High fidelity simulation is an innovative learning strategy that supports students in developing their critical thinking and clinical judgement abilities. This strategy is used in the School of Nursing at the University of the Free State (UFS) to enhance the acquisition of basic and advanced competencies of students. It was implemented for use in 2009 and is thus regarded as a new practice at the School. It was essential to determine the effectiveness of this strategy. A qualitative, descriptive and exploratory design was used to explore the learning experience of third-year Baccalaureate nursing students on high fidelity simulation (HFS). After the students were exposed to the HFS, they were invited to participate in focus group interviews. Fourteen of the 35 third-year students chose to participate. The inclusion criteria specified that the students should be registered for both their third-year nursing theory and their clinical modules and should have been exposed to the two high fidelity simulation sessions that had been presented. The focus group interviews were audio-recorded and transcribed. For triangulation purposes, data collected by means of the module evaluation questionnaire completed at the end of the semester was also used. Teschâs method was used to code the data and NVivo software implemented to simplify the process. The students described their learning experience as positive and highlighted the advantage and value of HFS as a learning strategy. They entered the learning environment anticipating that they would learn new things. Several emotions were experienced during all the phases of the simulation. They experienced fear before commencing the simulation scenario. This emotion developed into astonishment, alertness and anxiety during the simulation, but changed into self-confidence. The complexity of the simulated situation caused anxiety within the students since they were unsure of how to care for the patient. The students felt excited and stimulated after participating in the facilitated reflection session. The high-technological features of the human patient simulator, the convincing nature of the environment and the interaction within the team led the students to experience the simulation as real. Although authentic, the high fidelity simulation posed less risk than real patient care since students were permitted to make mistakes and learn from these. The students felt that they were able to integrate their theoretical knowledge with nursing practice. This integration occurred during the facilitated reflection session. The self- and peer assessment strategies to which they were exposed assisted the students in identifying gaps in their knowledge. An improvement in critical thinking and clinical judgement abilities was the result of the effective theory and practice integration that occurred. This led to an increase in self-confidence and the belief that the skills acquired during the high fidelity simulation session were transferrable to real instances of patient care. It was evident that proper preparation before the simulation is essential to ensure an optimal learning experience. The students also realised that they should have been better prepared on the subject matter, since this would have enabled them to meet the needs of the human patient simulator more effectively. It can be concluded that the HFS experiential learning opportunity that the third-year students were exposed to assisted them in integrating their nursing theory with practice. Repeated exposure to HFS learning experiences, commencing during their first year of study, might enable nursing students to develop their critical thinking and clinical reasoning skills and, together with patient contact instances, develop their clinical judgement abilities. This will prepare them, as registered nurses, to render safe and effective care to their patients.

Nursing as a profession is currently facing a multitude of difficulties and adversaries. Some of the difficulties and adversaries are poor planning within the managerial top structure of the profession, general negative opinion of the nursing profession, managed patient care by medical schemes, privatisation of hospital care and an ever changing patient profile. These factors lead to the professional nurses of today feeling overwhelmed and frustrated, who will easily leave the profession causing high rate of turnover and a loss of talent and expertise. During the course of this study the current situation within a specific private hospital was evaluated by using the Nominal Group Technique. Characteristics of a negative and a positive work environment were specified and the advantages of creating and maintaining a positive work environment were emphasised. The recommendations gathered during the nominal group sessions were categorised and prioritised to ascertain the most important and critical factors that could improve the work environment of the professional nurses. Strategies were formulated based on the recommendations generated by the professional nurses themselves to improve their work environment. These strategies could be used by the management of the hospital to improve the work environment of the professional nurses to be able to retain the existing staff and recruit interested candidates to fill the vacant positions. The hierarchical needs theory of Maslow was used during the study to indicate the importance of creating and sustaining a positive work environment for the professional nurse by first concentrating on the attainment of the lower order needs. Once the lower order needs are met, the higher order needs will become priority and once that is met, self-actualisation and fulfilment of the professional nurses will follow. Fulfilled staff working in a motivating, positive work environment will not think of leaving the profession and will deliver good quality nursing care leaving the patients feeling satisfied and well cared for.

