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Barreca, Rebecca J. "Lived Experiences of Nurses: Nurse Characteristics by Clinical Specialty." Kent State University Honors College / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1303941706.
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Usishkin, Monica Gun. "Nurse-patient communication in different clinical areas : the nurses' perspective." Thesis, Anglia Ruskin University, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440245.
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Gurbutt, Russell. "Demonstrating nurses' clinical decision-making." Thesis, University of Central Lancashire, 2005. http://clok.uclan.ac.uk/21842/.
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The study answers the question: 'How can nurses' properly considered decisions relating to patient care be demonstrated?' Nurses in the United Kingdom have a professional requirement to demonstrate': the properly considered clinical decisions relating to patient care' (UKCC, 1994; NMC, 2002). However, their decisionmaking has been reported as complex and poorly understood, and apart from nursing records, little evidence exists to demonstrate their decisions. The development of the nurses' role as a decision-maker is traced from an origin in Nightingale's text (1860) through to the present day. This role is shaped by organisational, nursing and medical profession influences. Having established that nurses have a role as decision-makers, a conceptual framework is used to examine different explanations about the decision process, outcome, context and how decisions are made. Before undertaking fieldwork, a survey of nurses' decision-making in general medical and surgical wards was conducted. The findings were compared with the conceptual framework to generate questions and avenues for enquiry. An ethnographic study was undertaken in 1999 - 2000 in four general medical wards in two English provincial NHS Trusts with registered nurses (general). A model of decision-making was developed as a mid range theoretical explanation of how they made decisions. This involved a narrative based approach in which nurses generated an account (narrative) of knowing a patient and used this to identify needs. The patient was known in a narrative through three categories of information: nursing, management and medical. These categories were constructed through nurses' information seeking and processing using a tripartite conceptual lens. These facets correspond to different aspects of the nurse's role as a carer, care manager and medical assistant. The patient is known in three ways in a narrative, as a person to care for, an object to be managed, and as a medical case. An oral tradition surrounded its use, and nursing records were not central to decision-making. The narrative was used to make decisions and influence medical decisions. Once it was established how nurses made decisions, a method was developed to show how they could demonstrate their properly considered clinical decisions relating to patient care. This involved using the narrative based decision-making model as an analytical framework applied to nurse decision narratives. Narrative based decisionmaking offers a development of existing descriptive theoretical accounts and new explanations of some features of the decision process. This particularly includes the use of personal note sheets, the role of judgements and the cycle of communicating the narrative to nurses and its subsequent development as a process of developing an explanation of how the patient is known. Having addressed how nurses can demonstrate their properly considered clinical decisions relating to patient care, conclusions are drawn and implications explored in relation to practice, professional regulation, education and method. Recommendations include a challenge to the assumption about decision-making underpinning existing NMC guidance on recordkeeping, and the need to recognise diversity of decision-making practice across different nursing sub-groups. The narrative revealed nurses' ways of constructing knowing patients and rendering this visible. Nurses' not only have a duty, but also a need, to demonstrate decisions so that they can render visible what it is they are and do.
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Cornes, Desmond. "An exploration of the perceptions of nurse lecturers, student nurses and clinical mentors of the utility of student nurses undertaking international clinical experience." Thesis, Glasgow Caledonian University, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.726765.
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Forbes, Helen V. "Clinical teachers' experiences of nursing and teaching." Connect to full text, 2006. http://hdl.handle.net/2123/2060.
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Thesis (Ph. D.)--University of Sydney, 2007.Title from title screen (viewed 22 November 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Education and Social Work. Degree awarded 2007 ; thesis submitted 2006. Includes bibliographical references. Also issued in print.
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Codier, Estelle. "The Emotional Intelligence of Clinical Staff Nurses." Diss., University of Hawaii at Manoa, 2006. http://hdl.handle.net/10125/22048.
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Dozens of studies throughout a wide range of professions and settings have demonstrated significant correlations between emotional intelligence and high levels of perfonnance, productivity, team effectiveness, lower levels of job stress and other positive organizational outcomes. There is little research on the emotional intelligence of nurses and none in the United States on the measured EI of clinical staff nurses.This descriptive, explorative and quantitative study was undertaken to analyze the emotional intelligence of clinical staff nurses. Clinical staff nurses from three urban hospitals on Oahu, Hawaii, participated in the study. An emotional intelligence instrument was used that was based on the ability model of emotional intelligence (MSCEIT v2).
Findings from this study support the conclusion of previous studies in non nursing literature that perfonnance level correlates positively with emotional intelligence scores. Nurses in this study demonstrated greater ability in emotional intelligence skills related to strategizing with emotions than the skills related to experiencing them. The highest branch scores were related to the skills of managing emotions and the lowest the skills of perceiving emotions. The findings of this study suggest that inclusion of emotional intelligence skills in nursing curricula, both in the academic and clinical practice settings, may be important to retaining and supporting a resilient and thriving nursing workforce in the future.
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Hobbs, Steven Douglas. "Clinical Nurses' Perceptions of Nursing Informatics Competencies." Diss., University of Hawaii at Manoa, 2007. http://hdl.handle.net/10125/22055.
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This is a descriptive study undertaken to identify competencies and supporting knowledge and skills in informatics perceived to be necessary by nurses for nurses engaged in clinical practice. This study applied a non-experimental, descriptive research design to a quantitative survey performed through web-based technology. Based upon the foundational work of Staggers, Gassert, and Curran (2001, 2002), the goal was to substantiate with clinical nurses and their direct nurse supervisors the clinical competencies that Staggers' identified for Beginning and Experienced clinical nurses through a Delphi methodology of nursing experts. All study facility Registered Nurses received an e-mail inviting their participation. Respondents logged on to a website and completed sections applicable to their situation; that is Beginning Nurse, Experienced Nurse, or Nurse Supervisor. Reminder emails were sent at two and four weeks after the initial invitation. Respondents who accessed and completed the survey received a $5.00 food coupon redeemable at the hospital facilities. All of the knowledge, attitudes and skills identified were supported as valuable, that is, a mean score greater than neutral. Value ranged from just above neutral to strongly agree. Factor analysis generally supported categorization; however, many items did not load into the anticipated categories. Categorization is one area which deserves further study.
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Dixon, Elizabeth May. "Examining clinical supervison with palliative care nurses." Thesis, University of Hertfordshire, 2009. http://hdl.handle.net/2299/3029.
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This study focuses on the current issues regarding the provision of clinical supervision for palliative care nurses. NICE (2004) recommendations stated that the task of supervision should be undertaken by „Level 4‟ practitioners such as clinical psychologists or psychiatrists. Palliative care nurses are recognised to experience high levels of stress due to the emotionality of their role. However there appears to be little understanding of how they cope with this aspect of their role. Self care is promoted as a useful strategy; however this is thought to have limitations due to the questionable ability for an individual to objectively and accurately assess their own mental and emotional state. Clinical supervision has been attempted with palliative care nurses but this appears to focus on the internal world of the nurse rather than the interaction between nurse and patient. This study employed a staff survey, including a demographic questionnaire, the Copenhagen Burnout Inventory and the General Health Questionnaire, followed by individual interviews and focus groups analysed using thematic content analysis. Participants were recruited from two teams within one cancer network. Results showed that there was an incidence of both high stress and psychiatric morbidity within the sample. Provision of clinical supervision was shown to be inconsistent across the two teams. Although there was recognition that clinical supervision would be beneficial, there was a certain amount of confusion regarding the concept as well as suspicion about the „real‟ agenda. These factors appeared to work together to produce a situation in which clinical supervision was not being provided or accepted in a way that would maximise its efficacy as its application was inconsistent with the theoretical basis. In conclusion, in order to better support palliative care nurses with the difficult aspects of their role, it was suggested that a more structured and consistent picture of clinical supervision was provided. This would enhance their practice, support their emotional needs and protect the patients under their care.
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Beattie, Heather, and res cand@acu edu au. "The Theory Practice Interface: A case study of experienced nurses' perception of their role as clinical teachers." Australian Catholic University. School of Educational Leadership, 2001. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp3.14072005.
