regard to spirituality and spiritual care in nursing practice. Objectives : To explore the views of nurses at public hospitals in KwaZulu-Natal regarding the role of spirituality and spiritual care in nursing practice. To investigate nursing practitioners’ views on the salience of spirituality to patients. To investigate whether nurses utilize spiritually based activities in nursing. To investigate whether current nursing education and training has prepared nurses for spiritual care. Methodology : The study utilized a descriptive survey utilizing a cross-sectional design. A quantitative research design was utilized to survey nursing practitioners at selected public hospitals through a process of multiphase random sampling. Data was collected using survey questionnaires. Findings : Findings of this study have shown that nurses do accept spirituality and spiritual care as being part of their role. Participants (n=385) acknowledged that spiritual care is a component of holistic patient care. This aspect of care, they agreed, lacks the attention it seriously needs. In addition, majority of nurses considered nursing to be part of their spiritual path. Results indicated that the more spiritual nurses viewed themselves, the more positive their perspectives were towards providing spiritual care.

The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings / Health Studies / M.A. (Health Studies)

Thesis (MCur) -- University of Stellenbosch, 2005. / ENGLISH ABSTRACT: A non-experimental descriptive study was conducted in four prisons in the Western Cape. The research focussed on the standard of care within primary health care settings in the purposively selected prisons. No official written standards existed to measure the quality of care. After an in-depth literature study, structure, process and outcome standards were formulated and validated. The main findings of the study indicated that: • Standards in these three dimensions of care did not meet the pre-set level of performance as determined by the researcher; • The clients were generally satisfied with the hygiene in the clinics; • Aspects of concern were the lack of explanation offered to the clients before and after consultations and nursing care interventions. The researcher recommends the implementation of a comprehensive quality care model for the health care of the prisoners with adequate human and nonhuman resources Core words: Qualtiy care, Correctional services health care, Nursing care in prisons. / AFRIKAANSE OPSOMMING: "n Nie-eksperimentele beskrywende studie is in vier gevangenisse in die Wes- Kaap uitgevoer. Die navorsing het gefokus op die gehalte van sorg binne primere gesondheidsorgomgewings in die doelbewuste geselekteerde omgewings. Geen amptelike geskrewe standaarde om die gehalte van sorg te meet, het bestaan nie. Na 'n in-diepte literatuurstudie is struktuur-, proses- en uitkomsstandaarde geformuleer en gevalideer. Die belangrikste bevindings van die studie het aangedui dat: • Standaarde in hierdie drie dimensies van sorg het nie aan die voorafbepaalde vlak van sorg voldoen het nie soos deur die navorser bepaal is; • Die kliente was oor die algemeen tevrede met die higiene in die klinieke; • Kommerwekkende aspekte het ingesluit die gebrek aan voldoende verduidelikings aan kliente voor en na konsultasies en verpleegintervensies. Die navorser bevel aan dat In omvattende gehalteversekeringsmodel vir die gesondheidsorg van gevangenes ingestel word met voldoende beskikbare mensen ander hulpbronne. Kernwoorde: Gehaltesorg, Korrektiewe dienste gesondheidsorg, Verpleegsorg in gevangenisse.

