Journal of Nursing and Health Studies

Making workplace culture in critical care visible: The "Big 7"

27^th Edition of World Congress on Nursing Education & Research
April 23-25, 2018 Rome, Italy

Tanya Heyns

University of Pretoria, South Africa

Keynote: J Nurs Health Stud

DOI: 10.21767/2574-2825-C1-001

Abstract

Introduction: Critical care nursing in South Africa experiences a crisis. Nurse leaders, managers and the public opinion reveal poor standards of nursing care, which is confirmed by headlines in the media. At the heart of these challenges and plaguing health care services lays the disengagement of nurses from their work and workplace cultures.
Objective: Reflecting on the crisis in critical care nursing, academics from the Department of Nursing Science, University of Pretoria, envisioned facilitation of change through practice development. Practice development is a continuous process which has the intent to address existing workplace cultures and bring about change towards the development of person-centred cultures. The process is enabled by facilitators. A three year practice development programme was initiated in September 2013. The first objective was to explore the current workplace cultures in selected public and private critical care units in Gauteng.
Methods: Practice development as a methodology was used to observe the workplace culture through utilising the Workplace Culture Critical Analysis Tool. A total of 230 hours of observation in 11 critical care units (six public and four private) was done. The observation was conducted by internal (critical care nurses) and external (academia) observers in four phases. The phases included pre-observation, observation, consiousness raising and problematisation, reflection and critique. The data was analysed using a creative hermeneutic data analysis method.
Results: The "Big 7" challenges relating to workplace culture in critical care practice were identified, namely: care and caring, communication, therapeutic environment, team effectiveness, learning environment, time management and professionalism (not in order of priority).
Conclusion: Using practice development as a methodology allowed critical care nurses to collaborate with academia and participate in data collection and analysis. Participating with the critical care nurses provided them with an opportunity to observe their practice, raise awareness for taken-for-granted practices and reflect on these practices. Stepping outside their usual role of doing and getting inside the prevailing workplace culture provided the first step for taking action and addressing change.

Biography

Prof T Heyns is a senior lecturer at University of Pretoria for past 19 years involved in the education and training of pre-graduate and post-graduate students. Her area of clinical expertise is Emergemcy Nursing Care. She has supervised post-graduate scholars to completion a total of 41 Masters and 3 PhD students.. Currently she is supervising 11 Masters and 10 PhD students. She is an external examiner at several national and international universities, has examined 25 Masters dissertations and 9 PhD thesis. She has presented at various National and International Conferences relating Trauma and Emergency care as well as Practice development in the Critical Care environment. She has 20 published article in National and International Journals and is a lead researcher in an International Practice development research project with NRF Funding. She is a Fellow of the Academia of Nursing in South Africa (FANSA), as well as the past president of the Emergency Nursing Society of South Africa.
Email:tanya.heyns@up.ac.za