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This research explores how experienced nurses perceive their role as clinical teachers in an environment that is challenged not only with on-going changes in healthcare delivery, but also by the expectation that it will continue to provide positive clinical learning opportunities for undergraduate student nurses. Schools of nursing in Australia have undergone rapid and far-reaching change as a consequence of the legislated transfer of nursing eduction to the tertiary sector. Expectations that nurse academics will possess higher degrees and be actively involved in research mean that faculty members have less time to be directly involved in their students learning during clinical practice placements. The literature indicates that the responsibility for moment to moment teaching and learning thus appears to have been implicitly given to clinical staff who may not possess any formal qualifications for teaching, yet are largely responsible for students learning through clinical placements. Indeed some clinicians report a worrying lack of knowledge of clinical supervision models giving cause for further concern about the nature of the clinical learning environment. Schools of nursing expect that clinical practica will provide opportunities for students to learn how to be a nurse through guided questioning, analysis and critical thinking. It is evident that in some settings, this represents an ideal situation and not the reality. Critical reflection on these issues has informed the purpose of this research and helped to shape the following questions that focus the conduct of the study: Research Question One. How do experienced nurses create positive clinical learning environments for student nurses? Research Question Two. How do experienced nurses resolve the often-contradictory demands of nursing students and those of the practice setting? Research Question Three. How do changes in the healthcare environment impact on the experienced nurse's role as a clinical teacher? The theoretical framework for this study was underpinned by the interpretive philosophies of hermeneutic phenomenology and symbolic interactionism, because they acknowledge the personal experiences and meanings of the participants. A case study approach was utilised because it acknowledges the given context of the participants. Data were collected from six experienced nurses through a series of semi-structured interviews, informal interviews and periods of participant observation supported by field notes and the researchers diary. Participants identified that their perception of their role as clinical teachers was constructed of three intersecting roles: that of facilitator of learning, assessor and socialiser. This study concludes that several factors influence these nurses perception of their role as clinical teachers. In particular, the positivist work culture of the clinical setting and nurses own past experiences and world view of nursing combine to shape these nurses perception of their role as clinical teachers. The research concludes that the expectations that students will be supported in their endeavours to be critically thinking, problem solving and reflective practitioners may, in fact, be unrealistic in the current, economically constrained, clinical environment. It is evident that experienced nurses, despite being willing to be involved with clinical teaching, have to function in rapidly changing environments that do not always offer opportunities for nurses to reflect on their practice. However, the creation of positive clinical learning environments in these circumstances requires an increased understanding and appreciation by both schools of nursing and their students of the impact of change on these nurses and their clinical environment. This appreciation may result in more effective collaboration between nursing education and nursing service to assist student nurses to learn not merely through repetitive practice and busywork, but also through opportunities to observe, question and understand their nursing practice.
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Prusky, Sharon, and University of Lethbridge Faculty of Education. "The impact of employing a clinical nurse educator on a nursing uni." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 1994, 1994. http://hdl.handle.net/10133/62.
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The issues of job satisfaction for nurses and nurses' continuing clinical competence have become major concerns for the nursing profession as evidenced by a growing volume of research into these areas. Both job satisfaction and clinical competence of nurses can affect quality of care (of which patient satisfaction is one facet). This study focussed on the concepts of job satisfaction and clinical competence of nurses, and patient satisfaction-their interelationships, and how they were affected by the implementation of a Staff Development Nurse on one nursing unit in an active treatment hospital. A hospital-based Job Enhancement Project provided a unique opportunity to combine a dynamic real-life situation with an additional case study approach to examining the issues though interviews and documentation of the relationships among the nursing staff over an 18-month period of time. Both quantative and qualitative methods were used to gather pertinent information in addressing the research questions. Focus unit nursing staff questionnaires returned initially (13 of 27) and at the one-year mark (six of 27) of the Project, and interviews with six key participant nursing staff were used to survey nurses' perceptions of their own job satisfaction and clinical competence as well as their perceptions of their peers' job satisfaction and clinical competence. The patients admitted to the focus unit during the Project time frame were also invited to complete patient satisfaction surveys. The Staff Development Nurse and the Nursing Unit Manager were interviewed to give their perspectives. The Staff Development Nurse kept a journal of her work for the 18 month period, and so did the researcher. Frequencies, percentages, and content analysis of qualitative data provided the statistical and descriptive information for inerpretation. One finding in this study was that the Staff Development Nurse did have a positive influence on the clinical competence of some of the nursing staff on the focus unit, which may have in turn had a positive influence on nurses' perceptions of job satisfaction. The Staff Development Nurse was an immense support for the Nursing Unit Manager. However, the major finding in this study was that there were many other factors which influenced nurses' perceptions of job satisfaction, many of them which were beyond the control of the SDN. The SDN actually became a mitigating factor or a buffering agent in helping the nursing staff cope with these other factors. This study contributes to the growing body of research
on nurses'quality of working life and some of the influecing factors. It may also provide insights into the realtionships between nurses and patients, and the role definition of a nurse educator on one nursing unit.xiii, 246 leaves : ill. ; 29 cm.
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Kinnaman, Mary Louise Wilson Thad. "Exploring the clinical decision-making strategies of nurses." Diss., UMK access, 2006.
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Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2006."A dissertation in nursing." Advisor: Thad Wilson. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed Jan. 29, 2007. Includes bibliographical references (leaves 213-230). Online version of the print edition.
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Meeks-Sjostrom, Diana. "Clinical decision-making of nurses regarding elder abuse." unrestricted, 2008. http://etd.gsu.edu/theses/available/etd-04302008-123109/.
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Thesis (Ph. D.)--Georgia State University, 2008.Title from file title page. Cecelia Gatson Grindel, committee chair; Anne Koci, Annette Bairan, committee members. Electronic text (144 p. : ill.) : digital, PDF file. Description based on contents viewed July 10, 2008. Includes bibliographical references (p. 82-86).
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Meeks-Sjostrom, Diana J. "Clinical Decision-Making of Nurses Regarding Elder Abuse." Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/nursing_diss/8.
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A descriptive correlational design based on an adapted model of Donabedian’s Structure, Process, Outcome model and Benner’s Novice to Expert theory was used to examine the clinical decision-making of nurses regarding elder abuse. The relationship of the nurses applied knowledge (assessment cues) of elder abuse; demographic questions (e.g. years of experience as a Registered Nurse (RN) and their clinical level of practice status), the use of intuition in nursing practice; and clinical decision outcomes (interventions) for patients in cases of suspected elder abuse was examined. A convenience sample of RNs who worked in the emergency department (ED) in three acute care hospitals, in southeastern United States were asked to complete questionnaires on education about elder abuse, their intuition use, demographic information, applied knowledge of elder abuse, and clinical decision outcomes for suspected elder abuse. The majority of the nurses had participated in the clinical level of practice status program.The convenience sample of 84 RNs consisted of 68 females (81%) and 16 males (19%). The average age of the respondents was 41.43 years. The mean number of years worked as a RN was 13.87 years. Multiple regression results indicated an overall model of two predictors (RNs applied knowledge (assessment cues) and years worked as a RN) significantly predicted clinical decision outcomes (interventions). The model accounted for 25.1% variance in clinical decision outcomes. The t-test revealed there was no difference (applied knowledge (assessment cues) of elder abuse, intuition use in nursing, years working as a RN, clinical level of practice status, and clinical decision outcomes (interventions)) between RNs who received elder abuse education at orientation and those who did not receive the education. The study results suggest that years of working as a nurse supported elder abuse recognition and intervention. The clinical level of practice status of nurses was found not to be a sensitive indicator. Elder abuse education during orientation varied between the hospital settings. The results indicate the educational need for nurses regarding suspected elder abuse.
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Scheiber-Case, Lisa M. "A Clinical Pathway Education Program for Pediatric Nurses." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1464.
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Clinical pathways have been studied to promote best practices in nursing and enhance patient satisfaction. For 10 years a pediatric orthopedic surgical team at a Midwest hospital has not had a clinical pathway to treat or standardize care for adolescents following posterior spinal fusion surgery. Pain scores and patients' length of stay were collected using a retrospective chart review. This information was used to revise preoperative education materials and develop a visual poster. The purpose of this project was to identify and develop a way to educate the pediatric nursing staff on the use of the developed educational materials, poster, and clinical pathway prior to its implementation. David A. Kolb's learning cycle and the experiential learning model was used as the theoretical foundation of this study. The quality improvement project for the nurses will be developed using a flipped classroom approach as the learning environment. Videos, scenarios, and small group activities will be created and used in an interactive learning environment. The study will use a pretest-posttest design of retrospective chart review data with the independent variable being the education provided to the nurses. Social implications related to this project are to provide information on the plan of care following surgery to the adolescent and caregiver. This project will promote positive social change for adolescents and caregivers who will be engaged in the postoperative care to increase their satisfaction and decrease their anxiety.
