Experiences of professional autonomy among critical care nurses in Kenya: a qualitative study

Exercising autonomy allows nurses to demonstrate their knowledge and skills. However, more information is needed about the critical care nurses' perceptions of their professional autonomy in rural areas. Objective: To explore the perceptions, facilitators and barriers to professional autonomy among critical care nurses in rural Kenya. Methods: The hermeneutic phenomenological study design was used in this study. Data were collected in a critical care unit using a semi-structured interview guide. A sample of 10 participants were recruited. The study was conducted in Nyeri County Referral Hospital. Results: Three themes emerged from the study on the nurses' experiences of professional autonomy, perceptions of autonomy, facilitators of autonomy, and barriers to autonomy. Conclusion: Autonomy undeniably plays a pivotal role in defining the professional status of the nursing profession. Perceptions, facilitators and barriers to professional autonomy form the background of the current professional status. Nurses, therefore, exercise autonomy effectively when it aligns with patient care needs and when a conducive environment supports it.

Men in the service of humanity: Sociocultural perceptions of the nursing profession in South Africa

Background. The classification of nursing as a female-gendered profession, along with patriarchally determined cultural gender roles, makes it difficult for men to select nursing as a career and to excel in their caring capacity as nurses.Objective. To gain in-depth insights into and an understanding of male nursing students' perceptions of the nursing profession. Methods. A generic qualitative approach, which was explorative, descriptive and contextual, was used to conduct the study. Sixteen male nursing students at two nursing education institutions in KwaZulu-Natal Province, South Africa, were purposively sampled to participate in the study. Data were collected using semi-structured interviews and unstructured observation. Thereafter, thematic analysis was used to analyse the data. Results. Three main themes were developed from the interview data. The participants perceived nursing as the extension of women's work, with low social status ‒ nursing is not considered to be a profession for men. During the provision of nursing care, feelings of discomfort and embarrassment were experienced. They feared misinterpretation of their care, especially when caring for the naked body when alone with a patient. They resorted to the use of cautious caring, where they do not provide physical care alone, but seek support, especially from female nurses.Conclusion. Male nursing students require role models to support them in their academic journey towards becoming competent practitioners. A male-friendly environment should be created to enable them to provide quality nursing care to all patients. The society needs to be empowered in understanding that men choose the nursing profession to provide care, and that they are capable of caring for the sick.

Online teaching and learning: Experiences of students in a nursing college during the onset of COVID-19

Background: The world has entered the Fourth Industrial Revolution. Utilisation of technology is inevitable. For the past years, the coronavirus disease 2019 (COVID-19) pandemic has halted normal operations, including in the physical classroom for nursing students. Students and facilitators had to move to a remote way of teaching and learning, utilising online teaching and learning. However, students and facilitators were not ready to use online teaching and learning. This not only resulted in numerous challenges, but also became an eye-opener for best practices and intervening strategies. Objectives: To explore and describe experiences of students in a nursing college with regard to online teaching and learning during the onset of the COVID-19 pandemic. Method: A qualitative, exploratory, descriptive and contextual research design was adopted. A purposive, nonprobability sampling approach was used to select participants from second year, third year and fourth year. First-year student nurses were excluded because they did not commence with classrooms at that time. Results: Seven themes emerged, namely knowledge, confidence, training, equipment, clinical exposure, course extension and flexibility, and all themes had subthemes. Conclusion: It is evident that students had more negative experiences during online teaching and learning than positive experiences.

