Dissertations / Theses: 'Nursing - General'

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Paxton, Fiona M. "Practice nursing : a time of change : a study of nursing in general practice." Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/22550.

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The view is offered within this thesis that nursing is essentially a practice-based discipline and therefore any theory of nursing must reflect what happens in practice. By analysing research material from a study of practice employed and attached nurses, the nurses' pattern of work was described within the context of the primary health care. Both delegated and more autonomous roles were examined, and the implications of these and their relationship with holistic care and experiential learning were described in view of the continued expansion of the role. The objectives were: a) to examine the process of care and identify any changes in workload or differences in working patterns of practice employed and attached nurses as a result of the introduction of the New GP Contract in April 1999; b) to measure patient satisfaction with nurse consultations and ascertain their views on the changing role of community nurses; and c) to determine the opinions and attitudes of community nurses and general practitioners to future developments and educational opportunities for primary care nursing. Thirty four nurses participated in 1990 with a total of 6675 consultations; 33 nurses in 1991 with a total of 6050 consultations. The largest proportion of patients seen by both groups of nurses during both periods of recording was by general practitioner referral. Practice employed nurses initiated more of their own appointments in the second year and saw fewer general practitioner referrals. This tend was reversed for attached nurses. By the second recording period both attached and practice employed nurses had experienced a reduction in the time spent on routine treatment room work and an increase in clinic activity. Practice employed nurses reported a higher level of therapeutic listening than the attached nurses both years. It was found that 39% of all nurse consultations in 1990 and 27% in 1991 had an interruption either before or during surgery sessions.

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O'Shea, Rose Ann. "The regulation of advanced nursing practice." Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4283/.

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The typical picture that is conjured up when one thinks of a nurse is that of a matronly figure, in a uniform and cap, sitting at the patient’s bedside administering care. Associated with this is the traditional view held by the public, in which nurses are beholden to doctors and dependent on them for instruction, and perform a generally subservient role. However, those who have had the misfortune to require treatment more recently will testify to a far different situation, in which nurses perform a more professional and clinically autonomous role, as well as having a caring and compassionate function. In fact, the picture that exists in most clinical environments is one in which nurses are recognised as knowledgeable and capable clinicians, and independent practitioners in their own right, rather than obedient medical handmaidens. The delivery of modern healthcare has also changed beyond recognition, with interventions that were once considered to be the domain of hospital practitioners now provided in a more liberated community-based system. Within this structure, the role of healthcare professionals has similarly been transformed, such that the ‘power’ has shifted away from doctors and towards non-medical clinicians. This has, in turn, resulted in non-medical practitioners, most notably nurses, having more authority, autonomy and responsibility for clinical decision-making, rendering them more equal in the clinical hierarchy and more evenly aligned as professionals. This thesis explores the range of traditional medical activities that are now performed by nurses who have expanded their practice in order to accommodate the additional responsibilities that this 'power' affords. In particular, it looks at those nurses who have advanced their practice such it constitutes a new clinical role and, in some cases, act as medical substitutes. With the further devolution of clinical tasks inevitable, and the creation of more clinical roles likely, this thesis looks at the regulatory framework that underpins advanced nursing practice. In particular, it questions whether the existing framework provides the regulatory safeguards that are required to ensure patient and public protection and asks whether an alternative approach, such as that which is provided by another professional regulator, may be more appropriate. In concluding, this thesis will assert that a compelling case for the statutory regulation of advanced nursing practice can be made, and will suggest a number of options regarding how this regulatory solution can be achieved.

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Chan, Yung-kwan Albert, and 陳容坤. "Hong Kong nursing students' learning approaches: why and how do hospital-based general nursing students learn?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31957055.

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Chan, Yung-kwan Albert. "Hong Kong nursing students' learning approaches : why and how do hospital-based general nursing students learn? /." [Hong Kong] : University of Hong Kong, 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1383289X.

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Loury, Sharon D. "History of Knoxville General Hospital’s School of Nursing 1902-1956." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/8189.

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Peet, Jacqueline Stephanie. "Strengthening nursing surveillance in general wards: A practice development approach." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/205383/1/Jacqueline_Peet_Thesis.pdf.

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This thesis evaluated an emancipatory practice development (ePD) approach to strengthening nursing surveillance on a single medical-surgical ward. A relationship was established, and a researcher embedded on a ward around a shared interest of strengthening nursing surveillance and patient safety. Ward engagement with ePD methods of critical reflection, holistic facilitation and active learning were supported through workplace workshops and the formation of an action learning set with a group of ward RNs. The ward travelled through a transformative and at time turbulent process of resistance and retreat towards a new learning culture where nursing surveillance is visible and valued.

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Laschinger, Heather Kathleen. "Learning styles of baccalaureate nursing students and attitudes towards theory-based nursing practice a validation study of Kolb's experiential learning theory." Thesis, University of Ottawa (Canada), 1987. http://hdl.handle.net/10393/5223.

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EHRAT, KAREN SUE. "LIBERAL EDUCATION SKILLS IN THE FIELD OF NURSING (GENERAL, NON-TECHNICAL)." Diss., The University of Arizona, 1985. http://hdl.handle.net/10150/187948.

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The primary purpose of the study was to identify liberal education skills necessary for competent, professional nursing practice and to compare baccalaureate and associate degree faculties' perceptions of the importance of liberal education skills and program emphasis on those skills. Further, the study sought to identify underlying factors of liberal education skills perceived by college nursing faculty to be required for competent, professional nursing practice. Finally, the study attempted to identify differences in baccalaureate and associate degree faculties' perceptions of the importance of liberal education skills and program emphasis place on those skills by public and private institutional membership and by National League for Nursing (NLN) geographic accrediting region assignment. The study's survey approach could be classified as a quasi-experimental design. The study utilized a multistage, stratified sample of 432 baccalaureate and associate degree nursing faculty. Seventy-two baccalaureate and 72 associate degree nursing programs were randomly selected from the four NLN geographic regions. Each dean or director of selected programs was requested to select three nursing faculty "most knowledgeable of the nursing curriculum" to complete the instrument. Data for the study were collected by means of the "Liberal Education Skills Inventory for Nursing" (LESIN). Data analysis was accomplished through the use of descriptive statistics, principal factors analysis, and analysis of variance. Major conclusions of the study were (1) nine of the ten LESIN subscales had mean faculty ratings suggesting high skill importance to competent, professional nursing practice; (2) one factor ("conceptual abilities") underlying faculty perceptions of liberal education skills importance was extracted; (3) there were statistically significant differences in baccalaureate and associate degree faculties' perceptions regarding skills importance on two of the LESIN subscales and regarding program emphasis on five of the subscales; (4) on each of the ten LESIN subscales, faculty from public and private institutions did not differ significantly on their perceptions of skills importance and did differ significantly on one subscale regarding program emphasis; and (5) the mean skill importance and program emphasis responses of faculty did not differ significantly on the ten LESIN subscales by NLN geographic accrediting region assignment. In addition, information regarding liberal education skills program evaluation measures or standards was reported.

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Jabareen, Hussein Mohammad. "Skill mix development in general practice : a mixed method study of practice nurses and general practitioners." Thesis, University of Glasgow, 2009. http://theses.gla.ac.uk/632/.