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Lewis, Malcolm Allan. "The social organisation of bullying in nursing : accounts of clinical nurses and nurse managers." Thesis, Manchester Metropolitan University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426929.
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Hansen-Salie, Nasieba. "Professional nurses' perceptions of newly qualified professional nurses competency and factors influencing competency." University of the Western cape, 2011. http://hdl.handle.net/11394/5406.
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Magister Curationis - MCurIn our constantly changing healthcare system and with large numbers of staff shortages in hospitals, newly qualified professional nurses are expected to be competent and work unsupervised in leadership capacities soon after they have completed their nursing programs. The study was aimed at determining the perceptions of professional nurses of newly qualified professional nurses' competency as well as factors that influence competency. A quantitative approach using a descriptive survey design was employed, using 34 experienced professional nurses working in selected private hospitals in the Western Cape. Data was collected by means of a peer evaluation questionnaire, namely the Competency Inventory for Registered nurses. Data was analyzed, using IBM SPSS 19 with the assistance of a statistician. The results of the 55-item Competency Inventory for Registered Nurses indicate that newly qualified nurses were perceived as highly competent in clinical care, leadership, interpersonal relation, legal/ethical and professional development. Newly qualified nurses were perceived as low in competency in teaching/coaching, critical thinking and research aptitude. All the factors identified using literature, were perceived as having an influence on competency. Recommendations were made to the institutions to assist newly qualified nurses in competence development.
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Msiska, Gladys. "Exploring the clinical learning experience : voices of Malawian undergraduate student nurses." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/7772.
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Very little has been done to define the process of clinical learning in Malawi and yet anecdotal observations reveal that it is more challenging than classroom teaching and learning. This set the impetus for this hermeneutic phenomenological study, the aim being to gain an understanding of the nature of the clinical learning experience for undergraduate students in Malawi and to examine their clinical experiences against some experiential learning models (Kolb 1984; Jarvis et al 1998). The study setting was Kamuzu College of Nursing (KCN) and the sample was selected purposively and consisted of 30 undergraduate students who were recruited through volunteering. Conversational interviews were conducted to obtain students’ accounts of their clinical learning experience and an eclectic framework guided the phenomenological analysis. The study raises issues which relate to nursing education and nursing practice in Malawi. From an experiential learning perspective, the study reveals that clinical learning for KCN students is largely non-reflective. The study primarily reveals that the clinical learning experience is enormously challenging and stressful due to structural problems prevalent in the clinical learning environment (CLE). In some clinical settings the CLE appears hostile and oppressive due to negative attitudes which some of the clinical staff display towards KCN students. Consequently, students’ accounts depict emotionally charged situations which confront them and this illustrates that clinical learning for KCN students is an experience suffused with emotions. In literature issues on emotions are commonly discussed under emotional labour (Hochschild 1983) and I used the concept as a basis for my pre-understandings and interpreted the students’ accounts of their clinical learning experience against such a conceptual framework. What resonated from their narratives was the depth of the emotion work they engage in. This enabled me to arrive at a new and unique conceptualisation of clinical learning redefined in terms of emotional labour within the perspective of nurse learning in Africa. The findings are a unique contribution to the literature on emotions and provide essential feedback which forms the basis for improving clinical learning in Malawi.
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Montgomery, Tamara L. "Staff Nurse Perception of Professional Role Modeling for Student Nurses in the Clinical Learning Environment." Otterbein University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1492596984491297.
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Aydin, Sinem, and Emilia Björk. "Nurses´ perceptions of caring behaviors in clinical practice : A questionnaire study with nurses in Vietnam." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7584.
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Cash, Penelope Anne, and mikewood@deakin edu au. "Women clinical nurses' constructions of collegiality: An ethnomethodological study." Deakin University. School of Nursing, 2000. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20051123.122031.
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This research is about a shared journey of being together. It involved thirteen women nurses (including myself) in a process approach to working with data collected through audio transcriptions of conversations during group get-togethers, field notes and journalling over twelve months. The project was conducted in a large acute care metropolitan hospital where the ward staff interests lie in a practice history of the medical specialty of gynaecology and women's health.
Prior to commencement ethical approval was gained from both the University and hospital ethics committees. Accessing the group was complicated by the political climate of the hospital, possibly exaggerated further by the health politics across the state of Victoria, at a time of major upheaval characterised by regionalism, rationalisation and debt servicing.
In order to ascertain women clinical nurses' constructions of collegiality I adopted an ethnomethodological approach informed by a critical feminist lens to enable the participants to engage in a process of openly ideological inquiry, in critiquing and transforming practice. I felt the choice of methodology had to be consistent with my own ideological position to enable me to be myself (as much as I could) during the project. I wanted to work with women to illuminate the ways in which dominant ideologies had come to be apprehended, inscribed, embodied and/or resisted in the everyday intersubjective realities of participants. The research itself became a site of resistance as the group became aware of how and in what ways their lives had become distorted, while at the same time it collaboratively transformed their individual and collective practice understandings, enabling them to see the self and other anew.
Set against the background of dominant discourses on collegiality, women's understandings of collegiality have remained a submerged discourse. Revealed in this work are complex inter-relationships that might be described by some as collegial!, but for others relations amongst these women depict alternative meanings in a rich picture of the fabric of ward life. The participants understand these relations through a connectedness that has empathy as its starting point.
In keeping with my commitment to engage with these women I endeavoured to remain faithful to the dialogical approach to this inquiry. Moreover I have brought the voices of the women to the foreground, peeling away the rhizomatic interconnections in and between understandings. What this has meant in terms of the thesis is that the work has become artificially distanced for the purposes of academic requirements. Nevertheless it speaks to the understandings the participants have of their relationships; of the various locations of the visible and invisible voices; of the many landscapes and images, genealogies, subjectivities and multiple selves that inform the selves with(in) others and being-in-relation. Throughout the journey meanings are revealed, revisited and reconstructed. Many nuances comprise the subtexts illuminating the depths of various moral locations underpinning the ways these women engage with one another in practice. The process of the research weaves through multiple positions, conveying the centrality of shared goals, multiple identities, resistances and differences which contribute to a holding environment, a location in which women value one another in their being-in-relation and in which they stand separately yet together.
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Black, Margaret Elizabeth. "Student nurses' clinical decision-making, key to professional practice." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ27764.pdf.
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Hewett, Deirdre. "Workplace violence targeting student nurses in the clinical areas." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5183.
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Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Workplace violence in health care is a worldwide phenomenon. In nursing, the nature of workplace violence is predominantly non-physical in nature. Literature reveals the devastating consequences for the individual nurse, both physically and / or emotionally, depending on the nature of the violence. The consequences for the organisation / institution and the profession are equally devastating, manifesting in reduced standards of patient care and increased attrition from the profession. The pervasiveness of this problem indicates that to date, remedial and protective measures have been unsuccessful. However, most of the research done on workplace violence in nursing has been conducted amongst qualified nurses. The purpose of this study was to investigate the extent of workplace violence, targeting student nurses in clinical areas. The setting was the Western Cape College of Nursing and the population was second, third and fourth-year, pre-registration students. The research objectives addressed various aspects, for example, type, prevalence, perpetrators, consequences and management of workplace violence. A quantitative research design, utilising a survey, was chosen for the study. A probability sample of n = 255 students was selected, using stratified, random sampling as the sampling method. The variables selected for stratification were gender and year of study. A self reported, anonymous questionnaire, guided by the literature review and by the research objectives, was utilised for data generation. Summary statistics were used to describe the variables, whilst distributions of variables were presented in the form of histograms and frequency tables. Where appropriate, the relationships between demographic and research variables were described, using suitable statistical analyses. The findings revealed that the perpetration of non-physical violence against student nurses is widespread, particularly that perpetrated by co-workers, more specifically registered, staff- and assistant nurses. The under reporting of workplace violence was a common finding. Student nurses suffer grave emotional consequences as a result of workplace violence. Almost half of the respondents admitted that they had considered leaving nursing due to workplace violence and that it had negatively affected their standard of patient care. The overall conclusion was that, in accordance with a worldwide trend amongst all categories of nurses, student nurses are targets of workplace violence in the clinical areas. These findings have particular implications for the management of nursing education institutions. The fact that student nurses are targeted to the extent revealed in this study indicates that existing preventive measures in the clinical areas have not been effective. The recommendations arising from this study therefore focus on equipping the vulnerable trainee with the tools to withstand workplace violence. As such, the recommendations are directed at the management of the nursing education institution, to create awareness around the problem, to empower students to confront and cope with workplace violence and to support students traumatised by workplace violence. Finally, this study suggests avenues for further research, for example, research in the same setting after implementation of the recommendations, or further research into the dynamics of workplace violence, targeting student nurses from the perspective of qualified nursing staff or patients.