Introduction and background: Dynamic environmental challenges compel different organizations such as the health sector to focus on innovative changes to address difficult health care challenges. The aim of the study was to develop a framework to support the fostering of intrapreneurship within unit/operational nurse managers working in three public hospitals situated in Mangaung, Free State.The objectives of the study were to analyse the concept of intrapreneurship using Walker and Avantâs framework for concept analysis; to explore the conduciveness towards intrapreneurship of unit/operational managers within the hospital working environment, to explore the intrapreneurial characteristics of unit/operational nurse managers as well as their understanding and view of intrapreneurship within the hospital working environment. Methodology: A convergent parallel mixed method design that included a concept analysis, exploratory qualitative research methodology in the form of focus groups and the application of a quantitative-type descriptive survey using Hillâs Intrapreneurial Index questionnaire III (2003) were used. Reliability was determined through the use of a pilot case study, split-half and test-retest reliability. An exploratory pilot study lead to the adaptation of a number of concepts in the survey to suit the population better. Purposive sampling was used to select participants for the qualitative data collection process that included five focus groups managed by an expert facilitator. In the quantitative data collection process, all members of the population (N=104) had a chance to participate. Ethical clearance was obtained from the Faculty of Health Sciences, University of the Free State. The ethical principles of beneficence, respect for human dignity, and justice were considered. Participation in the study was voluntary, participants were informed of the risks and benefits of the study and homogeneity of the group was maintained at all times. Findings: The concept analysis process underlined the complexity of the multifaceted concept of intrapreneurship and highlighted critical attributes such as innovation, creativity and risk-taking. The majority of the antecedents were located within the organization whilst the consequences highlighted innovative ventures, the identification of opportunities and improved performance. A total of 42 participants attended the focus group sessions with 8 to 9 participants per group. The participants were mostly women (89.7%) and between 50-59 years (55.3%). The focus group discussions yielded a number of interesting results. Participants considered the concept to relate to a business venture, innovation, involvement and of being valued. Factors that were considered conducive to intrapreneurship included for example training and development, planning, quality improvement initiatives and a business focus in the organization. They considered the infrastructure, limited resources, poor security, communication, limited respect for rights and lack of incentives as detriemental to intrapreneurship. Within the quantitative data collection process the response rate was 40% (n=42). Findings from the survey indicated a primarily low intrapreneurial intensity index. Five of the six intrapreneurial indexes as postulated by Hill scored low (leadership, policies, culture, structure and task) whilst only the employee index scored relatively high, indicating participantsâ self-valuing of own innovative vision, and courage to embrace change. Conclusion: The analysis and triangulation of data provided the conceptual data to develop a framework to support intrapreneurship in this context. The framework hinges on the external and internal environment â highlighting the positive and negative influences that come to play. The positive external environmental factors included environmental dynamicity and uncertainty as compared to negative factors such as limited organizational ownership and legislative obstacles. The internal environment outlines the importance of organizational wellbeing, organizational leadership, support and communication. Attributes within the intra-environment include innate, personal attributes of unit/operational managers, demographic and situational attributes. Recommendations from the study focussed on the enhanced teaching and learning of intrapreneurship principles and practices in the public hospital environment, the utilization of the intrapreneurship framework in nursing management programmes (formal and nonformal), the support of intrapreneurial activities at national and provincial level and the inculcation of a paradigm shift to embrace the intrapreneurial approach within health care services. The use of transformational leadership style and the capacity building of nursing teams seem to be pivotal in this process. Limitations: The small sample size in the quantitiatvie survey was a cause of concern, whilst the participantsâ limited knowledge and understanding of the concept of intrapreneurship may have influenced the meaningful identification of factors that hinder or foster intrapreneurship in the public hospital work environment â this might have lead to a focus on challenges they face from day-to-day. The current health care services context was seen to create uncertainty and fear of cutting positions. This may have resulted in insecurity amongst unit/operational nurse managers and their willingness to freely disclose matters of concern.

