A qualitative descriptive approach was undertaken to explore the leadership experience of seven first line nurse managers working in the Cook Islands. For the purposes of this study first line nurse managers are those nurses working as a charge nurse in a hospital, nursing supervisors, chief public health nurse, and nurses working autonomously in the outer islands of the Cook Islands. Nurses in these roles are in key positions to influence the practice of others and set the standard of practice and culture of a unit. The participants were recruited if they were currently employed in any of these positions. The seven participants were all Cook Islands women who received their undergraduate nursing education in the Cook Islands. The purpose of the study was to describe their leadership experience, to raise an awareness of their role, and to make recommendations to support and improve the preparation of nurses for leadership roles in the Cook Islands. Through face-to-face interviews, the participants' stories were audio taped and transcribed verbatim. Six of the seven transcripts required translation from Cook Islands Maori to English and this was conducted by the researcher who is fluent in both languages. Content and thematic analysis of the data revealed a spiritual, emotive and intuitive theme in the participants' leadership experience. The findings of the study revealed the self confidence of these nurses to manage in this role despite being challenged by management issues and the lack of preparedness for the role. The supportive network established within their staff, their family and the people around them has provided the impetus to continue to 'serve' their people. The findings also revealed that these nurses recognised the need to continue to learn and develop themselves and their staff. The findings of this study have significance for nurses aspiring to be nurse leaders in the Cook Islands or other Pacific Islands and rural communities. A key stakeholder in this study is the Cook Islands Ministry of Health, as insights and awareness gained can contribute to an appropriate preparation and support programme for nurses working in its organisation.

A qualitative descriptive approach was undertaken to explore the leadership experience of seven first line nurse managers working in the Cook Islands. For the purposes of this study first line nurse managers are those nurses working as a charge nurse in a hospital, nursing supervisors, chief public health nurse, and nurses working autonomously in the outer islands of the Cook Islands. Nurses in these roles are in key positions to influence the practice of others and set the standard of practice and culture of a unit. The participants were recruited if they were currently employed in any of these positions. The seven participants were all Cook Islands women who received their undergraduate nursing education in the Cook Islands. The purpose of the study was to describe their leadership experience, to raise an awareness of their role, and to make recommendations to support and improve the preparation of nurses for leadership roles in the Cook Islands. Through face-to-face interviews, the participants' stories were audio taped and transcribed verbatim. Six of the seven transcripts required translation from Cook Islands Maori to English and this was conducted by the researcher who is fluent in both languages. Content and thematic analysis of the data revealed a spiritual, emotive and intuitive theme in the participants' leadership experience. The findings of the study revealed the self confidence of these nurses to manage in this role despite being challenged by management issues and the lack of preparedness for the role. The supportive network established within their staff, their family and the people around them has provided the impetus to continue to 'serve' their people. The findings also revealed that these nurses recognised the need to continue to learn and develop themselves and their staff. The findings of this study have significance for nurses aspiring to be nurse leaders in the Cook Islands or other Pacific Islands and rural communities. A key stakeholder in this study is the Cook Islands Ministry of Health, as insights and awareness gained can contribute to an appropriate preparation and support programme for nurses working in its organisation.

