Exploring undergraduate nursing students’ understanding and application of the duty of care

Thesis (MCur)--Stellenbosch University, 2018.ENGLISH SUMMARY: Background The core of nursing practice is caring and if nurses do not care they failed to uphold the foundation that underpins nursing practice. A duty of care is required from all nurses and it is both an ethical and statutory obligation. If nurses negligently omit their duty of care or standards of practice, it could have detrimental consequences for the patient, nurse and employer. Rationale The researcher observed careless behaviours amongst nurses with reference to their fundamental duties, compelling the researcher to explore undergraduate nursing students’ understanding and application of their duty of care. Research question The research question which guided the study was: What is the undergraduate nursing students’ understanding and application of the duty to care? Research aim The aim of the study was to explore the undergraduate nursing students’ understanding and application of the duty of care. Research objectives The objectives were as follows: 1.Understanding and application of caring in nursing practice 2.Understanding and application of the duty to care 3.Understanding and application of ethics in nursing practice 4.Understanding and application of standards in nursing practice 5.Understanding and application of legalities in nursing practice 6.Understanding of negligence in nursing practice. Research design A qualitative explorative-descriptive design was applied to explore the undergraduate nursing students’ understanding and application of the duty of care. Sampling A purposive sampling method was applied to recruit participants from a nursing education institution in the Cape Metropolitan area. Ethical consideration Ethical approval was obtained from the Health Research Ethics Committee of Stellenbosch University (S16/10/230) and the nursing education institution (CPUT/HW-REC 2016/H15) where the study was conducted. Inclusion criteria Inclusion criteria consisted of fourth year undergraduate nursing students, following the BTECH degree programme in Nursing Science at the specific nursing education institution. Exclusion criteria Undergraduate nursing students in their first, second and third year of study at the specific nursing education institution were excluded from the study. Pilot study A pilot study was conducted with one participant from the target population. Trustworthiness Lincoln and Guba’s (1985) four criteria: credibility, dependability, confirmability and transferability were applied in this study, to ensure the trustworthiness of the study. Data collection A self-formulated interview guide was used during data collection. Ten semi-structured interviews were conducted. The interviews were recorded on a digital voice recording device. Data analysis Transcribed data was analysed applying the Terreblanche, Durheim and Painter’s model (2006). Eleven themes emerged from the data. Results The findings of the study suggest that the undergraduate nursing students do not entirely comprehend aspects of the duty of care. As stated by one student: “Carrying out the orders as prescribed that is your duty…call the doctor and make a way so the patient can get the best health possible.” (Participant 9) Recommendations Recommendations include that health departments and nursing education institutions urgently address shortages of staff, uncaring nursing behaviours and knowledge gaps as identified in this study.AFRIKAANSE OPSOMMING: Agtergrond Die kern van die verplegingspraktyk gaan oor versorging en indien verpleegsters dit nie uitdra nie, ondermyn hulle die basis wat onderliggend aan die verplegingspraktyk is. Daar word van alle verpleegsters verwag om ‘n versorgingsplig te hê en dit is beide ‘n etiese en statutêre verpligting. Indien verpleegsters as gevolg van nalatigheid hul plig versuim om te versorg of die standaarde van die praktyk nie nakom nie, kan dit skadelike gevolge vir die pasiënt, verpleegster en werkgewer tot gevolg hê. Rasionaal Die navorser het die nalatige gedrag onder verpleegsters ten opsigte van hulle fundamentele pligte waargeneem en was genoop om ondersoek in te stel na hoedat die voorgraadse verpleegstudente hulle versorgingspligte verstaan. Navorsingsvraag Die navorsingsvraag wat die studie gerig het, was: Hoe verstaan en pas voorgraadse verpleegstudente hul plig om te versorg toe? Navorsingsdoelwit Die doel van die studie was om te bepaal hoe die voorgraadse verpleegstudente hul plig om te versorg, verstaan. Navorsingsdoelstellings Die doelstellings was as volg: 1. Verstaan en toepassing van versorging in die verplegingspraktyk 2. Verstaan en toepassing van die plig om te versorg 3. Verstaan en toepassing van die etiek in die verplegingspraktyk 4. Verstaan en toepassing van standaarde in die verplegingspraktyk 5. Verstaan en toepassing van wettighede in die verplegingspraktyk 6. Verstaan en toepassing van nalatigheid in die verplegingspraktyk. Navorsingsontwerp ‘n Kwalitatiewe eksploratiewe-beskrywende ontwerp om te bepaal hoe die voorgraadse verpleegstudente hul plig om te versorg verstaan, was toegepas. Steekproefneming ‘n Doelgerigte steekproefmetode was toegepas om deelnemers van ‘n verpleegkunde instansie in die Kaapse Metropolitaanse gebied te werf. Oorweging vir etiek Goedkeuring vir etiek was verkry van die Gesondheidsnavorsingsetiekkomitee aan die Universiteit van Stellenbosch (S16/10/230) en die verpleegkunde instansie (CPUT/HW-REC 2016/H15) waar die studie uitgevoer is. Insluitingskriteria Die insluitingskriteria het bestaan uit vierdejaar-ondergraadse verpleegstudente wat die BTech-graad program in Verpleegkunde by die spesifieke verpleegkunde instansie volg. Uitsluitingskriteria Voorgraadse verpleegstudente in hulle eerste, tweede en derde jaar van studie aan die spesifieke verpleegkunde instansie was van hierdie studie uitgesluit. Loodsprojek ‘n Loodsprojek met een deelnemer van die teikengroep was uitgeoefen. Betroubaarheid Lincoln en Guba (1985) se vier kriteria: geloofwaardigheid, betroubaarheid, bevestigbaarheid en oordraagbaarheid was in die studie toegepas om die betroubaarheid van die studie te verseker. Data-insameling ‘n Selfgeformuleerde onderhoudsgids was gedurende data-insameling gebruik. Tien semi-gestruktureerde onderhoude was gehou. Die onderhoude was deur middel van ‘n digitale stemopname-toestel opgeneem. Data-analise Getranskribeerde data was deur middel van Terreblanche, Durheim en Painter se model (2006) geanaliseer. Elf temas het uit die data voortgespruit. Resultate Die bevindinge van die studie suggereer dat die voorgraadse verpleegstudente nie die aspekte rondom hul versorgingsplig ten volle verstaan nie. Soos een student dit gestel het: ‘Om opdragte soos voorgeskryf uit te dra, is jou plig... ontbied die dokter en maak dit moontlik dat die pasiënt die beste gesondheidsorg moontlik ontvang.’ (Deelnemer 9) Aanbevelings Daar word aanbeveel dat gesondheidsdepartemente en verpleegkunde instansies die tekort aan verpleegsters en die verplegingsgedrag om nie te versorg nie, asook die kennisgapings soos geïdentifiseer in die studie, indringend aanspreek