The aim of the study was to assess the injury profile of recruits during BMT at 3 SAI Bn Kimberley. The study objectives were to identify and describe the demography, socio-economic status and medical history of these recruits, as well as the type and mechanism of exercise-related injuries among them. The design involved a quantitative, non-experimental, descriptive design with a self-reported questionnaire as data collection technique. The demography of the recruits indicated a large majority of Blacks (83%) with very few Coloureds, Whites and Indians. The gender distribution was 46.9% (n=173) female and 53.1% male (n=196). Gender (P=2.351E-10) statistically contributed to injuries. Participants had significantly better socio-economic living standards than the average South African. The overall injury prevalence was reported as 25%, of which 19% were reported by female and 6% by male participants. Injury rates were the highest during weeks 3-4 of the BMT programme. Smoking, contraception use, amenorrhea and miscarriages prior to BMT were not found to be statistically significant injury risk factors. Being unfit was indicated as a statistically significant risk factor for injuries (P=0.0091). Having participated in sport (P=0.0296), and specifically in weightâbearing types of sport (P=0.0023), was found to have significantly reduced injuries. Females experienced higher stress levels which made a statistically significant (p=0.0034) contribution to injury prevalence. The most frequent sites of injury were the knee (40%), ankle (19%). lower leg (13%) and lower back (9%). Hydration and nutrition, as well as warm-up activities to prevent injuries were investigated. The biomechanical aspects that were reported, inter alia, indicated that the majority of the respondents had sustained injuries during activities which entailed running or falling, and most sustained muscle/tendon dislocation injuries during obstacle course training (P=0.0178). The questions regarding back-packs and external loads revealed that these did not have an impact on the prevalence of injuries. Environmental risk factor responses regarding the weather indicated that it was found very hot during training, but neither rain nor wind played a role in the injuries. The terrain mostly contributed to ligament injuries (P=0.0063) which occurred in the afternoon, especially in the middle of the training programme. The recommendations are aimed at establishing task teams to consider pre-enlistment fitness criteria, as well as remedial fitness training. Other recommendations deal with a balanced physical fitness programme, injury control programmes, and health promotion programmes. Attention is also paid to smoking, stress factors, communicable disease transmission; haemoglobin screening and the use of sun block.

No description available.

Epidemiological studies have shown that vascular diseases and specifically venous diseases are the cause of lower leg ulcers, that venous diseases are the cause of 70% of lower leg ulcers in the United Kingdom and 70 to 90% of all ulcers in North America and England. In North America 10 to 15% of ulcers are the result of a combination of venous and arterial insufficiency. Two treatment modalities are available for venous lower leg ulcers: ¿ sustained compression and ¿ intermittent pneumatic compression. The aim of this study was to compare the usefulness and effectiveness of intermittent pneumatic and sustained compression with each other. To attain this objective: ¿ the profile of patients with venous lower leg ulcers was described. ¿ the effectiveness of sustained versus intermittent pneumatic compression modalities regarding wound healing were compared. ¿ the effectiveness of sustained versus intermittent pneumatic compression modalities regarding pain were compared. ¿ The factors that influence the feasibility of the two treatment modalities were identified. This study consisted of two components. In the first place a descriptive study was undertaken of the patients with venous lower leg ulcers who visited the out-patient department of a Tertiary hospital in the greater Bloemfontein area. The second component was an experimental study in which the effectiveness of the two treatment modalities were compared. The patients in the experimental study were allocated to the experimental and control groups by means of a random list. Patients in the experimental group were treated with intermittent pneumatic compression for twelve weeks, while those in the control group were treated with four-layer compression bandages for the same period. The study lasted for 27 months until the desired sample size was reached. Data confirmed the information available in the literature regarding venous lower leg ulcers. Outstanding characteristics of the profile were the majority of the patients were obese and hypertensive. The misuse of topical antimicrobic drugs became clear from the patientsâ history. It also appeared that many of the patients lacked knowledge of and insight into the causes and nature of venous lower leg ulcers, as well as their prevention and treatment. It became clear that the ulcers of more patients treated by means of sustained compression were healed than those with intermittent pneumatic compression. This difference in wound healing was, however, not statistically significant. The pain levels of the patients of both groups decreased with treatment between the first and last assessment. However, the difference between the pain levels of the experimental and control groups was not statistically significant. The most import factors that influence the feasibility of the two treatment modalities were the following: ¿ A shortage of nursing staff and doctors were experienced due to the labour intensity of the study; ¿ Communication problems (it was necessary to use an interpreter at times); ¿ A shortage of wound dressings and bandages due to unforeseen circumstances; ¿ The Department of Health under-estimated the cost implications of the treatment modalities; ¿ Intermittent pneumatic compression as a treatment modality was available only to patients in the greater Bloemfontein area. Volgehoue versus intermitterende pneumatiese kompressie as behandelingsmodaliteite in pasiënte met veneuse onderbeenulkusse 35 ¿ Sustained compression â patients from outside the greater Bloemfontein area missed a treatment session if they missed the ambulance that transported them to the hospital. ¿ Patients experienced transport problems due to high taxi fares and transport was not always readily available on public holidays or over weekends. ¿ The continuity of sustained compression had, in some cases, to be broken for some patients if the patient presented with clinical signs and symptoms of infection.

There is a human tendency to make judgements about those one is working with, as well as about oneself. Performance appraisal seems to be both inevitable and universal. With its absence, people tend to judge the work performance of subordinates naturally, informally and arbitrarily. A qualitative study was undertaken to explore and describe the experiences and expectations of registered nurses in Lesotho regarding performance appraisal. Recommendations are made according to the results of the study and these will assist the NGOs which were part of this study and the Ministry of Health and Social Welfare in Lesotho in the planning and implementing of the performance appraisals of registered nurses. Six phenomenological focus group interviews were conducted within the selected institutions to ascertain the participantsâ experiences and expectations in relation to performance appraisal. The meaning of these experiences and expectations was also explored. Basic steps in qualitative analysis as outlined by Ulin, Robinson, Tolly, & McNeill (2002) were used to analyse the data. The participants reported various experiences regarding performance appraisal. They reported experiences such as an increase in motivation and performance, receiving training, gaining insight into their own performance and being able to refer problems to supervisors as a result of performance appraisal. There were also feelings of dissatisfaction such as performance appraisal being seen as a threat, a lack of commitment, poor appraisal skills, unreliable instruments, no benefits, unclear purpose and the poor administration of performance appraisals. They also expressed their expectations regarding performance appraisal. Most of them would like the organisations to clarify the purposes of performance appraisals and their involvement in them. Both appraisers and appraisees should be trained in performance appraisal. The instruments should be reviewed, consistency in the appraisal process should be ensured and organisational decisions should be based on the results of the appraisal. The poor attitude and weak appraisal skills, inconsistencies in the appraisal process, the unclear purpose, the inability of appraisers to provide feedback and do follow-up, and also organisational decisions such as salary increments not based on the results of appraisal, were a concern across all the focus group interviews. Recommendations were made in view of both the experiences and expectations of these registered nurses. The organisation should define and clarify the purpose and the relationship between appraisal, performance and rewards, the results of the performance appraisal should be analysed and used for making organisational decisions. The full involvement of appraisees, the training of both appraisees and appraisers, more frequent appraisals throughout the year, the development and availability of standards of nursing care, the review and development of appraisal instruments, and further research are needed.