Bachelor of Nursing students' HIV and AIDS knowledge in KwaZulu-Natal province: An evaluation study

Background: Currently, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) education and training in nursing suffer from various inadequacies and lack any real formalisation in their governance. As a result, Bachelor of Nursing students find themselves challenged in providing effective HIV and AIDS healthcare management, largely because of the deficit in training identified. An HIV and AIDS education intervention programme was introduced at a selected KwaZulu-Natal university to assist in bridging the perceived knowledge gap. This article communicates programme evaluation findings.Objectives: The aim of this article was to determine levels of HIV knowledge achieved following an HIV education intervention programme.Methods: A pure, descriptive quantitative research design was employed, using total population sampling (N = 133). A modified G3658-11 Collecting Evaluation Data: End-of-Session Questionnaire, developed by the University of Wisconsin­Extension, was administered for data collection.Results: Females predominated in the study, and most participants were African with 1 to 3 years of education programme exposure. Perceived HIV knowledge increase was evident: pathophysiology (n = 93, 70.2%); immunology (n = 97, 72.9%); transmission (n = 116, 87.5%); diagnosis (n = 109, 81.8%); prevention strategies (n = 118, 88.4%); staging and monitoring (n = 106, 80%); pre- and post-test counselling (n = 104, 78%). Conclusion: Pre- and ongoing in-service HIV and AIDS training can improve perceived HIV knowledge levels for both nursing students and professionals. Mandatory HIV and AIDS healthcare management training is therefore recommended in planning for its effective impartation by nursing educators

Nurses' perspectives on the impact of marketing mix elements (7Ps) on patients' tendency to kind of hospital

BACKGROUND: Marketing mix (7Ps) is a critical concept in healthcare management and health marketing. Hence, this study was conducted to investigating the role of 7Ps on patients' disposition to the kind of hospital from nurses' perspectives. METHODS: A cross-sectional study design was used in 2015. The study was conducted in one state in Iran (Mazandaran). The statistical population included nurses (n=235) in public and private hospitals were selected randomly through the list. Data were collected by questionnaire and were analyzed using SPSS software (version 22). RESULTS: The results showed that 38.6 percent of nurses were males and the others (61.4 percent) were females. Their mean age was 31.0±7.1 years, and the majority of them belonged to the 30-40 age group. The mean work experience of them was 11.42±6.5 years. The findings showed that there were significant differences between nurses' perspectives in public and private hospitals about the effect of 7Ps elements on patients' tendency to the public and private hospitals (p<0.05). CONCLUSIONS: According to the results, the officials of public hospitals should take more attention to the elements like product, place, promotion, people, physical assets and process management more than the past because these elements cause that the patients are disposed to the private hospitals while the government make more investment in public hospitals

Nurses' knowledge, attitudes and practices regarding evidence-based practice in the prevention of mother-to-child transmission of HIV programme in Malawi

Background: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission.Objectives: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi.Methods: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software.Results: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses.Conclusion: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted

Perceptions of Nursing Students Regarding Responsible Use of Social Media in the Eastern Cape

Background: Social media have become a popular communication system that has transformed communication from the traditional to the Web-based model. Because social media use has no limitations to place and time; it is now used extensively at clinical facilities. Social media useis becoming a popular activity amongst students at Nursing Education Institutions (NEI) in South Africa. However; lack of accountability and unethical use of social media by nursing students in South Africa has been reported. Objectives: The aim of the study was to explore and describe the perceptions of nursing students regarding responsible use of social media.Methods: A qualitative; descriptive; explorative and contextual research design was used to explore and describe the perceptions of nursing students regarding the responsible use of social media. Twelve nursing students registered for the undergraduate nursing degree were purposely selected and interviewed individually using a semi-structured interview method. Results: The results of this research study demonstrate that nursing students use social media irresponsibly. Nursing students experience blurred boundaries between personal and professional lines and lack accountability when using social media.Conclusion: The extensive use of social media in the clinical environment; by healthcare students; requires a joint effort by Nursing Education Institutions and healthcare facilities to ensure that social media are used in an ethically acceptable manner. The implementation of the recommendations of this research study could positively influence legally and ethically acceptable use of social media at healthcare facilities

Validation of the Integration of HIV and AIDS Related Nursing Competencies into the Undergraduate Nursing Curriculum in South Africa

