The aim of this study is to assess the pre-registration preparation of nurses as a means for producing women and men capable of doing new things, not simply repeating what other generations had done. The issues which are examined are:-(1) The purposes of nurse education (11) The extant forms of knowledge (111) The nature of teacher/student relationships in the process of learning. The study was carried out in three stages:- (1) Analysis of the literature from 1947 to 1963 by abstracting and utilising grounded theory approaches to identify the essential issues.(11) Opinion survey of student nurses utilising content and structural analysis of the audio-taped recordings of interviews to develop a theory of nurse education in the 1980's,(ill) Experimental testing of one operational hypothesis describing the effect of teacher behaviours on the student nurse’s clinical decision making. It is concluded that the pre-registration preparation of nurses is not an educational experience on the grounds that the extant forms of knowledge and the prevalent teacher/student relationships are inconsistent with the production of a critical, reflective and self-reliant practitioner. Because of this, the recommendations of UKCC Project 2000 must be carefully planned and closely monitored if the problems of the theory/practice gap are to be minimised rather than exacerbated.

The prevalence of obesity is increasing and due to its associated co-morbidities (WHO, 2011) obese people are at greater risk of being hospitalised. While it is evident that student nurses will increasingly be caring for obese patients, there has been a scarcity of studies exploring student nurses' conceptualisation of obesity and participation in obese patients' care. The aims of this study were to explore student nurses' care of obese patients and the meaning they assigned to obesity. I utilised an ethnographic approach that included 305 hours of participant observation of student nurses (n=11), qualified nurses (n=11), nurse managers (n=3) and health care assistants (n=10) in three hospital settings in Wales (orthopaedic, gynaecological-surgical, and respiratory). Data also included semi-structured interviews with student nurses (n=7), documentary analysis and the technique of drawing pictures. The thematic analysis generated three themes: 'student nurses' encounters with obese patients', 'constructing the meaning of obesity: the culture and context of care', and 'the consequences of student nurses' involvement with obese patients' care'. Student nurses found the intensity and frequency of their involvement with obese patients' care challenging, particularly in the areas of interaction, food and nutrition, physical care and moving and handling. Integral to their conceptualisation of obesity were student nurses' cultural norms and values, their limited knowledge regarding obese patients' care, professional socialisation, organisational constraints, and patients' contribution to their care. Student nurses felt disempowered because of the emotional and physical labour they experienced when caring for obese patients. In turn, they participated in the exercise of power over obese patients with both intended and unintended consequences. Equally important was the 'covert liking' (Johnson, 1997) that some students felt towards obese patients who engaged in empowering acts of care to compensate for others' controlling behaviours. The findings provided insights into the student experience of caring for obese patients and raised issues related to the role of culture and context of care in student nurses' conceptualisation of obesity. Drawing on Foucault's (1976) notion of power facilitated understanding of the significance of obesity-related discourses and associated power inequalities in clinical practice. Changes in nurse education and practice are proposed to ensure that nurses are adequately prepared to care for obese patients.

Transition of the newly qualified nurses from an educational focus to professional practitioner has long been identified as a conflicted time of critical personal and professional adjustment and staggering reality shock. This study explored the experiences of newly qualified R425 professional nurses during their first year of practice in the Eastern Cape Province at three selected hospitals. The study followed a qualitative, exploratory, descriptive design using a phenomenological approach. The sample included newly qualified professional nurses in their first year of employment. Convenience sampling was used to select the participants. Data collection was conducted by means of semi-structured interviews from ten (n=10) participants. Each interview took about 45 minutes. Ethical codes of research were followed. Data was coded manually and analyzed using content analysis Four themes and seven subthemes emerged from the data collected The findings revealed positive experiences such as sense of belonging and feelings of independence; negative experiences such as feelings of rejection, as well as management challenges The study identified challenges which impacted on the performance of new nurses, namely shortage of human and material resources and inadequate support in the working environment Recommendation: Introducing mandatory education by service institutions on transition as well as extended, sequential and structured orientation and mentoring programs for newly qualified professional nurses as this will assist them in their career development Managers to use different strategies in enhancing quality environments in order to reduce frustration for these newly qualified nurses.

The purpose of this study was to investigate the relationship between a measurement of empathy and performance of psychiatric student nurses.

