The theory and practice of undergraduate nursing ethics education programs in South Africa and Namibia : a critical appraisal

De Villiers, Josephine Elizabeth (2015-04)

Thesis (PhD)--Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: The history and evolution of nursing ethics situate caring as a central value of nursing. Since ancient times, codes of conduct, developed by societies, have protected the vulnerable. The value system of nursing in South Africa and Namibia is derived from Christian missionaries who hailed from England and Europe. Florence Nightingale is recognised as the founder of modern nursing and established a firm ethical foundation for nursing. Nursing ethics education has various aims, i.e. promotion of ethical insight of nurses and protection of patients. Ethics education is confronted daily with many challenges with continuous efforts to address these challenges through innovations. Throughout its history, the nursing profession has responded to moral challenges by developing ethical codes with guiding principles for nursing practice. An ethic of care gained ground as an important approach in nursing practice. The values and obligations proclaimed in the codes of ethics of some countries and the International Council of Nurses reveal shared values and beliefs in nursing. These codes of ethics describe the obligation of nurses towards patients, the nursing profession, society, co-workers and themselves as individual nurses. Nurses ought to develop certain required character traits. Aristotle’s ideas on intellectual virtues and practical wisdom specifically may provide nursing ethics educators with a viable approach in the teaching-learning of nursing ethics. The status of nursing ethics education in South Africa and Namibia revealed variability in most aspects of undergraduate nursing ethics education in institutions of higher education. This lack of standardisation complicates assessment of the quality of nursing ethics education. Nursing ethics educators in South Africa and Namibia identified challenges regarding the teaching-learning environment, practising nurses, students and educators as well as challenges related to the regulatory authorities and political and legislative framework. Suggestions to address these challenges were also offered by the nursing ethics educators. The effective internalisation of nursing values requires the efforts of nursing educators, students, practising nurses as well as stakeholders beyond institutions of higher learning. A critical assessment of nursing ethics education in South Africa and Namibia highlighted certain deficiencies in relation to regulatory and managerial aspects in nursing education and various issues related to nursing education generally and nursing ethics education specifically. Improving nursing ethics education needs nursing ethics educator specialisation, standardisation of ethics education and innovative teaching-learning strategies, including the inculcation of practical wisdom in nursing students. Health care facilities need upgrading, and practising nurses and educators must support nursing students effectively. Managerial and regulatory aspects need improvement. The challenges identified in this study can be resolved by improved collaboration amongst institutions of higher learning, nursing councils and service providers. Nursing ethics educators remain hopeful that nursing ethics education has the potential to be significantly improved both in South Africa and Namibia.

AFRIKAANSE OPSOMMING: Die geskiedenis en ontwikkeling van verpleegetiek dui op versorging as die kernwaarde van verpleegkunde. Sedert die vroegste tye sien die gedragskodes wat deur samelewings ontwikkel word, na kwesbare lede van die gemeenskap om. Die waardestelsel van verpleegkunde in Suid-Afrika en Namibië kan teruggevoer word tot die Christen-sendelinge wat uit Engeland en Europa gekom het. Florence Nightingale word as die stigter van moderne verpleegkunde beskou en het ’n stewige etiese grondslag vir verpleegkunde gelê. Verpleegetiek onderrig het verskeie doelwitte, waaronder bevordering van die etiese insigte van verpleegkundigies en beskerming van pasiënte. Etiek onderrrig word daagliks gekonfronteer deur menige uitdagings met volgehoue pogings om hierdie uitdagings deur innovering aan te spreek. Oor die geskiedenis heen het die verpleegberoep op morele uitdagings gereageer deur etiekkodes met rigsnoere vir die verpleegpraktyk op te stel. Mettertyd het die etiek van versorging veld gewen as ’n belangrike benadering tot verpleegpraktyk. Die waardes en verpligtinge wat in die etiekkodes van sommige lande sowel as dié van die Internasionale Raad vir Verpleegkundiges vervat is, toon bepaalde gemeenskaplike beginsels en oortuigings. Hierdie etiekkodes beskryf verpleegkundiges se plig jeens pasiënte, die verpleegberoep, die samelewing, hul medewerkers én hulself as individuele verpleërs. Verpleegkundiges behoort sekere vereiste karaktereienskappe te ontwikkel. Veral Aristoteles se gedagtes oor intellektuele deugde en praktiese insig kan verpleegetiekopvoeders van ’n lewensvatbare benadering tot onderrig en leer op hul vakgebied voorsien. Tog bied hoëronderwysinstellings in Suid-Afrika en Namibië oënskynlik wisselende mates van voorgraadse verpleegetiekonderrig. Hierdie gebrek aan standaardisering maak dit moeilik om die werklike gehalte van verpleegetiekonderrig te bepaal. Die verpleegetiekopvoeders in Suid- Afrika en Namibië wat vir hierdie studie geraadpleeg is, maak melding van uitdagings met betrekking tot die onderrig- en leeromgewing, verpleegpraktisyns, studente en opvoeders, die reguleringsowerhede sowel as politieke en regskwessies. Die opvoeders het ook voorstelle gemaak oor hoe hierdie uitdagings hanteer kan word. Die doeltreffende internalisering van verpleegwaardes vereis toewyding van verpleegopvoeders, -studente en -praktisyns sowel as belanghebbendes buite hoëronderwysinstellings. ’n Kritiese beoordeling van verpleegetiekonderrig in Suid-Afrika en Namibië dui op bepaalde tekorte wat regulerings- en bestuursaspekte van verpleegonderrig betref, en ook verskeie uitdagings met betrekking tot verpleegonderrig oor die algemeen en verpleegetiekonderrig in die besonder. Die verbetering van verpleegetiekonderrig vereis spesialisering deur verpleegetiekopvoeders, die standaardisering van etiekonderrig, en innoverende onderrig- en leerstrategieë, onder meer die inskerping van praktiese insig by verpleegstudente. Gesondheidsorgfasiliteite moet opgeknap word en verpleegpraktisyns en -opvoeders moet verpleegstudente doeltreffend ondersteun. Ook bestuurs- en reguleringsaspekte moet verbeter word. Die uitdagings wat in hierdie studie na vore kom, kan die hoof gebied word deur beter samewerking tussen hoëronderwysinstellings, verpleegrade en diensverskaffers. Intussen bly verpleegetiekopvoeders vol hoop dat verpleegetiekonderrig in Suid-Afrika en Namibië verbeter kan word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/96810
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