Background. Tuberculosis is increasing in the Free State and Northern Cape provinces of South Africa, but it is not clear how much of the disease is caused by reactivated latent infection and how much is attributed to interpersonal transmission. The discovery of the transposable DNA insertion sequence, IS6110, provided the desired polymorphism among different strains to track routes of transmission, study the degree of inter-person transmission versus reactivation, to detect laboratory contamination and disease outbreaks. Alternative methods include spoligotyping and the mycobacterial intergenic repetitive units or variable number of tandem repeats (MIRU-VNTR). Sustained studies performed on a small area in the Western Cape Province and some mines in the Gauteng Province of South Africa have found person-to-person transmission of tuberculosis to be high in these populations. In addition, resistance determinants to key antituberculosis drugs have remained unknown among tuberculosis causative organisms circulating in the Free State and Northern Cape. Thus, extensive DNA fingerprinting and gene mutation studies are needed to address these problems. Methods. An area in the Free State suitable for long-term surveillance studies was defined using available information from the governmental database, the 1996 census statistics, and tuberculosis (TB) case loads and transfer data obtained from the National Tuberculosis Database. Each clinicâs catchment information was provided by clinic managers and the population movement data from a 2002 student project. Sputum samples were collected and Mycobacterium tuberculosis isolated from tuberculosis positive patients from the defined area (Gamadi). Isoniazid resistant isolates received from a representative sample from the Free State and a few strains from the Northern Cape Province were also included in the study. IS6110-directed restriction-fragment-length polymorphism (RFLP) analysis was performed on all isolates and drug susceptibility testing (indirect proportion method) done on the Gamadi isolates. Subtyping of identical strains (RFLP clusters) and some of the isolates with less than six IS6110 bands was done using spoligotyping and the MIRU-VNTR typing. DNA sequencing analysis of the katG and rpoB genes was done in resistant isolates and a rapid PCR-based restriction enzyme katG gene mutation detecting method evaluated. Results. An area characterised by extreme poverty (unemployment rate 69.0%), a relatively young population (69.0% below 35 years) of 61534 and with high incidence of tuberculosis (840/100 000) suitable for long -term surveillance studies was identified in the Free State. The area is served by three clinics and a hospital and is situated near the rural town of Thaba Nchu in the Free State province. Eighty eight M. tuberculosis isolates and a mycobacterium-other-than-tuberculosis (MOTT) were isolated from the 286 sputum specimens collected from the Gamadi area. Only two M. tuberculosis isolates tested isoniazid (INH) resistant and no rifampicin (RIF) resistant isolates were found. The MOTT was resistant to INH (0.2, 1 and 5 µg/ml) and to RIF. Standard IS6110-based DNA fingerprinting of 84 of 88 (96.5%) isolates from the defined area was performed. Four of the isolates were cultured from duplicate sputum specimens provided by four patients. Two of these had identical fingerprint patterns to the first isolate of the patient and two had a different profile. The latter pair could be attributed to laboratory error. IS6110 sequences were not detected in six isolates. Fourteen isolates had less than six IS 6110 hybridisation bands and four strains were in clusters. The remaining 57 (88.9%) strains had distinct RFLP profiles with more than six bands. The number of IS6110 copies varied from seven to 21. A total of five strains was distributed in two clusters, one with two and the other with three members. Thirteen family groups, clustered at 65.0% on the similarity dendogram, each with two to eight strains, but no dominant groups were evident. A cluster of three isolates with five identical IS 6110 bands each was confirmed as one strain