Background: Being in its fourth decade; HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV; increasing health care access; and strengthening the health care system. South Africa has made the fight one of its top priorities; and has developed plans to increase the role of nurses in the management of HIV; demonstrating its willingness; commitment and progress in the fight against HIV.Objective: This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa.Methods: This study adopted a constructivist paradigm; using a qualitative approach; applyingthe design step of the process model of curriculum development; to validate the inte gration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum.Results: For each competency; outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum; as well as the feasibility and practicability of the integration.Conclusion: Required resources for integration of HIV and AIDS related nursing competencies; such as human resources and nurse educators' continued personal development were identified; as well as barriers to integration; and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated

Ethical Issues that Confront Nurses in Private Hospitals in the Western Cape Metropolitan Area

Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts; target setting; the shortage of nurses and expertise. Objectives: The objectives of the study were to identify ethical issues related to patient care; to describe ethical issues related to patient diversity; rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment.Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5) was drawn from all nurses and caregivers (N = 2990) working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables.Results: Results included (95) of respondents provided safe and committed care to their patients; (99) loved to care for their patients and (93) believed in the Nurses' Pledge of Service. Fifty percent (50) of the respondents indicated verbal abuse from patients and only (59) experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient

Exploring the Perceptions of Psychiatric Patients Regarding Marijuana Use

There is limited understanding on marijuana use by psychiatric patients; specifically with regard as to why they continue to smoke marijuana despite the negative consequences; such as readmittance to psychiatric hospitals following marijuana-induced psychosis. It is; therefore; important to understand why psychiatric patients continue to use marijuana; despite experiencing its negative effects. The purpose of this study was to explore and describe the perceptions of psychiatric patients with regard to marijuana use in Potchefstroom; North West Province; as well as to formulate recommendations for nursing education; nursing research and nursing practice; with the aim of reducing the readmission of psychiatric patients following marijuana-induced psychosis. A qualitative; exploratory; descriptive and contextual research design was followed in order to give 'voice' to the perceptions of psychiatric patients about marijuana use. Purposive sampling was utilised to identify participants who complied with selection criteria. The sample size was determined by data saturation; which was reached after 10 individual interviews with psychiatric patients. Unstructured individual interviews were utilised to gather data after written approval from the Ethics committee of the North-West University (Potchefstroom Campus); North West Provincial Department of Health; the clinical manager of the psychiatric hospital where data were collected; as well as from the psychiatric patients. The co-coder and the researcher analysed the data independently. The findings of this study include perceptions of psychiatric patients on the use of marijuana; the negative effects of marijuana use; marijuana use and mental illness; and quitting marijuana. Recommendations were formulated for nursing education; nursing research as well as for nursing practice

The Academic Transitional Experiences of Masters' Students at the University of the Western Cape

Transition has been a major focus of educational institutions. However; most of the research into student transition focuses on the challenges related the transition from high school to university. Not much emphasis has been placed on the transition from undergraduate to postgraduate studies; despite the steadily increasing postgraduate enrolment rates in higher education institutions. The discrepancy between the enrolment and completion rates is an indication that postgraduate students are facing transitional challenges when engaging with postgraduate studies. The aim of this research study was to describe the academic transitional experiences of masters' students in the Faculty of Community Health Sciences at the University of the Western Cape. The objectives were to determine the academic preparedness of postgraduate students; to explore their primary motivations for pursuing postgraduate studies; and to assess their utilisation of the available support services at UWC. A quantitative; exploratory; descriptive research design was employed. A cross-sectional survey was conducted with masters' students during 2009; using convenience sampling. Data was statistically analysed using the SPSS to provide descriptive statistics. The majority of the sample indicated a lack of academic preparedness; even though most of them had a bachelor's degree. The primary reasons listed as motivation for master's study were to improve knowledge and reaching self-actualisation. The majority is still eager to complete their studies. Most support systems were utilised and students rated these services as a positive experience that facilitates smooth academic transition. However; concerns are that not many students utilised the academic writing centre and those who did; rated the overall service as average. One of the main recommendations was that a research culture needs to be established