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General practice has undergone considerable change in the last two decades. New roles for nurses working in general practice have extended to include tasks that were previously delivered by general practitioners, in particular chronic disease management, and the development of new, advanced roles such as independent nurse prescribing. There have been few research studies investigating the impact of these changes, especially after the introduction of the new General Medical Services contract in April 2004. The overall aim of the work presented in this thesis was to examine the emerging roles of practice nurses, the forces influencing that development, and the effects of these changes on doctor-nurse skill mix in general practice within NHS Scotland. The work employed a mixed methods approach, with three inter-linked studies. The first study was a quantitative, desk-based analysis of workload and clinical activities of doctors and nurses working in 37 practices across Scotland for the year 2002. The second study was a postal questionnaire to all practice nurses working within NHS Greater Glasgow (n=329), conducted in autumn 2005 and achieving a 61% response rate. The third study was a qualitative study, consisting of eighteen interviews with a doctor and nurse inform each of nine general practices. The interviews were conducted between January and July 2006 and practices were selected according to the number of partners and the deprivation status of the practice population. Analysis of workload data showed that practice nurses and general practitioners dealt with 27.5% and 72.5% of total face-to-face encounters, respectively. Many of the encounters with nurses involved chronic disease management, with 20% of such encounters appearing similar in content to the work of GPs. The postal survey found that one third of practice nurses were aged over 50, and will be approaching retirement within 10 years. The majority worked in small teams of nurses, although 31% worked alone. This may have contributed to the finding that 52% (n=103) reported feeling isolated in their workplace. Many had attended CPD training on chronic conditions, but identified minor illness treatment as an area for future training. The qualitative study showed that the Quality and Outcomes Framework of the 2004 contract had been a key driver of changes in general practice service delivery. This has led to an increasing shift in routine care from doctors to nurses. As new roles for practice nurses have evolved, GPs have been able to focus on treating complex morbidities that need medical diagnosis and intervention. The incentivised targets of the new contract have made chronic disease management a predominant activity for practice nurses, with treatment room and non-incentivised activities featuring less and increasingly being provided by new, lower grade nurses or nurse replacements such as Health Care Support Workers (HCSW). There was no consensus between interview participants in terms of the most appropriate use of doctor-nurse skill mix in general practice. Nor did they agree on the merit of advanced roles for practice nurses. However, respondents did emphasise that nurses who wanted to have an independent/advanced role in the practice would need to combine three competencies (independent nurse prescribing, triaging, and minor illness treatment). Most practice nurses interviewed were concerned with obtaining a fair financial return to match their increasing responsibilities, especially after the introduction of the nGMS contract. GPs, however, tended to believe that nurses were appropriately remunerated for the level of responsibility they had within the practice. The continuing role of the GP as the employer of practice nurses was problematic for some nurses and many felt there would be advantages to being employed on Agenda for Change terms and conditions. However, the majority of nurses interviewed preferred being employed by a GP rather than the Health Board. There was little support amongst either nurses or GPs for the notion of nurse partners within practices. Overall, these studies provide lessons which will be of value in planning the future training and development of practice nurses. It suggests that practice nurses should obtain proper training and support in order to meet their individual needs and to carry out new responsibilities and roles. In addition, the impending shortage of practice nurses due to retirement, lack of retention and potential recruitment difficulties needs to be addressed urgently at the level of primary care policy and manpower planning.

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Goodchild-Brown, Beatrix. "Carinus Nursing College : an historical study of nursing education and management using the general systems approach, 1947-1987." Master's thesis, University of Cape Town, 1992. http://hdl.handle.net/11427/26620.

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The purpose of this dissertation is to research aspects of the historical development of Nursing Education and Nursing Management at the Carinus Nursing College from 1949 to 1987; to determine and explain how the College has adapted and coped with historical change and to determine whether proposals for the future can be made. Research has been done by applying the general systems theory and by using the standard methods of historical analysis. Data has been collected by means of oral history, literature search and documentation. The variables isolated are the College as a system; the government or influential super systems; resources such as financial, personnel and students and material inputs; and throughput or processing the work in the output, which leads to the professional nurse. The models used are Bucheles' organizational system, Sharma's flow chart pattern, Mintzberg's parts of organizational systems, and power flows and as shown in Emery, Feibleman and Friends relations and rules of interaction in systems thinking. Parsons' "imperatives of maintenance of a system" as well as Alvin Toffler's "second and third wave phenomena as responses to change" were two further models that were used. By using Robert Buchele's model, the work is divided into four parts: - i) the College as a system ii) the super systems iii) the resources iv) the throughput or processing. A further design that emerged was that two eras could be distinguished, within which three historical phases: - Early, Middle and Late are developed.

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Spiteri, Mary Carmen. "Postnatal perineal trauma and general health in Maltese women." Thesis, University of Hull, 2009. http://hydra.hull.ac.uk/resources/hull:2384.

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Over the last twenty years there has been an increasing international research interest in women's experience of postnatal perineal trauma and its impact on their physical, psychological and sexual health. To date, however, no research on perineal morbidity and general health has been undertaken in Malta. Using a longitudinal descriptive correlational design, a homogenous systematic sample of 144 Maltese postnatal mothers was recruited with the aim of exploring the relationship between perineal trauma and general health following normal delivery. Self-administered questionnaires within 48 hour s of delivery and again at 10 days, 6 weeks and 13 weeks sought to assess perineal pain, urinary and faecal continence, resumption of sexual intercourse and dyspareunia. The General Health Questionnaire-12 (Goldberg and Williams, 1998) assessed mothers' psychosocial health. Open-ended questions explored further their experience of perineal trauma and general health. The retention rate at the end of time 4 was 86.1%. Following descriptive and inferential statistical analysis, the key findings revealed a constant decline in perineal trauma and an inconsistent but significant rise in general health over time. Mothers sutured by senior hospital officers reported higher scores of well-being, and resumed sexual intercourse earlier than those sutured by registrars and senior registrars. Significant negative correlations persisted between postnatal total perineal trauma and resumption of sexual intercourse at 13 weeks but not at 6 weeks.Qualitative data generated three main themes: experiencing total perineal trauma, resuming sexual intercourse and maintaining general health. Mothers identified tiredness, exhaustion and emotional pain as other burdens alongside a painful perineum. 'Being not ready yet', 'fear of falling pregnant again' and 'caring for the baby and family' were reasons preventing postpartum sexual intercourse. Tedeschi, Park and Calhoun's (1998) post-traumatic growth theory provided an overarching theoretical framework.

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Norman, Kay. "Year 11 pupils' perception of nursing : an exploratory study." Thesis, Keele University, 2014. http://eprints.keele.ac.uk/626/.

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This thesis aims to explore Year 11 pupils’ perceptions of nursing, the influences that affect these perceptions, and the way in which these reflect the discourses within and about the nursing profession. The objective of this research is to provide data which will contribute to the body of knowledge around nurse recruitment and career advice; to foster an increasing understanding of nursing roles, requirements, opportunities, and how to make nursing more appealing to young people. Forty individual interviews were conducted with Year 11 pupils from four different comprehensive schools within the West Midlands region (age 15-16 years). They were interpreted using a qualitative approach; drawing on social constructionism. Findings suggest that nursing continues to be viewed in stereotypical terms as a vocation, lacking status as a profession and unappealing as a career. Although nursing appears to be respected, evidenced in expressions of ‘moral worth’ in society, it is not perceived to be seen as producing the expected outcomes of financial reward, status and social credibility. There is an apparent lack of knowledge and understanding of nursing roles, educational requirements and opportunities available within nursing, with few current terms of reference that can be drawn upon. Parents and family are seen to have the biggest influence on perceptions of careers. Pupils who identified nurses within their families portrayed a negative image of nursing to participants. Conclusions suggest that higher education institutes, the nursing profession, media, schools, and career personnel need to work together to ensure a current, comprehensive understanding of nursing is portrayed to young people. The nursing profession must identify role models to champion the image of nursing, to inspire and encourage conditions that will motivate the current workforce to promote a positive culture within itself, to represent this to others.

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Haakestad, Andrea. "Exploring the experiences of enrolled nurses regarding quality nursing care in general nursing units in the private healthcare setting." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96099.

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

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Allen, Davina. "The shape of general hospital nursing : the division of labour at work." Thesis, University of Nottingham, 1996. http://eprints.nottingham.ac.uk/11119/.

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This thesis is about nursing work and the ways in which nurses in a general hospital accomplished occupational jurisdiction. It is based on ethnographic data generated on a surgical ward and a medical ward in a single NHS trust hospital. The study is set in the context of recent developments in nursing and medical education (DHSS, 1987; GMC, 1993; UKCC, 1987) and health policy (DH, 1989) which have created the impetus for shifts in the division of labour in health care, reviving deep-rooted historical tensions between professional and service versions of nursing. Drawing on the work of Hughes (1984), Abbott (1988) and Strauss and colleagues (Strauss et al, 1963; Strauss et al, 1964; Strauss, 1978) the aim of this project was to move on from the policy debates and develop a less essentialist account of the nursing role through an exploration of the ways in which nurses managed the parameters of their work in the course of their everyday activities. Hughes concept of 'dirty work' is employed as a sensitising device. The work of hospital-based general nurses is explored through the analysis of five key nursing boundaries: nurse-doctor, nurse-support worker, nurse-patient/relative, nurse-nurse, and nurse-management. The professional and sociological literature suggested that as a result of recent policy developments, there would be an increased need for negotiation of nurses' inter-occupational boundaries with medicine and support workers and that this was likely to be subject to some tension. But field observations revealed that nurses accomplished these inter-occupational boundaries with minimal negotiation and little explicit conflict. Conversely, there were policy-related tensions at the three other key nursing boundaries - at nurses' infra-occupational boundary, at the boundary between nurses and patients and their relatives, and at the boundary between ward-based nurses and nursing and general management - which were largely unanticipated.

