Thesis (PhD--History)--University of Auckland, 2007.

The hospices attempted to offer a way of dying with dignity which would counter the growing lobby for euthenasia legislation by taking account of 'total pain' (mental, social, spiritual, physical). Participation on an NHS/Macmillan Continuing Care Unit indicated that the nurses were committed to giving 'total patient care', but were conscious of their inability to fulfil their principles. They explained their care of the dying in terms of a tension between 'care' and 'work'. The practical outcome of the tension on the terminal care unit is analysed as 'carework'. This emergent nursing practice, where physical care tends to overshadow 'emotional care', is observed in the routines and rituals of the Unit, of which 'normal death' is one example. The two separate social frameworks of 'care' and 'work' reflect a gender division of labour in which 'caring' is commonly domestically based and carried out by women, and 'work' is in the public domain and dominated by men. Public service 'people work' requires that the two frameworks be amalgamated. The tension between 'care' and 'work' is described as a failure of accommodation between the two which is exacerbated by a science based model of illness. It is suggested that these effects combine in a pattern of resistance which opposes the full implementation of hospice movement aims.

D.Cur. / The overall objective of this research study was to develop a model of emotional intelligence for the facilitation of wholeness in critical care nurses in South Africa. Critical care nurses often nurse three or more critically ill patients during one shift (Fiakus, 1998). The environment in the critical care unit is highly stressful, highly emotionally charged and emotionally demanding for the nurses that work there. This can lead to the nurse developing burnout (Coates, 2001 ). Burnout in a critical care nurse can have devastating consequences such as decreased well-being of the nurse, decreased quality of care, poor communication and increased costs to the employer related to absenteeism and high staff turnover (Poncet, Toullic, Papazian, Kentish-Barnes, Timsit, Pochard, Chevret, Schlemmer & Azoulay, 2006). In a study by Shipley, Jackson and Segrest (2004), it was found that staff with increased emotional intelligence enjoyed better emotional health and more satisfaction both at home and at work. The question that arose was what is the emotional intelligence of critical care nurses in South Africa. A theory-generative, exploratory, descriptive and contextual research design was used. The research study was carried out using a modification of the method of theory generation as described by Chinn and Kramer (1985). Step one dealt with the empirical phase in which the main concept was distilled from the results of the data analysis. The quantitative research design used for this phase was a typical descriptive survey design. The entire accessible population (N=380) consisted of registered nurses that attended the Critical Care Congress in 2009. They represented a wide range of registered nurses that worked or had worked in critical care in both the private and public health sectors in South Africa. The data collection instrument consisted of a biographical datasheet from which the sample (n=220) was divided into various context groups. Participation was voluntary and all participants signed a consent form. The second part of the data collection instrument consisted of the Trait Emotional Intelligence short form (TEIQue-SF). The data was analysed using SPSS. The sample consisted mainly of a group of mature, female and professionally experienced critical care nurses. They held a variety of job descriptions in critical care nursing. Nurses who are older and have more experience in critical care appear to have a higher range of emotional intelligence. This was also confirmed in a study by Shipley et al. (2004) in which emotional intelligence was associated with work experience. Based on the tests of normality, there was no significant difference in the emotional intelligence of the various context groups that were identified from the single sample (n=220). The exploratory factor analysis identified eight factors as having eigenvalues greater than 1. The statistical evidence pointed to concentrating on factors 1 and 2, and pragmatically these two factors became the focus of the model, as they form the central essence of emotional intelligence of the critical care nurse. The facilitation of inherent affective and mental resourcefulness and resilience was the main concept of the model. Step two comprised the definition and classification of the central and related concepts. This was achieved by finding dictionary meanings and their subject usage. The attributes identified were synthesised to form a definition in chapter five. Step three provided a description of the model. A visual application of the model was shown in chapter six, which highlighted the concepts as proposed by Dickoff, James and Wiedenbach (1968). Three stages of the process of facilitation of emotional intelligence were used to develop the inherent affective and mental resourcefulness and resilience of the critical care nurse. Step four entailed the description of guidelines for operationalising the model in practice to facilitate the emotional intelligence of the critical care nurse in South Africa. Evaluation of the model was undertaken according to Chinn and Kramer (1991 ). To ensure valid results a model of trustworthiness proposed by Guba (1981, in Krefting, 1999) was utilised for the macro argument for the total model. In this study ethical conduct was applied as described by Burns and Grove (2009). The limitations of the research study are highlighted in chapter seven and recommendations of the model for nursing practice, nursing research and nursing education are also made.

