A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are:  to identify strategies which nurses use to cope with the changes in the health care services;  to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and  to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses:  team-work and support;  to voice your opinion when necessary and good communication between staff;  regular breaks during working hours;  inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope;  family support;  the provision of quality care is rewarding;  the assistance and support from the church (congregation);  the effective re-organisation of health services;  continuous support programs for staff; and  continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

Dissertation submitted in fulfillment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2011. / Background Working in the intensive care unit can be traumatic for nursing personnel. Critical care nurses are faced with repeated exposure to death and dying as they are involved in caring for patients who are actively dying or who have been told that they have a terminal illness and are faced with the possibility of impending death. Critical care nurses relate in different ways to the phenomena of death and dying within their nursing profession and their scope of practice. These nurses often have a difficult time coping with the stress that comes with caring for those who are dying or relating to loved ones of those that are dying. Aim of the study The aim of the study was to explore the critical care nurse’s experiences of death and dying. Methodology A qualitative, descriptive phenomenological approach was used to guide the study. Four nurses were recruited and rich descriptions of their experiences were gained through individual face-to-face interviews. One broad question was asked: ‘What are your experiences regarding death and dying of your patients in ICU?’ iii Results The findings of this study revealed that issues such as communication, multicultural diversity, education and coping mechanisms relating to caring for the critically ill and dying patient are essential in nursing education and practice. Critical care nurses need to have support networks in place, not only to assist in providing care, but also for their own emotional support / M

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are:  to identify strategies which nurses use to cope with the changes in the health care services;  to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and  to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses:  team-work and support;  to voice your opinion when necessary and good communication between staff;  regular breaks during working hours;  inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope;  family support;  the provision of quality care is rewarding;  the assistance and support from the church (congregation);  the effective re-organisation of health services;  continuous support programs for staff; and  continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received. / Health Studies / M.A. (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.

Abortion is a highly controversial subject that has again come into the spotlight in South Africa due to the legalisation of abortion on demand in 1996. The results of various studies conducted since the Choice on Termination of Pregnancy Act 92 of 1996 was implemented, have indicated that abortion providers have met with a great deal of negativism and ostracism. This study focused on the implications of abortion work on nurses' social relationships with family, friends, colleagues and their communities. Recent literature was reviewed on the subject. The researcher however, found little information on this specific aspect of abortion. The study was conducted with abortion nurses from two government designated hospitals in the East London area responsible for abortion services. Thus, results cannot be generalised. This is a qualitative study that aimed at obtaining firsthand information regarding the personal experiences of abortion nurses. A non-probability sampling technique was used viz. criterion sampling. The Interview Guide Approach was used whereby in-depth, semi-structured interviewed were conducted with the guidance of a set of questions in the form of an Interview Schedule. The ten respondents were asked to share their recommendations as to possible measures that could address the challenges mentioned during their interviews. The researcher came to the conclusion that nurses' social relationships and lives are definitely impacted by abortion work. This impact is largely negative as the majority of respondents experience labelling, stigmatization and ostracism from family, friends, and their colleagues. Abortion nurses also experience a lack of social support, ambivalent feelings with regard to abortion, and a range of negative emotions ranging from stress and depression to frustration and anger. A number of repeat abortions are being done and there seems to be a general lack of contraception. The need exists for nurses to go to Value Clarification Workshops and also to get support in terms of compulsory, continuous, counselling. Separate wards should be set up for abortions whilst sex education should be included in school curriculums at both primary and secondary schools. Family planning and facts about the abortion process should also be included in these sex education programmes. Overall. the need exists for family planning initiatives to promote contraception and deter women from using abortion as a means of contraception. As this study reveals, conducting abortions has come at a great cost for the majority of nurses who lack social support and bear the brunt of anti-abortion sentiment expressed by significant others in their lives. The latter being the people who would normally be the one's they would turn to for help, counsel, support and assistance

Divorce is a phenomenon that affects the emotional, physical and social wellbeing of the divorcees and those close to them. The situation becomes complicated if the affected person has a responsibility of providing caring and nurturing services to the sick, either as a manager or as a practitioner. The extent of how the impact of divorce affects the performance of professional nurses in their roles as carers and as managers was unknown. The nature and quality of services that they render to their patients, their coping strategies and the support systems were unknown. The purpose of the study was to describe and explore the impact of divorce on work performance of professional nurses at the East London Hospital Complex with the aim of ensuring high quality patient care. The objectives of the study were to: explore and describe the lived experiences of female divorced professional nurses with regard to the impact of divorce on their work performance; identify their coping strategies and their support systems. An exploratory descriptive and contextual qualitative research design was used. A phenomenological approach was used. The participants were twelve (12) divorced female professional nurses. The purposive and snowball sampling as non-probability sampling techniques were used. An interview guide was used to conduct the interviews. Audiotape was used for recording the data. Tesch’s steps (1990) of analyzing qualitative data guided the data analysis process. According to the lived experiences of the participants, divorce is traumatic and painful with emotional, physical, financial and social impact. It had a negative impact on the professional nurses’ work performance. The coping strategies included acceptance of the reality, studying, involvement with club and church activities. Support was available from the families, church, friends, and colleagues. Recommendations are that: the employee assistance program be marketed more effectively by hospital management and be included in the hospital, departmental and unit orientation programmes; that a dedicated psychologist, as well as preventive intervention programs, be made available to employees dealing with divorce.

The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received. / Health Studies / M.A. (Health Studies)

The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. / Health Studies / MA (Health Studies)