BSc (Hons) Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7259
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Item How do Accident & Emergency nurses deal with emotional labour?(2019)Background: In order to provide holistic care in emergency services, registered nurses have to deal with their own emotions and the ones from the people they care for depending on the situations they face. The gap between the emotions they portray and the ones they experience, the emotional labour, can cause psychological and physiological issues on the long term and affect the care they provide. Objectives: A preliminary literature review investigated the current evidence existing on emotional labour in nurses working in Accident and Emergency (A&E) services, in order to assess a possible gap in research. Then a research proposal was formulated to answer the gap identified in research, as part of a dissertation from the final year of a Bachelor Honours in Adult Nursing. Design: A qualitative exploratory phenomenological research study seek to answer the research questions: What do Scottish A&E nurses know about emotional labour? How do Scottish A&E nurses deal with emotional labour? Methods: A theoretical sampling would recruit 15 to 20 registered nurses from a main Scottish A&E to investigate their views and opinions during semi-structured interviews lead by the single researcher of the study until saturation of the data. Ethical implications are investigated and the data analysis is hypothesised within the restricted resources, limited funding and the single researcher involved. All arguments are justified and supported by research evidence. Results: The possible findings may inform how aware A&E registered nurses are of their emotional work and what experiences they have that inform them on how to cope in a challenging and emotionally demanding environment. It may highlight what they perceive as challenging or comforting and supportive within their occupational demands and professional duties. Conclusion: The findings permit to inform a gap in knowledge from current literature on emotional labour in nursing, in A&E departments. The highly emotional burden lived by registered nurses in this high pressured and fast paced environment may not be effectively managed and lead to burnout and depersonalisation. This information confirms the need for further professional development and educational resources to develop emotional intelligence in nursing in order to have capable, safe and confident caring nurses whom are able to fully provide holistic person centred care.Item How do changes and developments in technology impact on person-centred practice? – a nursing perspective(2019)Key Words: technology, nursing practice, person-centred, change The purpose of this research is to explore the thoughts and opinions of nurses on changes in technology, and how it can impact on their person-centred care. The main aims include exploring the impact of technology on person-centred care, and the concepts of change within health care. It is important that these are viewed from the perspective of nurses, to gain an understanding of their own awareness of their thoughts and opinions. To do this, participatory action research will be utilised to ensure that nurses are co-researchers in the process and can guide the study in a way in which will make the most impact for them. This process will be rewarding as they take an active part in changing practice in a direct and meaningful way for themselves. The end goal of this research is to create a framework for the implementation of innovations that can be used by different areas to cater the processes of change to a more productive and beneficial technique. This will require further work with nursing staff that will aim to change practice in the future and aid in the goal of achieving a truly person-centred service.Item What are the facilitators and barriers that influence an individual’s transition from critical illness to acute illness?(2019)Aims and Objectives: The aims of this dissertation are firstly to explore the literature regarding the transfer process from critical care to the ward for patients and nurses, theme findings and identify gaps that can be taken forward for further research; and secondly, to formulate a research proposal that describes how research would be carried out to investigate the facilitators and barriers that influence an individual’s transition from critical illness to acute illness. Background: This project was prompted by a conversation regarding transfer to the ward, leading to further definition of critical care and related psychological and nursing theory. Subsequently a literature review question was posed: “How do patients describe their lived experience of transfer from critical care to an acute ward, and how does nursing care impact this?”. Themes from the review included communication and the experience and understanding of the transfer process. Design: From the literature review findings an exploratory descriptive, ethnographic study is proposed to answer the question: “What are the facilitators and barriers that influence an individual’s transition from critical illness to acute illness?”. Features of the study such as ethical considerations, method of access, sampling and recruitment, data collection methods and analysis, and rigour are discussed. Methods: Data will be collected using participant observation, interviews and participant diaries. This will enrich and deepen the data collected and act as a triangulation method, increasing rigour. Results: Data collected from the methods will undergo thematic, inductive analysis in order to define the meaning behind the transition by seeking out new themes, patterns or categories. Facilitators and barriers will also be highlighted. Conclusion: Implications for future nursing practice and research limitations are described, and avenues for further study are given. Finally, opportunities for dissemination of the study findings are explored.Item Exploring the experiences of patients and nurses in using Mindfulness for the management of cancerrelated fatigue in gynaecological cancers(2019)This research proposal seeks to explore the experiences of patients and nurses in using Mindfulness for the management of cancer-related fatigue (CRF) in gynaecological cancers. A review of