Baggrund: Pleje af borger med diabetes og demens kræver betydelig planlægning og gennemgang, og der skal foretages løbende vurdering af patientens egenomsorgsevne, som blandt andet fødeindtag, og evnen til at administrere medicinen på en forsvarlig måde. Diabetes og demens kan manifesteres samtidigt, hvor den ene er potentielt livstruende, mens den anden forårsager et alvorligt progressivt tab af hukommelse og kognitiv funktion. Ved tilstedeværelsen af begge diagnoser, udsættes sygeplejersken for udfordringer med hensyn til at udføre sit arbejde når det kommer til at yde sygepleje interventioner til patienter, der har mistet evnen til at yde egenomsorg. Formål: Studiets formål er at undersøge hjemmesyglejerskens erfaring i at yde sygepleje til ældre borger i eget hjem som er diagnoseret med diabetes og demens. Metode: Et beskrivende kvalitativ design, hvor data blev indsamlet med interviews (n=10) og transskriberede data blev analyseret ved hjælp af en kvalitativ indholdsanalyse.Resultat: Hjemmesygeplejersken arbejder opgavecenteret frem for personcentreret, hvor Sygeplejersken udtrykker at de er hverken fagligt eller personligt er klædt på til at kunne håndtere disse udfordringer, da retningslinjerne er for generelle og er ikke tilpasset den komplekse multisyge borger. Sygeplejerskerne efterlyser mere undervisning, mere forskning og flere specialiseret sygeplejersker på arbejdspladsen som er letter tilgængelig, hvor sygeplejersken kan henvende sig ved behov. Der understreges at der også er behov for kontinuitet i arbejde da de demente borger har brug for tid og trygge rammer. Konklusion: Sygeplejerskernes erfaring er at de dagligt udsættes for udfordringer, hvor sygeplejerskens kernekompetence og faglighed bliver sat på prøve. Sygeplejerskerne udtrykker at de er hverken fagligt eller personligt klædt på til at kunne håndtere udfordringerne i forhold til kost, medicin og forebyggelse af komplikationer. De efterlyser mere forskning, uddannelse inden for diabetes og demens. Sygeplejerskerne de mener at efteruddannelse vil løfte kompetencerne som vil være til gavne for disse borger. / Background: Care for patients with diabetes and dementia requires significant consideration and ongoing review. Continuous assessment of the patient's self-care must be carried out, not only with regards to food intake but also the ability to administer the medicine in an appropriate manner. Diabetes and dementia can manifest simultaneously; the first being potentially life threatening; the second causing a serious progressive loss of memory and cognitive function. In the presence of both diagnoses, the nurse is exposed to challenges in performing their work in providing nursing interventions to patients who have lost their ability to provide self-care. Aim: To gain insight into the home nurses’ experience in providing partially compensating nursing care to citizens with the diagnosis of Diabetes and dementia in their own home. Method: An interview study conducted with 10 home nurses in different municipalities in the Danish capital Copenhagen. Data was analyzed based on a qualitative content analysis. Result: The Danish Home nurse experience in providing nursing is expressed in how the nurse describes the citizen's ability to self-care in their own home, the nurses’ experience in working preventatively and experience in providing partially compensating nursing, and with the nurses’ experience in relation to daily nursing challenges. Conclusion: The nurse is experiencing daily challenges that expose the nurses’ core competence and professionalism to the test. The nurse expresses that they are neither professionally nor personally prepared to handle these challenges. They are looking for more research, better education, and more time to do their work.

To a student, postgraduate research is often characterised as a very emotional process, more often associated with negative emotion that may hinder successful and speedy completion of the postgraduate degree. The supervisory relationship may impact greatly on the emotion the student experiences. Emotional labour is the induction or suppression of emotion in order to sustain an outward appearance. Being bound in a professional and often subordinate relationship, the student may not be willing, or able to, outwardly display their emotions. Yet, the existence of, and experience of emotional labour on students in a postgraduate supervisory relationship have not been studied to date. The purpose of the study is to explore the meaning and existence of emotional labour within the postgraduate supervisory relationship from a student’s perspective. By using a qualitative, descriptive approach, in-depth information has been gathered by means of three focus groups. The