Problems in integrating theory with practice in selected clinical nursing situations

Text in EnglishThe current changes in health care systems challenges knowledgeable, mature and independent practitioners to be able to integrate theoretical content with practice. The study aims to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on the rendering of family planning services to clients which is a component of Community Nursing Science. The findings of the study reveal that there is a need for an integrated holistic curriculum which will address the needs of the community. It was concluded that a problem-based and community-based curriculum, safe and patient-friendly clinical environments, intersectoral collaboration between college and hospital management and student involvement in all processes of teaching and learning will improve the integration of theory and practice. There also appears to be a need for tutors to be more involved in clinical teaching, accompaniment and the continuous evaluation of students.Health StudiesM.A. (Nursing Science

Collaboration in implementing problem-based learning for nursing education: Nurse educators’ and managers’ views in south Africa

Background:  Problem based learning is advocate as teaching strategy for development of the 21st century health care practitioners. Collaborative partnerships are much-touted values in organizational life today Purpose: To explore and describe the perceptions of nurse educators and manager on collaboration in implementing PBL in nursing education in South African context Methodology: An exploratory sequential mixed method was used to collect data from purposively recruited participants from three of the five South African universities implementing PBL in nursing education and three North-West Provincial hospitals where PBL students are place for clinical learning. Ethical clearance certificate is NWU-00033-11-A9 Results: Both qualitative and quantitative data indicated the need for various types of collaboration; benefits of collaboration to staff, students, organizations and health care users; factors to successful collaboration in implementing PBL Conclusions: Successful implementation of PBL can be achieved through collaboration of clinical spaces. The strategic management and leadership should be committed to the collaboration by offering support and commitment of time, energy and resources.   Recommendations For practice, the strategic management and leadership should be committed to the collaboration by offering support, commitment of time, energy and resources. Effective communication should be to promote participation in the collaboration. Further research on collaboration in implementing PBL at different levels of operations; cultural influences on collaboration; criteria to assess effectiveness of collaboration is necessary

Nurses' experiences of delivering Voluntary Counselling and Testing Services for people with HIV and AIDS in the Vhembe District, Limpopo Province, South Africa

Voluntary counseling services are seen as a cost-effective strategy for HIV prevention and management because they help people to cope with their illness and reduce infection rates in others. This study explored and described the experiences of 20 nurses who rendered voluntary counseling in the Vhembe district, Limpopo Province, South Africa. A qualitative and contextual research design was used, with data gathered from in-depth individual interviews and analyzed using an open-coding method.The main experiences of the nurses rendering voluntary counseling and testing arose in the following themes: challenges related to inadequate resources; the emotional drain associated with stress and burnout; and frustration related to certain behaviors and practices of clients and community members. The main conclusions drawn from the findings were that nurses are continuously exposed to emotionally draining activities with very little support from their supervisors, which makes them prone to experiencing burnout.Health Studie

Between a rock and a hard place : ethics, nurses' safety, and the right to protest during the COVID-19 pandemic

AIM : In this paper, we critically discuss the ethics of nurses' choice to strike during the COVID-19 pandemic, considering legal and ethical arguments, overlaying the Ubuntu philosophy, an African ethic. BACKGROUND : The recent unprecedented coronavirus disease pandemic and the increased reports on the absence of personal protective equipment in South Africa places many health workers' lives at risk. Nurses spend most of their time with patients, which exposes them to fatal risks as they work in unsafe environments. RESEARCH METHODS : Exploratory literature review was conducted using Pubmed, CINAHL, Google Scholar and Science Direct) and law cases repository. FINDINGS : Nurses thus may be justified in striking to protect their safety. State healthcare entities are obliged to ensure safety and protect the health of professionals during the pandemic. According to their Code of Practice and Pledge of Service, they are ethically obliged to put patients first, and as a result, they are legally barred from engaging in strike action. CONCLUSION : We conclude that there may be constitutional human rights arguments to support strike action. We also find that ethical principles alone do not provide clear direction to guide nurses in making justified and ethical decisions regarding service provision in an environment threatening to compromise their safety.https://wileyonlinelibrary.com/journal/inrhj2022Nursing Scienc

Factors facilitating trained NIMART nurses' adherence to treatment guidelines : a vital matter in the management of TB/HIV treatment in South Africa

BACKGROUND: Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The study aimed to determine the factors facilitating nurse-initiated management of antiretroviral therapy (NIMART) trained nurses’ adherence to TB/HIV treatment guidelines. METHODS: The study employed an exploratory-descriptive design. The study was conducted in Ugu and Ngaka Modiri Molema Districts of KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and ATLAS T.I. was used for data analysis following the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured. RESULTS: The singular theme of factors facilitating NIMART trained nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. CONCLUSION: Continuous training, support supervision, and improved relationships with colleagues need to be enhanced to enable NIMART trained nurses to adhere to treatment guidelines.Atlantic Philanthropies and Thuthuka NRF.http://www.biomedcentral.com/bmcnurspm2020Nursing Scienc

Mozambican immigrants to South Africa : their xenophobia and discrimination experiences

