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Background: Online platforms have gained considerable support from students and lecturers post COVID-19, however they are associated with student exhaustion and fatigue. Aim: To determine Zoom exhaustion and fatigue in nursing students at a selected university in South Africa. Methods: A quantitative cross - sectional study was conducted in KwaZulu-Natal to collect data from 146 nursing students registered at the selected university for the 4-year Bachelor of Nursing programme. The Zoom Exhaustion and Fatigue Scale collected data on responses to domains of general fatigue, visual fatigue, social fatigue, motivational fatigue, and emotional fatigue. The data were analysed using the International Business Machines, Statistical Package for Social Sciences, version 26.0. Descriptive statistics were calculated for demographics, a total score was calculated and mean scores and 95% confidence intervals for the different domains were calculated. Mann Whitney U and Kruskal Wallis Independent Tests were calculated to determine associations between demographics and Zoom usage. Results: The overall Zoom exhaustion and fatigue score was 46.71 (s.d. = 10.50). The motivational fatigue construct had the highest mean score of 3.29 (s.d. = 0.83), followed by general (3.18 s.d. = 0.81), social (3.11, s.d. = 0.88), emotional (3.06, s.d. = 0.99) and visual fatigue (2.92, s.d. = 0.94). Conclusion: The study concluded that while the overall mean score indicated moderate levels of Zoom exhaustion and fatigue among respondents, majority of the respondents scored high levels ( 48) of Zoom fatigue. Students reported higher levels of motivational fatigue compared to the other 4 constructs.

Background: Clinical mentors are experienced practitioners who play an important role in encouraging the professional development of students in clinical areas. The responsibility of clinical mentorship in nursing is often difficult to maintain. However, there is a dire need for clinical mentorship in maternity units, especially in South African hospitals were high maternal mortality rates remain alarmingly high. Aim: This study aimed to describe the perceptions of registered midwives regarding the clinical mentorship of midwifery students. Setting: The study occurred in a semi-rural state regional hospital in the eThekwini district, KwaZulu-Natal. Methods: A qualitative exploratory and descriptive design was conducted using in-depth individual interviews with midwives in maternity units. A purposive and convenient sampling method recruited 17 registered midwives from 3 maternity care areas within a single setting. Interviews were audio-recorded and all data were analysed using qualitative content analysis. Results: Five categories emanated from this study namely, sharing knowledge and skills; encouraging role model behaviour; promoting self-worth; Is a challenging task; and requiring additional support. Conclusion: Clinical mentorship has a reciprocal effect on teaching and learning in maternity care areas and encouraged registered midwives to lead as role-models. The process demands competence, professionalism, and leading by example. Despite the confidence, satisfaction and interest in clinical mentorship, registered midwives often find the process challenged by patient care priorities. Therefore, registered midwives require additional support to mentor students in clinical practice. Contribution: This article shows that clinical mentorship places various challenges on registered midwives and formal mentorship training could be beneficial.

Background: Family nursing practices (FNPs) are gaining momentum in global literature, but the available research has targeted qualified nursing professionals. There are limited studies exploring this phenomenon in undergraduate student nurses in South Africa. Aim: The study aimed at exploring the undergraduate student nurse perceptions of FNPs. Setting: The study was conducted at a selected university in KwaZulu-Natal, South Africa. Methods: A descriptive survey design was used to purposively select undergraduate nursing students. The Family Nursing Practice Scale (FNPS) was used to collect data online. Descriptive and inferential statistics were used to analyse quantitative data. Open ended questions were analysed using content analysis. Results: Out of 154 participants, 77 responded to the questionnaire, translating to a response rate of 50%. Compared with other studies in literature, student nurses rated their overall FNP as being low (M = 3.43, s.d. = 0.99). A further descriptive analysis revealed better FNPs (2.97) for 3rd year compared to 2nd year (3.90) nursing students with significance differences in the means (p 0.0001). While family conflict, maintaining confidentiality, ill prepared and absent family were challenges experienced in FNP, advantages included obtaining detailed information, ability to plan individualised care and enhanced student nurse-family relationship. Conclusion: A lower critical practice appraisal and lower perceptions of interaction and reciprocity in the nurse-family relationship were identified. There is need for an inclusive curriculum that promotes and advocates for family nursing within the undergraduate programme. Contribution: This study highlights the importance of teaching family nursing to undergraduate student nurses.

Background: Oncology nurses are involved through the often protracted and potentially traumatic continuum of diagnosis and treatment of their patients, which places them at high risk of developing compassion fatigue. Aim: The aim of the study was to develop and implement an in-facility intervention to manage compassion fatigue among oncology nurses in Durban, South Africa. Setting: The study was conducted with oncology nurses at state, private (private health insurance) and non-governmental oncology facilities (Hospice). Methods: The Self-Care Intervention for Oncology Nurses was developed and implemented using action research with a mixed methods sequential explanatory design. It involved an integrative review, Professional Quality of Life (ProQOL) v 5 questionnaires (n = 83) and in-depth individual interviews (n = 8). Results: Developed from the findings of the integrative review, quantitative and qualitative data, the Self-Care Intervention for Oncology Nurses comprised three components, namely psycho-education on risks (booklet), practices of remembrance (remembrance tree) and support structures (support group and follow-up family call). Overall, the participants enjoyed reading the booklet and engaging in the support group. There were varied responses to the remembrance tree and hesitancy to partaking in the follow-up phone call. Conclusion: The developed intervention could encourage awareness of compassion fatigue amongst oncology nurses’ engagement in self-care practices such as symbolic remembrance of patients and recognition of the value of support structures. Contribution: The intervention may assist oncology nurses in the provision of compassionate caring for their patients and potentially minimise compassion fatigue.

Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families’ needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions. Contribution: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused.

Background: Caring for cancer patients can take a toll on the emotional health of oncology nurses, which may lead to compassion fatigue, resulting in decreased quality of nursing care, absenteeism and decreased retention of staff. Aim: The aim of this study was to describe compassion fatigue from the perspective of oncology nurses. This study is part of a larger mixed-methods action research study to develop an in-facility intervention to manage compassion fatigue in oncology nurses. Setting: This study was conducted at Durban, KwaZulu-Natal, South Africa. Methods: The research setting comprised one state hospital (with oncology clinics and wards), a private hospital (with oncology wards) and a hospice in Durban, KwaZulu-Natal, South Africa. Semi-structured individual interviews (guided by Figley’s Compassion Fatigue Process, 2005) were conducted with eight participants. Data were analysed using manifest content analysis. Results: Five categories emerged from the data, namely, emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance. Conclusion: The findings revealed that oncology nurses are affected emotionally in caring for their patients, thus making them prone to compassion fatigue. Oncology nurses need to acknowledge compassion fatigue and be able to self-reflect on how they are managing (both positively and negatively) with the stressors encountered in the oncology wards or units.

Introduction: Mental health workers who listen to stories of fear, pain and distress of traumatised clients may develop deleterious emotional, cognitive and physical consequences (Cairns, 2007). This phenomenon has been called secondary traumatic stress (STS) (Perez, Jones, Englert, & Sachau, 2010). Rwanda is well-known for the 1994 genocide, with the death of hundreds of thousands of people in a planned campaign of violence. Numerous mental health workers operating in Rwanda were also victims of the violence and it has been suggested that there is a high level of STS in mental health workers in Rwanda (Iyamuremye & Brysiewicz, 2008). Aim: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda. Method: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers) as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale) in these health workers. Results: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS) was synthesised from these findings and includes preventive, evaluative and curative strategies to manage STS in mental health workers in Rwanda at the individual, social and organisational levels. Conclusion: The model will offer mental health professionals an effective framework for addressing the issue of STS.

Introduction: In recent years there has been a movement to promote patients as partners in their care; however this may not always be possible as in the case of critically ill patients, who are often sedated and mechanically ventilated. This results in family members being involved in the care of the patient. To date, this type of care has been represented by three dominant theoretical conceptualizations and frameworks one of which is family centered care; however there is a lack of consensus on the definition of family centered care. Hence the objective of this study was to explore the meaning of family care within a South African context. Methodology: This study adopted a qualitative approach and a grounded theory research design by Strauss and Corbin (1990). Participants from two hospitals: one private and one public were selected to participate in the study. There was a total of 31 participants (family members, intensive care nurses and doctors) who volunteered to participate in the study.Data collection included in-depth individual interviews. Open, axial and selective coding was conducted to analyse data. Nvivo data analysis software was used to assist with the data analysis. Findings: The findings of this study revealed that family care is conceptualized as togetherness, partnership, respect and dignity. Conclusion: During a critical illness, patients' families fulfil an additional essential role for patients who may be unconscious or unable to communicate or make decisions. FMs not only provide vital support to their loved one, but also become the “voice” of the patient.

Background: The training of undergraduate midwifery students to identify and manage post-partum haemorrhage, is an essential skill in midwifery. Aim: The aim of this study was to develop, implement and evaluate a simulation learning package (SLP) on post-partum haemorrhage for undergraduate midwifery students using high fidelity simulation without risks to real-life patients. Methods: An exploratory sequential mixed methodology was used in this study. The study was made up of three phases namely; the development, implementation and evaluation of the learning package. The research participants were fourth year baccalaureate of nursing midwifery students and midwifery experts involved in teaching midwifery. Data was collected using an evaluation checklist for experts, a student satisfaction survey and focus group sessions. Quantitative data were analysed using SPSS Version 23.0 and the qualitative data was analysed using content analysis as described by Graneheim and Lundman(2004). Results: The evaluation checklist for experts revealed that the developed SLP was considered suitable for undergraduate students. It encouraged active learning, teamwork and accommodated diverse learning styles. The package was easy to use and offered opportunities for student feedback. The student satisfaction survey revealed that the pre-simulation support received was adequate and helpful, and the post simulation outcomes showed that using high fidelity simulation improved clinical skills, knowledge, critical thinking, self-confidence and satisfaction. The focus group sessions revealed that the SLP was an innovative and interactive method of learning; it improved the student's perception of their clinical competence, stimulated critical thinking and increased self-confidence. Conclusion: A simulation learning package, that uses high fidelity simulation, can be an innovative and interactive method to teach midwifery emergencies.

Introduction: Mental health workers who listen to stories of fear, pain and distress of traumatised clients may develop deleterious emotional, cognitive and physical consequences (Cairns, 2007). This phenomenon has been called secondary traumatic stress (STS) (Perez, Jones, Englert, & Sachau, 2010). Rwanda is well-known for the 1994 genocide, with the death of hundreds of thousands of people in a planned campaign of violence. Numerous mental health workers operating in Rwanda were also victims of the violence and it has been suggested that there is a high level of STS in mental health workers in Rwanda (Iyamuremye & Brysiewicz, 2008). Aim: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda. Method: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers) as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale) in these health workers. Results: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS) was synthesised from these findings and includes preventive, evaluative and curative strategies to manage STS in mental health workers in Rwanda at the individual, social and organisational levels. Conclusion: The model will offer mental health professionals an effective framework for addressing the issue of STS.