Core competencies and challenges among nurses transitioning into positions of leadership ­ a Caribbean perspective

Purpose ­ Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. Design/methodology/approach ­ This was a mixed-methods study that targeted nurses (N= 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. Findings ­ Most participants were female (n= 112), had 15 or more years' experience (n= 71) and an associate degree/diploma in nursing (n= 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by oneway ANOVA for delegation, motivation and leadership as core competencies based on occupations roles.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

Background: Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses. Purpose: The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development. Methods: An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics. Results: The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica. Conclusion: Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey

Background: Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning. Objectives: Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses. Design: A cross-sectional survey. Settings: The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK. Participants: Student nurses from each of the countries that consented to participate met the inclusion criteria. Methods: 1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics. Results: WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation. Conclusion: Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum

ET/WOC nursing ­ leadership lessons learned from the COVID-19 pandemic: an opinion

The coronavirus disease 2019 (COVID-19) pandemic has brought uncertainty and opportunity to nurses and healthcare. As part of the nursing profession, enterostomal therapy (ET) / wound, ostomy, continence (WOC) nurses offer specialised care that is critical to the health of persons with wounds, ostomies and continence. ET/WOC nurses' knowledge and practice have positioned these nurses as integral partners in leadership and the delivery of care during these challenging times. The aim of this paper is to highlight five leadership themes for ET/WOC nurses that have evolved during the pandemic, namely interprofessional practice, emotional intelligence, ethical practice, advocacy, and self-care.

The prevalence of burnout, psychological distress and frequently used coping strategies among primary care health workers in North West and North Central Regional Health Authorities

Background: The prevalence of mental health issues among health care workers, including primary care workers, has reached concerning levels globally. The presence of the more common conditions such as the burnout syndrome and psychological distress among primary care workers in Trinidad and Tobago has not been examined. Objectives: This study aimed to determine the prevalence of the burnout syndrome and psychological distress among primary care health care workers in Trinidad, as well as their associations with socio-demographic factors, workplace factors and stress coping strategies. Research Design and Methods: This was a cross-sectional study of 245 primary care physicians and nurses within the North West and North Central Regional Health Authorities. The Maslach Burnout Inventory, General Health Questionnaire and the Brief COPE measured outcomes through a self-administered questionnaire. Results: The overall prevalence of burnout among participants was 32.7% and 25.3% were distressed. Younger age groups (<45 years) had significant associations with both burnout [OR 2.91 (1.66-5.12)] and distress [OR 2.73 (1.48-5.04)]. Physicians were also significantly more likely to be burnt out as compared to nurses [OR 2.95 (1.69-5.14)]. Increased odds for burnout were also found for those who had no children, or less than three children, those with postgraduate qualifications or enrolled in a training programme. Spending less thanfour hours a day in leisure activities increased the odds of both burnout and psychological distress. Avoidant and emotion focused coping were significantly associated with burnout and distress. Use of religion was significantly associated with those in the non-burnout and non-distressed groups. Conclusion: The results reveal that prevalence of mental health issues is significant among primary care workers in these two settings. Individual and organizational prevention and intervention strategies can be utilized to address this issue, targeting physicians, younger workers and addressing stress coping strategies.

Prevention of needle stick injury in the clinical setting among new registered nurses

Background: Needle stick injury is one of the greatest work-related health hazard, that registered nurses encounter on an everyday basis for example the risk of being exposed to dangerous and deadly blood borne pathogens through contaminated needle sticks such as human immunodeficiency virus (HIV) and hepatitis viruses. New registered nurses' lacking knowledge and skills regarding standard precautions are exposed to needle stick injuries from unsafe practices such as recapping of needles, manipulating used needles such as bending, breaking or cutting hypodermic needles and passing needles from one nurse to another (American Nurses Association 2002). Methods: This was a quantitative descriptive study. The dependent variable was the needle stick injury and the independent variables consisted of factors which influenced the occurrence of needle stick injuries among new registered nurses. The factors are practice, knowledge, resources and attitudes. The population was new registered nurses with less than three years' experience at the San Fernando General Hospital. A total of 120 new registered nurses were employed during the period under review and the entire population was used as the sample. A 26 item instrument was used to collect data which were analyzed using SPSS version 20. Findings: Most of the respondents 59 (49.2%) were between the ages 20-<30 years and 88 (73.4%) were female. The most common years' experience was 53 (44.2%). Almost half 54 (45%) respondents had experienced a needle stick injury with the most common exposure being while in use (17.5%) and recapping needles (215%). A total of 49 (40.8%) respondents had at least one to less than 3 needle sticks since employment and this was most common among staff on the medical wards. There was a moderate correlation between respondents knowledge about institution's policies and need for training (r0.409, p0.01) and strong correlation between their perception of the need to be more vigilant and the quality of the sharps that they are provided with (r0.913, p0.01). Conclusion: Avoidable practices such as non-adherence to standard precautions while using hypodermic needles are contributing factors to needle stick injuries. Prevention of NSI's should be an integral part of occupational health programs in the work place. Therefore, mandatory training and evaluation of health care worker's, knowledge and attitude regarding safety practices and proper use of available resources should be enforced when carrying out their duties in the clinical area.

