Exploring newly qualified nurses experiences of their compulsory community service year at an urban district hospital

Scheepers, Vanessa Christina (2020-03)

Thesis (MNur)--Stellenbosch University, 2020.

Thesis

ENGLISH SUMMARY : Background: Compulsory community service in the South African health sector was initiated by the National Department of Health with two distinct goals (Parker, Steyn, Mchiza, Wentzel-Viljoen, Dannhauser, Mbhenyane, Nthangeni & Moeng, 2011: 1412) firstly, to ensure improved delivery of health services to all South Africans; and secondly, to provide opportunities for newly qualified health professionals to develop their knowledge, practical skills, critical thinking abilities and professional behaviour (Hatcher, Onah, Kornik, Peacocke & Reid, 2014: 2). Despite the secondary goal (providing newly qualified health professionals with opportunities to develop their knowledge, practical skills, critical thinking abilities and professional behaviours), literature shows there are facilitators and barriers that seem to influence a person’s experience of the community service year (Reid et al., 2018: 44-45; Netshisaulu & Maputle, 2018: 4-6). It seems that, similarly to the experiences of other healthcare professionals, nurses engaged in community service at the public health facility where the researcher is employed do not seem to benefit from this stated secondary goal. The purpose of this study was therefore to explore and describe newly qualified nurses’ experiences of the compulsory community service year at an urban district hospital. Methods: A qualitative approach with an exploratory, descriptive research design was used for the study. A purposive sampling method was applied, and the final study sample comprised of five participants out of the 13 community service nurses. A semistructured interview guide was used to collect narrative data from participants and field notes were made. Qualitative content analysis was used to analyze the data collected. Results: Three overarching themes and eight sub-themes emerged through the data analysis process. The first theme, a complex experience, described the varied experiences of the participants during their compulsory community service year. The second theme, support, highlighted participants’ experience of the support they had received. The third theme, on the floor, described the positive experiences and challenges the participants encountered in the clinical environment. Conclusion: The research question of this study was answered through an analysis of the participants’ rich, in-depth experiences. Community service nurses had varied experiences of the community service year. The overall experience was positive, with community service nurses being able to develop their knowledge, practical skills, critical thinking abilities and professional behaviour. Their experiences identified specific facilitators and barriers that influence newly qualified nurses’ experience of the community service year. This understanding can inform a review and revision of the current support strategies for newly qualified nurses doing compulsory community service in public urban hospitals.

AFRIKAANSE OPSOMMING : Agtergrond: Verpligte gemeenskapsdiens in die Suid-Afrikaanse gesondheidsektor is deur die Nasionale Departement van Gesondheid met twee afsonderlike doelstellings geïnisieer (Parker, Steyn, Mchiza, Wentzel-Viljoen, Dannhauser, Mbhenyane, Nthangeni & Moeng, 2011: 1412): eerstens, om verbeterde lewering van gesondheidsdienste aan alle Suid-Afrikaners te verseker; en tweedens, om geleenthede aan pas-gekwalifiseerde gesondheidswerkers te bied om hul kennis, praktiese vaardighede, kritiese denkvaardighede en professionele gedrag te ontwikkel (Hatcher, Onah, Kornik, Peacocke & Reid, 2014: 2). Ten spyte van die sekondêre doel (om aan pas-gekwalifiseerde gesondheidswerkers geleenthede te bied om hul kennis, praktiese vaardighede, kritiese denkvermoë en professionele gedrag te ontwikkel), toon die literatuur dat daar fasiliteerders en hindernisse is wat blykbaar die persoon se ervaring van die gemeenskapsdiensjaar beïnvloed (Reid et al., 2018: 44-45; Netshisaulu & Maputle, 2018: 4-6). Dit wil voorkom asof verpleegkundiges wat betrokke is by gemeenskapsdiens by die openbare gesondheidsorgfasiliteit waar die navorser werksaam is, net soos ander gesondheidsorgkundiges, nie baat by hierdie vermelde sekondêre doel nie. Die doel van hierdie studie was dus om pasgekwalifiseerde verpleegkundiges se ervarings van die verpligte gemeenskapsdiensjaar in 'n stedelike distrikshospitaal te verken en te beskryf. Metodes: 'n Kwalitatiewe benadering met 'n verkennende, beskrywende navorsingsontwerp is vir die studie gebruik. 'n Doelgerigte steekproefmetode is toegepas, en die finale studie steekproef het uit vyf deelnemers uit die 13 gemeenskapsdiensverpleegkundiges bestaan. 'n Semi-gestruktureerde onderhoudsgids is gebruik om narratiewe data van deelnemers in te win en veldnotas is gemaak. Kwalitatiewe inhoudsanalise is gebruik om die ingewinde data te ontleed. Bevindinge: Drie oorkoepelende temas en agt subtemas het na vore gekom deur die proses van data-ontleding. Die eerste tema, 'n ingewikkelde ervaring, het die uiteenlopende ervarings van die deelnemers tydens hul verpligte gemeenskapsdiensjaar beskryf. Die tweede tema, ondersteuning, het die deelnemers se ervaring van die ondersteuning wat hulle ontvang het, beklemtoon. Die derde tema, op die vloer, het die positiewe ervarings en uitdagings wat die deelnemers in die kliniese omgewing teëgekom het, beskryf. Slotsom: Die navorsingsvraag van hierdie studie is beantwoord deur die analise van die ryk, diepgaande ervarings van die deelnemers. Gemeenskapsdiensverpleegkundiges het uiteenlopende ervarings van die gemeenskapsdiensjaar gehad. Die algemene ervaring was positief, aangesien gemeenskapsdiensverpleegkundiges hulle kennis, praktiese vaardighede, kritiese denkvaardighede en professionele gedrag kon ontwikkel. Hul ervarings het spesifieke fasiliteerders en hindernisse geïdentifiseer wat pas-gekwalifiseerde verpleegkundiges se ervaring van die gemeenskapsdiensjaar beïnvloed. Hierdie insig kan 'n oorsig en hersiening van die huidige ondersteuningstrategieë vir pas-gekwalifiseerde verpleegkundiges wat verpligte gemeenskapsdiens in openbare stedelike hospitale doen, inlig.

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