by MIRU-VNTR typing while two further isolates (both had three bands of different sizes) were confirmed as different strains by MIRU typing. A total of 37 isoniazid-resistant M. tuberculosis was analysed. DNA fingerprint profiles showed nine isolates with less than six insertions (24.3%). Six of these isolates were from the Free State and three from the Northern Cape Province. Three of these isolates were multidrug resistant. The remaining 28 isolates (75.7%) contained between 9 and 18 copies of the IS6110 insertion sequence. Twenty-six different IS 6110 RFLP types were identified. Only two clusters with two isolates, respectively, were found in each province. Eight clonally related groups (65.0% similarity) with two to four strains were present. Three clusters of two isolates (each with more than six bands) also exhibited identical spoligotype patterns. Spoligotyping of two of three isolates from a fourth cluster (4 RFLP bands each) showed two different banding patterns and all were shown to be different by MIRU-VNTR typing. The fifth cluster (2 bands) was made up of one isolate from each province. Spoligotyping of these strains was identical, but the MIRU was different. One isolate from Bloemfontein had identical IS 6110-RFLP and spoligotyping patterns to a susceptible isolate from Gamadi. Isoniazid resistance in 22/37 isolates was sequence linked to altered nucleotides of codon 315 of the katG gene. Twenty harboured the ACC variant at the codon. One strain carried the AAC mutation at this codon and the other GGC. The remaining 15 carried the wild type (AGC) genotype at this site. Two of the strains harbouring the AGC315ACC mutation belonged to the same IS6110 cluster. Two mutations were found at codon 463 (CGG ® CTG; CGG ® CCG). Thirteen MDR strains were investigated for rpoB gene alterations. Four of these isolates carried no mutations within the 157-bp amplified fragment while the others had various mutations. Analysis of an 808bp fragment of the katG gene from INH-resistant M. tuberculosis isolates after restriction with Msp I agreed with results obtained by sequencing. Thirteen isolates carried a pattern consisting of 228, 153, 146, 109, 79, 65 base pairs with the 153 bp fragment indicating the presence of the wild type AGC at codon 315 of the katG gene. Seventeen isolates demonstrated the 228, 146, 132, 109, 79, 65, 21 profile with the 132 bp fragments indicating the presence of an ACC mutation. Three isolates contained a mixed genotype and were digested into the fragments 228 bp, 153 bp, 146 bp, 132 bp, 109 bp, 79 bp, and 65 bp. Fragments with 146 bp and 65 bp are seen in strains with no mutation (bases CGG) at codon 463, while a 211 bp fragment shows a mutation at this spot. Four strains had the fragments 228, 211, 153, 109, and 79 bp. One strain was digested into six fragments of 228 bp, 211 bp, 132 bp, 109 bp 79 bp and 21 bp containing both a 315 (ACC) and 463 (CTG) codon mutation. Discussion and conclusions. An area consisting of ten villages and characterised by a high incidence of tuberculosis was defined for long-term surveillance studies. Resistance in the area appears to be low and compares favourably to the situation in the Free State. Strains received from this area were highly diverse, but the presence of a cluster of five isolates indicated the need for continuous investigation. Recent transmission of INH resistance in the Free State province is not a significant factor, but since the isolates from the Northern Cape were not representative, no deduction could be made for this province. Resistance to INH is mostly associated with mutation AGC to ACC at codon 315 of the katG gene. The absence of alterations in a proportion of isolates is in agreement with published data implicating the involvement of more genes in causing INH resistance. Resistance to RIF was associated with various point mutations in the 81-bp core region of the rpoB gene. The high proportion of the ACC allele found among INH-resistant strains, cost effectiveness, ease to perform and rapid results, make PCR-RFLP an attractive option for detection of resistance especially in resource-poor countries.