Thesis (MBA)--University of Stellenbosch, 2011. / Healthcare systems of the world’s poorer nations have been heavily impacted by economic globalisation. This has resulted in a steady deterioration of working conditions, resulted in less job security and has led to an increase in the spread of communicable diseases in developing countries such as South Africa. It is factors such as these, against the backdrop of a global recession, that have contributed to the escalation in global healthcare costs which has itself augmented the strain on already strained hospital resources in developing economies (Issues paper: Economic Globalisation, 2009). The current workplace faces complicated challenges which extend beyond the effects of the global recession. One of these challenges is the task of managing the diversity of the modern day workforce. This includes differences in gender, race, religion, culture, language, physical and mental ability, sexual orientation as well as generational differences. As a result, organisations that choose to exploit these differences are able to leverage a competitive advantage from them. This ability is however determined by the flexibility of organisations’ policies and practices. Furthermore, adapting an organisation’s human resource policies and practices pertaining to attracting, retaining, developing, promoting and managing a generational diverse workforce is only possible once these cohorts have been clearly identified, analysed and understood (Manion, 2009). Nurses are the pillar of healthcare systems throughout the world. In South Africa, however, the high staff turnover of nurses compared to the relatively small number of new recruits is of great concern due to its impact on the South African government’s capacity to provide a healthcare model of sustainable service delivery (Mokoka, 2007). The reality of the decline in the number of newly qualified nurses was clearly evident in the results of this study. Twenty-eight percent of the current community service nurses had previously considered leaving the profession, eight percent reported that they were considering leaving the profession within the next year and 20 percent intended leaving the public health sector after completing community service. The purpose of this qualitative study was to determine factors that preclude better remuneration that would influence community service nurses’ decision to remain employed in the public health sector. According to the Western Cape Nursing directorate, 270 nurses were registered to complete community service in the Western Cape in 2010. The 25 registered nurses who were scheduled to complete community service at Groote Schuur Hospital at the end of 2010 constituted the study sample. A self-administered questionnaire was used as the instrument for data collection from this fixed, convenient sample. Confidentiality of the participants was assured throughout the study and findings were reported as combined facts and figures using histograms. The majority of the participants were between the age of 20 and 25 years (48%). Furthermore, 88 percent of the participants were below the age of 35 years, largely representative of Generation X and the Millennials, Generation Y. The results of this study suggested an extremely complex interplay between intrinsic and extrinsic motivators, in influencing the decision of whether or not to remain employed in the public health sector. It was further evident that most of the factors that were rated to be of high importance were strongly self-centred, largely geared at personal reward and recognition. This finding is in clear agreement with literature published by Manion (2009) who supports the thinking that generations representative of Generation X and Y have a strong need for personal achievement and reward. Eighty percent of participants indicated a dire need for hospital management to recognise and manage generational diversity in the current workforce as this presented a daily challenge in the workplace. It was perceived that fundamental differences in needs, work ethic and values exist between Generations X and Y, compared to those of nurse and hospital managers who were representative of Baby Boomers. Consequently, there appeared to be a mismatch in the expectations and opportunities presented in the current workplace among the three generations. These findings merit further discussion on whether the permanent multi-disciplinary team at hospitals understand the influential role that they have on the complex task of retaining community service nurses in the public health service. Furthermore, 92 percent of community service nurses highlighted the need for mandatory orientation and induction programmes in each ward prior to commencing duty. This in itself was identified as a huge cause for anxiety and discord. In conclusion, even though this study was designed to establish factors that preclude better remuneration which could influence the decision of community service nurses to remain employed in the public health sector, it found that more than half the participants of this study recommended that receiving a more competitive salary was still an important issue for government to prioritise. However, it did not appear to be the overshadowing theme of dissatisfaction amongst community service nurses.