Nursing in Indonesia is attempting to achieve a higher standard of education to enable nurses to migrate to global areas of nursing shortages. Assessment of nursing practice during undergraduate nursing education in Indonesia requires investigation to assist in achieving a higher standard of education. For assessment to occur, there are several variables reported in the literature that must be included in the process of assessment, that is assessors, students, methods and tools of measurement as well as clinical environment. It is acknowledged that those factors influence the successfulness of the clinical assessment process. The purpose of this descriptive exploratory study utilising a self report clinical instructor and student nurse questionnaire was to investigate the clinical assessment of Indonesian student nurses undertaking the professional stage of the undergraduate nursing course. Specifically, the study investigated how clinical teachers assess student nurses and how students perceive the clinical assessment process. Data were collected from four nursing institutions in Jakarta, Indonesia during July 2006. Quantitative and qualitative data analysis were undertaken to meet the purpose and objectives of the study. Quantitative data analysis utilised frequency tables, cross tabulations and ANOVA. Participants’ responses to open-ended items were analysed using content analysis procedures. The findings of this study have shown that there are many important issues surrounding the assessment of Indonesian student nurses, such as the model of assessment process employed and the characteristics of clinical instructors, students and clinical environment. From this study, it was revealed that the assessment of student nurses employed skilledv based assessment, despite the global trends towards competency-based assessment. Findings from this study also illustrate that nursing education development has been occurring in Indonesia with already half of the clinical instructor participants being educated to master’s level and most student nurse participants held diploma III qualifications prior to their Bachelor of Nursing course, which means that they want to continue their study to a higher level. However, improvement in nursing curriculum which focuses on competency-based curriculum is needed. Improvement in the nursing curriculum will lead to improvements in the nursing profession. That is a higher standards of professionalism for nursing and nurses in Indonesia. Recommendations from the study include promoting changes in curriculum, particularly regarding the assessment process to employ competency-based assessment for student nurses. This study also endorses the use of a standardized assessment in clinical setting. In addition, further research related to replication of the study at a national level and comparison of clinical assessment in other countries should be conducted.

This thesis reports a study which attempted to explore how a group of student nurses perceived their experience of being learners of nursing. In order to obtain the students' accounts of this experience, a qualitative methodological approach has adopted, drawing upon the work of Glaser and Strauss (1967) on the generation of 'grounded theory'. The fieldwork took the form of informal interviews with forty student nurses. Certain predetermined topics provided the overall direction of the fieldwork; the students were encouraged to develop these and to raise any others which they thought to be pertinent to nursing. The interviews were tape recorded and their analysis resulted in the emergence of six conceptual categories which served as a framework for the presentation of the substantive issues raised by the students. Three major themes are taken up from the data, these are: the student experience as a preparation for staff nurse work, the functional interchangeability of the student and the nursing auxiliary and, the concept of medical dominance. This study sheds some light on the process of occupational socialisation in nursing and examines the question of profession and professionalisation in relation to nursing. The concluding discussion moves beyond the data and examines the occupational structure of nursing; this is relevant to the study because the students were preparing to become part of that structure. Moreover the occupational structure has implications for the recruitment of students and the organisation of their training. Four sub-groups within nursing are identified, namely: 'new managers', 'new professionals', 'rank and file' and 'academic professionalisers'. A speculative discourse upon how these groups might articulate with each other, in order to produce an efficient nursing service, is offered and areas for further study are suggested.

Thesis (M.S.)--Boston University

This study was carried out using a Foucauldian discourse analysis and involved the examination of three statutory reports into the provision of occupational health in the workplace. The reports analysed were the Report of the Select Committee on the Bill for the Regulation of Factories (1832); the Safety and Health at Work Report (1972); and Working for a Healthier Tomorrow (2008). Additionally, analysis was carried out on oral events with nursing students, which sought to understand their perceptions of referral to occupational health. The objective of this study is to explore how referral is constructed through discourse, categorising how this practice is constrained or liberated by specific discourses and how nursing students are positioned by these discourses. My study highlights both structural and subjective barriers to the use of occupational health. At the structural level, it is observed that referral to occupational health commenced as a form of governmentality, introducing dividing practices which subjected the workforce to forms of classification and surveillance. For those classified as healthy a culture developed within workplaces in which health behaviours needed to comply with the standards set down by occupational health and by the risk management approach. Risk management processes and stigmatisation are used to ensure compliance with the state’s wishes for a healthy and productive workforce. This trend is seen across the reports analysed, and is increased within the Black Report to the surveillance of health both in and out of the workplace for those of a working age. Subjectively, occupational health was identified as a disciplining and subjugating structure by the nursing students. The students evidenced notions of Cartesian duality in their discussions of the outcomes of referral, as they readily accepted surveillance of the body whilst seeking to avoid surveillance of their mental health capabilities. Through observation of architectural signs and organisational images of discourse, students categorised occupational health as an instrument of the higher education institute and not as a form of holistic health support. The research highlights how occupational health acts as a barrier to the students’ fulfilling their societal roles as good students and good nurses. The research also highlights a desire on the part of the student nurses to utilise occupational health within a public health framework which addresses their health in a preventative rather than punitive manner.

Compassion has been associated with the nursing profession since the days of Florence Nightingale. It is a general expectation that nurses should be compassionate when they are caring for people. In the United Kingdom (UK) concerns have been raised recently that nurses are failing to be compassionate as they carry out their nursing duties. There is little evidence within the literature of how student nurses perceive compassion as they engage in the pre-registration-nursing programme. In this study, I use narrative to produce case studies as a vehicle for the students to voice their perceptions of compassion. My ethnographic analysis of their stories is framed by my own experience as a professional registered nurse and nurse educator situated within their learning environment, and applies theories of compassion and learning. In my study, themes emerge that demonstrate commonalities, differences and tensions relating to the students’ individual beliefs and behaviours, and to the impact of their professional development as they transcend from university learning spaces into clinical practice.

Thesis (M.S.)--Boston University