The Status of Academic Integrity amongst Nursing Students at a Nursing Education Institution in the Western Cape

Honesty is regarded as a basic ethical value in all educational programmes; and academic integrity is of undisputed importance in educational environments. The literature reviewed revealed that academic dishonesty is wide-ranging and also encountered in the nursing education environment. This phenomenon is of concern to the nursing fraternity because of the proven positive correlation between unethical academic practices and future unethical professional behaviour. Limited research data regarding academic dishonesty at nursing education institutions in South Africa and this correlation motivated the present study. The purpose was to examine the status of academic integrity amongst nursing students at a nursing education institution in the Western Cape. Formulated bjectives guided investigation of several variables which impact upon academic integrity; for example the incidence of and student perceptions around academic dishonesty. A quantitative; descriptive survey design was used; with a self-reported questionnaire (based on literature review and study objectives) designed to obtain information about academic dishonesty. Provision was also made for qualitative input from the respondents by including three open-ended questions. It was found that academic dishonesty was a reality at the nursing education institution where this study was done. Cheating associated with plagiarism and assignments was identified as the main problem area. An unacceptably high level of dishonesty in completion of practical records was also an area of concern. The main recommendations are development and implementation of a code of honour and implementation of comprehensive academic integrity policies at the nursing education institution; with practical measures aimed at combating cheating in tests and examinations

Scoring Clinical Competencies of Learners: A Quantitative Descriptive Study

This article reports the correlation between different clinical assessors' scoring of learners' clinical competencies in order to exclude any possible extraneous variables with regard to reasons for poor clinical competencies of learners. A university in Gauteng; South Africa provides a learning programme that equips learners with clinical knowledge; skills and values in the assessment; diagnosis; treatment and care of patients presenting at primary health care (PHC) facilities. The researcher observed that; despite additional clinical teaching and guidance; learners still obtained low scores in clinical assessments at completion of the programme. This study sought to determine possible reason(s) for this observation. The objectives were to explore and describe the demographic profile of learners and the correlation between different clinical assessors' scoring of learners. A purposive convenience sample consisted of learners (n = 34) and clinical assessors (n = 6). Data were collected from learners using a self-administered questionnaire and analysed using a nominal and ordinal scale measurement. Data from clinical assessors were collected using a checklist; which was statistically analysed using a software package. The variables were correlated to determine the nature of the relationship between the different clinical assessors' scores on the checklist to ensure inter-rater reliability. Findings showed that there was no significant difference in the mean of the scoring of marks between clinical assessors after correlation (p 0.05). Thus; scoring of marks did not contribute to poor clinical competencies exhibited by learners

The Competencies of the Shift Leader in the Intensive Care Unit Setting; in a Private Hospital Group in South Africa

Newly qualified intensive care nurses are forced into positions of authority and responsibility as shift leaders at an early stage and are not given a chance to consolidate their new knowledge with practice. They have to be responsible and accountable not only for their own actions; but also for those of their staff. The purpose of this study was to explore and describe the competencies of the shift leader in the intensive care unit setting to determine whether there is a gap between what is expected of the shift leader and what is happening in reality. A quantitative; descriptive design was used and cluster sampling was implemented. Questionnaires were used to gather data from three clusters; comprising 11 hospitals from a single private hospital group. Of the 251 questionnaires that were handed out to intensive care personnel (including trained and non-trained staff); 98 were returned; resulting in a response rate of 39. An in-depth literature study and submission of questionnaires to experts before being administered to respondents ensured validity and reliability. Results were used to describe a typology of the competencies of the shift leader in the intensive care setting and indicated that respondents classified competencies related to the application of the nursing process in the intensive care unit in all its facets as essential competencies. None were classified as a critical competency and only four were classified as specific competencies. All respondents in the three clusters regarded their shift leaders as competent

A Cross-Sectional Survey to Compare the Competence of Learners Registered for the Baccalaureus Curationis Programme using Different Learning Approaches at the University of the Western Cape