The aim of this study was to capture nurses’ experiences and reality of practice in order to understand their views on National Health Insurance (NHI) policy. A hermeneutic phenomenological research design was used to collect data from professional nurses working at Embuleni Hospital in the Gert Sibande District of Mpumalanga province. A sample of 10 professional nurses was included in the study and semi-structured interviews were used to collect data which was analysed following van Manen’s (1990) approach. The results revealed that professional nurses are of the view that the policy on management of hospitals is the source of health system problems which have caused inequalities and insufficient management of rural hospitals, thus affecting their efficiency in service delivery. However, the study revealed that professional nurses viewed the same policy in the light of national core-standards which they use as an objective tool for the purpose of monitoring their practice. The findings present an opportunity for policy makers to use evidence-based knowledge in realigning policy for relevance, bringing nurses on board in the policy process and understanding the key constituents of policy content. / Health Studies / M. A. (Public Health)

The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis (MCom)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: South Africa has a population of just over 50 million people. However, there are only approximately 260 698 nurses according to the register of the South African Nursing Council. The nursing shortage is not only limited to South Africa, but is a global phenomenon, and this shortage is getting worse every day. Various factors can be blamed for the increasing nursing shortage. Every day nurses face demanding working hours, stressful work environments and a large shortage of resources. Nurses from private hospitals regard themselves as "overworked money-making machines". Nevertheless, the health care needed by the population of South Africa is rapidly increasing. The high prevalence of HIV/AIDS is also a challenging contributor, worsening the nursing shortage crisis. The current dysfunctional nursing situation in the healthcare facilities of South Africa reflects a negative image of the nursing profession. Consequently, the number of individuals considering nursing as a profession is decreasing. The nursing shortage is not only a threat to the wellbeing of nurses, but to the lives of millions of South Africans who need health care. A common phenomenon amongst nurses is burnout, which leads to decreased quality of care and high turnover rates and contributes to the nursing shortage. Also, other nurses experience work engagement and display organisational citizenship behaviour in the same working environments than the nurses who experience burnout. Work engagement (WE) and organisational citizenship behaviour (OCB) are ideal outcomes. This study investigated distinguishing factors between nurses that allow them to experience WE and exhibit OCB. The Job Demands-Resources model played an integral role in the study. Therefore, the specific focus of the study was job and personal resources, as well as job demands, as factors contributing to WE and OCB amongst nurses. Servant leadership (SL) as job resource, psychological capital (PsyCap) as personal resource, and IT (Illegitimate tasks) as job demand were identified as possible factors that explain the variance in WE and OCB. A literature review was conducted in which prominent antecedents of WE and OCB were identified. A number of hypotheses were formulated and tested by means of an ex post facto correlation design. The unit of analysis was nurses from two of the largest private hospital groups in South Africa. The nurses were employed at one hospital in Gauteng and three hospitals in the Western Cape. Data was collected from 208 nurses located within the chosen hospitals. Data collection on all five variables, namely work engagement, organisational citizenship behaviour, servant leadership, psychological capital and IT, was conducted by means of self-administered questionnaires. The measurements included in the self-administered questionnaire were selected in terms of their validity and reliability. The following measurements were included; Utrecht Work Engagement Scale (UWES), Organisational Citizenship Checklist (OCB-C), Servant Leadership Questionnaire (SLQ), Psychological Capital Questionnaire (PCQ) and the Bern Illegitimate Task Scale (BITS). The data collected was analysed by means of item analyses and structural equation modelling. A PLS path analysis was conducted to determine the model fit. The most significant findings were that SL, as a job resource, and PsyCap, as a personal resource, were positively related to WE amongst nurses. The results also revealed that PsyCap was positively related to OCB. Lastly, it was found that IT, as a job demand, are negatively related to WE amongst nurses. These results support the assumptions of the JD-R model that specific job and personal resources lead to WE. The results provide guidelines regarding practical managerial implications and strategies to address the challenges experienced by nurses. The results, together with the managerial implications, made it possible to provide valuable insights and recommendations for industrial psychologists, as well as for further studies. / AFRIKAANSE OPSOMMING: Suid-Afrika het ‘n bevolking van