Thesis (M.Sc. (Curations)) --University of Limpopo, 2015 / The purpose of the study was to determine the experiences of professional nurses with ethical dilemmas at the Witbank hospital Nkangala district Mpumalanga province. The objectives of the study were to describe the experiences of professional nurses with ethical dilemmas in nursing practice and to determine supportive measures to help professional nurses to deal with ethical dilemmas encountered in nursing practice. The research question was: what are the ethical dilemmas that professional nurses experience in nursing practice? Kohlberg theory of moral development was used as a theoretical framework. A qualitative exploratory, descriptive and contextual research design was used to describe the experiences of professional nurses with ethical dilemmas in nursing practice. Purposive sampling was used to sample fourteen (14) professional nurses. Data was collected using semi-structured interviews. Open-coding method of data analysis was used and four themes and sub-themes emerged. The study found that professional nurses experience ethical dilemmas related to death and dying, distribution of both human and material resources, respect of patients’ autonomy and the nurses’ rights. The study recommends continuous ethics education and the inclusion of ethics in nursing curricula, creation of a supportive working environment, knowledge and understanding of the pledge of service, Inter- disciplinary teams to discuss ethical issues, availability of ethics experts and ethics mentors in the wards.

Thesis (NCur (Nursing Science))--University of Stellenbosch, 2008. / The current shortage of nurses has reached crisis proportions in South Africa and the effects of decreased numbers of health professionals are enormous. This results in far-reaching consequences for the health industry. An increased use of less-skilled personnel, in an attempt to meet the health care needs, impacts negatively on quality care. Personnel are often utilised outside their scope of practice, creating a high-risk therapeutic environment for the patients and health care workers alike. Consequently, the nursing managers and employers of nurses are currently faced with major challenges in ensuring that the nurses practise their profession within a safe and healthy environment, and within the legal and ethical framework of the nursing profession. For the purpose of this study the researcher decided to explore legal and ethical aspects influencing the clinical practice of the nurse. Specific objectives were set for the study. • Are nurses functioning outside their scope of practice? • Do nurses exercise their nursing right? • Do nurses function within ethical and legal guidelines? • Do caregivers function as nurses? • Do nurses still believe in the nursing philosophy? • Are nurses exploited in their area of work? • How much overtime do nurses work? These objectives were met through an in-depth explorative descriptive research design with a quantitative approach to explore legal and ethical aspects in the nursing practice. A stratified sample was drawn of all categories of nurses in selected private hospitals in the Western Cape Metropolitan area. Through the use of a questionnaire, data was collected personally by the researcher. Data analysis techniques that were used were based on descriptive and explorative procedures. Data was compressed in frequencies, percentages, means and standard deviations. The Chi-square test was applied. Findings include the following: • 53% of enrolled nursing assistants do not function under indirect supervision. • 40% of caregivers assist nurses with interventional nursing care. • Nurses still believe in the philosophy of the nursing profession. • The nurse’s rights are in contradiction with the patient’s rights (p = 0.08). • Nurses feel exploited in certain areas of work, depending on their qualifications. • Nurses do recommend the profession (p = 0.043). • Enrolled nursing assistants do not respect other religions (p = 0.04). • Nurses feel free to discuss the patient’s progress with the doctor depending on the nurses’ years of experience (p = 0.03). • 23% of nurses love to care for their patients. Recommendations were made based on the findings. • The patient approach should be respectful, not judgemental, accepting the patient’s right to self-autonomy. • Nurses should realise their autonomous role in addressing concerns. • A staff mix should be utilised that facilitates safe and professional nursing care. • Unfavourable or unsociable working conditions in some units such as the theatre should be addressed. • Managers should match the work load with a proper skills mix and competency. • Nursing practice should take place within the professional and statutory scope of practice of the nurse. • Nurses should keep up to date with knowledge through continuous professional development. • Caregivers should be regulated, installing the nursing philosophy and ethics into their practice.

