Abstract
Student nurses are the next generation of nurses, and they must be empowered and prepared to provide quality caring to patients with unconditional regard. The caring provided to patients leaves much to be desired and some have even said “nursing has gone to dogs”. The image of caring in South Africa requires much attention as patients lose their lives unnecessarily. However, there are still a few nurses out there who may go on unnoticed and may be swallowed up by the existing narrative or the bad image of nursing. Student nurses are new entrants into the field, and they can still be shaped to be the engine of the nursing fraternity.
The current study was founded in the researcher’s master’s study entitled ‘Student nurses’ perception of the relationship between mindfulness and caring’. This was a quantitative study, which revealed student nurses provide caring to patients, but they do so without awareness and that they fail to be present in the moment. Therefore, the researcher expanded on that study by looking at what could be done to empower and assist the student nurses to provide caring to patients while being present in the moment and acting with awareness. Presence and awareness are attributes of mindfulness, and these are important because they can only be provided by human beings. Though the world has gone digital and most of the work that human beings used to do is now done by robots, nursing remains a career with room for human bodies in the form of nurses who can take care of patients and provide valuable support by being present, aware and proving physical touch, eye contact and a smile to the patient in their time of need.
Thus, the researcher conducted a search to determine if any models have been developed to assist student nurses in providing caring through mindfulness. The search yielded no results of such models in existence. Due to the dearth of these models, the researcher decided to ask the following question, “What can be done to assist student nurses in facilitating mindfulness in caring?” With this, the researcher decided to develop a model as a framework to of reference to facilitate caring through the development of mindfulness.
Therefore, the purpose of the study was to develop, describe, implement, and evaluate a model as a framework of reference for student nurses to facilitate caring through the development of mindfulness. The theory underpinning the study was Watson’s theory of human caring. A theory generative, qualitative, exploratory, descriptive, and contextual research design was employed to answer the research question. The purpose of this study was achieved using Walker and Avant’s method of concept analysis and Chinn and Kramer’s
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strategies. The following steps were followed: Step 1 was an identification of the concepts and definition and classification of the central concept. The researcher identified the concept from her master’s study as the ‘facilitation of caring through the development of mindfulness’. The concepts were defined using English dictionaries and subject literature, and classified by following the strategies by Dickoff, James and Wiedenbach. Step 2 included a description of the relationship between concepts, and Chinn and Kramer’s strategies were used to describe the relationships between the concepts and the assumptions that arise due to the interrelationships between the concepts.
Step 3 was the development, description, and evaluation of the model. The model’s development and description were done according to the strategies of Chinn and Kramer, focusing on understanding, simplicity, interpretation, generalisability, accessibility, and importance. The model was evaluated by a panel of experts. Step 4 was the model’s implementation. This step took place in two phases; the first was a preparation for the workshop and the second was the model’s implementation. Ethical clearance was obtained before the commencement of the workshop. The researcher gathered all the necessary information to assist the students in understanding the model. The workshops were structured over three phases, namely the relationship phase, where the researcher-built rapport, the working phase, and the termination phase. The workshops were conducted online due to the Covid-19 pandemic. The workshop was then implemented by the participants in the clinical area for three months. The researcher supported the participants during the model’s implementation in case the participants had any questions for clarification.
After implementing the model, it was evaluated through focus group interviews. A phenomenological approach was followed, and a purposeful sampling method was employed to select student nurses in their third and fourth year of study. Four focus group interviews were conducted, and data saturation was reached with the fourth focus group. The central question that guided the focus group interviews was: “what were your lived experiences of implementing the model?” The central theme that emerged from the data was: the model has empowered participants to love themselves and practice the art and science of nursing. The model’s implementation was enhanced by an enabling environment and impeded by a disenabling environment. Suggestions for future implementation of the model were provided by participants. The five themes that emerged from the data were: the model empowered the participants to love themselves; the model assisted the participants to practice the art of nursing; they reported an enabling environment for model implementation; a disenabling environment for model implementation; and offered suggestions for future implementation of the model. The study’s findings were conceptualised into current literature and
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recommendations were described. Furthermore, recommendations for nursing education, nursing practice, nursing research and nursing policy were presented, and the study’s strengths and limitations were outlined.
Lincoln and Guba’s strategies for trustworthiness were followed, namely credibility, dependability, confirmability, and transferability. Prior to conducting the research, ethical clearance was obtained and the relevant gatekeepers provided necessary permissions. The researcher adhered to the following ethical principles throughout the study: autonomy, beneficence and non-maleficence, and justice.
The study added value to professional nursing, nursing education, nursing research and research practice by adding a model that serves as a framework of reference for student nurses to facilitate caring through the development of mindfulness. This study was qualitative, and it was conducted at one higher education institution in Johannesburg. Further research could possibly look at a quantitative study, or interview the patients on their experiences of receiving care from student nurses who had implemented the model under discussion. Possible research could be conducted where this model is implemented among older professional nurses, including baby boomers, generation X, and generation Y, and they could be interviewed on their experiences of implementing the model.
Keywords: caring, concept analysis, facilitation, Love, mindfulness, student nurses, Ubuntu.