All nurses should have the ability and disposition to engage in therapeutic relations with people who have learning disabilities. Therapeutic commitment is described as a therapeutic attitude that is influenced by nurses' perceptions of role competency and role support. It is essential to the provision of nursing care leading to improved patient outcomes. The study aimed to explore final year adult (AD), mental health (MH) and learning disability (LD) student nurses' perceptions of therapeutic commitment towards people with learning disabilities and the factors they perceived influenced it. A mixed method, convergent approach for complementarity and expansion purposes was used. A survey collected quantitative and qualitative data from 398 final year student nurses across four Higher Education Institutes in Scotland. Integrated findings suggested when caring for people with learning disabilities that student nurses are therapeutically committed, with LD student nurses' perceptions being greater than their counterparts. LD student nurses also perceived greater role competency and reported they could access experienced support more readily. Having education, a personal experience, the opportunity to provide care whilst on clinical placement and previous work experience with people with learning disabilities influenced the therapeutic commitment and role competency all students perceived. Other influencing factors included receiving thanks, being challenged by the task and the attitudes and qualities held by the nurse. Some AD and MH student nurses believed that people with learning disabilities characteristics negatively influenced their therapeutic commitment. This study has implications for nursing practice and education as it builds on the theory of therapeutic commitment, providing new knowledge of the factors that influence it, either positively or negatively when caring for people with learning disabilities. This knowledge will support nurses to engage in positive therapeutic relationships with people with learning disabilities to enhance the delivery of nursing care.

This thesis has explored the characteristics, in terms of masculine traits on the Bem Inventory that student nurses in a diploma nursing program believed their role models in nursing possessed. In the study, student nurses nearing the end of their basic nursing education selected a greater number of masculine traits for their role models than did student nurses beginning their basic nursing education.The thesis also explored the position of the students' role model. Student nurses nearing the end of their basic nursing education more frequently identified staff nurses as their role models, followed in frequency by supervisors and nursing faculty. Student nurses beginning their basic nursing education more frequently identified nursing faculty as role models, followed in frequency by staff' nurses.Ball State UniversityMuncie, IN 57406

Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--University of Michigan, 1982.

M.Cur. (Professional Nursing Science: Nursing Management) / The history of nursing focuses almost exclusively on a female-dominated profession, created with the assumption that such a role is inherently natural to women only. Yet, men have worked as nurses since the profession’s infancy, 250 BC, but their contributions seem to be unnoticed and underrepresented. Male nurses ascribe to a minority status within the nursing profession, with only 6.8% currently registered with the South African Nursing Council. Men who enter the nursing profession will fall victim to prejudice, stereotyping, role strain and isolation (often referred to as the islands in nursing). International literature provided significant evidence that men are well served with nursing as a career. It is unclear how South African male professional nurses experience nursing as a career in the light of the deterring factors mentioned previously. The purpose of this qualitative, exploratory, descriptive and contextual study was to explore and describe the experiences of male professional nurses regarding nursing as a career in a private hospital in Johannesburg in order to develop strategies to support them in their career. The target population consisted of male professional nurses working in all disciplines in the private hospital. A purposive sampling technique was used. Data were collected by means of four (4) in-depth, semi-structured individual interviews, five (5) naïve sketches and field notes until data saturation was obtained. Data analysis was done by following Tesch’s open coding strategy (Creswell, 2013:158). The data obtained was incorporated into existing literature during the conceptualisation phase of this study. Trustworthiness of the study was ensured by employing the model promulgated by Denzin & Lincoln (2005:290 – 326), focussing on credibility, transferability, conformability, dependability and authenticity. The principles of ethical considerations, as suggested by Dhai & McQuoid-Mason (2010:14 – 15) pertaining to privacy, confidentiality, anonymity, informed consent and beneficence were applied in this study.