The study explored moral and ethical dilemmas experienced by Black nurses in a local community clinic. In particular, it examined the influences of the concept of self or personhood in nurses' ethical and moral decision-making. Influences of culture and family on morality were also investigated. Using the interview methodology developed by Gilligan (1982), nurses were asked to tell stories involving moral dilemmas in their work. Interviews were analysed using the voicecentred relational method. This method involves reading the interview narratives a number of times, each reading focusing on a particular aspect of a respondent's narrative. Results show that nurses often find themselves caught between two opposing moral and ethical viewpoints in their practices. On the one hand are hospital procedures, which are informed by universalist approaches to the person and the moral. From these are derived ethical principles emphasizing individual autonomy and choice. On the other hand, the majority of patients subscribe to a communal view . ofpersonhood. From this perspective, to be moral entails knowing one's position and responsibilities within family and community. Dilemmas arose from nurses' identification with patients' moral perspectives while realizing that this could lead to "unethical" conduct, (given , their training and current codes of ethics). It is recommended that moral and ethical deiiberations should dialogue with alternative, marginalised, viewpoints, in order to be culturally responsive. It is further recommended that ethics be conceptualised as a practical-moral engagement, rather than a detached application of knowledge. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.

Transcultural nursing refers to the provision of nursing care to patients whose values, beliefs and life-style differ from those of the nurse. To enable nurses to honour their ethical obligation to provide quality care, they must have the necessary knowledge to nurse patients across cultural boundaries. This study was conducted to determine the nurse's knowledge of and attitudes towards the culturally different patient. A questionnaire was used to collect the data. Although nurses see it as a challenge to nurse patients from different cultures, it was found that they do not have the necessary knowledge to provide culture-sensitive care. Other factors, such as the nurse's attitude towards culturally different patients, communication problems, mistrust, prejudice and a lack of understanding of cultural uses and traditions, contribute to the lack of culture-sensitive care. The nursing profession should pay attention to these problems. / Health Studies / Van Tonder, Sally / M.A. (Nursing)

A qualitative, non-experimental, explorative and descriptive research design based on the phenomenological philosophical tradition by Heidegger to broaden hermeneutics was conducted. The study was conducted at Umkhanyakude District to investigate the perspectives of eligible nursing students relating to the provision of spiritual care to patients. A purposive sample of 9 participants was recruited and consent form obtained. An unstructured interview guide, with a grand tour question, was used to conduct face to face individual interviews. The Thematic analysis and interpretative phenomenological method of analysis were employed until three themes, six categories and eleven subcategories emerged from the data. Data analysis revealed that nurses had difficulty to differentiate spiritual care from religious care. Commonly cited methods of providing spiritual care were prayer, reading sacred text and singing spiritual songs. Nurses still felt inadequately prepared educationally on how to provide spiritual care in nursing practice. Most of the participants provided spiritual care out of their own interest and not as part of their professional responsibility. Recommendations proposed that the matter be taken up by nurse managers to conduct related in-service education and mentoring programs and nurse educators to guide curriculum planning which evidently include spiritual care. / Health Studies / M.A. (Health Studies)

Transcultural nursing refers to the provision of nursing care to patients whose values, beliefs and life-style differ from those of the nurse. To enable nurses to honour their ethical obligation to provide quality care, they must have the necessary knowledge to nurse patients across cultural boundaries. This study was conducted to determine the nurse's knowledge of and attitudes towards the culturally different patient. A questionnaire was used to collect the data. Although nurses see it as a challenge to nurse patients from different cultures, it was found that they do not have the necessary knowledge to provide culture-sensitive care. Other factors, such as the nurse's attitude towards culturally different patients, communication problems, mistrust, prejudice and a lack of understanding of cultural uses and traditions, contribute to the lack of culture-sensitive care. The nursing profession should pay attention to these problems. / Health Studies / Van Tonder, Sally / M.A. (Nursing)

