Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The profession of nursing is a twofold vocation that has a scientific theory as the foundation of all nursing intervention or skill. Despite clinical preceptorship being a useful strategy of teaching, many training hospitals and clinical facilities are without this avenue of learning and where available, it is often not optimally utilised. The aim of this study was to explore the role of the clinical preceptor in enhancing nursing education at Edendale Hospital and Edendale campus of a nursing college. A mixed method approach was applied utilizing both qualitative and quantitative methods to collect information about the experiences and challenges as well as clarify existing problems. Samples were drawn from all stakeholders of nursing education i.e. nursing students, nurse educators and ward managers of Edendale Hospital and Campus using random and purposive sampling respectively. Data were collected using selfadministered questionnaires for students and nursing managers and an interview guide for focus group interviews for nurse educators. Ethical approval was sought from the Health Research Ethics Committee at the Faculty of Medicine and Health Sciences at Stellenbosch University, the Department of Health, the Kwazulu-Natal College of Nursing and Edendale Hospital and Campus. The findings of this study support Weidenbach’s Prescriptive Theory in which the author maintains that nursing is a practice discipline designed to produce explicit desired results which here refers to the enhancing of nursing education with the contribution of clinical preceptorship. Patricia Benner’s Dreyfus and novice to expert models were used to express the need for meaningful practical experience in nursing students and to shows nurse educators how to identify the practical learning needs of the students and assist them acquire competence. The results of the study suggest that the clinical preceptor is a mentor and a guide who facilitates the correlation of theory and practice in nursing education. The results also suggest that students are experiencing problems in clinical practice and that clinical preceptorship is needed. A number of recommendations are made based on limitations identified in the present teaching-learning process. One of the recommendations is that partnership building strategies be fostered between the hospital, the campus and the Faculty of Nursing Education. This team approach could clearly define the role of the clinical preceptor to ensure optimum nursing education. Further research is recommended. / AFRIKAANSE OPSOMMING: Verpleging is ’n tweeledige beroep met ’n wetenskaplike teorie as grondslag vir elke verpleegintervensie of -vaardigheid. Ten spyte daarvan dat kliniese instruksie (“preceptorship”) ’n nuttige onderrigstrategie is, ontbreek dit by baie opleidingshospitale en kliniese fasiliteite, en waar dit beskikbaar is, word dit dikwels suboptimaal aangewend. Die doel van hierdie studie was om ondersoek in te stel na hoe belanghebbendes by verpleegopleiding by Edendale-hospitaal en -verpleegkampus kliniese instruksie ervaar, en om sodoende vas te stel of kliniese instruksie verpleegopleiding by daardie fasiliteite versterk. ’n Gemengde benadering van sowel kwalitatiewe as kwantitatiewe metodes is gevolg om inligting oor die ervarings en uitdagings in te win en bestaande probleme te verklaar. Steekproewe is met behulp van onderskeidelik lukrake en doelbewuste seleksie uit alle belanghebbendes by verpleegopleiding by Edendale-hospitaal en - verpleegkampus geneem, met inbegrip van verpleegstudente, verpleegopvoeders en saalbestuurders. Data is deur middel van selfvoltooiingsvraelyste vir studente en eenheidsbestuurders, en ’n onderhoudsgids vir fokusgroepgesprekke met verpleegopvoeders ingesamel. Etiekgoedkeuring is verkry van die Gesondheidsnavorsingsetiekkomitee van die Fakulteit Geneeskunde en Gesondheidswetenskappe aan die Universiteit Stellenbosch, die Departement van Gesondheid, die KwaZulu-Natalse Verpleegkollege sowel as Edendale-hospitaal en - verpleegkampus. Die bevindinge van die studie ondersteun Wiedenbach se voorskriftelike teorie, waarin sy volhou dat verpleging ’n praktiese dissipline is wat ontwerp is om bepaalde gewenste resultate te behaal. Patricia Benner se Dreyfus- en beginner-tot-kennermodel is ook gebruik om die behoefte aan sinvolle praktiese ervaring by verpleegstudente te staaf, en om verpleegopvoeders te wys hoe om studente se praktiese leerbehoeftes te bepaal en hulle vaardighede te help ontwikkel. Die resultate van die studie dui daarop dat die kliniese instrukteer as mentor en begeleier die korrelasie tussen teorie en die praktyk van verpleegonderwys fasiliteer. Die resultate dui verder daarop dat student probleme in kliniese praktyk ervar en kliniese instruksie benodig. ’n Aantal aanbevelings word gedoen op grond van beperkinge wat in die huidige onderrig-en-leer-proses uitgewys is. Een van die aanbevelings is die ontwikkeling van strategieë om vennootskappe tussen die hospitaal, die verpleegkampus en die fakulteit verpleegkunde te bou. Hierdie spanbenadering kan die rol van die kliniese instrukteur duidelik omlyn ten einde optimale verpleegopleiding te verseker. Verdere navorsing word aanbeveel.

Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: In South Africa, currently enrolled nurses make up the largest proportion of members of the nursing healthcare team. As in direct contact with patients it is essential that the practice environment supports patient and nursing outcomes. Studies confirm the complexity of the practice environment and the impact on both personnel and on the quality of nursing care provided. Job satisfaction is integrally linked to the quality and safety of care provided. The scarcity of registered professional nurses, particularly in the South African context, has resulted in enrolled nurses being widely used to continue to deliver acute care in quite complex situations. It is well documented that the use of suboptimal nursing personnel levels or substituting enrolled nurses for registered professional nurses is associated with an increase of adverse events such as infections, pressure ulcers and unanticipated death. The purpose of this study was to explore the experiences of enrolled nurses regarding quality nursing care in general nursing units in the private healthcare setting. The objectives being: - The exploration of the enrolled nurses understanding of the concept of quality care - The exploration of the enrolled nurses understanding of her value and contribution to quality care and - The exploration of the enrolled nurses experiences (positive and negative) of quality nursing care in private health care setting A descriptive qualitative methodology was applied. A purposive sample size of n=13 was drawn from the total population of N=387. An exploratory interview was completed. Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability were applied and ethical principles were met. Findings demonstrated that enrolled nurses experienced both positive and negative work experiences, some more negative than others. They had a very good understanding of quality care but had difficulty in reconciling the patient’s needs with what they were able to deliver, due to workload pressures and resource constraints: P6: “I miss the quality because that patient that needs just that back rub or just to hold his hand ...the thing is with quality nursing we don’t do quality nursing on the patient anymore.” Most participants experienced registered professional nurses absolving their clinical supervisory responsibility. This endangers the quality and duty of care of patients and is a legal liability. A recommendation is that registered professional nurses require professional development through utilising good role models. This exposure to positive learning experiences will enable their professional development and ethical behaviour. Registered professional nurses need to be taught the skills of how to be team players. / AFRIKAANSE OPSOMMING: Ingeskrewe verpleegsters maak huidiglik die grootste deel van die verplegingsspan se gesondheidsorg uit. As gevolg van die direkte kontak met pasiënte, is dit belangrik dat die omgewingspraktyk pasiënt- en verpleeguitkomste moet kan ondersteun. Navorsingsstudies bevestig die kompleksiteit van die omgewingspraktyk en die impak wat dit op beide personeel en op die kwaliteit van verpleging wat verskaf word, het. Werksbevrediging vorm ’n geïntegreerde skakel met die kwaliteit en veiligheid van sorg wat verskaf word. Die tekort aan geregistreerde professionele verpleegsters, veral binne die Suid-Afrikaanse konteks, het tot die gevolg dat ingeskrewe verpleegsters oral gebruik word om akute sorg in taamlik komplekse situasies te lewer.. Dit is goed gedokumenteer dat die gebruik van suboptimale verpleegpersoneelvlakke of die vervanging van geregistreerde professionele verpleegsters met ingeskrewe verpleegsters, geassosieer word met ’n toename in nadelige gevalle soos infeksies, druk-ulkusse en onverwagte dood. Die doel van hierdie studie is om die ervaringe van ingeskrewe verpleegsters ten opsigte van die kwaliteit van verpleegsorg binne algemene verpleegeenhede in die private gesondheidsorgomgewings te ondersoek. Die doelwitte is ’n ondersoek na die ingeskrewe verpleegsters se: - begrip van die konsep van kwaliteitsorg - begrip van hul waarde en bydrae tot kwaliteitsorg en - ervaringe (positief en negatief) van kwaliteit verpleegsorg binne private gesondheidsorgomgewings. ’n Beskrywende, kwalitatiewe metodologie is toegepas. ’n Doelgerigte steekproefgrootte van n = 13 is geneem uit die totale populasie van N = 387. ’n Voortoets is voltooi. Lincoln en Guba se kriteria van geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid is toegepas en etiese beginsels is nagekom. Bevindings het bewys dat ingeskrewe verpleegsters beide positiewe en negatiewe werkservaringe gehad het; sommige meer negatief as ander. Hulle het ’n baie goeie begrip van kwaliteitsorg, maar vind dit moeilik om aan die pasiënt se behoeftes, vanweë drukkende werkladings en beperkte bronne te voldoen. P6: “Ek mis die kwaliteit want al wat die pasiënt benodig is die vryf van die rug of net die vashou van sy hand…die probleem met kwaliteitsorg is dat ons nie meer kwaliteitsorg op die pasiënt doen nie.” Die meerderheid van die deelnemers verklaar dat die geregistreerde professionele verpleegkundiges hulle kliniese toesighoudende verantwoordelikheid afskeep. Die gedrag is bydraend tot swak kwaliteit pasient sorg en het direkte wetlik implikasies. Die aanbeveling is dat professionele ontwikkeling van geregistreedrde verpleegkundigies verbeter kan word deur gebruik te maak van goeie rol modelle. Die blootstelling aan positiewe leer ervarings en omgewing sal bydrae tot hulle professionele ontwikkeling en etiese gedragspatrone. Geregistreerde verpleegkundiges moet die vaardighede aanleer om as deel van ’n span te kan funksioneer.