A Model for Higher Education Campus Health Services

This study was undertaken in order to develop a holistic healthcare model that would assist registered nurses who are employed at a higher education campus' health service to render a healthcare service relevant to the healthcare needs of the campus healthcare consumers. A theory-generative; qualitative; explorative; descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare service on campus. The main concepts of holistic healthcare were identified from the information obtained from the in-depth; focus group interviews that were conducted with the participants. The process of theoretical model generation was conducted according to the steps of theory generation as proposed by Walker and Avant (1995:39); namely that of concept analysis; the placing of concepts in relationships; a description of the model and guidelines to operationalise the model. This model provides a structured holistic healthcare frame of reference for registered nurses employed in a campus health service at a Higher Education Institution (HEI) and could be used to assist all campus healthcare consumers to become balanced whole persons who are able to realise their dreams and maintain consistency with regard to optimal health and capacity

The experience of childbrith in first-time mothers who received narcotic analgesics during the first stage of labour.

This research has focused on the birthing experience of first-time mothers who received the narcotic analgesic combination of Pethidine and Hydroxyzine during the first stage of labour. A qualitative research methodology was used to collect data. Unstructured interviews were held with first-time mothers to obtain accounts of their experience of childbirth. These narrations were audio-taped while the participants were still being cared for in the postnatal ward of the hospital where delivery took place. Nine interviews were conducted with first-time mothers who gave birth normally vaginally after a normal pregnancy and who received a narcotic analgesic in the first stage of labour. The transcribed interviews were analyzed using Tesch's method of descriptive analysis (in Creswell, 1994:115). Four themes with sub-themes emerged from the analysis. The participants reported on the physical experience of labour and described experiencing a lot of pain for which analgesics were given. They also described how these drugs dulled the pain but made them sleepy and unable to cooperate with the midwives. They described their emotional experiences, which included joy and happiness as well as anxiety, anger and despondence. They also reported that they were not sufficiently informed about labour and child-birth. In the last theme they described the methods they used to help them cope with labour including distracting techniques, leaning on a supportive person or praying. Guidelines to help midwives overcome these problems were developed.

Registered nurses' experience of the withdrawal of treatment from the critically ill patient in an intensive care unit.

In this article the results of research undertaken to explore and describe the experience of Registered Nurses regarding the withdrawal of treatment from the critically ill patient in an Intensive Care Unit (ICU), are discussed. Withdrawal of treatment from a critically ill patient in an Intensive Care Unit (ICU) is a very traumatic experience for all those involved. The Registered Nurse has the most contact with all those who are involved throughout the process. This raises questions regarding how the nurse experiences the withdrawal of treatment, and about guidelines that can be developed to accompany the nurse during the process of treatment withdrawal. The study was qualitative, descriptive, exploratory, descriptive and contextual in nature. Data was gathered by means of phenomenological interviews conducted by the researcher. Trustworthiness was ensured through the implementation of Guba's model (in Krefting 1991: 214). The following themes were identified: 1. The relationships the nurse develops with individuals involved in the process of treatment withdrawal. 2. The inner moral conflict experienced by the nurse relating to the ethical aspects of withdrawal of treatment. The focus of this article is on the discussion of these experiences of the registered nurses. Based on the identified themes, guidelines were developed to accompany the nurse during the process of withdrawal of treatment.

In-service education and training as experienced by registered nurses.

Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for in-service training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective in-service training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch's descriptive approach (in Creswell, 1994:155). Two main themes emerged, namely that registered nurses experienced in-service training programmes as inadequate and reacted negatively towards them. This article focuses on the experiences of registered nurses relating to in-service training programmes, as well as the formulation of guidelines to assist nursing service managers in the development of effective in-service training programmes.

The clinic supervisory system as experienced by nurse supervisors.

A lack of proper monitoring and supervision of clinics in the King William's Town Health District (Eastern Cape) was highlighted by members of the public in the local newspaper, The Daily Dispatch, during 1999. A clinic audit conducted by the Health Information Unit of the King William's Town Health District further revealed the inadequacies of clinic supervision in this district. This article describes the qualitative study that was conducted with the aim of optimising clinic supervision in this health district. The study brought to light two issues that appear to be paramount in ensuring optimal clinic supervision. These are: The importance of formal and informal preparation of clinic supervisors for the supervisory role The support system that the clinic supervisors require to perform their duties effectively. The focus of this article will be on the discussion of the research findings as well as guidelines that were developed to optimise clinic supervision.