Mini-thesis submitted in partial fulfilment of the requirements for the degree Master of Technology: Public Management in the Faculty of Business at the Cape Peninsula University of Technology 2014 / Maternity service in South Africa faces particular problems in the provision of care to birthing mothers. Violence and abuse have been reported and maternity death rates are high, being related to inadequate provision of care (Myburgh, 2007:29). Ethical conduct plays a significant role in service delivery in Midwife Obstetrics Units (MOU) in general. This is of particular importance since every patient, especially pregnant women, should to be handled with the utmost care, respect and dignity. The research problem emanates from nurses’ behaviour towards patients in MOU labour wards, where women continue to be victims of abuse. Ironically, it is regrettable that they are abused by those who are supposed to be their advocates. The objectives of the study were to assess if nurses in MOU labour wards conduct themselves ethically when dealing with patients, to determine the perceptions of patients towards nurses during child birth stages, as well as to examine factors in maternity wards that may influence a nurse’s performance when dealing with patients. The study adopted the quantitative research method to answer the research question and data interpretation was based on statistical analysis. This method was deemed to be the most effective for collection of a large quantity of data and numerical (quantifiable) data is considered objective. A Likert-type questionnaire comprising closed-ended questions was the measurement instrument. This was considered to least inconvenience nurses and postnatal patients to whom these questionnaires were administered. Answer choices were graded from 1 to 4, being strongly agree, agree, disagree and strongly disagree. The population comprised nurses and postnatal patients in MOUs in the Western Cape, South Africa. Consecutive sampling was conducted in two selected MOUs, being Michael Mapongwana (MM) and Gugulethu (GG), with 311 questionnaires being distributed to both nurses and postnatal Patients in these two facilities. The findings indicated that the ethical conduct of nurses in both MM and GG maternity wards was relatively good. However, some survey findings revealed some unsatisfactory gaps that exist in what both hospitals currently offer to patients in the areas of individual patient care, communication and baby security certainty. Furthermore, the findings indicated that a significant number of patients who chose to make use of MM and GG hospitals, are satisfied with the standard of service received during their stay. However, there were some discrepancies in terms of senior management service where excellence in the monitoring role emerged as being lacking. There is a need for improvement in the current levels of ethical conduct of nurses in both the MM and GG labour wards. These needs for improvement relate to working conditions, especially linked to the human resource (HR) function, leadership and management functions, and improved monitoring and control mechanisms.

MCur / Department of Advanced Nursing Science / Background: Doctors and nurses working in ICU are always confronted with ethical dilemmas when caring for critically ill patients no matter where they practice. The ethical dilemmas experienced by ICU nurses and doctors include amongst other: freedom of choice, truth telling, distribution of resources and confidentiality. Purpose: The study sought to explore the ethical dilemmas experienced by healthcare professionals working in ICU, Vhembe district in Limpopo province. Setting: The setting of the study was Tshilidzini hospital, Vhembe district in Limpopo Province Methodology: A qualitative, explorative, descriptive design was used. The population was nurses and doctors working in ICU, Tshilidzini hospital, Vhembe district in Limpopo province. A purposive sampling was used to select the study sample, and the study hospital. Data was collected by means of Semi-structured, in-depth interviews. Data was analyzed using Tesch`s method. Ethical considerations were adhered to. Findings: Participants expressed ethical dilemmas related to lack of resources, unsuitable infrastructure, hospital policies and patient`s decision making. Recommendations: The study recommends better policies by government and critical care societies to help guide resource allocation for ICU services. The number of ICU beds must be allocated according to the population it serves, in-service trainings to be conducted on regular bases in order to equip ICU health care professionals with knowledge of ethics and skills of decision-making, an active ethics committee to be elected to assist ICU practitioners when they encounter ethically challenging situation. / NRF

The purpose of the study is to explore past and current professional nursing organisations by means of historical inquiry and to explain the factors that influenced the development of such organisations, as well as the contribution that these organisations made to the professional development of South African nursing in the period between 1914 and 2014. The researcher conducted a literature review and collected data from archival primary and secondary sources. A priori codes provided structure and historical context, yet allowed flexibility. Philosophically critical realism guided the research and enabled the researcher to explain and critique the social world in which South African nursing organisations historically functioned and exerted their professional influence. The findings revealed that in the past one hundred years political, economic and cultural factors present in the social world influenced the nature of South Africa’s professional nursing organisations. Determined to create a female professional image, status and educational exclusivity, South African nursing leaders of the 20th century opted to establish the South African Trained Nurses’ Association (SATNA), a professional nursing association. Influential associations such as SATNA and the South African Nursing Association (SANA) guided the profession to develop a nursing culture based on philosophical and ethical principles of practice. The result was a recognised, respected and trained nursing corps. Over time, however, a social class system, religion, political ideology and nurses’ economic needs reshaped South Africa’s nursing associations and consequently the profession. By the end of the 20th century, South African nursing leaders accepted that nurses needed their socio-economic welfare to be prioritised and therefore the Democratic Nursing Organisation of South Africa (DENOSA), a professional organisation with a trade unionist stance, was established. The result was a trained, politicised, fragmented nursing corps struggling to find its collective professional voice. The greatest legacy bestowed on South African nursing by its first influential organisations is the professional associations evident today. Over time, the South African Nursing Association’s discussion groups that had been established in the 1950s to discuss nursing-related topics evolved into the specialist groups and associations that were present in 2014. / Health Studies / D. Litt et Phil.