focus groups consisted of students at different stages of the postgraduate supervisory process. The study resulted in the linking of a student’s perspective of the supervisory process to the emotional labour process. It was found that emotional labour is indeed present in the postgraduate supervisory process, but is dependent on the relationship between the supervisor and the student. Since emotional labour has limitedly been explored in the academic environment, it is believed that supervisors as well as students can benefit from this exploration in this fresh context. This linking of emotional labour to the supervisory process is only the first stage in this research and seeks only to describe the process. / Dissertation (MCom)--University of Pretoria, 2012. / Human Resource Management / unrestricted

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Dans le système de santé québécois, il est attendu des infirmières qu’elles développent et démontrent un niveau élevé de leadership clinique infirmier [LCI] dans leur pratique. En effet, des auteurs soutiennent que le développement de cette compétence est primordial à l’optimisation de la qualité des soins et de la sécurité des patients (Goudreau, Pepin, et al., 2015; Stanley et Stanley, 2018). D’autres soutiennent que l’exercice du LCI présente un important défi pour les infirmières nouvellement diplômées [IND] qui continuent d’apprendre à prioriser, à organiser les soins et à déléguer (Benner, 2001; Ekström et Idvall, 2015). Une recension des écrits sur le LCI des IND n’a permis d’identifier que cinq recherches-clés. Elles portent sur le processus de développement du LCI (Pepin et al., 2011), ainsi que sur les moyens de soutenir ce développement et l’exercice de cette compétence en milieux cliniques (Chappell, & Richards, 2015 ; Ekström et Idvall, 2015 ; Larue et al., 2013 ; Won, 2015). À notre connaissance, seules une recension systématique (Chappell et Richards, 2015) et quatre études qualitatives (Ekström et Idvall, 2015 ; Larue et al., 2013 ; Pepin et al., 2011 ; Won, 2015) se seraient intéressées à l’exercice du LCI spécifiquement chez des IND. Ces articles illustrent les difficultés rencontrées très tôt dans la pratique des IND. Le développement et l’exercice du LCI permettent aux infirmières de faire face à l’exercice de leur rôle professionnel et ultimement à l’amélioration de la qualité de la prestation de leurs soins. Afin de mieux comprendre comment les IND exercent cette compétence auprès des patients, ce mémoire de recherche, publié par article, s’intéresse au parcours expérientiel du LCI chez des IND. Grâce et à une posture épistémologique constructiviste (Guba et Lincoln, 1994), cette étude descriptive interprétative (Thorne, 2016) avait comme but de décrire le parcours expérientiel de l’exercice de cette compétence infirmière à travers la première année de pratique professionnelle. De plus cette étude avait comme autre objectif d’identifier les éléments du contexte de pratique qui facilitent ou contraignent l’exercice de cette compétence chez les infirmières bachelières nouvellement intégrées dans le milieu professionnel. Pour y arriver, le cadre de référence de cette étude reposait essentiellement sur le modèle de développement de l’expertise professionnelle (Benner, 2001), ainsi que sur la notion d’individuation au travers des parcours de vie, élaborée par Carpentier et White (2013) Grâce à un échantillonnage de convenance, huit infirmières ayant respectivement 1, 5 (n=2), 6 (n=3), 10 ou 11 mois de pratique clinique, ont été recrutées dans un centre hospitalier universitaire francophone. Des entretiens semi-dirigés d’une durée de 45 à 60 minutes ont été effectués. Une analyse de contenu thématique (Thorne, 2016) selon la méthode proposée par Paillé et Mucchielli (2016) a été réalisée. Les résultats indiquent que pour les IND le LCI est difficile à exercer durant les premiers mois de pratique clinique. Néanmoins, l’exercice de cette compétence s’avère évolutif et exponentiel à l’expérience clinique. Sur une trajectoire de 12 mois, les IND décrivent cinq manières cumulatives d’exercer leur LCI dans leur pratique clinique au chevet des patients, soit par 1) le maintien d’une qualité des soins optimale ; 2) la collaboration et la communication efficace avec les équipes inter et intra professionnelle 3) l’adoption du rôle de précepteur clinique ; 4) l’implication professionnelle au-delà des soins aux patients 5) la consultation des résultats scientifiques à des fins d’amélioration des pratiques. De plus, celles-ci identifient différents facteurs facilitants et contraignants l’exercice de cette compétence. Ces facteurs se regroupent dans trois grandes catégories, soit : 1) les équipes de soins, 2) les quarts de