AFRIKAANSE OPSOMMING: Geweld in die gesondheidsdienste werksplek is ‘n wêreldwye verskynsel. In verpleging is geweld in die werksplek oorwegend nie-fisies van aard. Die literatuur wys op die ingrypende fisiese en / of emosionele gevolge vir die individuele verpleegkundige, afhangend van die aard van die geweld. Die gevolge vir die organisasie of instelling, asook vir die verpleegberoep, is eweneens ingrypend en manifesteer in verlaagde standaarde in pasiëntsorg en ‘n toename in verpleegkundiges wat die beroep verlaat. Die algemene verskynsel van die problem dui aan dat regstellende en beskermende maatreëls tot dusver onsuksesvol was. Die meeste navorsing oor geweld in verpleging is egter tot dusver onder gekwalifiseerde verpleegkundiges gedoen. Die doel van hierdie studie was om die omvang van werksplek-geweld, met studenteverpleegkundiges as teikengroep, in die kliniese areas na te vors. Die studie is by die Wes-Kaap Kollege van Verpleging uitgevoer en die populasie was al die tweede, derde en vierde-jaar, voor-registrasie studente. Die geformuleerde navorsingsdoelwitte vir die studie het verskeie aspekte aangespreek, soos byvoorbeeld, tipe, frekwensie, die uitvoerders van geweld, gevolge en die hantering van werksplek-geweld. ‘n Kwantitatiewe navorsingsontwerp, met gebruikmaking van ’n opname, is vir die studie geselekteer. ‘n Waarskynlikheidsteekproef van n = 255 studente is deur middel van gestratifiseerde, ewekansige steekproefneming geselekteer. Geslag en jaar van studie was as die veranderlikes vir stratifikasie gekies. Die instrument vir data-insameling was ‘n self-voltooide vraelys, gebaseer op die literatuurstudie en gerig deur die navorsingsdoelwitte. Opsommende statistieke is aangewend om die veranderlikes te beskryf, terwyl die verspreidings van veranderlikes in die vorm van histogramme of frekwensie-tabelle aangebied is. Waar toepaslik, is die verhoudings tussen demografiese en navorsingsveranderlikes met behulp van toepaslike statistiese analises beskryf. Die bevindinge het onthul dat die pleeg van nie-fisiese geweld teenoor studenteverpleegkundiges algemeen voorkom, veral daardie deur mede-personeel, meer spesifiek geregistreerde, staf– en assistent verpleegundiges. Die onderrapportering van werksplek-geweld was ‘n algemene bevinding. Studenteverpleegkundiges ly aan erge emosionele gevolge, as gevolg van werksplek-geweld. Byna die helfte van die respondente het erken dat hulle oorweeg het om die beroep te verlaat en dat sodanige geweld hul standaard van pasiëntsorg negatief beinvloed het. Die oorkoepelende gevolgtrekking was dat studenteverpleegkundiges, in ooreenstemming met ‘n wêreldwye neiging onder alle kategorieë van verpleegkundiges, die teiken van werksplek-geweld in die kliniese areas is. Hierdie bevindinge hou spesifieke implikasies vir die bestuur van verpleegonderriginrigtings in. Die feit dat studenteverpleegkundiges tot die mate, soos in die studie onthul, geteiken word, het aangetoon dat bestaande voorkomende maatreëls in die kliniese areas oneffektief is. Die voorstelle vanuit hierdie studie is dus daarop gerig om die ontvanklike nuweling toe te rus om werksplek-geweld teë te staan. As sulks is die voorstelle gemik op die bestuur van die verpleegonderrig-inrigting, om bewustheid rondom die probleem te skep, om studente te bemagtig om geweld te konfronteer en te hanteer, en om studente, wat as gevolg van werksplek-geweld getraumatiseer is, te ondersteun. Laastens word moontlikhede vir verdere navorsing voorgestel, soos byvoorbeeld, navorsing in dieselfde omgewing na die implementering van die voorstelle, of verdere navorsing in die dinamika van werksplek-geweld teenoor studenteverpleegkundiges, vanuit die perspektief van gekwalifiseerde verpleegpersoneel of pasiënte.
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Clark, Rebecca Culver. "Clinical decision making by beginning nurses: a naturalistic study." Diss., Virginia Tech, 1996. http://hdl.handle.net/10919/37767.
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Van, Wyngaarden Angeline. "Educational practices for promoting student nurses' clinical reasoning skills." Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/61674.
Full textAbstract:
Background: Clinical reasoning is the ability to reason as a clinical situation changes and is an
essential component of competence in nursing practice. However, some traditional teaching
and learning strategies do not always facilitate the development of the desired clinical
reasoning skills in nursing students.
Problem statement: Nurse educators at a military nursing college in Gauteng are
predominantly utilising traditional teacher-centred teaching and learning strategies. The
concern is that if students are predominantly taught by means of traditional teacher-centred
strategies this may not contribute to the development of the desired clinical reasoning skills
required for nursing practice. To improve educational practices to promote the development of
student nurses' clinical reasoning skills, the researcher conducted an action research study.
Aim: The aim of the study was to facilitate a process of change towards improving educational
practices in order to promote the development of undergraduate student nurses' clinical
reasoning skills.
Methodology: Action research was used to conduct the research study by means of three
phases. During Phase 1: the Baseline phase, data was collected by means of unstructured
interviews with nurse educators and head of departments to explore and describe the
challenges experienced by nurse educators in utilising alternative educational practices.
During Phase 2: the Action Research Process phase, an action research group was
established to co-construct an action plan to address the identified challenges. Four action
research cycles each comprising four steps, namely plan, act, observe and reflect was
implemented. Phase 3, the Evaluation of the Action Research Process phase, evaluated the
outcomes of the action research process by means of the World Café data collection method.
Qualitative data from Phase 2 was analysed using the steps outlined in Saldaña (2013). The
activities conducted during the action research group workshops were recorded and minutes
were kept. Data from the World Café was analysed using the creative hermeneutic data
analysis method as suggested by Boomer and McCormack (2010).
Findings: The challenges encountered by nurse educators were explored and the following
four main themes emerged: educational practices; clinical learning environment; military learning environment; and role players in the teaching and learning environment. The
challenges were prioritised by the action research group into four strategies: teaching, learning
and assessment strategies; the clinical learning environment; continuous professional
development; and support and selection of students and nurse educators. An action plan was
co-constructed during Phase 2 by the action research group participants. The project was
evaluated by the action research group as successful. The action research process contributed
to the professional development of the nurse educators and resulted in the utilisation of more
student-centred teaching, learning and assessment strategies.
Conclusions: An action plan was developed to improve educational practices at the South
African Military Health Service Nursing College. The researcher also developed a conceptual
framework to promote clinical reasoning skills. Addressing nurse educator challenges in
collaboration and empowering them with the means, opportunity and skill to utilise studentcentred
teaching and learning strategies may contribute to the development of undergraduate
student nurses' clinical reasoning skills.Thesis (PhD)--University of Pretoria, 2017.
Nursing Science
PhD
Unrestricted
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Astley-Cooper, Jean. "The lived experiences of student nurses in clinical placement." Thesis, Swansea University, 2012. https://cronfa.swan.ac.uk/Record/cronfa42762.
Full textAbstract:
Nurse education over the last 30 years has undergone radical change which has transformed the nature, design and content of pre-registration nurse education. In Britain there is little known about the total impact of practice placement on learning and development of nurses' identity from the students' perspective. How nursing practice is understood and interpreted influences students practice experience, in addition to how they learn and construct their identity as registered professionals. This research study explores student nurses' experiences of clinical placement whilst undertaking a pre-registration adult branch nursing course. A qualitative hermeneutical phenomenological approach was used and after ethical approval was received the experiences of 9 student nurses were collected using unstructured, individual interviews which were transcribed and analysed. The key findings showed that clinical placement experience fell into three main categories; successful, unsuccessful and failing communities of practice. Mentors influenced the experience students had in practice in these three categories. In successful placements, students practiced alongside registered nurses with opportunities to observe these nurses at work. In unsuccessful practice communities, students described impressions of not belonging, loneliness and confusion, and compartmentalised their experience into the work and learning which affected their over-all learning experience. Failing communities of practice exposed and subjected the students to unprofessional values and behaviours from registered nurses, which if adopted and applied, impacted detrimentally on the care that patients received. As the experience of clinical placement influences how students are socialised into the practice of nursing, how they learn and construct their identities as registered nurses, solutions designed to strengthen the clinical placement component of nurse education have been suggested in the following areas: belonging and modelling, placement quality and organisation, curriculum development, and mentor preparation and updating.