South African nursing profession is in a crisis as professional nurses leave the country in search of lucrative work overseas. This exodus will have a catastrophic effect on the delivery of health care over the next decade. It is also clear that the shortages of staff due to the turnover problems in hospitals are also creating various other problems such as enormous pressure on existing employees, job stress and job dissatisfaction. Financial constraints to compete with international competitors, exchange rates, tax-free foreign money, the existence of many job opportunities overseas and the tendency that a person’s career is enriched with overseas experience, makes the retention of professional nurses almost uncontrollable for nursing employers in South Africa. The question was therefore asked whether employers should not rather focus their retention strategies on things they can control internally to retain their employees. An alternative approach, to build strategies around the needs and work circumstances of professional nurses, was therefore proposed. The focus of this study was to develop a predictive model with organisational culture and the selected mediating variables, namely knowledge sharing, organisational commitment, organisational citizenship and job satisfaction, as well as various demographic variables (sub-cultures, tenure, age, level of education, gender, race, home language, level of seniority, marital status, number of dependents) of turnover intentions. A General Linear Model approach was adopted to answer the research question. The relationship between organisational culture and turnover intentions was determined, followed by the independent and/or interdependent role of the demographic variables in predicting firstly, organisational culture and secondly, turnover intentions on a bivariate and a multivariate level. Thereafter, the objective was to determine the independent and/or interactive role of the independent variable (organisational culture) and the selected mediating variables (knowledge sharing, organisational commitment, organisational citizenship behaviour, job satisfaction) in explaining turnover intentions. The next objective was to determine whether knowledge sharing, organisational commitment, organisational citizenship behaviour and job satisfaction mediates the relationship between organisational culture and turnover intentions. The final objective was to determine a most parsimonious model by entering all demographic variables, the independent variable and the mediating variables simultaneously into an equation to determine which variables independently and/or interactively emerged to predict turnover intentions. The most important finding was that 49% of the variance in turnover intentions was explained by the proposed model when all the variables were simultaneously entered into the equation. Organisational commitment emerged as the only independent predictor in the final most parsimonious model of turnover intentions. This result support theoretical evidence of the importance of organisational commitment as predictor of turnover intentions. Organisational culture, in interaction with knowledge sharing and job satisfaction, emerged as predictors in the final model decreasing turnover intentions, while organisational culture in interaction with organisational citizenship behaviour increases turnover intentions of professional nurses. Organisational culture also emerged in interaction with white professional nurses, as demographic variable, decreasing turnover intentions. Organisational culture is therefore an important concept in determining turnover intentions, clearly emphasising the responsibility of nursing employers to seriously embark on internal strategies to prevent turnover amongst professional nurses. Various other demographic variables also emerged in interaction to determine turnover intentions in the final model. They are professional nurses in ICU/casualties and 50 years and older, 1-5 years in unit and an incumbent of a chief professional nurse position, 11 years and more in the current hospital and no dependents above 18, being married/co-habitating and no dependents above 18, 50 years and older and no dependents under 18 and working in ICU/Casualties and in possession of a degree. Finally, knowledge sharing, organisational commitment and job satisfaction mediated the relationship between organisational culture and turnover intentions, although only partially, while OCB’s did not mediated this relationship. Various conclusions and recommendations, theoretically, methodologically and empirically, were made as a result of this study. Further theoretical development of the concepts, especially knowledge sharing, the value of General Linear Modelling and further development of turnover models amongst professional nurses and other health professional alike, were recommended. / Prof. Gert Roodt

Most attempts to lessen the nursing shortage have focused on external factors, such as wages and benefits. In view of the continuing shortage, however, it appears that most of these attempts have not been effective. Research studies are inconclusive as to factors influencing the nursing shortage. The majority of studies examined why nurses leave nursing; this study investigated why they stay. The purpose of the study was to determine if selected demographic variables (age, basic nursing education, time in profession, type of hospital, clinical area of practice) and/or personality factors are related to nurses' job satisfaction and intent to stay in nursing. This was a descriptive exploratory design in which the survey method was used for data collection. The sample consisted of 200 randomly selected staff nurses who met the study criteria; there were 104 usable returns. Instruments were the California Psychological Inventory (CPI), the Minnesota Satisfaction Questionnaire, and a Data Sheet designed by the investigator. Data were analyzed by descriptive statistics, chi-square analysis, t tests, and discriminant analysis. Results showed no statistical significance between demographic variables and Job Satisfaction or Intent to Stay. These CPI subscales were statistically significant: for Job Satisfaction-Responsibility, Achievement via Conformance, Psychological-mindedness, and Socialization; for Intent to Stay-Sociability, Dominance, Self-Acceptance, Capacity for Status, Femininity/Masculinity, and Socialization. Based on the CPI, some of the conclusions were that satisfied nurses take their duties more seriously, find conforming easier, are more at ease in structured settings, and are more interested in why people act than in what they do. Nurses intending to stay are less assertive, dislike competition, are less sociable, readily assume blame when things go wrong, find conforming easier, are more sensitive to criticism, and are more sympathetic. Significant predictor variables were identified for both Job Satisfaction and Intent to Stay. Implications for counseling, education, and nursing were discussed, and recommendations for further study were included. / Ed. D.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Nurses are subjected to occupational stress factors that can result in the syndrome of burnout. This study compared levels of burnout in nurses in a medical-surgical ICU setting to those in non-ICU medical-surgical settings. A randomized sample of 40 nurses of an urban hospital in Taiwan, twenty nurses in an ICU and 20 in five non-ICU settings (general medical-surgical wards), who returned the questionnaire used to measure burnout, were included in the study. The instrument utilized was the Staff Burnout Scale for Health Professionals. The study found no significant difference in levels of burnout in the two groups. Both groups in this study experienced a higher level of burnout than was reported in other studies in United States literature. In particular, two general medical-surgical wards which had high patient/nurse ratios, had very high levels of burnout. The study also found that all nurses with lower educational levels and ICU nurses with more years of work experience had more burnout. / 2999-01-01

The study investigated factors influencing nursing turnover in selected private hospitals in England as the United Kingdom recruited 57 136 nurses from non-European countries from 1998 till 2003. Herzberg's Theory of Motivation was used to contextualise the research results obtained from 85 completed questionnaires. In terms of Herzberg's Theory of Motivation the intrinsic factors (motivators) that could influence nurses' turnover rates were nurses' dissatisfaction with irregular promotions, lack of recognition by doctors, and nurses' lack of autonomy. The extrinsic (hygiene) factors included dissatisfaction with their salaries, and marked dissatisfaction with organization and administration policies and nurses' inability to access information about patient care and about the management of their units. Nurses' turnover rates might be reduced if promotion policies could be consistent, doctors would value nurses' work and if nurses could be more autonomous. Enhanced communication about policies and about accessing information, as well as improved salaries,could contribute to reduced turnover rates among nurses. / Health Studies / M. A. (Public Health)

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