current literature investigated different Mindfulness practices and methods of delivering these to patients with cancer for symptom management, establishing how patients and nurses perceive Mindfulness and when is considered an appropriate time to introduce this. It was determined that Mindfulness is an acceptable and feasible symptom management strategy, particularly in the management of CRF. Studies showed that improvements instigated by Mindfulness impacted how patients associated their symptoms, commonly improving the way this was perceived rather than improving actual symptom incidence. This study proposes carrying out individual interviews of patients and nurses using narrative inquiry. The aim is to interview a maximum of fourteen participants, using purposive and quota sampling to gain participant equality. Qualitative data will be gained through the interview process seeking patient and nurse experiences, attitudes and understandings of using Mindfulness for CRF management in gynaecological cancer, also establishing if and how Mindfulness is introduced to these patients. Nurse participants will work in an oncology setting with experience of caring for women with gynaecological cancer, whilst the patients will have a diagnosis of gynaecological cancer and a previous experience or existing understanding of Mindfulness. Implications for practice include an enhanced understanding of patient and nurse experiences with Mindfulness and their perception of implementing this into a person-centred fatigue management care plan.Item Exploration into the resilience of A&E nurses following their involvement in care after a catastrophic event(2019)The purpose of this study is to explore if the resilience of nurses differs following their involvement in care after a catastrophic event. Due to the nature of the job, nurses encounter emotionally traumatic situations regularly which can have dramatic effects on the psychological health of the nurse. Through a robust literature search, it was uncovered that much literature regarding traumatic or ‘catastrophic’ events often highlight the prevalence or effects of secondary traumatic stress (STS) or post-traumatic stress disorder (PTSD). This study differs in that it looks to explore the positive effects of these events by exploring the resilience of the nurse. Resilient individuals are better able to deal with adversity and move on from such catastrophes. It aims to identify if nurses consider there to be a change in this resilience caused by the catastrophic event encountered, and will pay particular attention to the influence of social support on resilience. Finally, it looks to compare support received during their involvement with patients who have experienced a catastrophic event to the support received in accident and emergency day-to-day. The study hopes to fulfil its aims by using individual, semi-structured interviews with ten participants. The proposed study takes place over a six-month period from initiation of the study to the production of a final report. Findings should suggest if there is a difference in the resilience of nurses’ post-catastrophic event and if so, the influence in which social support had on this. As an exploratory study, it hopes to retrieve meaningful description surrounding the phenomena being studied. In doing so, it could identify emerging themes and potentially provide a basis for future studies.Item Are nurses aware of the gender and sex based differences affecting women in the diagnosis of acute coronary syndrome (ACS)?(2019)Background In Scotland, coronary heart disease (CHD) kills nearly twice as many women as breast cancer (British Heart Foundation (BHF), 2017) yet there is no media campaign in existence for female coronary care in the United Kingdom (UK) which matches the scale of the Wear It Pink (2019) campaign for breast cancer awareness. CHD often leads onto a condition known as acute coronary syndrome (ACS). ACS is a term which describes a spectrum of symptoms that indicate myocardial infarction (MI) or unstable angina (UA). Detection of ACS in women is complex and incorporates physiological and gender and societal based stigmas. Aims The aim of this study is to gain a deeper understanding into the experiences of nurses who care for female patients with a confirmed or suspected diagnosis of ACS, with a view to establishing areas where patient care and support for nurses can be improved, as well as increased awareness of the presentation of ACS in women. Methods 10 nurses who work in cardiology will be recruited for the purposes of this study. Participatory Action Research (PAR) is the chosen research design, therefore collaborative working between researcher and participants will be present. A focus group will be deployed in the first cycle of PAR in order to allow the participants to identify areas from the literature review that they deem important to their practice and to nursing care. Subsequent cycles of PAR will be informed based on the data collection and the findings in the first cycle. Positive change and participant empowerment are the main goals the researcher hopes to achieve through the use of PAR.Item An Exploratory study of the effects which twelve-hour shifts have on nurses and patients within the acute care setting(2019)The purpose of this research proposal is to explore the effects of twelve-hour shifts on both patients and nurses within the acute care setting. This study aims to explore the thoughts, perceptions and opinions nurses and patients have of twelve-hour shifts. This study will also use a phenomenological approach in order to discover more about the experiences both patients and nurses have of these long working hours. The move from eight-hour shifts to twelve-hour shifts has brought about many concerns such as reduced quality of patient care, increased stress for nurses and more nurses becoming fatigued. However, many now favour this new schedule as it allows them to have more work free days allowing them greater flexibility. Over the course of three months, three nurses and three patients from three general medical wards in a large teaching hospital in Scotland will be offered the opportunity to take part in this study. Those selected will take part in a semi-structured interview. Findings will highlight if there are areas of the twelve-hour shift pattern which