The central objective of the study was to better understand 5th and 6th year school pupils’ perceptions of nursing as a career choice and to obtain current data regarding the recruitment situation pertaining to school leavers pursuing nursing as a career choice. This was achieved by utilising a multi-strategy approach which involved the use of a self-administered questionnaire (n = 1062) and the interviews of 20 paradigmatic cases. The school pupils came from 11 schools, with different socio-demographic profiles, from one educational area in Scotland. The study found that only 8.8% (n = 56) of school pupils who had made a career choice had chosen to pursue nursing as a career, despite the fact that 82.4% of the school pupils in the sample had the necessary academic qualifications to enter the student nurse education programme. Merely 21.2% of all the pupils had actually considered nursing as a career choice. The findings would appear to suggest that those pupils who had chosen to pursue nursing as a career choice are committed to this choice. As 93% of the pupils would still continue to pursue nursing as a career choice even if they obtained better grades in their examinations than they expected. Equally resolute in their choice were the pupils who had chosen not to pursue nursing. Of the school pupils in the sample who had not chosen to pursue nursing as a career choice 88.5% of the school pupils stated that even though they did not get the exam grades that they expected they still would not pursue nursing as a career. What was also significant was that of the school pupils who had not chosen nursing as a career choice 86.9% of the pupils stated that they would not consider nursing as a career option in the future. The gender breakdown of school pupils who had made a career choice showed that 2.5% of male pupils who had made a career choice had chosen to pursue nursing. 14% of female school pupils who had made a career choice had chosen to pursue nursing. Further examination in relation to the gender breakdown of those pupils who had chosen to follow nursing as a career revealed that males only accounted for 12.5% whereas females accounted for 87.5%. This would seem to propose that a gender bias still exists in relation to nursing as a career choice. Nursing was not ranked particularly highly by the pupils as a career choice. Male pupils ranked nursing 13th out of the 14 main career choice categories. While female pupils ranked nursing 8th out of the 14 main career choice categories, this being only slightly better than secretarial/administration. Parents appeared to have a major influence on the pupils’ career choice and there was evidence that parents as well as further significant others were influencing against a career in nursing. Nursing does not seem to be a popular career choice among school pupils. There is strong evidence from the questionnaire data to suggest that there are a number of problem indicators which could propose that recruitment of school pupils into nursing could prove extremely difficult even with the proposed increase in the number of school leavers entering higher education. This could have a serious impact on nursing care delivery within the United Kingdom as the nursing population continues to age. The paradigmatic cases interviewed were 20 high academic achieving school pupils who at one stage in their career choice process had considered nursing as a career choice. Despite considering nursing as a possible career choice none of the 20 pupils went on to pursue nursing as a career. The qualitative interview findings appeared to suggest that nursing was not a credible career choice consideration for high achieving pupils. There was a very strong feeling amongst the pupils that nursing would be a waste of their academic qualifications with a belief that nursing was not a career choice for intelligent pupils with good examination grades. Also that they could help people at a much higher level than nursing by becoming a doctor with a prevailing belief that knowledge and caring are polarised – doctors cure and nurses only care for patients. The status of nursing as a career choice was not high amongst the pupils and this was influenced by the type of person that they had observed who were nurses mostly, in their opinion, women who were weak and had no power within society. Also the perceived nature of the job that nurses do with the prominent belief that what nurses do is principally practical in nature having no intellectual aspects, for example making beds, washing and feeding patients. The influence of significant others, these being specifically parents, guardians, guidance teachers and careers advisors was very apparent in the data in that they had a very negative view regarding nursing as a career choice for high academic achieving school pupils. Participants reported that their parents were actively and vigorously discouraging them away from a career in nursing because of the pupils’ good examination grades and the belief that the pupils could do something better than nursing. Also the participants reported that their guidance teachers and careers advisors were assertively steering them away from nursing as a career choice because of their perception that nursing was a low status career choice requiring little intellectual ability and was on a par with hairdressing, office work and being a secretary. In addition the school pupils stated that guidance teachers and careers advisors were more interested in and attempted to have a greater influence on the career choice of the high academic achieving school pupils opposed to other less academic pupils. Only two of the pupils stated that they believed that their career choice was their own decision. With the majority of school pupils valuing the opinion of their parents regarding career choice and with parents along with associated significant others being a major influence on the school pupils’ career choice and advising against a career in nursing. There was strong evidence from the interview data to suggest that the chances of recruiting high academic achieving school pupils into nursing would appear to be negligible. There was also evidence that the image of nursing as an occupation was an important determining factor in the school pupils’ career choice. The pupils displayed a negative image of nursing and this was influenced by a number of factors. The negative image of nursing depicted in television programmes; the negative image of nursing portrayed by people who are nurses; the sexual stereotype image of female and male nurses; and the image that it is very easy to get into train to be a nurse. What was also concerning was that the pupils had few positive and contemporary images of nursing. Also with regard to the image of nursing the data showed that the pupils considered it important to join a profession. Nursing was deemed not to be a profession and did not merit being a profession because it was believed that the entry to student nurse education programmes is not strictly controlled therefore it is easy to get into nursing. There was a strong consensus among the high achieving school pupils regarding their image of the archetypical school pupil who would select nursing as a career choice – their view was of a predominantly unexceptional individual who was mostly female, no more than average intelligence, kind, caring, good listener, good practically and can follow task orders. This view of the typical school pupil who would enter nursing as a career, that of a person with a low academic achievement record, conflicts with their own personal typology and thus became a further important dissuading factor regarding nursing as a career choice for them.