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Hold, Judith L. "A good death| The experiential ethics of nursing." Thesis, The University of Alabama, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3612092.

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During end-of-life care, nurses face ethical dilemmas on a daily basis with minimal operative scholastic preparation and professional expertise. The diverse source of ethical quandaries includes patient care issues related to legalities, inappropriate medical interventions, social roles, and professional and personal values. Ethical discourse in end-of-life care occurs within institutions where policies, professional relationships, and economic factors constrain ethical reflection. Thus, it is imperative that ethics education take into account the professional and social context of nursing, in addition to traditional teachings focused on many principles and theories, codes of conduct, and legal ramifications. The purpose of this research was to explore how experienced nurses' successfully resolved day-to-day ethical dilemmas during end-of-life care. This study utilized narrative analysis to analyze data generated from one-on-one interviews with six hospice nurses. The semi-structured interviews were conducted in two phases. Using core story creation, several different ethical dilemmas were identified divulging struggles with key stakeholders. Thematic analysis was then used to create three main themes: Ethics within Practice, Ethical Knowledge, and Ethical Solutions discussed within the framework of situational context, deliberations, and ethical actions. The results gained from this research provide information on how to improve nursing ethics education through the use of narratives of experienced nurses. The nurses used in this research told their stories depicting a keen awareness of ethical conflicts situated by contextual factors including social, political, and personal issues. Their deliberations were informed through formal, experiential, and intuitive knowledge creating a sense of phronesis as they negotiated the right course of actions. The nurses solved ethical predicaments by either following rules or choosing acts of resistance. It is my contention that the results of this study will empower practicing nurses and nurse educators to appreciate and incorporate context and different forms of knowledge to inform ethical discourse. We can utilize the experienced nurses' wisdom to improve nursing ethics education which ultimately translates to providing better deaths for patients.

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O'Connor, Thomas. "Men in the nursing profession : masculinities and gendered identities." Thesis, Keele University, 2013. http://eprints.keele.ac.uk/3733/.

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Nursing as a profession has historically been largely dominated by females, both in terms of the demographical profile and the common perception of nursing being a task for women. A small minority of men do however practice as nurses and as such are anomalous in a female dominated profession. Drawing on profeminist theories of masculinities this study aimed to investigate the experiences of men working as nurses in Ireland, how they relate to masculinities and how they negotiate a gendered identity. Using a qualitative interpretative methodology 16 in-depth interviews were conducted with practicing male nurses. Results reveal tensions and contraindications for men in negotiating gendered identities as nurses with significant evidence of positioning in relation to hegemonic ideals. The fluidity and contingency of masculinities is also revealed, particularly in relation to emotionality and embodiment. This study contributes to the knowledge base of sociological theories of masculinities but also to knowledge about the nursing profession and its gendered aspects.

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Swann, David. "NHS at home : co-designing a 21st century nursing bag." Thesis, Royal College of Art, 2012. http://eprints.hud.ac.uk/13324/.

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Healthcare providers throughout the world are facing unprecedented change. In rising to social, demographic and economic pressures, the National Health Service is mobilising hospital treatments into patient’s homes (Darzi, 2006). The black nursing bag, the universal transportation tool of the district nurse has remained impervious to design change for over 100 years. The goal of the PhD is to equip newly formed neighbourhood care teams working in this emergent healthcare setting with a 21st century nursing bag. The design practice seeks to optimise the efficient delivery of patient care, standardize patient experiences in an inconsistent setting and enhances patient safety performances through design. The PhD by practice is sponsored by the Engineering Physical Sciences Research Council (EPSRC) and supported by NHS East Riding of Yorkshire (NHS ERY). The PhD is participatory and proposes a refined theoretical model to achieve its objectives: a strategy- system- experience- product continuum. Qualitative and quantitative methods have: identified variance in the nursing bags used in practice; captured the presence of MRSA inside and on bags; applied Lego Serious Play to envision aspirational products; analogous case studies determining the discrete attributes of world-class services delivered in confined spaces and luxury travel products; captured workflow using link analysis of simulated treatments; determined the efficacy of hand-cleaning techniques; evaluated of design forms using UV analysis to enhance the effectiveness hand-cleaning; heuristic evaluations informing design decisions: stakeholder presentations, international design competitions and industry opinion. Analytical, creative and experimental collaborative practices have contributed to the co-creation of a world-class nursing bag fit for the challenges of the 21st century. Validation workshops have verified that the new bag reshapes the way home healthcare is delivered, experienced and accepted: increases clinical efficiency through modularity, standardises the patient’s service experience and delivers economic benefits to the commissioners of home healthcare services.

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Hamilton, Deborah. "The historical development of intensive care nursing at Vancouver General Hospital, 1960-1985." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/24245.

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This thesis describes the historical development of intensive care nursing in the adult medical and surgical intensive care unit (ICU) at Vancouver General Hospital (VGH) from 1960 until 1985. The ICU was established to group a new, emerging cohort of critically ill patients in one centralized place the hospital. Doctors referred critically ill patients to the ICU, believing the patient would benefit from the continuous nursing care of a bedside nurse in the ICU. The concepts of place and space, specialty nursing education, professionalism, gender, and the expansion of new medical technologies used in critical care, form the central categories for analysis. I examine the broader social, cultural, economic influences, and the hospital context that shaped critical care nursing in Western Canada in the 1960s, using one hospital as a case study. An analysis of the transformation from one-to-one nursing of the most critically ill patients on the general nursing wards, to specialized critical care nursing in the ICU, significantly contributes to the history of nursing. As nurses developed new critical care nursing expertise, their work relationships with other nurses and health professionals changed. As their expertise deepened, nurses integrated new technologies that were introduced into the ICU into their practice. Nurses created critical care nursing theory in a grassroots process using their experiences in critical care, as the foundation. They also formalized this knowledge into a critical care nursing program. This process was not without its tensions, as nursing education was also beginning to make the transition from hospital-based to degree based education. It was a question of where and how the education of critical care nursing would fit in. Oral history accounts from former and practicing nurses and physicians involved in the establishment of the ICU at VGH form the primary source material, augmented by archival hospital and government records, and photographs. The individual experiences of bedside nurses provide a unique lens to understand the evolution of critical care nursing knowledge and practice at VGH in the broader context of critical care nursing history.

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Ehrmann-Vanderbilt, Irine 1932. "Survival status of elderly nursing home residents following involuntary relocation." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/278389.

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Survival status of 45 elderly skilled nursing care residents was examined over a 42 month period following involuntary interinstitutional relocation. Medical and relocation planning records provided data to examine survival status of residents in relation to focal and contextual stimuli. Results were compared to a relocation study previously conducted in the same community. Significant relationships existed between survival status and family support and participation in relocation planning event. A higher percentage of subjects survived who did not have family support and did not participate in planning events. A significant relationship was found between time intervals in which deaths of male and female subjects occurred. In the first nine months, 13 of 14 males died; six of the 14 females died. No significant relationships were found between survival status and age, gender, mobility, or dementia. Findings suggest the need for continued study of variables affecting survival status of relocated elders.

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Lu, Wei. "Economic determinants of quality of care in nursing homes." Thesis, Wayne State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3626093.

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This dissertation examines the factors that will affect nursing home quality of care using several national data sources on market regulation, county demographic characteristics, market structural and the characteristics of different types of long-term care providers in 2010.

The first study examines how nine different measures of nursing home care quality respond to the greater levels of local market competition from these alternative providers of long-term care, as well as other nursing homes. Findings reveal that faced with greater competition from assisted living facilities, nursing homes are left to care for more disabled, less healthy patients. Although the nursing home's staff-to-bed ratios rise in response, other measures of care quality decline, such as more process- and outcome-based measures. Competition from home health agencies likewise has mixed effects on nursing home care quality, and competition from other nursing homes in a market tends to decrease care quality. These finding suggest that care quality in nursing homes may continue to erode as the market for alternative, community-based long-term care services expands.