The Choice on Termination Act , No 92 of 1996 determine the circumstances in which and conditions under which the pregnancy of a woman may be terminated; believing that termination of pregnancy is not a form of contraception or population control. The act however grand women permission to terminated their pregnancies during the first 12 weeks of the gestation period, solely on her request and without reason. According to the statistics of termination of pregnancy of the Department of Health in the Free State an enormous increase in termination of pregnancies were noted after the implementation of the Act, No 92 of 1996. The believe for the practice of termination of pregnancies was that it should be done only according to the provisions of the Act, and under no circumstances as a form of contraception or to rid unwanted pregnancies. The enormous increase in the statistics of termination of pregnancies might therefore be seen as a consequence of unwanted pregnancies. The researcher thus decided due to this observation to launch an investigation to clarify the reasons leading to the increase in termination of pregnancies. The aim of the study was to identify the reasons for the high incidence of termination of pregnancies in the Free State. The objectives of the study was to identify: 1) the possible reasons for unwanted pregnancies 2) the possible reasons for termination of pregnancies. The researcher used a descriptive design as it provided an accurate portrayal of the characteristics of a paticular group in a real life situation. Data was obtained by individual structured interviews directed by the researcher by using a questionnaire. The participants in the study consisted only of clients visiting the termination clinics requesting a termination. The data was obtained in three of the institutions in the Free State rendering termination services. The instutions was selected purposively, though the participants were conveniently selected. The data-analysis was conducted by the Biostatistics department at the University of the Free State. Explanatory data, namely frequencies and percentages for categorical variables and medians and percentages for continuous variables, have been determined. The coding of the questionnaires was done by the researcher and the data was presented by using tables and figures. The researcherâs conclusion is thus that women whom request termination of pregnancies use their terminations as a form of contraception, which is forbidden by the Act, No 92 of 1996. The majority of the participants in this study however named socioeconomic reasons for their decision to have a termination. The prevention of pregnancy might decrease requests for termination of pregnancies. According to the data-analysis and conclusions, recommendations were made to increase the incidence of termination of pregnancies. Specific recommendations regarding the following aspects of the research findings were made: 1) sexual education, 2) the effective use of contraception, 3) the prevention of termination of pregnancies, 3) support of parents and family in the decision to have a termination, and 4) counselling. Recommendations regarding ongoing research according to the data-analysis and conclusions were made and focuses primarily on counselling, repeated termination of pregnancies and the psychological condition of women whom request termination of pregnancies.

Florence Nightingale was 206 years ago of opinion that Nursing is not a household sercide or charity service and that nurses should be educated Nursing today is acknowledged as a profession and the aim of Nursing Education, as formulated by the South African Nursing Council (SANC) is that student nurses should be holistically developed. In contrast to 20 years ago, professional nurses today have to function autonomously, scientifically, within legal and ethical frameworks as well as cultural congruently. It is no more expected from professional nurses to only act on doctorsâ prescriptions, to perform technical procedures or to only observe patients and record information. They have to practice as independent practitioners. In accordance to SANC requirements, students are educated in the science and art of Nursing, other related sciences as well as Ethics and Professional Practice (Björkstrom, et al., 2006:505; Davis, Tschudin & de Raeve, 2006:21; Jormsri, Kunaviktikul, Ketefian & Chaowalit, 2005, intyds; Gastmans, 2002:intyds; Taft, 2000:intyds; Hussey, 1996:251) When students apply for registration with SANC after they have completed their studies, they actually declare that they comply with the autonomy, responsibility, values and norms of Nursing and are prepared to practice accordingly. This implies that they declare that they have developed a professional identity. Development of professional identity is an ongoing process and has to be addressed, amongst others, in the teaching of Ethos and Professional Practice. The aim of this study was to understand what the nature of Professional Practice is and to assess the process of teaching of Ethos and Professional Practice at national level. The research was explorative, descriptive and explainatory in nature and both quantitative techniques and qualitative techniques were used for gathering of data. Data gathering was done in different phases, namely analysis of disciplinary hearings, focus groups, literature analysis as well as telephone interviews. The results indicate that the majority of nursing institutions teach the content appriopriate to SANCâs guidelines. These guidelines were drafted in 1985 and is currently being revised. The profile of the students who are entering Nursing has changed. It is therefore a concern that traditional teaching techniques, such as lectures, class room discussions as well as written assessment are still mostly used in teaching Ethos and Professional Practice. These techniques do not improve development of professional identity. The time allocated to the teaching of [Ethos and] Professional Practice is problematic if the development of professional identity is required. Teaching and following-up of students with regard to [Ethos and] Professional Practice in the clinical setting was found to be insufficient. Taking this into account as well as the fact that there are not sufficient positive role models present, make it impossible for students to develop a professional identity. Students who do not develop a professional identity have a greater risk of unprofessional conduct. A framework, aimed at teaching [Ethos and] Professional Practice in order to develop a professional identity was compiled. This aimes to enhance professional conduct.