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Tyne, Sheila. "Critical Thinking and Clinical Judgment in Novice Registered Nurses." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4822.
Full textAbstract:
The health care field has become increasingly more complex, requiring new nurses to be prepared upon graduation to respond to a variety of complex situations. Unfortunately, many graduates from associate degree nursing (ADN) programs are not able to think critically upon entering the work force. This presents a major problem for the nurse and for the employer. The purpose of the study, therefore, was to gain a deeper understanding of the graduates' perceptions of their ability to critically think during their first year of clinical practice, and if they believed their program prepared them to be critical thinkers. The key research questions focused on how the novice nurses reconciled their performance on a critical thinking, online assessment, the Health Sciences Reasoning Test (HSRT), with their perception of their critical thinking skills, and if they felt prepared, during their first year of clinical practice, to critically think. The conceptual framework applied was Bloom's Taxonomy and Tanner's clinical judgment model. A purposeful sampling of 7 novice nurses from 3 ADN programs was chosen. After completing the HSRT, audio-taped phone interviews were conducted. The data indicated that the participants felt unprepared to respond to emergent patient situations, thus undermining their self-worth and clinical competency. The participants agreed there was a need for a critical thinking course in ADN curriculum. A project was created for a 9-week critical thinking course, incorporating theory, clinical practice, and simulation exercises. Social change is expected to occur when student nurses are able to critically think upon graduation, resulting in positive patient outcomes, both of which will benefit patients, their families, and their communities.
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Lulloff, Amanda J. "Nutrition Related Clinical Decision Making of Pediatric Oncology Nurses." Thesis, Boston College, 2018. http://hdl.handle.net/2345/bc-ir:107898.
Full textAbstract:
Thesis advisor: Judith A. VesseyPurpose: The purpose of this study is to investigate staff nurses’ clinical decision making (CDM) regarding pediatric oncology patients’ nutritional status. Background: Malnutrition, both under- and over-nutrition, in children can lead to significant morbidity and even mortality. Pediatric cancer patients are at high risk for malnutrition secondary to the disease process and treatment side effects; malnutrition in pediatric oncology patients is associated with poorer outcomes. Pediatric oncology nurses, with frequent and consistent contact with patients, are in an ideal position to assess nutritional status. Early identification and intervention for nutritional concerns in patients has been shown to improve outcomes. However, research on the quality of pediatric oncology nurses’ CDM regarding nutritional status does not exist. Methods: A web-based survey was distributed to members of the Association of Pediatric Hematology Oncology Nurses; it was comprised of three sections: a demographic data collection form, pediatric oncology nutrition related vignettes, and the New General Self-Efficacy Scale. The vignettes were rated on a one to five scale with one being under-nourished and 5 being over-nourished. Participants were asked to report their confidence in their rating and select cues in the vignette supporting the rating. A multi-level regression analysis was utilized to assess the quality of nurses’ CDM, the confidence of the nurses’ CDM, and the factors associated with CDM. Results: No nurse or organizational factors could be identified as useful in predicting the accuracy of the participants’ nutritional rating; however, nurses were significantly likely to under-rate the vignette when comparted with the expert panel’s rating. Nurses were significantly likely to select fewer cues supportive of nutritional rating than the expert panel. Conclusions: Further research regarding nutritional assessment and nurses’ clinical decision making is warranted. Evidence-based guidelines for nutritional assessment of pediatric oncology patients should be developed and implemented to ensure this patient population receives the highest quality of care
Thesis (PhD) — Boston College, 2018
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Rose, Anna-Karin. "Newly Graduated Nurses’ Experiences Of The Intervention Practitioner Training Nurse. : A Qualitative Interview Study." Thesis, Malmö universitet, Institutionen för vårdvetenskap (VV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-42164.
Full textAbstract:
Aims and objectives: To describe newly graduated nurses’ experiences of the intervention practitioner training nurse. Background: Newly graduated nurses need support to establish the profession. Several studies have shown that the first years in the profession, is the most challenging time. Method: The intervention practitioner training nurse was initiated to empower, and support newly graduates nurses in their professional role. Data were collected through semi-structured interviews with ten newly graduate nurses having experience of the intervention. The data were analysed using qualitative content analysis. Results: The analysis results in the overarching theme; “Organizational prerequisites” The theme consisted of three categories, "Activator" comprised the subcategories compiliating and attractive workplace. This involved that the practitioner training nurse were the activator creating a clear structure and the wards became more attractive workplaces. “Supportive nursing" comprised the subcategories present assistance, emotional support, and patient safety. This involved that practitioner training nurse constituted an important support function and helped to ensure patient safety. “Professional development” comprised the subcategories nurse's competence, feeling of security, and learning. This created the opportunity for professional development. Conclusion: The newly graduate nurses' experience of the intervention shows that the creation of an organisational structure enabled the practitioner training nurse to be an important support and to contribute to professional development. This was accomplished by strategic decision of the hospital management. Relevance to practice: The results of the current study can be transferred to other similar healthcare organizations and can be a support for managers who plan to initiate interventions to empower and support newly graduated nurses.
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Buthelezi, Sibusiso. "Clinical learning experiences of university male student nurses during their placement in a clinical setting." University of the Western Cape, 2014. http://hdl.handle.net/11394/4174.
Full textAbstract:
Magister Curationis - MCurAn increasing number of males is entering the nursing profession. The researcher in his position as a clinical supervisor at the School of Nursing at the University of the Western Cape (UWC), through informal ward rounds with student nurses in the wards, has received concerns raised by male student nurses regarding their dissatisfaction with their clinical learning. Given the paucity of literature about the experiences of males working in a profession dominated by females, the researcher embarked on this study to understand how male student nurses experienced the clinical learning environment. The aim of the study was to explore and describe the lived clinical learning experience of male student nurses during their experiential learning in the clinical setting. A descriptive phenomenological design was used. Purposive sampling was used to select participants from the second, third and fourth year of their study. Three focus group discussions, consisting of six participants per group were used to collect data. One open-ended question guided the interviews. Focus group discussions were audio-recorded and transcribed verbatim. Data analysis was conducted by means of Colaizzi`s (1978) seven steps method of qualitative analysis. Three major themes identified focused on the experiences regarding the constraints in the learning environment, the impact on the self and social support of students working in a female dominated profession. The participants in this study were male students only, but after looking at the findings and literature, the problem of not being given opportunities to practise clinical skills in a clinical learning environment, particularly according to their level of study, is a problem that faces both male and female students. The findings indicate that male nurses do have different experiences compared to female nurses because of their masculinity, hence they are limited in the care that they can provide to female patients.
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Poon, Wai Sha. "Staged participation : student nurses' and clinical facilitators' perceptions of the clinical learning environment in Macau." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/20988.
Full textAbstract:
With the movement of nurse education into the higher education sector, the role of student nurses has moved from that of apprentices to learners with full student status on placement. Although supernumerary status is key to current nursing training, not much attention has been paid to its influence on student participation in the community of practice of the workplace. This thesis has set out to address this research gap. A qualitative dominant mixed methods study closely examined student participation on placement by comparing and contrasting students’, mentors’ and clinical instructors’ clinical learning and mentoring experiences and their perceptions of supernumerary status was carried out. Data were collected in a nursing college in Macau. In the qualitative part, a sample of seven third year and six fourth year student nurses were recruited to participate in a focus group interview corresponding to their year of study. In addition, five mentors and five clinical instructors were interviewed individually. Views from participants were compared and contrasted. For the quantitative part, all second to fourth year students were invited to respond to a questionnaire after placement. One hundred and fifty-one questionnaires were returned. Descriptive and inferential statistics were used to analyse the quantitative data. This study revealed that there is a lack of clarity about supernumerary status among student nurses. However, students’, mentors’, clinical instructors’ and nurses’ perceptions of clinical learning and supernumerary status exert an impact on student participation on placement. Although students were temporary peripheral participants of the workplace, they had to be engaged in the clinical environment and authentic practice in order to create connections with the workplace and develop nurse identities. It was found that students who were facilitated by mentors, who were drawn from ward staff, had more opportunities to participate in qualified nurses’ work and work with the nursing team on placement than those supported by university-based clinical facilitators.
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Winfield, Catherine V. "Clinical decision making in district nursing." Thesis, University of Surrey, 1998. http://epubs.surrey.ac.uk/2830/.
Full textAbstract:
The two studies described here address the question of how District Nurses determine patients' nursing problems and plan care. The theoretical framework for the investigation is derived from Information Processing Theory. A process tracing methodology was used to capture the content of District Nurses' thinking during an assessment visit to a newly referred patient. Data was collected in the natural setting to ensure ecological validity. The assessment visits were tape recorded and immediately following the visit a stimulated recall session was conducted in which the nurse was asked to describe her thinking during the assessment, prompted by the tape recording. This session was itself tape-recorded. Thus two verbal protocols were elicited for each assessment: a visit protocol and a recall protocol. Data were analysed by content analysis. The verbal protocols were assessed to ensure that they met the criteria for validity and reliability of the coding schedules was established using two measures or interrater reliability. The first study sought evidence of hypothetico-deductive reasoning by nurses and describes the type of decisions made by nurses. Although evidence of hypothesis generation and testing was found, nurses' knowledge was found to determine how they interpreted data initially and what data they sought. It was therefore concluded that a model of diagnostic reasoning that focused on cognitive processes alone was insufficient to explain the dynamics of clinical problem solving. The second study, therefore, sought to establish the structure and content of District Nurses knowledge and the cognitive processes they used during an assessment. The results suggest that nurses attend to both clinical and personal phenomena in order to make a judgement about the state of the patient and that their knowledge is organised internally as schema. This provides an explanation of how nurses recognise salient information and determine what further data is required. Four key cognitive activities were identified: search, inference, action and plan. The study concludes by drawing a line of reasoning to show how nurses integrate knowledge and reasoning processes to accomplish clinical problem solving.
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Mhlongo, Eva Otshepeng. "Perceptions of Registered Nurses regarding nurse-nurse communication during bedside clinical handover in a private hospital in Mpumalanga Province." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/75025.
Full textAbstract:
Aim and objectives
The aim of the study was to obtain the perceptions of registered nurses regarding nurse-nurse communication during bedside clinical handover in a level three private hospital of Mpumalanga province. The objectives were to obtain the participants’ demographics, their perceptions regarding the clinical bedside handover and the communication during the clinical bedside handover. Recommendations for clinical practice and education were provided thereafter.
Background
Communication during bedside clinical handover is described as the transfer of the patient, information, equipment, professional responsibility and accountability from one professional person or group to another. Effective communication during bedside clinical handover is vital in providing high quality care. Failure to communicate essential patient information by the registered nurse can lead to undesirable adverse effects.
Methods
A quantitative descriptive design was used to obtain an answer to the research question. Total population sampling, due to the relatively small population, was used to single out registered nurses working in nine units of the selected hospital. A structured questionnaire was used to collect data and frequency distributions and descriptive statistics with graphs and Fisher’s exact test were used to analyse data. Testing was done at the 0.05 level of significance. Cronbach’s alpha was computed to assess internal reliability.
Results
Four major results emerged from the data:
• Timing of the handover process remains a challenge to the quality of communication during bedside clinical handover.
• Lack of confidence and experience of the registered nurse present a threat to the quality of communication during bedside clinical handover.
• Team dynamics including the use of indigenous language during bedside clinical handover resulted in lack of teamwork and trust, posing a threat to the quality of communication during bedside clinical handover.
• Task factors, environmental factors, organisational factors and nurse factors affects the quality of communication during bedside clinical handover.
Conclusion
The results of the study will be communicated to the management team including the nursing staff of the selected hospital under study. Challenges and threats identified related to the quality of bedside clinical handover will be used as a management tool for quality improvement.
Key words: Communication, Bedside Clinical Handover, Nurses, PerceptionDissertation (MNurs)--University of Pretoria, 2020.
Nursing Science
MNurs (Nursing Management)
Unrestricted
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Mwilila, Mary Chandeu. "Work-related low back pain among clinical nurses in Tanzania." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8701_1271624569.
Full textAbstract:
Low back pain (LBP) is a significant problem among the nursing population worldwide. Manual lifting and shifting of heavy objects and patients are primary contributing factors. Nurses are supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Strategies to reducing the incidences of LBP in nurses have been previously implemented but with little outcomes. The purpose of this study was to explore the relationship between occupational risk factors and the prevalence of LBP in nurses at MOI, Tanzania. Therefore, the study examined
the prevalence of LBP amongst nurses, work-related risk factors contributing to LBP, knowledge and effectiveness of back care techniques, and barriers to effective back care techniques in clinical nurses.
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Calman, Lynn Ann. "Patients' views of nurses' clinical competence : a grounded theory approach." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/24043.
Full textAbstract:
This thesis examines, from the viewpoint of the patient, what is meant by competent nursing and how, with this perspective in mind, patients would regard the prospect of assessing the competence of nurses. The study utilises a grounded theory approach. Twenty-seven patients were interviewed about their views of nursing care. Preliminary data collection was undertaken in general medical and surgical areas. A theoretical sampling strategy was developed to include more experienced patients in three specialty areas renal dialysis, cystic fibrosis and diabetes care. Data were analysed, in keeping with the grounded theory tradition, utilising the constant comparative method. Patients described the process of becoming a patient and how they come to understand the complex social world of the hospital and the role of nurses within this. They identified the features of a good nursing encounter as being patient led, personal and individualised. Patients also identified their own responsibilities, specifically how to be a ‘good’ patient. Previous studies have highlighted the importance of the quality of the nursing encounter – the nurse/patient relationship, individualised patient care and empathy for example. This study specifically raises the issue that patients take technical competence for granted and highlights the important finding that when technical competence is assumed than these interpersonal factors become the most important indicator of the quality of nursing care. These personal and highly individual encounters between the patient and nurse and personality characteristics displayed such as caring and kindness, empathy and sense of vocation are difficult to measure or make objective judgements about. Although patients can discriminate between nurses who have these attributes and skills, being involved with the formal assessment of these attributes is considered a difficult prospect. The study findings emphasise that patient assessment of nursing competence is complex and implications for nurse education and service provision are highlighted.
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Ho, Wai Yu. "Nurses' use of iPads for clinical documentation : a usability study." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/45686.
Full textAbstract:
Background/Purpose: Handheld devices are becoming increasingly prevalent in healthcare settings; however, few studies have examined the use of handheld devices for clinical documentation in the acute care setting. The purpose of this study was to investigate how nurses use the iPad for clinical documentation in the acute care setting. Methods: End user usability testing with think-aloud protocol was performed in a laboratory environment. Nurses who worked on an orthopedic surgery unit that use electronic clinical documentation were given a fictitious patient scenario with seven clinical documentation tasks that maximized the use of different functions of the iPad interface. A coding scheme was developed based on user and system behaviours defined by Dawson and Kushniruk. Results: Nine nurses participated in the usability testing. Nurses were in the nursing profession for an average of 13.2 years and in the study setting for an average of 11.5 years. All nurses reported that they had a desktop computer for personal use, and some nurses also owned an iPad (50%) and Smartphone (62.5%). Coded events were categorized into problems related to navigation, screen size, data entry, and login/logout. Navigational problems were mainly characterized by extra taps, mistaps, and the switch between tapping with finger and stylus. Nurses also had problems with the screen size when reading the font and icons, and selecting objects. Data entry problems were related to using a small external keyboard, and the mismatch with how data is saved between the iPad and the desktop computer terminals. Login/logout problems were significant barriers to clinical documentation as the process for both were time-consuming and required multiple steps. Conclusion: Improvements in clinical practice and the organization are warranted to enhance the use of iPads in the acute care setting, including education on the unit, and structural and technical supports from the organization. Organization supports include improving organizational infrastructure, incorporating stakeholder engagement and testing into the planning and implementation processes, and evaluating the compatibility of the operating systems employed by the handheld device and the organization. Further research in this area is warranted to better inform practice and future decision-making.
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Hermiz, Mary E. "Teaching critical thinking skills to student nurses in clinical settings." Virtual Press, 2001. http://liblink.bsu.edu/uhtbin/catkey/1221272.