The second study examines the Medicare regulation effects on nursing home quality controlling for the whole long-term care market competition structure. In many local markets nursing homes now compete with assisted living facilities for residents, yet most previous studies of the effects of Medicaid nursing home reimbursement policies on care quality have analyzed nursing homes in isolation, ignoring the presence of nearby competitor firms, and how state regulation of assisted living facilities might also affect care quality in nursing homes. This study uses a richer model specification that accounts for a much broader range of state long-term care regulations as well as the structure of a nursing home's local market. Findings reveal that a higher Medicaid reimbursement rate leads to significant improvements in nine different aspects of nursing home quality, while state certificate-of-need programs for nursing homes lead to a decline in several (but not all) dimensions of it. A large presence of assisted living beds in a local market also tends to reduce nursing home quality, and state regulations regarding assisted living facilities indirectly affect nursing home care quality by altering the nature of local market competition. Overall, these results suggest that state laws related to all long-term care providers, not just nursing homes, are important determinants of nursing home care quality.

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Grainger, Angela. "'Fit for nursing'? : a qualitative analysis of disabled registered general nurses' and other health professionals' views on health and illness in relation to nursing employment." Thesis, University of Huddersfield, 2008. http://eprints.hud.ac.uk/id/eprint/714/.

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The employment of registered general nurses (RGNs) is underpinned by management’s need for economic utility in that the cost of salaries must be reconciled with the need to meet the demands inherent in service provision. Using grounded theory, interviews captured the experience of physically disabled RGNs, who use the phrase ‘physically disabled’ to describe themselves. Their collective experience was then compared with nondisabled RGNs working in the clinical areas of general medical wards, general surgical wards, and day case units, situated in three district general hospitals. Data collection was by partial participant observation, and interviews. The data revealed that both nurseinterviewee groups share an understanding of the meaning of health and illness. Both the physically disabled and non-disabled RGNs manipulate working time to take unauthorised breaks in order to ‘accommodate tiredness’ and ‘stamina lack’. ‘Accommodating need’ is the identified basic social process (BSP) and ‘pacing’ is the identified core category. RGNs distinguish between using a ‘public’ voice and a ‘private’ voice. In respect of a physically disabled RGN ‘doing nursing’, the data uncovered stigma relating to a spoiled identity. Theoretical sampling interviews with senior nurse managers, occupational health doctors, and trade union officials (termed ‘elite groups’), reflected the data findings of both the physically disabled, and non-disabled RGNs, in identifying the factors limiting the employability of physically disabled RGNs. Moreover, data from the elite group interviews revealed the importance of economic utility, in that management has to take account of diminishing returns. This is the crux of the employment issue. ‘Maintaining organisational pace’ is the generated grounded theory, and was confirmed by aligning data to the established literature on Labour Process Theory (LPT) in a supplementary theoretical sensitivity validation process.

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Redman, Judith Hilary. "General hospital nursing in Sheffield during the early years of the NHS, 1948-1974." Thesis, University of Sheffield, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.427175.

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Kasey, Jennifer Channel. "Building cultural competence in health care professionals : an instrumental case study of nursing students /." Full-text of dissertation on the Internet (673.46 KB), 2010. http://www.lib.jmu.edu/general/etd/2010/doctorate/kaseyjc/kaseyjc_doctorate_04-16-2010-03.pdf.

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Wishart, James. "Producing nurses, nursing training in the age of rationalisation at Kingston General Hospital, 1924-1939." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq20713.pdf.

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Edlebeck, Catherine. "The Relationship of General Science Grades to Program Completion in an Associate Degree Nursing Program." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2048.

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High attrition of nursing students in the United States may contribute to a shortage of registered nurses and inefficient use of scarce resources. The purpose of this study was to explore the relationship between nursing student grades in 3 science prerequisites and length of time to program completion on each of the study college's 4 campuses. Ausubel's theory of subsumption, wherein a learner's ability to meaningfully learn new data depends on the existing cognitive structure within which the new material is assimilated, was used as a theoretical framework. Prerequisite science course grades for 575 nursing students attending a Midwestern technical and community college with 4 campuses were obtained along with data on program completion. Grade data from 2005-2015 were analyzed using a 1-way or Welch ANOVA and Pearson product-moment correlation. Significant differences were found among campuses in both mean science grades and time to completion. Most science course grades did not demonstrate a significant correlation with time to completion. Based on these findings, it is possible that student preparation in general science courses is not equivalent among campuses and may not provide the cognitive structure necessary for meaningful learning in nursing courses. To enable faculty from both disciplines to collaboratively document, examine, and align content in science and nursing courses, a curriculum mapping project was designed. Registered nurse graduates contribute to the economic and social well-being of their communities. By providing more insight about science and nursing courses and degree completion, this study is intended to promote positive social change.

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Villena, Anna Liza D. "Challenges & struggles: Lived experiences of individuals with mental illness, substance abuse, and general medical conditions." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3297810.

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Cortes, Kathryn R. "Comparing a General and Transitional Registered Nurse Orientation to Facilitate Quality Improvement." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5548.

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Most hospitals orient new graduate nurses and experienced nurses in the same generalized orientation programs. To address the cost of orientation to specialty units, a pediatric hospital developed a tailored transitional residency orientation program for experienced nurses. The purpose of this project was to describe, compare, and evaluate the existing generalized orientation program and the transitional orientation program to determine how the orientations differed in structure, process, and outcomes. Donabedian's model assessing quality of care services and Benner's novice-to-expert theoretical framework served as guides in evaluating the orientation outcomes. Qualitative data about residency classroom time, preceptor selection and time, mentor selection and time, debriefing, and total length of orientation were collected for the generalized and transitional programs. The findings were that interview process and time, classroom time, mentor time, debriefing time, and length of orientation were decreased in the new transitional orientation program. Orientation costs were less for the transitional program than the generalized program ($20,000 to $30,000 versus $50,000 per nurse, respectively) and nursing staff retention was better for the transitional program than the generalized program (90% versus 68%). The generalized orientation and separate transitional orientation have resulted in a social change by delivering cost-effective orientation to both novice and experienced nurses. Outcomes will be of interest to hospital human resource departments and nurses who conduct orientation programs.

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Wälivaara, Britt-Marie. "Mobile distance-spanning technology in home care : views and reasoning among persons in need of health care and general practitioners." Licentiate thesis, Luleå tekniska universitet, Omvårdnad, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-26437.

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The overall aim of this licentiate thesis was to describe views and reasoning about the use of mobile distance-spanning technology (MDST) in health care at home, from the perspectives of persons in need of health care and general practitioners (GP). A descriptive qualitative approach was chosen to achieve the overall aim. Individual qualitative research interviews and qualitative group research interviews were used for data collection. Qualitative content analysis and qualitative thematic content analysis were used for data analysis.The findings show that persons in need of health care at home recognized MDST as being similar to the technology used at hospital. They described the MDST at home as acceptable but still in its infancy. The limited experiences in using MDST led to some persons doubting the reliability of the examinations routinely carried out at home instead of at hospital. When using the MDST, more examinations can be performed at home but there was some overconfidence concerning the possibility of what MDST can achieve. They saw the staff as users of the MDST, and the MDST should not be used by the persons or their family members. The MDST was seen as possible for distance communication but personal meetings with a GP or a nurse also have to be possible. The GPs must know the person concerned before making decisions at a distance. The persons felt that as long as it is easy to go to the healthcare centre or to the hospital the examinations should be done there, but if they are in a bad condition and there are long distances, then examinations at home become relevant. In an emergency situation, going to hospital rather than staying at home was inevitable and obvious. The MDST at home was described as a part of a chain which can be efficient only when other parts of the chain are taken good care of. When the MDST was assumed to be safe and secure then it could be used on a permanent basis at home, but this decision had to be made by DNs and GPs. The GPs reasoned that the MDST should be used with caution. There is a professional caution, which is based on the GPs' professional experiences, responsibilities and skills. Human meetings were seen as important for performing secure judgments and as the basis for health care, but some meetings can be replaced by virtual meetings. A virtual meeting could be useful for the patients and their families but it depends on their expectations. It could benefit them but there is also an overconfidence concerning what MDST can do. The GPs reasoned about the MDST in general and the usability of different diagnostic tools. The MDST was described as being not yet fully developed. Sometimes the MDST could support the GPs' decisions, but when handling very complicated cases, meeting the patient and understanding his or her context was seen as highly important. Expanded access to patient records facilitates the GPs work but the patient's integrity has to be ensured. It is easy for nurses to do more during home visits, but there must be an agreement between the nurse and the GP regarding how to handle the responsibility.The results in this thesis indicate that the participants attach both positive values about MDST as well as believing that some tools have no value at all. This is important when attempting to understand what is important for persons in need of health care and for GPs benefit when planning health care at home for the future.
Godkänd; 2009; 20091021 (brival); LICENTIATSEMINARIUM Ämnesområde: Omvårdnad Examinator: Professor Siv Söderberg Extern opponent: Professor Kenneth Asplund, Mittuniversitetet, Sundsvall Tid: Fredag den 20 november 2009, klockan 13.00 Plats: Sal E246, Luleå tekniska universitet

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Ehrlich, Carolyn Elsie. "Implementing Care Coordination in General practice: Embedding New Methods." Thesis, Griffith University, 2011. http://hdl.handle.net/10072/366389.