We explored Mozambican immigrants’ lived experiences of xenophobia and discrimination in South Africa. Informants were 15 Mozambican immigrants (female = 7, male = 8) living in an informal settlement in Zandspruit, Gauteng Province. They completed open-ended written narratives on xenophobic and discriminatory experiences. Following thematic analysis, we identified three themes to characterise the Mozambican immigrants’ experiences of xenophobia and discrimination: (i) abusive attitudes, (ii) ethnic discrimination, and (iii) scapegoating. The Mozambican immigrants’ experiences of xenophobia and discrimination are consistent with findings from the extant international literature on ingroup/outgroup social strife with real or perceived scarcity of resources.http://www.tandfonline.com/loi/rpia202019-07-09hj2018Nursing Scienc

A psycho-educational programme of support to couples experiencing domestic violence in rural communities of Limpopo Province

D.Phil.The extent of the problem of domestic violence within the rural communities challenges all individuals to be involved in fighting the problem. This calls for a change in mindset that issues of domestic violence are communal rather than private. Resources such as shelters are not available in the whole Province and this makes it difficult for the victim to secure a safe home. The community needs to be involved in providing the necessary support to couples experiencing domestic violence such as provision of a home to the victims and their children in times of need. The community should stop victim blaming and make the perpetrator accountable for his behaviour. The overall aim of this study is to develop, implement and evaluate a psycho-educational programme of support to couples experiencing domestic violence to facilitate their mental health. The researcher had prolonged engagement with the victims of domestic violence and the communities, which are involved. A programme development, qualitative, exploratory, descriptive, evaluative and contextual study was conducted. Four steps were used to develop, implement and evaluate a psycho-educational programme of support to couples experiencing domestic violence. The first step involved situation analysis and key stakeholders were identified. Phenomenological interviews were conducted with the victims and perpetrators of domestic violence. The interviews were conducted to explore and describe the phenomenon of victims and perpetrators of domestic· violence. Focus group and individual interviews were conducted with stakeholders who deal with domestic violence to describe their views regarding domestic violence

Knowledge and uptake of occupational post-exposure prophylaxis amongst nurses caring for people living with HIV

Background: Nurses caring for people living with HIV (PLWH) are at higher risk of exposure to the human immunodeficiency virus (HIV) by needle sticks, cuts, getting body fluids in their eyes or mouth and skin when bruised or affected by dermatitis. Objectives: To determine knowledge, insight and uptake of occupational post-exposure prophylaxis (OPEP) amongst nurses caring for PLWH. Method: A cross-sectional descriptive design was used in this study. Stratified random sampling was used to sample 240 nurses. The study was conducted in a regional hospital in Limpopo province. Both parametric and non-parametric statistics were employed to analyse data. Results: A total of 233 nurses participated in the study. Sixty per cent (n = 138) of all nurses had a situation at work when they thought that they were infected by HIV and 100 (43%) nurses had experienced the situation once or more in the past 12 month. Approximately 40% did not know what PEP (post-exposure prophylaxis) is, and 22% did not know or were not sure if it was available in the hospital. Only few participants (n = 68, 29%) had sought PEP and most (n = 37, 54%) of them did not receive PEP when they needed it. There was a significant association between the knowledge and availability of PEP (r = 0.622). Conclusion: The study recommend an urgent need for policy makers in the health sector to put in place policies, guidelines and programmes that will rapidly scale up PEP services in health care settings, so that preventable occupationally acquired HIV infection can be minimised amongst nurses. Keywords: Post-Exposure Prophylaxis; Nurses; HIV, Occupational Exposure; PLW

A model of collaboration between nursing education institutions in the North West Province of South Africa

Background: Professional nursing in South Africa is obtained through a 4-year diploma offered at nursing colleges, or a 4-year degree in universities, and the South African Nursing Council (SANC) registered both for professional nursing. New SANC legislation now requires a bachelor’s degree for registration as professional nurse. Objectives: The aim of the study was to explore and describe perceptions of nurse educators and stakeholders to develop a model of collaboration for joint education and training of nursing professionals by colleges and universities through a bachelor’s degree. Method: A mixed methods approach was used to explore perceptions of nurse educators utilising a questionnaire, and perceptions of other nurse training stakeholders through interviews, about a model of collaboration between the college and the university. Results: Themes that emerged from the interviews included identifying collaboration goals, establishing a conducive environment, maximising exchange of resources, role clarification and perceived challenges. Quantitative results showed high agreement percentages (84.13%–100%) on most basic concepts and themes. A model of collaboration was developed indicating a framework, agents, recipients, procedure, dynamics, and terminus. Conclusion: A model of collaboration was acceptable to the majority of nurse education stakeholders. Other implications are that there was a need for the improvement of scholarship among nurse educators and clinical mentors, sharing rare skills, and addressing perceived challenges

Knowledge and psychosocial wellbeing of nurses caring for people living with HIV/AIDS (PLWH)

The challenges of caring for people living with HIV (PLWH) in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n = 108), enrolled nurses (n = 58) and enrolled nursing auxiliaries (n = 66). Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92) on HIV/AIDS knowledge. Depersonalization (D) (83.7%) and emotional exhaustion (EE) (53.2%) were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = −0.592), depression (r = −0.584) and stigma and discrimination (r = −0.637). A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH