M.Cur. / There is a tendency that the registered nurse migrate from the public health sector to the private hospital. In the private hospital the registered nurse is faced with demands to render a consumer orientated service. The greater demands on the registered nurse within the independent nursing practice has the result that her striving for professional and personal wholeness is impaired, leading to ineffective functioning as an independent nursing practitioner. The purpose of this study is to develop an orientation programme for registered nurses. This will facilitate professional and personal wholeness. The purpose is operationalized by means of a qualitative descriptive study, that explore and describe the experience of the registered nurse in the private hospital, as well as the expectations of the doctor (as consumer)). From these two aspects the obstacle were identified that can encumber the registered nurse to function as independent nursing practitioner. Three sets of premises were drawn up out of which the contents of the programme were differentiated by means of inductive logic. The subjacent philosophical elements of the. orientation programme are the Nursing Theory for the Whole Person (whole person), the adult as learner and accompanied self study.

Thesis (doctoral)--Umeå University, 2005. / Includes bibliographical references.

M.Cur. / The cardiothoracic intensive care unit is a dynamic environment which is characterised by a high patient turnover, staff shortages, medication, doctor's and nursing protocols and specialised nursing skills are required of the registered nurse. The registered nurse working in this environment is an independent practitioner and is accountable for her acts and omissions. The registered nurse can only accept accountability if she/he has the ability (knowledge, skills and values), the responsibility and authority to carry out the actions (Bergman, 1982:8). The learner enters the cardiothoracic intensive care unit as part of the clinical teaching she receives at a specific university. Due to staff shortages, the learner is often given the responsibility and authority to carry out actions for which she is accountable, without having the ability (knowledge, skills and values) to act. She may, therefore, not be able to nurse the patient safely and effectively. The unit manager is responsible for creating a learning climate in the unit and utilises an orientation programme to create this climate. An orientation programme introduces new staff members to the philosophy, goals and procedures necessary to work in a particular setting (Brookfield, 1986:64). The adult learner wants to learn that which is task- and problem-orientated in a selfdirective, independent way ida climate that is conducive to learning. The question arises: What must the content of an orientation programme for a certain cardiothoracic intensive care unit of a specific private hospital be and how must it be managed to facilitate safe and effective nursing by learners working in the cardiothoracic intensive care unit? The objective of the study is to explore and describe the content and management of an orientation programme for a specific cardiothoracic intensive care unit in a specific private hospital. A qualitative, exploratory and descriptive contextual study was conducted to explore and describe the content and management of the orientation programme. A contextual framework is described and focus group interviews were conducted with learners and registered nurses. From the results of the conceptual framework and focus group interviews, the content and manageent of the orientation programme was described. Due to the function perspective of the study, an orientatio nprogramme was developed from the results of the study.

M.Cur. / Please refer to full text to view abstract

Psychiatric nurse practitioner (NP) turnover is a significant cost to healthcare employers. Psychiatric NP turnover due to private practice creation is not well understood. The purpose of this study was to better understand the transition of Psychiatric NPs as they moved from ambulatory/outpatient employment to private practice. Using a hybrid Grounded Theory approach, 17 Psychiatric NPs in private practice were interviewed from October - December 2023. Facilitating factors to private practice creation were: The COVID-19 pandemic, changes to telehealth regulation during the pandemic, increased demand for psychiatric services and decreased supply of providers, and progress within the NP full practice authority movement. While employed, NPs reported experiencing burnout, high patient load, poor schedule, poor compensation, increased administrative tasks not budgeted within the NP workday, and rampant disrespect of the NP role. NPs reported being managed by inappropriate supervisors from other disciplines, and reported little opportunity for growth. Most participants voiced an initial reluctance to enter private practice, and reported being “pushed” to entrepreneurship out of concern for their long term wellbeing. These factors combined contributed to poor NP job satisfaction and NP turnover. Strategies to improve the job satisfaction of employed psychiatric NPs were recommended.