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In Australia, the health care system is complex, constantly changing and comprised of multiple layers. Within this complex system, service fragmentation, care segmentation, and confusion about access to and provision of health care services, is likely to be the usual experience of both consumers and providers of health care. Chronic condition care coordination is frequently touted as one solution to these problems, but its implementation has been less successful. Given that access to the health care system most frequently originates in general practice, implementation within this context is particularly important. However, implementing chronic condition care coordination within general practice is not likely to be simple because a complete reorientation of general practice will be required, from an acute care focus towards the ongoing management of chronic conditions. Nurses (RNs) who work in general practice provide an opportunity for achieving this type of reorientation, but the sustainability of any changes will be dependent on the way in which practices become routinely embedded in the work of general practice. This research examines the implementation of RN-provided chronic condition care coordination in general practice. According to Normalization Process Theory (NPT) (May & Finch, 2009), the extent to which any new practice or innovation becomes embedded in usual practice is dependent on the extent to which its components are workable within the context and are capable of being integrated into existing ways of operating. Thus, the most appropriate theoretical framework to apply to the interpretation of this research is NPT.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Human Services and Social Work
Griffith Health
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Andrews-Evans, Marion Shirley. "Learning from failure : an exploratory study of what makes a successful nursing service." Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/42980/.

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The research study aspired to ascertain what, if any key factors can be identified by the Senior Nurses in Wales to improve the quality and safety of the service delivered by the nursing service. Numerous reports with recommendations for improvement have been published following significant service failures in the nursing service. Despite these reports, failures continue. This thesis details the methodology and findings of a research study undertaken with Senior Nurses in Wales, to ascertain their views on what factors are needed to have a successful nursing service. It explores what needs to be in place in the nursing service to prevent failure and deliver high quality, safe care to patients. A mixed-method research approach was used which comprised three stages. Stage one analysed secondary qualitative data in the form of case study inquiry reports into service failures. The second stage comprised semi-structured elite interviews with nine Senior Nurses in Wales. The final stage, which was used to prioritise and validate the results from stage two, was a questionnaire sent to 65 Senior Nurses in Wales, with 41 returned. From the analysis of the above research, a Senior Nurses’ Framework covering 6 main themes and containing 35 key factors was developed, which if implemented could potentially lead to a successful nursing service. In addition the thesis explores why Senior Nurses find it difficult to implement such actions, their lack of empowerment and how it is important for their voices to be heard if failure is to be prevented in the future.

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Payne, Linda Gail. "The experience of caring for women with drug or alcohol problems in the general hospital." Thesis, Florida Atlantic University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10154941.

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The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and / or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participants’ meaning of their experience. The theoretical framework that was used to explore the nurses’ experience of caring for women who abuse or are dependent on alcohol was Boykin and Schoenhofer’s Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood.

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Moriarty, Abigail. "The development, implementation and evaluation of personal tutor guidelines in a pre-registration nursing curriculum." Thesis, University of Huddersfield, 2009. http://eprints.hud.ac.uk/id/eprint/9237/.

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Aim of the Study: Personal Tutoring is a scholastic mechanism to aid and support students while on a demanding academic and clinically orientated pre-registration nursing programme. Personal Tutoring is widely used in nurse education programmes, although it is often poorly structured with a minimal evidence base and rarely evaluated. The increased numbers of student nurses has seen the role of the Personal Tutor as an intrinsic factor towards a positive student experience. Attrition is an important consideration, but this study aimed to enhance the staff and student roles through tutoring. Methods: this study, influenced by ethnography, adopted an action research methodology as it encapsulated a constant problem-solving technique. This involved the exploration of academic staff and student perceptions of a Personal Tutor's role within a School of Nursing and Midwifery. Staff and students contributed to semi-structured interviews after a series of focus groups. The focus group discussions utilised the nominal group technique to rank the key points of the posed questions. These priorities were the basis of five staff and five student follow-up semi-structured interviews; the transcripts were manually analysed for trends and complemented with the use of the computer software NVivo 7. This resulted in the development and implementation of School Personal Tutoring Guidelines based on 'good practice', along with supporting evidence from published research. A follow up focus group and questionnaire evaluated the staff's and students' experience of the guidelines, along with a more detailed analysis of two case studies using appreciative inquiry. Findings: the staff and student focus groups both agreed on areas of good and poor practice in relation to Personal Tutoring; there was also clear agreement about what did and did not contribute towards a supportive Personal Tutor commitment. The Personal Tutoring guidelines were formulated around eight key and shared areas of responsibility, which was a shift from previous approaches. The guidelines were implemented for staff and students through formal mechanisms and the Personal Tutor relationship became a central instrument for existing and future curriculum development and teaching and learning strategies. The follow-up evaluation continued to illustrate variable commitment from both staff and students towards Personal Tutoring, although the majority of the data indicated a positive influence on staff and student experience. Conclusions: the established guidelines form a standardised Personal Tutoring system based on academic staff and student perceptions of the tutoring role. This has subsequently been disseminated to all areas of the faculty, therefore utilising the cyclical ethos of action learning. Kolb's (1984) experiential learning cycle is used to illustrate the originality of this work and demonstrates how it has added to the existing body of knowledge on Personal Tutoring.

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Patterson, Elizabeth, and E. Patterson@mailbox gu edu au. "Primary Health Care Nursing: A Case Study Of Practice Nurses." Griffith University. School of Nursing, 2000. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030228.104735.

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In 1978, Primary Health Care (PHC) was formally recognised, in the Declaration of Alma-Ata, as the key to achieving the World Health Organisation's goal of 'Health For All by the Year 2000' (HFA). PHC was seen as the solution to the inadequate illness management systems that had developed throughout the world. It was hoped that PHC would address some of the major inequalities in health observed both within and between countries by its balanced system of treatment and disease prevention. The WHO envisaged that PHC would take place as close as possible to where people live and work and be the first element of a continuing health care process. Additionally, health service collaboration and multi-professional partnerships were expected to replace professional boundaries and competition. Shortly after the Declaration of Alma-Ata, the World Health Organisation, supported by national and international nursing bodies, proposed that nurses would be the driving force behind the HFA movement as active partners in inter-professional teams, leaders in health care and resources to people rather than resources to other health professionals. In the ensuing years, although community health nurses were acknowledged by the government and the nursing profession as key players in PHC in Australia, practice nurses (nurses who are employed in general medical practices) were not identified within this group. Hence, it appeared as though these practice nurses were 'invisible', not considered important to PHC in Australia, or simply overlooked as a major influence on population health. The purpose of this study was to describe the current role of these nurses and to identify and analyse the factors that influenced their scope of practice and hence their contribution to PHC. The research was conducted as a case study of practice nurses in one Division of General Practice in southeast Queensland. The study was influenced by the constructivist paradigm of inquiry and utilised a complementary sequence of quantitative methods followed by qualitative investigation. The first stage of the study comprised a telephone followed by mail survey of general practitioners and practice nurses employed within the Division. This was followed by a second stage, which involved group and individual interviews of key informants and was supported by document review and observation. The study revealed that the practice nurse role is essentially one of assistant to the general practitioner wherein the nurse undertakes basic assessment procedures to aid the medical diagnosis, carries out delegated therapeutic procedures, and contributes to the administrative functioning of the practice. Autonomous nursing initiatives, which appear to be largely opportunistic and incidental to delegated activities, include physical and emotional support of patients, clarification and reinforcement of medical instructions, and the provision of health education. The practice nurse's role, and hence contribution to PHC, was found to be constrained by a number of factors. These factors include the current funding arrangements for general practice, the view that practice nurses are an option rather than a necessity, the general practitioners' control of the practice setting, the appropriation of nursing work to medical receptionists, the lack of professional development opportunities, and the practice nurses' passive acceptance of their circumstances. However, both general practitioners and practice nurses appreciate the value of nursing services in general practice and GPs would sanction the employment of more nurses, if given financial incentives, especially for the purpose of preventive care. The majority of practice nurses believe their role should be expanded to include autonomous functioning while most of the GPs were amenable to some extension of nursing practice but reticent or opposed to any independent interventions. There appears a need in Queensland for courses to prepare practice nurses for advanced practice if they want to expand their role in PHC beyond that of assistants to GPs. It would also seem to be in the nurses' interests to initiate a professional association of practice nurses as a vehicle to explore other issues relevant to their professional development. In addition, if PNs want to expand their role they will need to demonstrate improved patient outcomes and cost effectiveness.

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Patterson, Elizabeth. "Primary Health Care Nursing: A Case Study Of Practice Nurses." Thesis, Griffith University, 2000. http://hdl.handle.net/10072/365891.

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In 1978, Primary Health Care (PHC) was formally recognised, in the Declaration of Alma-Ata, as the key to achieving the World Health Organisation's goal of 'Health For All by the Year 2000' (HFA). PHC was seen as the solution to the inadequate illness management systems that had developed throughout the world. It was hoped that PHC would address some of the major inequalities in health observed both within and between countries by its balanced system of treatment and disease prevention. The WHO envisaged that PHC would take place as close as possible to where people live and work and be the first element of a continuing health care process. Additionally, health service collaboration and multi-professional partnerships were expected to replace professional boundaries and competition. Shortly after the Declaration of Alma-Ata, the World Health Organisation, supported by national and international nursing bodies, proposed that nurses would be the driving force behind the HFA movement as active partners in inter-professional teams, leaders in health care and resources to people rather than resources to other health professionals. In the ensuing years, although community health nurses were acknowledged by the government and the nursing profession as key players in PHC in Australia, practice nurses (nurses who are employed in general medical practices) were not identified within this group. Hence, it appeared as though these practice nurses were 'invisible', not considered important to PHC in Australia, or simply overlooked as a major influence on population health. The purpose of this study was to describe the current role of these nurses and to identify and analyse the factors that influenced their scope of practice and hence their contribution to PHC. The research was conducted as a case study of practice nurses in one Division of General Practice in southeast Queensland. The study was influenced by the constructivist paradigm of inquiry and utilised a complementary sequence of quantitative methods followed by qualitative investigation. The first stage of the study comprised a telephone followed by mail survey of general practitioners and practice nurses employed within the Division. This was followed by a second stage, which involved group and individual interviews of key informants and was supported by document review and observation. The study revealed that the practice nurse role is essentially one of assistant to the general practitioner wherein the nurse undertakes basic assessment procedures to aid the medical diagnosis, carries out delegated therapeutic procedures, and contributes to the administrative functioning of the practice. Autonomous nursing initiatives, which appear to be largely opportunistic and incidental to delegated activities, include physical and emotional support of patients, clarification and reinforcement of medical instructions, and the provision of health education. The practice nurse's role, and hence contribution to PHC, was found to be constrained by a number of factors. These factors include the current funding arrangements for general practice, the view that practice nurses are an option rather than a necessity, the general practitioners' control of the practice setting, the appropriation of nursing work to medical receptionists, the lack of professional development opportunities, and the practice nurses' passive acceptance of their circumstances. However, both general practitioners and practice nurses appreciate the value of nursing services in general practice and GPs would sanction the employment of more nurses, if given financial incentives, especially for the purpose of preventive care. The majority of practice nurses believe their role should be expanded to include autonomous functioning while most of the GPs were amenable to some extension of nursing practice but reticent or opposed to any independent interventions. There appears a need in Queensland for courses to prepare practice nurses for advanced practice if they want to expand their role in PHC beyond that of assistants to GPs. It would also seem to be in the nurses' interests to initiate a professional association of practice nurses as a vehicle to explore other issues relevant to their professional development. In addition, if PNs want to expand their role they will need to demonstrate improved patient outcomes and cost effectiveness.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing
Griffith Health
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Ali, Gulnar. "Multiple case studies exploring integration of spirituality in undergraduate nursing education in England." Thesis, University of Huddersfield, 2017. http://eprints.hud.ac.uk/id/eprint/34129/.

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Introduction: Difficulties persist in conceptualising spiritual needs and understanding their relationship to religious needs and wellbeing in healthcare and particularly in nursing education. This research was undertaken to explore approaches and challenges associated with this area in undergraduate nursing education in England. Methods/Methodology: Using a systematic approach, a literature review covering the period 1993-2017 was undertaken to explore potential issues and challenges reported. Applying case-study methodology, data were collected from three university nursing schools from different parts of England. Sources for data triangulation within schools included, curriculum review of undergraduate nursing courses, exploring the views of nursing educators through semi structured interviews and focus group studies with nursing students. Template analysis was used to identify themes in the data. Findings: Due to the module based curriculum, the integration of spirituality in nursing education appeared to be treated as a matter of personal choice and convenience rather than as an essential domain of teaching and learning practice in England. Owing to conceptual complexity, addressing religious needs was often considered to be synonymous with addressing spiritual care need. Factors were identified contributing to the difficulties in the issue of educating nurses in this area. These were: lack of clarity in curriculum documents; uncertainty as to how far nurses should address these issues and how far this was a specialist chaplaincy function; fear of being judged or rejected in a multicultural environment; and the dominance of disease-centred care. The participants voiced a desire for developing a shared understanding through developing a more explicit representation of spirituality in nursing education and the recognition of appropriate educational approaches in this area. Based on the findings of this study a learning framework is proposed; SOPHIE (Self-exploration through Ontological, Phenomenological, Humanistic, Ideological, and Existential expressions), to encourage self-awareness and reflexivity among nursing educators and students. SOPHIE aims to bring ontological authenticity and congruency to the forefront of nursing knowledge and practice. Conclusion: Constructing knowledge through ontological learning engagements among educators and students is essential to develop role clarity, authenticity and empowerment in understanding and addressing spiritual care needs. A multidisciplinary teaching approach integrating medical anthropology, humanistic psychology and existential phenomenology should be explored as a basis for an integrated nursing curriculum that could explore spirituality in its widest sense.

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Yuill, LaVon Eileen 1957. "Near-death experiences: An exploration of perceived responses, effects of interventions, and impact." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/291908.

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This study explored near-death experience (NDE) survivors' perceptions and communication in the disclosure of NDEs to health care professionals and significant others, interventions encountered, and effects of those actions. Eight adult NDErs, selected through network sampling, were interviewed. Content analysis was used to describe the interactions from the experients' perspective. A dynamic communication process emerged as central to disclosure about NDEs. Study subjects identified several barriers to disclosure. Actions that were most helpful included listening, showing interest, offering opportunities for disclosure, and providing information and confirmation. Negative actions and their impacts included ignoring or refusal to listen, minimizing the experience, discounting, and medicating the person. Health care professionals were perceived to lack knowledge of the phenomenon and to appear afraid, disinterested, or too busy to talk. All experients conveyed a need to talk about the NDE. Implications for nursing practice include widespread dissemination of information about NDEs and maximizing communication skills to meet NDE patients' needs.

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Drummond, John Stuart. "The call to training : a genealogy of governmentality in early modern general nursing in the nineteenth century." Thesis, University of Dundee, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.262804.

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Burns, Shirley Ann. "Perceptions and experiences of Practice Nurses and Health Care Assistants following the introduction of the HCA role into General Practice." Thesis, Edinburgh Napier University, 2012. http://researchrepository.napier.ac.uk/Output/5685.

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A longitudinal constructivist grounded theory study was undertaken in Scotland with the aim of exploring the on-going perceptions and experiences of HCAs and PNs withinGeneral Practice following the introduction of the HCA role. Data collection and constant comparative analysis took place within two contrasting regions in Scotland over a two year period with each participant. An emergent theory oF HCA role growth and identity was identified.

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Prescott, Stephen Francis. "The nursing profession and graduate status in England : perspectives from student nurses and health professional educators." Thesis, University of Huddersfield, 2017. http://eprints.hud.ac.uk/id/eprint/33732/.