travail, ainsi que 3) les ressources. Cette étude contribue au développement des connaissances sur le LCI et fournit des pistes quant aux stratégies permettant d’appuyer l’exercice de cette compétence critique au sein de la pratique infirmière. Les IND sont une ressource précieuse « et tout devrait être mis en œuvre pour améliorer la rétention des effectifs et réduire le roulement de personnel de ce segment important de la main-d’œuvre infirmière » (Fallatah, Laschinger et Read, 2017, p. 173, traduction libre). Ainsi, de nombreuses pistes de réflexion ont été proposées pour la pratique, la recherche, ainsi que la formation. / In the Quebec health system, nurses are expected to develop and demonstrate high level of clinical nursing leadership (CNL) in their practice. In fact, researchers argue that the development of this competency is essential to optimizing the quality of patient care and patient safety (Goudreau, Pepin & al., 2015; Stanley & Stanley, 2017). Other researchers argue that the exercise of CNL presents a significant challenge for newly graduated nurses (NGN) who are still trying to learn how to prioritize, organize and delegate care (Benner, 2001; Ekström & Idvall, 2015). We found only five key research studies from our review of the CNL of new graduated nurses. They focus on the development process of this competency (Pepin & al., 2011), as well as ways to support this development and exercise it in clinical settings (Chappell & Richards, 2015, Ekström & Idvall, 2015, Larue & al., 2013, Won, 2015). To our knowledge, a systematic review (Chappell & Richards, 2015) and only four qualitative studies (Ekström & Idvall, 2015; Larue & al., 2013; Pepin & al., 2011; Won, 2015) have focused on CNL practice in NGNs specifically. The literature provides an understanding of the development of this nursing competency, with landmarks of its exercise, but remains silent regarding the pathways of its exercise. In order to better understand and complement the existing research, this qualitative interpretive descriptive study (Thorne, 2016) based on a constructivist epistemological theory (Guba & Lincoln, 1994), described the experiential path of exercising CNL among NGNs in their first year of professional practice, including the identification of elements that facilitated or impeded its exercise, from their perspective. The conceptual framework guiding this study encompasses the development of clinical nursing expertise (Benner, 2001) and the notion of individuation through life courses (Carpentier & White, 2013). Through convenience sampling, eight nurses with respectively 1, 5 (n=2), 6 (n=3), 10 or 11 months of clinical practice, respectively, were recruited from a francophone university hospital center. Semi-structured interviews varying in length from 45 to 60 minutes were conducted with each of the nurses recruited. A content analysis based on themes (Thorne, 2016) according to the method proposed by Paillé & Mucchielli (2016) was carried out. The results indicate that for NGNs, it is difficult to exercise CNL during the first months of practice. However, the exercise of this nursing competency is evolutionary and exponential to clinical experience. We found that over a 12-month period, NGNs identified five cumulative ways of exercising their CNL in their bedside clinical practice, either by 1) maintaining an optimal level of quality of their patient care; 2) collaboration and effective communication with the care team; 3) adopting the role of clinical preceptor; 4) professional involvement beyond the patient care; 5) improving practices through consulting scientific evidence. In addition, we identified various factors facilitating and impeding the exercise of their CNL. In all, these advanced-beginner nurses identified four facilitating factors and five impeding factors. We conclude that the influence of organizational contexts and institutional cultures plays a role in the exercise of this particular leadership competency at the beginning of clinical practice is present. These factors are grouped into three main themes: 1) teams; 2) shifts and 3) resources. We believe that this study contributes greatly to the literature and provides insights into strategies to support the practice of this critical competency in nursing practice. In addition, we hope that this study will serve as a guide for health institutions in adopting strategies that support the exercise of CNL in the nursing field. NGNs are a valuable resource “and every effort should be made to improve retention and reduce turnover of this important segment of the nursing workforce” (Fallatah, Laschinger & Read, 2017, p. 173). Thus, many recommendations have been proposed for practice, research, as well as education.