can be improved upon to give a better experience for both nurses and patients. This proposal has the potential to add to the current quantitative research on this topic, as well as bring rich new findings from a different, qualitative, vantage point. It will present how twelve-hour shifts effect both nurses and patients. It is hoped this will illuminate ways for the healthcare system to adapt and develop to boost nurse’s health and wellbeing and therefore improve patient’s quality of care. Key words: Twelve-hour shifts; patients; nurses; acute care setting; phenomenologyItem Exploring Nurses’ Knowledge and Practice of Delirium Recognition and Assessment(2019)Delirium is a brain disorder which is described as ‘disturbed’ consciousness and is one of the most misunderstood phenomena within acute care. This dissertation provides a critical review of the literature surrounding nurses’ knowledge and practice of delirium recognition and assessment. Themes that emerged from the literature review were different types of assessment tools and some of the barriers to implementing delirium recognition and assessment. These have helped to develop the aims for the research proposal. The aims of the research proposal are to explore nurses’ knowledge of delirium; nurses’ practice of delirium recognition and assessment and to understand some of the triggers to initiating delirium assessment. The study will be underpinned by a theoretical framework and is inductive and exploratory. Ten nurses in a Scottish general hospital will be invited to take part in a one hour long interview about their experiences of recognising and assessing delirium in practice. Participants will be able to share their thoughts, feelings and perceptions during semi-structured face-to-face interviews. Vignettes will be created collaboratively with colleagues from practice to illustrate a patient with hypoactive delirium. The participants will be provided with a vignette prior to their interview to prompt participants’ memory of similar experiences of delirium from their practice. This will also assist the interviewer to explore nurses’ knowledge and decision making in relation to delirium recognition and assessment. The qualitative data collected from the research will provide insight into the lived experiences of nurses’ who have recognised and assessed those with delirium in hospital. It is anticipated that the findings from this research will be an enlightening and useful source for nurses caring for those with delirium. It is also hoped that the findings will also inform nurses’ practice of delirium recognition and assessment in the future.Item The power of detention in migrants with MDR-TB: the challenges facing nurses providing effective person-centred care(2019)Tuberculosis is one of the world’s most dreaded pandemics known to mankind, resulting in approximately 1.6 million deaths in 2017. The misuse of first-line antibiotics; Isoniazid and Rifampicin has seen the surge of multidrug resistant tuberculosis (MDR-TB), with approximately 558,000 people worldwide developing resistance in 2017. The TB patient-centred care model created by the World Health Organisation (WHO, 2018), has been adapted globally. Within the model, directly observed treatment (DOT) allows individuals to obtain antibiotics outside of hospital. Despite this available method, less than half of individuals with TB were not offered DOT in the UK in 2013. Moreover, a recent paper highlighted how physicians would issue threats of detention to patients in order to ensure they would comply to treatment. The detaining of patients following a diagnosis of MDR-TB and registered nurse experience has yet to be addressed in the UK. The purpose of this research proposal is to explore how TB detention impacts nurse/patient relationships and the ability of nurses to provide person-centred care. This qualitative research will use a purposive strategy and will be conducted over a 9-month period in two health boards within Scotland: NHS Lothian and NHS Borders. Patients with MDR-TB and registered nurses will be invited from infectious diseases and respiratory wards to participate in semi-structured interviews. It is hoped that this research will help to define how both participants feel throughout this process and alter future person-centred practice and bring clinical change. Keywords: Qualitative, Tuberculosis, MDR-TB, Detention, Nurses, UK.Item What are Nurses/BSL User’s Understanding of Deaf People’s Specific Care Needs?(2019)Aims: The aims of this study are to record understandings of participants and analyse the decisions and options they would conclude at, when deciding how to proceed with communicating for a member of the Deaf community to promote a high quality of care. This study will explore the experiences of Deaf, BSL users in healthcare as well as the experiences nurses have when caring for Deaf people. Background: Members of the Deaf community face barriers in communication when under the care of the NHS – a primarily hearing lead healthcare. Themes from existing literature have identified such barriers as: lack of awareness of British Sign Language (BSL) in health care staff, effects of the communication barriers on the nurse-patient relationship and a lack of BSL/English interpreters available. This study will explore the different experiences of Deaf people and nurses who work in the NHS to gain an insight into their understanding of the care needs required by Deaf people. Methodology: Through focus groups of 12-15 participants each, nurses will be asked to discuss their experiences caring for Deaf people and the challenges they faced, along with positive experiences. Additionally, Deaf, BSL users will be invited to discuss the care they were provided as an inpatient within the NHS in the same environment. Both groups will be asked to identify their understanding of specific care needs of Deaf people while in hospital and how they think communication can be improved using new or existing communication aids. Conclusion: It is hoped that the findings from this study encourage the implementation of new communication aids throughout NHS wards in Scotland. Additionally, it is hoped that the need for more research in this area will become evident and will inspire further investigation. Key Words: Deaf, BSL users, Nurses, Communication barriers, healthcare.