Full textAbstract:
What strategies are effective for clinical nurse instructors to use in developing critical thinking in student nurses? Many clinical strategies have been discussed in, literature, but only a few have been verified through research as to their usefulness.This study used the qualitative research methodology of multiple case studies. Participants were six clinical nurse instructors. Nursing experience ranged from 17-27 years, teaching experience involved 2-24 years. Four instructors had doctorates, one nurse had a masters degree, and the sixth nurse lacked two courses before completing a masters degree. The six instructors were from five areas of nursing: medical/surgical (beginning and intermediate level), maternity, mental health, community health and management.Each instructor was interviewed three times during the same semester, approximately two weeks apart. Interviews were audio recorded and transcribed. Spradley's (1979) domain and taxonomic analyses were used to analyze the data.Data analysis showed that some strategies were used by all instructors, with adaptations made for the specialty. The strategies used by all instructors were questioning, nursing care plans and clinical conferences. More than one instructor used student journals, teaching projects, research articles, milieu assessments, and case studies/scenarios.This research strongly supported the use of questioning to help the student progress in critical thinking. Contrary to some research, the present research found that questioning by the instructors was not detached but was situated in the client setting which helped the student synthesize facts into a whole. The research identified many questions used by the clinical nurse instructors.Instructors identified their role in assisting students toward critical thinking as helper, facilitator, coach and guide. Instructors also identified the following characteristics as necessary to help students: caring attitude, creativity, perseverance, knowledgeable, listener, encourager and learning attitude. The instructors motivated students as they progressed in critical thinking through verbal and nonverbal rewards. Students gained self-confidence as they experienced success in their journey towards critical thinking. Implications for nursing practice are provided. The importance of this research lies in the rich depth of discovering how these strategies, roles, characteristics, and motivators assist nursing students in developing critical thinking skills in different clinical settings.2Department of Educational Leadership
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Bignell, Vivien. "The promotion of continence : implementing clinical guidelines for community nurses." Thesis, University of Surrey, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423535.
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Suiter, S. R. "Factors influencing Western Australian clinical registered nurses in discharge planning." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1166.
Full textAbstract:
A descriptive quantitative study was conducted to determine what factors nurses considered when discharge planning, and how these factors compared with factors identified in the literature as being effective in planning for discharge. This study was undertaken because with the intended Prospective Payment System (PPS) of funding to hospitals, it is essential that Western Australian Clinical Registered Nurses are able to prepare patients for discharge effectively to prevent the financial burden of cost outliers and re-admissions. Anderson and Steinberg ( 1984) in their studies of factors that influence the cost of hospital care for the elderly, found that the results of inappropriate and premature discharges resulted in a 22% readmission rate within 60 days of discharge for all Medicare hospitalisation. Their (1988) study of readmission rates of Medicare beneficiaries between 1974 and 1977 showed that the added costs associated readmissions cost the U.S. government more than US$2.5 billion per annum. It would seem probable that such a system introduced into the Australian health:care system will have the potential to produce similar effects for Western Australian patients, nurses and nursing.
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L'Ecuyer, Kristine Marie. "Attitudes of staff nurse preceptors related to the education of nurses with learning disabilities in clinical settings." Thesis, Saint Louis University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3624082.
Full textAbstract:
This dissertation presents a quantitative study of the attitudes of staff nurse preceptors toward nursing students with learning disabilities. There are an increased number of nursing students with learning disabilities. These students may have additional challenges in clinical settings, particularly if clinical settings do not understand or support their educational needs. Stigma exists towards people with learning disabilities, and it is unclear if staff nurse preceptors are accepting of nursing students with learning disabilities and willing to serve as a preceptor.
Attitude was measured with the following four constructs developed for this study: perceived levels of preceptor preparedness, level of confidence in implementation of preceptor role, preceptor beliefs of student potential, and agreement with the provision of reasonable accommodations. These constructs were developed through a review of the literature and found to best represent the dynamic relationship between the preceptor and the preceptee.
This study analyzed data from an electronic survey to examine the preceptor's attitudes towards learners with learning disabilities and their willingness to serve in the preceptor role for students with learning disabilities. Preceptor's familiarity with learning disabilities, knowledge of issues related to learning disabilities, and their concerns regarding nursing students and new graduate nurses with learning disabilities were assessed. The preceptor's familiarity with learning disabilities and knowledge of issues related to learning disabilities were low, and their concerns were high. However their attitudes were mixed. Preceptors reported that they were not well prepared and had low levels of confidence in their ability to support and accommodate those with learning disabilities. However, they had strong beliefs in the potential of both nursing students and new graduate nurses with learning disabilities, and they had high levels of agreement that reasonable accommodations should be provided.
The preceptors indicated a high willingness to serve in the role of preceptor for both nursing students and new graduate nurses with learning disabilities. Attitudes toward new graduate nurses with learning disabilities were slightly more positive than the attitudes toward nursing students with learning disabilities, and willingness to precept was higher for new graduate nurses than nursing students. The conclusions of this research are that preceptors are accepting and willing to take on the challenge of precepting nursing students with learning disabilities, however they need information and support from their institutions and nurse educators.
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Suzuki, Kerry. "Perceptions of the Role of Nurses in Providing Psychosocial Care for Patients with Cancer." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/910.
Full textAbstract:
Psychosocial care for patients with cancer is aimed at detection, diagnosis, treatment, and prevention of psychological distress (PD). PD is a universal clinical phenomenon experienced by at least 38% of patients with cancer, yet only10% are identified as having PD. Nurses are presumed providers of psychosocial care, yet no research examined what nurses perceive as their role in caring for patients with cancer, and whether nurses believe that providing psychosocial care to patients with cancer is within their role. Patient care that rests on assumptions is too precarious; nurses' role beliefs are critical in light of their impact on practice and psychological distress. Accordingly, a multinational sample of 10 nurses was snowball recruited for this focus group study to discuss prior research findings on psychological distress and the role of the nurse. Lazarus's cognitive motivational relational theory informed the study. Discussion narratives were coded for psychosocial care, role beliefs, barriers, and solutions. Provider domains were analyzed using Burnard's content thematic analysis method. Results indicated that nurses' role beliefs could not be determined as a barrier to psychosocial care; providing psychosocial care for all patients in all diagnoses was claimed as fundamental nursing work. However, nurses' current psychosocial care practice may fail to detect, treat, or prevent psychological distress, even in the absence of structural barriers. Nurses' psychosocial care appears to lack reflection on its clinical significance. Implications for social change include improving psychosocial care for patients and survivors of cancer that could result in improvements in quality of life.
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Chutkan, Sophia S. "Preferences of dietitians and nurses for artificial nutrition and hydration." FIU Digital Commons, 2003. http://digitalcommons.fiu.edu/etd/2363.
Full textAbstract:
Dietitians are responsible for recommending artificial nutrition and hydration (ANH) for elderly patients with a diminished mental capacity. Research is non-existent regarding how the beliefs of dietitians influence their recommendations; however, data are available on the attitudes of physicians and nurses regarding ANH. This study was designed to determine how the beliefs of dietitians and nurses affect their decisions regarding administering ANH. Dietitians and nurses, 1500 of each, were asked to agree or disagree with thirteen belief statements related to ANH. The participants also recommended ANH for eight scenarios, which depicted elderly patients with different moods and mental capacities. Results indicated dietitians significantly (p<0.001) more than nurses agreed with the belief statement "when in doubt feed". In all the scenarios, dietitians recommended ANH significantly (p<0.001) more than nurses. Nurses would recommend a trial (p<0.01) or not recommend (p<0.01) ANH more than dietitians. Also, a greater percentage of professionals had a tendency to recommend feeding for the happy patient rather than the unhappy patient. A patient's mood may influence a professional's decision as whether or not to recommend ANH. Dietitians are more likely to recommend ANH to elderly patients with a diminished mental capacity whereas nurses are less aggressive in their recommendations.
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Miller, James Alexander. "An investigation into the management of clinical incidents involving qualified nurses." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/24980.