net oor die 50 miljoen mense. Daar is egter volgens die register van die Suid-Afrikaanse Verpleegkunderaad net omtrent 260 698 verpleërs. Die tekort aan verpleërs is nie net tot Suid-Afrika beperk nie, maar is ‘n globale fenomeen, en die tekort word elke dag groter. Verskeie faktore kan vir die toenemende verpleërtekort blameer word. Verpleërs word elke dag gekonfronteer met veeleisende werksure, stresvolle werksomstandighede en ‘n groot tekort aan hulpbronne. Verpleërs by privaat hospitale beskou hulleself as “oorwerkte geldmaakmasjiene”. Nietemin neem die gesondheidsorg wat deur die Suid-Afrikaanse bevolking benodig word, vinnig toe. Die hoë voorkoms van MIV/VIGS is ook ‘n uitdagende bydraer wat die verpleërtekort vererger. Die huidige wanfunksionele verpleegtoestand in die gesondheidsorgfasiliteite van Suid-Afrika word weerspieël in die negatiewe beeld van die verpleegberoep. Gevolglik verminder die getal mense wat verpleging as ‘n beroep oorweeg. Die verpleërtekort bedreig nie net die welstand van verpleërs nie, maar ook die lewens van miljoene Suid-Afrikaners wat gesondheidsorg benodig. ‘n Algemene verskynsel onder verpleërs is uitbranding (burnout), wat lei tot ‘n afname in die kwaliteit van sorg en hoë omsetkoerse en bydra tot die verpleërtekort. Ander verpleërs ervaar egter werksbetrokkenheid (work engagement) en vertoon organisatoriese burgerskapsgedrag (organisational citizenship behaviour) in dieselfde omgewing waar verpleërs uitbranding ervaar. Werksbetrokkenheid en organisatoriese burgerskapsgedrag is ideale uitkomstes. Hierdie studie het onderskeidende faktore onder verpleërs ondersoek wat hulle toelaat om werksbetrokkenheid te ervaar en organisatoriese burgerskapsgedrag te vertoon. Die model van werkseise en hulpbronne (Job Demands-Resources (JD-R) model) het ‘n integrale rol in die studie gespeel. Die spesifieke fokus van die studie was dus op werks- en persoonlike hulpbronne, sowel as werkseise, as faktore wat bydra tot werksbetrokkenheid en organisatoriese burgerskapsgedrag onder verpleërs. Dienaarleierskap en sielkundige kapitaal as werkshulpbronne, en illegitieme take as werkseis, is geïdentifiseer as moontlike faktore wat die verskil in betrokkenheid en organisatoriese burgerskapsgedrag verklaar. ‘n Literatuuroorsig is onderneem waarin belangrike antesedente van betrokkenheid en organisatoriese burgerskapsgedrag geïdentifiseer is. ‘n Aantal hipoteses is geformuleer en deur middel van ‘n ex post facto korrelasie-ontwerp getoets. Die eenheid van analise was verpleërs werksaam by twee van die grootste privaathospitaalgroepe in Suid-Afrika. Die verpleërs was werksaam by een hospitaal in Gauteng en drie hospitale in die Wes-Kaap. Data is by 208 verpleërs in die gekose hospitale versamel. Dataversameling oor al vyf veranderlikes, naamlik werksbetrokkenheid, organisatoriese burgerskapsgedrag, dienaarleierskap, sielkundige kapitaal en illegitieme take, is deur middel van selftoepasvraelyste versamel. Die volgende metings is ingesluit: Utrecht Work Engagement Scale (UWES), Organisational Citizenship Checklist (OCB-C), Servant Leadership Questionnaire (SLQ), Psychological Capital Questionnaire (PCQ) en die Bern Illegitimate Task Scale (BITS). Die versamelde data is deur middel van item-ontleding en struktuurvergelykingsontleding geanaliseer. ‘n Gedeeltelike kleinstekwadrate-baananalise (partial least squares path analysis) is onderneem om die passing van die model te bepaal. Die belangrikste bevindinge was dat dienaarleierskap, as ‘n werkshulpbron, en sielkundige kapitaal, as ‘n persoonlike hulpbron, positief verband hou met werksbetrokkenheid onder verpleërs. Die resultate toon ook dat sielkundige kapitaal positief verband hou met organisatoriese burgerskapsgedrag. Laastens is bevind dat illegitieme take, as ‘n werkseis, negatief verband hou met werksbetrokkenheid onder verpleërs. Hierdie resultate ondersteun die aannames van die model van werkseise en hulpbronne (J-DR) dat spesifieke werks- en persoonlike hulpbronne lei tot werksbetrokkenheid. Die resultate verskaf riglyne vir praktiese bestuursimplikasies en strategieë om die uitdagings wat deur verpleërs ervaar word, aan te spreek. Die resultate, tesame met die bestuursimplikasies, het dit moontlik gemaak om waardevolle insigte en aanbevelings vir bedryfsielkundiges, asook vir verdere studies, te maak.

Recognising the enormous challenges in South Africa confronting the nursing of the mentally ill, the project was conducted in a public hospital in Gauteng. The purpose of the research was to describe professional nurses' perception of nursing mentally ill people in a general hospital setting and was carried out amongst a sample size of 124 professional nursing staff using a self-administered tool. The study looked at four different types of perceptions guided by categories of conceptual framework proposed by Mavundla (2000:1569-1570), namely perception of self, perception of patients, perception of environment and perceived feelings. The study found that the majority of professional nurses have a predominantly positive self- perception of nursing mentally ill people in a general hospital, although a significant number have a negative perception of patients, the nursing environment and perceived feelings. Lack of knowledge, skill and experience affect the nursing care of mentally ill people in the general hospital. / Health Studies / M.A. (Health Studies)