The purpose of the study was to compare the extent to which the different teaching approaches applied in the Baccalaureus Curationis programme adequately prepare graduating learners for professional competence. The research methodology was a quantitative approach; based on descriptive research; with a clinical competence development model to guide the data collection procedure. The target population of the study included a sample of 250 learners in the four-year B.Cur programme; that extended from first-to-fourth-year. Stratified random sampling was applied to select the sample learners for this research and data were collected by means of a five-point Likert scale questionnaire. Data were organised and managed using the SAS statistical software package. Descriptive statistics were gathered with measures of central tendency and dispersion included; and their findings were illustrated on descriptive tables. A correlation technique was applied to determine the effects of the independent variable on the dependent variable. The results of the study indicated that progression in competence did not occur as learners progressed through higher levels of their training; except during the third-year of study. However; the study's results confirmed the strengths of the Case-based clinical reasoning approach to teaching and learning. This approach is able to combine the strengths of the traditional methods; which dealt with large class sizes and that had a focus on learner centred learning; with a focus on clinical practice. This approach provides realistic opportunities for learners to experiment with solutions to dilemmas encountered in real life situations; from the protected and safe environment of the classroom. The first-year learners who were observed in this study; who although novices; were exposed to Case-based teaching approaches and showed more self-perceived competence than learners in later years. This occurred in spite of the limited exposure of the first-year learners to real life clinical situations. The outcome of this study recommends that more studies are conducted; in the School of Nursing at the University of the Western Cape (UWC); to explore teaching and learning approaches that fully maximise the clinical and theoretical competencies of the learners. The outcome further recommends that learner-centred teaching approaches; such as Case-based method; are applied to all year levels of study in the B.Cur programme; due to its proven value when it was applied to first-year learners. The Case-based clinical reasoning approach to learning; that has been implemented at the school; promotes competence and self confidence in learners and has enhanced their sense of responsibility to be actively involved in their own learning

Fresh simulation options in critical care nursing education

Context and setting The Critical Care (General) Nursing Programme in the Faculty of Health Sciences; Stellenbosch University; South Africa is a one-year post graduate programme. The practical component of the course consists of a number of individual practical procedures e.g. suctioning of the intubated patient as well as several case presentations. In order for students to be able to do a case presentation they need to understand and integrate the critically sick patient's disease process as well as the medical and nursing management. In order for the students to pass the case presentations satisfactory is often a challenge as a much higher cognitive level is expected than when performing the individual practical procedures. Why the idea was necessary During the course of the programme weekly individual clinical guidance is provided to the students at the bedside in the critical care units. The purpose of these bedside sessions is for the students to discuss the critically sick patients with a critical care nurse educator in order to develop their integration; reasoning and case presentation skills. Students however tend to use these teaching opportunities only to practice and to be assessed on the individual practical procedures. Therefore graduates often possess of the skills to do the individual practical procedures; but because they find it difficult to integrate and understand the patient's disease process they lack insight in the holistic picture of the patient. What was done A case study design was used for this study. The practical procedures identified as suitable for simulation were demonstrated; practiced and assessed in simulation in the Clinical Skills Centre (CSC). The study focused on describing how the tutors and students involved experienced the use of simulation as well as how the use of the CSC for reaching competency in some of the practical procedures impacted on the available teaching time in the clinical settings. Evaluation of results and impact The result of completing the majority of the practical procedures in simulation was that more time was available for the students to practice doing case presentations with the critical care nurse educators during their clinical teaching sessions. students and tutors valued the use of simulation and enjoyed the sessions in the CSC. The issue of how successful the transfer of learning from the CSC to the clinical areas takes place poses very valid questions when it comes to simulation. It is vital that students should be able to transfer the learning that has occurred in the simulated setting to the clinical context. Further research on this subject could serve to establish whether students can apply the procedures they have been assessed on in the CSC equally well on real patients; or; if not; what measures can be implemented to facilitate this process