Full textAbstract:
Background: The researcher’s interest in the emerging areas of clinical governance and risk management within the National Health Service (NHS) was the genesis of this study. A growing concern about the apparent exponential rise in the number of untoward clinical incidents, the lack of studies of such incidents involving nurses and the developing interest in the apportionment of blame, were the basis of this research study examining the management of untoward clinical incidents involving qualified nurses. Conclusions: A number of conclusions were drawn from the data using these principle sources. Throughout the study the policy framework changed, reflecting the dynamic nature of this matter within the NHS. 1. There was a perception among qualified nurses that senior nurses involved in the investigation of an incident sought to blame and punish a nurse for their role within an incident as opposed to reviewing systems and processes potentially contributing to an error. 2. Nurses attributed different approaches to different ‘types’ of nurse mangers. It was evident that such punitive approaches prevented nurses from reporting incidents for fear of the reprisals. Some nurses attempted to deflect blame away from themselves and to attribute it to organisational issues whilst others accepted blame as a result of their involvement in an incident. 3. A consistent finding was nurses reported a blame-free culture was neither realistic nor desirable but described a ‘just and fair’ culture as being more appropriate. Such a culture recognising that errors are part of everyday life and should be seen within this context whilst ensuring that patients remain protected by calling nurses to account for any actions which may be regarded as negligent. 4. It was regularly reported that the lessons learned from such incidents were not disseminated either within the managerial units or across the organisation as a whole. Maintaining confidentiality in relation to the nurses involved was cited as the main reason for this lack of sharing. 5. There is little evidence that the wider literature available in respect of error management has been incorporated into policy development. The pre-determined standards in relation to this area of corporate governance, although at an embryonic stage have attracted significant criticism. 6. The determination produced from Fatal Accident Inquiries (FAIs) highlight shortcomings and within systems and processes likely to have contributed to a death. Sheriffs’ have used the determinants to redress the balance of some of the very negative and unjustified reports in the media. There is little evidence that these determinations are used as learning opportunities.
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Yeo, Jenny. "Influences on self-evaluation during a clinical skills programme for nurses." Thesis, University of Newcastle upon Tyne, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438356.
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Howell, J. "An analysis of the involvement of community nurses in clinical governance." Thesis, University of Edinburgh, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.652633.
Full textAbstract:
The introduction of clinical governance requires that community nurses participate in the development of corporate accountability for clinical performance, accounting for normality as well as exceptional events in practice. The ability to deal with change has become a necessary part of the community nursing role, a factor complicated by the geographical spread and stratification of community nursing teams. If the development of clinical governance is to avoid domination by medical or managerial perspectives, each staff group is required to represent their standpoint. This is a study of the enacted narrative in the community context, to understand how nurses narrate and justify their involvement in these reforms and, to examine the development of a negotiated consensus by community nursing teams. A research approach within the social constructionist tradition informed by Burke’s (1969) dramatist pentad was used to explore and interpret the respondents’ accounts. Narratives of clinical governance were obtained from unstructured interviews with twenty staff, including district nurses and managers in two NHS trusts. The study findings suggested the continuing penetration of nursing practice by management systems, and associated hybridisation of nursing and management roles. Nursing governance is enacted through clinical audit and standard setting systems, building on the history of nursing involvement in these initiatives to develop a nursing consensus on the governance of nursing practice. The majority of nurses are presented as disengaged from these events, with the resultant nursing governance systems underpinned by an apparent rather than actual consensus. The uncertainty of the community nursing knowledge base in the face of clinical governance is illustrated, with practitioners reliant on rationalities drawn from managerial and evidence based logics. It is argued that the marginalisation of the nursing perspective by nursing governance systems, may result in a failure of the profession to develop the dialectical skills and articulacy required to present the nursing perspective in this and future developments. Difficulties arising from the way in which clinical governance is being developed are identified. The findings suggest the requirement of a revised approach to the management of nurses, enabling the explicit inclusion of the nursing majority in future policy implementation.
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Duncan-Grant, Alec. "Clinical supervision activity among mental health nurses : a critical organizational ethnography." Thesis, University of Brighton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299192.
Full textAbstract:
This qualitative study IS underpinned by interpretive-constructionist methodological governing principles, and took shape around a developing research focus and aim rather than in relation to pre-existing research questions. The focus of the research is on clinical supervision activity. This refers to formal and informal research encounters with participants and significant others in the organization in which the study was carried out, about: the experience of the practice of clinical supervision; attempts to translate textual prescription and description of clinical supervision into organizational reality; finally, the meaning endowment placed on both of the above by myself, my participants, and significant others associated with my research. In order to address an important gap in the literature, the aim of the research developed as the need to unpack and clarify the meaning, and the affective and organizational theoretical implications of clinical supervision activity. Part one of the ethnographic report is constructed around three overlapping categories: owning, resisting and feeling. These categories are developed around the proposition that the bureaucratic rationality inscribed within both the literature on clinical supervision, and in organizational attempts to implement it, fails to take account of both the emotional underlife of the organization and otherorganizational factors. Specifically, I argue that clinical supervision activity, and my inscription within it as 'insider' researcher', was influenced, shaped and constrained by the pre-existing interpersonal rules and norms of the organization in which my research was conducted. Those governed what could and could not be done or said in or about clinical supervision activity, arguably undermining organizational goals to implement it. Part two of the ethnography explores the maIn theoretical and conceptual implications an sIng from the preceding ethnographic construction, around structural organizational power and politics. This addresses a significant gap in the contemporary literature in clinical supervision in nursing and mental health nursing. I conclude with a critical auto-critique of the study itself, around a discussion of its strengths and limitations and possible future research directions
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Godwin, James Malcolm. "What, how and from whom student nurses learn in clinical practice." Thesis, Manchester Metropolitan University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414840.
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LoMonaco, Marina Lucia. "Investigation of registered nurses' clinical decision-making processes in aged care." Thesis, Australian Catholic University, 2014. https://acuresearchbank.acu.edu.au/download/82226bdbfa1530c6d8ab4af6a353544c82d3bc780769c21c2f7a712a069d908e/2826137/201404_Marina_LoMonaco__PhD_FINAL_28Feb2015pdf.pdf.
Full textAbstract:
An ageing global population places increasing humanitarian and financial loads on government, health and welfare agencies; necessitating change and innovation to meet and manage clinical and physically complex needs and demands. Australian residential aged care has been influenced by these international and jurisdictional socio-political forces. This thesis aims to inform healthcare professionals and others about Australian aged care registered nurse (RN) decision-making processes, as well as convey understanding of the responsibilities and contextual influences upon RNs working in this sector and scope of practice according to their professional responsibilities...
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Sehume, Gloria Gaogakwe. "Ethical decision-making the experience of nurses in selected clinical settings /." Diss., Pretoria :b [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-05132009-125706.
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Stahley, Amy. "Lived Experience of Post-licensure Nurses in a Perioperative Clinical Rotation." Diss., NSUWorks, 2019. https://nsuworks.nova.edu/hpd_con_stuetd/55.
Full textAbstract:
A projected deficit in the perioperative workforce of 32,000 perioperative nurses retiring by 2024, creates an inability to meet the nursing needs of the United States population. The need for experienced perioperative nurses has been increasing while the availability of nurses with perioperative education has been decreasing. The purpose of this phenomenological study was to explore the lived experience of post-licensure nurses who participated in a perioperative clinical rotation within their baccalaureate nursing program and did that experiential experience affect the recruitment and employment for perioperative nursing to halt the impending shortage. The integrations of Kolb’s experiential learning theory and Bandura’s theory of self-efficacy model was the framework that supported the study. Thirteen interviews were conducted using van Manen’s (1990) method for researching the lived experience. The two themes emerging from the data were value and attitude. Subthemes under value are gaining knowledge and skill set and a different type of nursing. Subthemes under attitude are (a) communication with the medical team and advocacy for families and patients. The experiential perioperative clinical rotation affected the study participants’ interest for working in the operating room (OR). Most had a highlighted interest in the specialty, and those participants’ not choosing the OR as their choice of employment expressed that the experience positively affected the type of nurse they are today. Experiential learning can build the fundamental knowledge necessary to understand the novice perioperative nurse’s role as a career choice.
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Mochaki, Nare William. "Clinical teaching by registered nurses." Diss., 2001. http://hdl.handle.net/10500/2457.
Full textAbstract:
The purpose of this quantitative, descriptive study was to describe how registered nurses
utilise teachable moments to enhance students' learning in the clinical setting. The research
questions were: What are the problems faced by registered nurses when they teach students in the
clinical setting? and How do registered nurses utilise teachable moments to teach students? A pilot
study was conducted in the clinical setting involving the respondents who had similar
characteristics than the population. The sample consisted of 45 registered nurses who provided
direct patient care in the clinical setting. A self administered, structured questionnaire was
used to collect data. Data analysis was done by using descriptive statistical tests. The findings
brought to light strengths and weaknesses with regard to the utilisation of teachable moments by
registered nurses, and problems faced by registered nurses with regard to clinical accompaniment in
general. Recommendations to improve clinical accompaniment by registered nurses through effective
utilisation of teachable moments were made. Further research was recommended to explore some
problematic areas that emerged from this study.Health Studies
M.A. (Nursing Science)