Exploring the experiences of enrolled nurses regarding quality nursing care in general nursing units in the private healthcare setting

[摘要] ENGLISH ABSTRACT: In South Africa, currently enrolled nurses make up the largest proportion of members of thenursing healthcare team. As in direct contact with patients it is essential that the practiceenvironment supports patient and nursing outcomes. Studies confirm the complexity of thepractice environment and the impact on both personnel and on the quality of nursing careprovided. 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, hasresulted in enrolled nurses being widely used to continue to deliver acute care in quite complexsituations. It is well documented that the use of suboptimal nursing personnel levels orsubstituting enrolled nurses for registered professional nurses is associated with an increase ofadverse events such as infections, pressure ulcers and unanticipated death.The purpose of this study was to explore the experiences of enrolled nurses regarding qualitynursing 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 toquality care and- The exploration of the enrolled nurses experiences (positive and negative) of qualitynursing care in private health care setting A descriptive qualitative methodology was applied. A purposive sample size of n=13 was drawnfrom the total population of N=387. An exploratory interview was completed. Lincoln and Guba'scriteria of credibility, transferability, dependability and confirmability were applied and ethicalprinciples were met.Findings demonstrated that enrolled nurses experienced both positive and negative workexperiences, some more negative than others. They had a very good understanding of qualitycare but had difficulty in reconciling the patient's needs with what they were able to deliver, dueto workload pressures and resource constraints: P6: 'I miss the quality because that patient that needs just that back rub or just to holdhis hand ...the thing is with quality nursing we don't do quality nursing on the patientanymore.Most participants experienced registered professional nurses absolving their clinical supervisoryresponsibility. This endangers the quality and duty of care of patients and is a legal liability. Arecommendation is that registered professional nurses require professional developmentthrough utilising good role models. This exposure to positive learning experiences will enabletheir professional development and ethical behaviour. Registered professional nurses need tobe taught the skills of how to be team players.

[发布机构] Stellenbosch University