Image of nursing profession as viewed by secondary schools students in Ilala District, Dar es Salaam

Objectives: The Broad objective: To assess knowledge and attitudes of secondary school students in Ilala district towards the nursing profession Specific objectives: To determine the awareness of nursing as a profession by secondary school students in Ilala district; explore factors that promote aspiration to enroll in nursing schools and to explore factors that deter aspiration to enroll in nursing schools. Methods: The study was exploratory cross sectional using both qualitative and quantitative methods and was conducted in Azania and Jangwani secondary schools in Ilala district. The sample size included 50 male and 50 female students who were opting for Physics; Chemistry and Biology from form III to form VI in the above mentioned schools. Results: Awareness above 50for males was 79.2(95CI: 66.6; 91.8) while that of females was 76.9(95CI: 65.4; 88.4). Awareness below 50was 31.4(95CI: 8.4; 54.4) for the males while that for females was 31.1(95CI: 11.3; 50.9). Non awareness was mostly about nurses being capable of independent practice; making decisions for themselves; working with high technology; following physician's orders without questioning and feeling good about what they do. Factors that were pointed out included: social; economical; educational and individual perceptions of different students. Although students were aware of nursing; they did not want to opt to join the profession. Conclusion: This study has shown that students are at least aware of the profession but they do not want to opt for it due to the image they have of it from the public. The factors that have been addressed in this research have to be put in consideration if at all we are to increase the nurse patientratio in Tanzania

A Woman-Centred Childbirth Model

A model for woman-centred childbirth was developed through four phases in accordance with the objectives of the study; namely; a description of mothers' experiences of childbirth and that of attending midwives of managing mothers during childbirth concept analysis of woman-centred care; model development; and an evaluation phase. The identified concepts and sub-concepts were classified and developed into in a conceptual model within the six elements of the practice theory; as outlined by Dickoff; James and Wiedenbach's (1968:423) survey list cited by Madela-Mntla (1999:69) in Tlakula (1999:119). These elements are recipient; agent; context; procedure; purpose and dynamic. The relational statements derived after conceptualisation of each of the six concepts were inferred through the process of deductive analysis and synthesis. The development of the woman-centred childbirth model contained six components; namely; goals; concepts; definitions; relationships; structures and assumptions; as outlined in Chinn and Jacobs (1987:116). The model was evaluated in accordance with Chinn and Kramer's (1995:134-135) method and refined by experts in midwifery practice and model generation. Limitations were recognised and recommendations made

Foreign Nursing Students: Their Profile and Perceptions Ofnursing Care in Namibia

A survey was conducted using open and close-ended questions to determine how visiting nursing students in Namibia could be assisted during their visits (cultural encounters). Many students decide to complete their clinical exposure in a foreign country; either for personal reasons or in order to meet the course requirements for transcultural nursing. Since 1998; Namibia has received a number of these students. In discussion and from passing remarks from the students themselves; the question has arisen as to how an optimum placement for each student might be achieved. Aspects of the Campina-Bacote model and The Process of Cultural Competence in the Delivery of Health Care Services were used to answer this question. It was decided to gather both biographical (profile) information and information on perceptions of nursing care in Namibia from such foreign nursing students. The biographical (profile) information collected indicates a prevalence of certain shared biographical characteristics among international students. Such students tend to be adventurous; caring and sensitive to human rights issues. This finding correlates with the constructs of cultural desire and cultural awareness as described in the model of Campina-Bacote. Based on this finding; specific recommendations were made for clinical allocations. From the data gathered from the open-ended questions; three themes emerged: firstly; nursing in Namibia has identifiable characteristics; secondly; there is a paternalistic and one-sided communication style among nursing caregivers in Namibia; and finally; nursing care delivery in this country is often characterised by a detached attitude. It was concluded that these themes correlated with a cultural awareness and cultural knowledge among the nursing students. The discovery of these themes was useful for making recommendations for clinical guidelines to help these students adapt; as well as for providing a foundation and substantiation for clinical placement