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This study investigates all graduate entry to nursing in England, focusing on the perceptions and experiences of nursing students and health professional educators at one English university. It presents a history of nurse education, debates the cases for and against the move to an all graduate entry, and introduces a conceptual framework based on the influences on, and expected outcomes of, the undergraduate nursing student. The study adopts a single-embedded case study design. Data was collected between October 2012 and September 2014 using questionnaires and focus groups. Statistical analysis and thematic analysis (using the framework devised by Braun and Clarke, 2006) were undertaken on the quantitative and qualitative data respectively. The undergraduate student nurses reflected a positive attitude towards nursing, seeing a therapeutic relationship and the values underpinning ‘compassion in practice’ as fundamental to the role of Registered Nurse (RN). They also demonstrated motivations that reflected these principles and, to some extent, recognised them in themselves. The importance of developing and demonstrating graduate attributes was acknowledged, but these were not seen to be as significant as the fundamental principles of what it means to be a nurse. The majority of health professional educators supported the move to an all graduate entry to nursing, with nurse educators being more in favour that their Allied Health Professional colleagues. There was also clear recognition that the role of the RN had changed and that RNs needed graduate attributes in order to manage the complexities of twenty-first century healthcare. Participants in this study saw the move to all graduate entry as welcome and necessary, although this view was not universal. Reasons students gave for pursuing a career in nursing reflected those identified in earlier studies. The students’ experiences in clinical practice were affected by the standards of care they observed, the quality of mentorship and by issues related to ‘belongingness’. The study highlights and contributes to the on-going debate surrounding the development of nursing as a profession, confirming that the ideals of altruism have not been lost in the development of academic processes and identity.

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Davis, Ruby T. "Occupational Stress Among Nurse Administrators in General Hospitals in Tennessee." Digital Commons @ East Tennessee State University, 1992. https://dc.etsu.edu/etd/2903.

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The purpose of this study was to determine the level of occupational stress among nurse administrators and to identify the types of strategies used by nurse administrators to deal with or manage occupational stress. The study examined the relationship between selected demographic variables, occupational stress, and strategies. The research design included five research questions along with seven null hypotheses testing the relationship between occupational stress and demographic variables--age, gender, marital status, years of professional nursing experience, years as a nurse administrator, educational attainment, and hospital bed capacity. There were seven additional hypotheses testing the relationship between the same demographic variables and three categories of coping strategies. The instrument used included the researcher-designed Demographic Questionnaire, the Health Professions Stress Inventory (HPSI), and a listing of 17 coping strategies. Nurse administrator's HPSI overall mean stress score was lower than the HPSI mean stress level scores reported for nurses in previous studies. Five subscales of stressors (Stress Factors) were identified by analyzing the HPSI using Principal Components Factor Analysis. A statistical significant difference (p $<$.05) was revealed for nurse administrators for: (1) overall stress level when tested by three of the demographic variables, years as a nurse administrator, educational attainment, and hospital bed capacity; (2) subscale level of stress when testing the HPSI five stress factors by marital status, years as a nurse administrator, and educational attainment. A statistical significant difference (p $<$.05) for strategies used by nurse administrators was revealed with testing: (1) Avoidance strategy by demographic variables--age, number of years of professional experience, number of years as a nurse administrator, and hospital bed capacity and, (2) Active Cognitive strategy by demographic--gender. The Spearman Rho correlation coefficient procedures used to correlate the HPSI five Stress Factors with Active Cognitive, Active Behavioral, and Avoidance strategies revealed: (1) Stress Factor 1, Professional Conflicts was significantly related to Avoidance strategy (r$\sb{\rm s}$ =.24). (2) Stress Factor 2, Lack of Recognition as a Professional, was negatively significantly correlated with Active Cognitive Strategy (r$\sb{\rm s}$ = $-$.22). (3) Stress Factor 3, Work Overload, was significantly related to Active Cognitive strategy (r$\sb{\rm s}$ =.23). (4) Nurse administrators overall stress was significantly related to Avoidance Strategy (r$\sb{\rm s}$ =.28).

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Rennick, Janet Elizabeth. "Children's psychological responses following critical illness and exposures to invasive technology." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36051.

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Children who are hospitalized in a pediatric intensive care unit (PICU) are subjected to a barrage of highly invasive, often painful interventions necessary in overcoming the critical period of their illness. While the majority of these children survive, little is known about the impact of critical illness on their subsequent psychological adjustment. The purposes of this study were (a) to compare the psychological responses of children hospitalized in a Pediatric Intensive Care Unit (PICU) with those of children hospitalized on a general ward; and (b) to determine whether there was a relationship between children's psychological responses post-hospital discharge and their age, the number and type of invasive procedures to which they were exposed during hospitalization, severity of illness, and length of hospital stay. A prospective cohort design was used to study two groups of children (N = 120). The study group included 60 children who had been hospitalized in a PICU, and the comparison group 60 children hospitalized on a general ward. Data were collected just prior to discharge, at six weeks and six months following discharge, from two metropolitan children's hospitals. Groups were compared on the following psychological responses: (a) the child's sense of control over his or her health; (b) the child's medical fears; (c) intrusive thoughts and avoidance behaviors related to hospitalization, as indicators of post-traumatic stress; and (d) changes in the child's behavior following hospitalization. In order to examine the possibility of post-traumatic stress responses in these children, the 'Child Impact of Event Scale' was developed in this study as a modified version of an adult measure originally developed by Horowitz and colleagues (1979). Other psychological responses were measured using established instruments. Relationships between the children's psychological responses and their age, the number and type of invasive procedures to which they were exposed d

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Lang, Ariella. "Parental grief reactions and marital intimacy following infant death." Thesis, McGill University, 1991. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=60525.

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The grief reactions of bereaved mothers and fathers and their perception of their marital relationship following the death of their infant were examined and compared with nonbereaved couples. The correlation between bereaved parents' grief reactions and their marital intimacy was also explored.
A total of 114 couples participated in the study, 57 bereaved couples and 57 nonbereaved. Bereaved couples had lost an infant ($>$20 weeks gestation and $<$1 year of age) within 24 months of the home visit. Bereaved women rated their grief reactions higher than their spouse. Bereaved women also differed in their perceptions of their marital intimacy compared to their husbands.
Although no differences were found between bereaved and nonbereaved couples' ratings of their marital intimacy, aspects of the marital relationship emerged as predictors of mothers' and fathers' grief reactions. Thus, it would appear that the expressions of grief of bereaved parents and their relationship with each other are closely linked following the death of their infant.

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Della, Ratta Carol. "The Journey from Uncertainty to Salient Being| The Lived Experience of Nurse Residents Caring for Deteriorating Patients." Thesis, Adelphi University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3663096.

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Nurse Residency programs have been developed to ease the transition for new graduates to the workplace, one in which they face fast-paced patient encounters such as emergency response situations. During this one year educational experience, nurse residents persistently cite caring for deteriorating patients as a clinical challenge. There is a paucity of research on the unique needs of nurse residents when encountering such challenges. Philosophically underpinning this Hermeneutic study were tenets of Heidegger and Gadamer within which nurse residents' lived experiences of caring for a deteriorating patient were explored. In-depth interviews with eight nurse residents were analyzed and interpreted using Diekelmann's process for narrative analysis. The Journey from Uncertainty to Salient Being described the ontological-existential meaning of participants' lived experiences of caring for a deteriorating patient during their residency year. Three distinct constitutive patterns were identified each with themes: dwelling with uncertainty, building me up, and a new lifeline: salient being. Dwelling with uncertainty was experienced during encounters with deteriorating patients with its deeply felt impact upon nurse residents as they transitioned from student to professional nurse. The pattern of building me up was influenced by the participants' expressed need for, and importance of, trusted relationships with preceptors, nurse colleagues, and/or mentors. Because of these relationships, and through reflection on their experiences, they were able to develop a sense of salience. To situate and explain the study's findings within existing nursing knowledge, these patterns were then compared and contrasted with nurse residency research findings, and theories and research in nursing and sociology such as transition, socialization, professional role development, and role formation. The findings from this study extend and support role adaptation and transition theories. Implications from the study's findings can be used to improve the transition to the professional role, for preceptor development, and for refining nurse residency curricula.

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Smith, Harold W. "Identifying motivators among individuals selecting gerontology as a career specialization." Thesis, New Mexico State University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3582399.