All professions have practitioners who are considered to be experts. Less is known, however, about how these people achieve this level of excellence and about the factors that influence the attainment of expert practice in any profession. Using acknowledged expert nurses as a focus, this dissertation explored and evaluated the following factors that the literature suggested affect the progression from novice to expert: information-processing, problem-solving, and intuition abilities: mentors and mentoring: motivation and education: experience: and institutional incentives. An additional factor -- intrinsic motivation, which was not identified a priori, emerged in the course of the research. The conceptual framework used for this study was the novice-to-expert progression developed by Dreyfus & Dreyfus and applied to nursing by Benner. Benner's framework comprises novice, advanced beginner, competent, proficient, and expert. A qualitative case study method was used employing in interviews of ten clinical nurse specialists (CNSs). Data analysis was conducted following standard procedures for qualitative descriptive analysis. The study demonstrated that all of the CNSs progressed through each of Benner's stages during their careers. The following factors were identified as influential in their achieving expertise: information-processing and problem solving; mentors and mentoring; motivation and education; experience; intrinsic motivation. Institutional incentives and intuition played very weak roles and were not considered influential in achieving expertise, although the CNSs stated that the latter was an important element of their practice. This study has several implications for practice and research. With respect to practice, there is a clear need for mentoring programs, graduate education, internship programs, a stronger emphasis on experience, and policies to assure patient assignments are correlated with the level of the practitioner. Further research is suggested on all factors identified, especially the clinical ladder. The study contributes to adult education theory by clarifying the factors which foster the attainment of expertness, and to practice by suggesting areas in which interventions and innovation might be effective. / Ph. D.

Emergency nursing is an evolving field in Kenya with the Nursing Council of Kenya (NCK) yet to list it as a speciality area. This study wished to identify and describe the core competencies that should be included in an emergency nurse training programme based on the views of nurses and doctors who work in emergency units in a level 1 hospital in Nairobi, Kenya. The researcher used qualitative explorative and quantitative descriptive designs in phases 1 and 2, respectively, and convenience and purposive sampling. The study found that the respondents emphasised the inclusion of 137 (93.2%) of the 147 skills in the questionnaire as core competencies and disagreed with 10 (6.8%). Concomitantly, the vast majority of the respondents (93.6%) supported the inclusion of the skills compared to those (6.3%) that did not. Based on the findings, the researcher made recommendations of the core competencies to be included in the programme. / Health Studies / M.A. (Health studies)

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Emergency nursing is an evolving field in Kenya with the Nursing Council of Kenya (NCK) yet to list it as a speciality area. This study wished to identify and describe the core competencies that should be included in an emergency nurse training programme based on the views of nurses and doctors who work in emergency units in a level 1 hospital in Nairobi, Kenya. The researcher used qualitative explorative and quantitative descriptive designs in phases 1 and 2, respectively, and convenience and purposive sampling. The study found that the respondents emphasised the inclusion of 137 (93.2%) of the 147 skills in the questionnaire as core competencies and disagreed with 10 (6.8%). Concomitantly, the vast majority of the respondents (93.6%) supported the inclusion of the skills compared to those (6.3%) that did not. Based on the findings, the researcher made recommendations of the core competencies to be included in the programme. / Health Studies / M.A. (Health studies)