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Lived experiences and the power of memories of significant personal events to influence an individual's choice of career path is well documented in studies of students pursing careers in nursing. Less researched are the personal motivators that influence students' choices of specialization within career paths. Gerontology focused educational research provides a growing body of evidence pointing to the attitudinal disposition of students based on their life experiences and attachment to family members or significant others, not classroom exposure, as the primary predictor of vocational choice. What remain unclear are the types of naturally occurring motivators that propel students either toward or away from professional involvement with the elderly and in particular, the chronically and terminally ill. The questions of what motivates so many non-traditional nursing students, in particular, to work with elderly patients and what might motivate others who have shown no interest in this patient group to specialize in gerontology, is central to this interpretative phenomenological inquiry and frames the methodology used to define and interpret motivators among nursing students expressing an interest in or selecting gerontology as a career specialization. A synthesis of seven themes identified and analyzed from data collected through 30 in-depth interviews with 15 nursing students and other individuals closely associating with nursing education, suggests familial attachments, maturity, and traumatic or transformative experience, as the primary three motivators fueling an expressed desire to work with older patients. Conclusions also suggest motivators are identifiable and may be artificially replicated, and that strategic recruitment may also provide a solution for meeting geriatric nursing shortfalls. The purpose of the study has been to understand this complex phenomenon and to add to the body of knowledge surrounding nursing students' motivations and preferences for career specialization. The goal of the study has been to understand what elements might lead to new ways of increasing interest in the field of gerontology and specifically in direct care to elderly patients. Improvement in the numbers of BSN graduates electing to pursue early careers in geriatric direct care would provide a systemic remedy to the real-world problem of inadequate numbers of qualified nurses with adequate competencies to serve this high needs patient population.

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Al, Dhabbari Fatma. "Nurses' perceptions of patient safety culture in Oman." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30724/.

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Rush, Steven L. "Hegemonic preservation of heteronormativity: Experiences of gender in boyhood." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3311342.

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Leis, Berta 1957. "Translation of the Verran and Synder-Halpern Sleep Scale into Spanish." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/291805.

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The purpose of this study was to translate the Verran and Snyder-Halpern (VSH) Sleep Scale into Spanish and assess equivalence of translation. Criteria for establishing cross-cultural equivalence and concepts in translation served to guide the research and provide impetus in developing a flow chart for equivalence of meaning in asymmetrical translation. Nineteen Mexican national or Mexican-American bilingual subjects were recruited from the community. The translation protocol contained two phases. Phase One consisted of four steps, specifically: (1) content equivalence analysis, (2) back translation, (3) analysis of translations and back translations, and (4) bilingual meaning error checks. Phase Two involved field pretesting using the random probe technique. Descriptive statistics were used in Phase One. Qualitative data analysis was done in Phase One and Phase Two. Findings indicated tool items were relevant in the target culture and cultural equivalents were available. In addition, equivalence of meaning was established.

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Dalton, Autumn G. "Examining General versus Condition-Specific Health Related Quality of Life across Weight Categories in an Adolescent Sample." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/243.

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Approximately 34% of adolescents are overweight or obese which can be accompanied by physical, psychosocial, and economic consequences. Increasingly, pediatric overweight/obesity research has focused on Health Related Quality of Life (HRQoL) as a health outcome. This study examined differences in HRQoL across weight categories in adolescents, specifically, the sensitivity of using a general versus condition-specific measure. Further, the influence of gender was explored. Data were extracted from Wave 2 of Team Up for Healthy Living, a school-based obesity prevention program targeting adolescents in Southern Appalachia. Participants (N = 918; 50% Female; 93% Caucasian; 90% 9th graders) completed the Pediatric Quality of Life (PedsQL) Inventory (general) and PedsQL Multidimensional Fatigue Scale (condition-specific) measures as part of a larger survey. Body mass index-for-age and -sex percentiles were calculated using actual height and weight, and students were classified as underweight, healthy weight, overweight, or obese according to Centers for Disease Control and Prevention (CDC) criteria. Two 4 (weight category: underweight vs. healthy weight vs. overweight vs. obese) x 2 (gender: male vs. female) factorial analyses of variance (ANOVAs) were calculated to compare mean scores of total HRQoL (both generic and condition-specific). Additionally, 7 factorial multivariate analyses of variance (MANOVAs) were conducted with each measure’s subdomains. Fisher’s Least Significant Difference post hoc analyses were run to assess differences between groups, at a significance level of p<0.05. The current study revealed no interaction effect between total HRQoL (assessed via the generic or condition-specific measure) and weight category and gender; however, main effects were found for both weight category (assessed via a generic measure only) and gender (assessed via both generic and condition-specific measures). Additional research is needed to examine the impact of utilizing different measures and the potential role of gender as well as other factors that may influence HRQoL across weight categories. These issues are important as researchers to date utilize a variety of HRQoL measures making interpretation of findings difficult and often do not consider other variables such as gender that may influence findings.

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Palmer, Deborah Lyn. "Who cared for the carers? : a study of the occupational health of general and mental health nurses 1890 to 1948." Thesis, University of Exeter, 2009. http://hdl.handle.net/10036/96946.

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This thesis set out to explore the neglected field of nurses’ occupational health. Evidence from the three case study hospitals confirms that attitudes toward nurses’ health changed between 1888 and 1948. The health of nurses was an issue that was always taken seriously but each institution approached the problem differently and responses showed much variation over time. There were good reasons for this but the failure to adopt a coherent and consistent policy worked to the detriment of nurse health. This difficulty helps explain the ambiguous treatment of occupational health within wider histories of nursing. This can lead to the erroneous conclusion that occupational health was somehow neglected by contemporary actors, thereby facilitating the omission of the subject from historical studies concentrating on professional projects and the wider politics of nursing. This study takes a different approach showing that occupational health issues were inexorably connected to these nursing debates. Occupational health cannot be understood without reference to professional projects. This is as true in debates where occupational health was obscured as it was in cases of overt concern. The history of the occupational health of nurses is also important because it offers a new perspective on two other themes central to nursing history, particularly class and gender. This focus helps understand why attitudes towards the care of sick nurses changed over time and varied between different types of institutions. By concentrating on individual nurses’ experiences we reveal something new about the way national conversations affected ordinary nurses’ lives. Recognition that nursing presents a serious occupational health risk is a relatively recent phenomenon; it was not until the 1990s that most nurses had access to occupational health units. This study not only sheds light on why nurses’ health attracted little attention before the Second World War but also explains why this situation began to change from the 1940s.

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Wigley, Wendy. "Carrying hope : a grounded theory study of pre-registration nursing students' understanding and awareness of their spirituality from experiences in practice." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/358908/.

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Spirituality is a phenomenon integral to health and wellbeing and a fundamental element of nursing care. Nonetheless, empirical evidence suggests that spirituality is a frequently ignored aspect of care provision. While there is evidence that examines the relevance of providing spiritual care to service users, minimal research has been undertaken that examines the spiritual needs of pre registration nursing students. This study used a Glaserian grounded theory design to explore and explain pre registration nursing students’ personal understanding of their own spirituality and the relationship between experiences in clinical practice and spiritual awareness. Participants comprised seven pre-registration nursing students undertaking a three-year educational programme. Data was collected between 2008 and 2013 through two focus groups, twelve one-to-one interviews and theoretical sampling of a variety of literature and media, including artefacts created by the participants. The findings identified that pre-registration nursing students’ awareness of spirituality can be explained in three main Basic Social Processes [BSPs]: struggling, safeguarding and seeking. When their spirit was at risk of becoming broken by negative experiences in clinical practice, then their hope to carry on was at risk and struggling, safeguarding and seeking were evident. These three concepts are integral to the theory that emerged from the findings: a theory of carrying hope that explains participants’ resolve between clinical experiences and spiritual awareness. This study highlights that the challenges associated with spiritual awareness may impact on attrition from pre-registration nursing programmes. If students’ spiritual needs and awareness are not adequately nurtured and supported there are implications linked to the aspiration of nursing to recapture the 6Cs (DH 2012). Recommendations from this study include the identification of role models in clinical practice and the implementation of a model of pastoral care for tutors supporting pre-registration nursing students. Further research is required to examine how role modelling and pastoral care can enhance spiritual awareness in pre registration nursing students. While this study focused on nursing, implications for other vocational professions are identified.

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Dissertations / Theses on the topic 'Nursing - General'

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