Breaking the glass ceiling: the stories of three Caribbean nurses

The history of nursing and those who shaped the profession and health care has been an interest of mine for as long as I can remember. For many years, I taught courses in the history of nursing to nursing students in Canada. Consequently, within recent years, with the formation of history of nursing associations, I became a member of the Ontario, Canadian and American history of nursing associations. I recall vividly at one of the very early conferences in Canada being the only person of colour, and the presenter, speaking about the contribution of black nurses from a small developing nation .... Since I felt strongly that the contributions and accomplishments of Caribbean nurses were not recognised or documented, it was logical that I would embark upon this project. The opportunity to pursue this goal came in the form of a six-month sabbatical, from January to June 1996, from McMaster University in Hamilton, Ontario. I documented the achievements and lived experiences of three Caribbean nursing leaders in the development of nursing and health care in the Caribbean and the wider world during the colonial and postcolonial era 1940-1990. I chose that period as it covered the late colonial era, about two decades prior to independence of many of the islands, and two to three decades into the postcolonial period. The late colonial and early postcolonial decades were a watershed in Caribbean history as the struggle for indigenous leadership in all areas of West Indian society was being fought. But equally important was the fact that many of the nurses who provided leadership at that time had died or were ageing and it was critical for me to capture their stories and see their experiences from their vantage point. I do not lay claim that this is a definitive historical or feminist work but rather it is a narrative of the lives of these women, albeit not as comprehensive as it could be. I seek merely to begin the journey and it behoves others to continue the task. Specifically, I documented their contributions and examined from a feminist and colonialist perspective the political, social and economic context prior to and during their personal and professional development. The factors and influences that contributed to or hindered their development were explored, and I identified and located some of the other nursing leaders of Caribbean heritage in the West Indies. The latter could provide a preliminary database for future researchers (AU)

Jamaican nurses' perception of their work experiences with foreign nurses

OBJECTIVE: To explore the perception of Jamaican nurses regarding their work experiences with nurses from Cuba, Nigeria and Ghana. METHOD: A 24-item pretested self-administered questionnaire was distributed to 30 Registered Nurses working with foreign nurses on five selected wards at Kingston Public Hospital. Twenty-three nurses (77 percent) completed the questionnaire. Data were analysed using SPSS Version 6.13. RESULTS: In terms of clinical performance, ability to communicate with patients and staff and pleasant work attitude, the nurse rated those from Ghana highest, followed by Nigerians and Cubans (p<0.001). The majority (91 percent) of the respondents were concerned about the cost of recruiting foreign nurses, some of whom they perceived to be lazy and incompetent. They felt that Jamaican nurses should be treated better by improving salaries and benefits. Sixty-one per cent suggested that the benefits to foreign nurses surpassed their own. CONCLUSION: Nurses from Ghana were the most popular with Jamaican nurses. The cost of improving salaries and benefits to retain Jamaican nurses should be weighed against the cost of recruiting foreign nurses to work in Jamaica.(Au)

Stress among nurses working in intensive care units (ICUs) - Poster presentation

ICU nurses are subject to great stress in view of the serious nature of the patients and intensive monitoring and the shift work. We designed a study to assess the effect of some of these potential stressors: "working" or "nonworking origin", as well as to determine those working stimuli which produce anxiety. A study was done among 14 nurses (age 23 to 33, 1-7 years of experience) from different ICUs. Arterial blood pressure (ABP) and heart rate (HR) were measured twice daily in 8 different working days, along with body temperature (BT). Results of the survey were analyzed using Square Chi test (p=0.05) and the other variables through the Analysis of Variance test (p=0.001). The results of ABP, HR and BT showed no differences neither each day nor among the 8 different days. Only three stimuli of any origin showed significance: loss of interest to family activities or the job, the feeling of tension or anxiety, and non-serious condition of diseases. The most anxiogenic stimuli were scarcity of supplies and the shortage of qualified staff. These results agree with previous findings in relation with the low disturbing effects of working conditions in ICU and some non-labour conditions. The most anxiogenic stimuli were related to the responsibility and qualification of the surveyed nursing staff (AU)

Knowledge, attitude and practice of practical nurses in selected parishes in Jamaica

The knowledge attitude and practice of Practical Nurses who cared for elderly clients were studied over an eight weeks period in selected parishes in Jamaica. In the study all the respondents were females in age range 20 to 59 years. Most of the respondents were single and the highest numbers attained the Seconday School education standard. The highest numbers of respondents were qualified at the Jamaica School Certificate (J.S.C.)level. Approximatley 81.0 percent of the respondents were trained as Practical Nurses. Twenty-five different Practical Nursing Schools were responsible for the training of the Practical Nurses. Their hours of theory and practical experiences varied from individual to individual as also the duration of their training. Most respondents had good knowledge base and their attitude towards caring for the elderly clients were also good. Most of the respondents were motivated to care for the elderly clients by the level of nursing education they attained, while others were motivated by the job itself. There is need of development or improvement of curriculum for the training of Practical Nurses and a definite policy towards the regulation of the training which should ultimatley lead to licensure and registration by the Nursing Council of Jamaica (AU)

Coping with retirement: a comparitive and analytic study of retired nurses and dock workers in Jamaica

The populations of the world are aging especially those of developing countries like the Caribbean and specifically Jamaica where life expectancy at birth is 74 years. This study looked at retired public sector registered nurses and compared the findings with those of a similar study done concurrently on retired dock workers in Jamaica [Cumbertbatch, E. 1996]. The studies examined the coping strategies and assessed the two groups paying special attention to their health and social status. The data gleaned from the studies showed that the majority of retired nurses found were in the age group 60-64 years, only 5 percent of those over 75 years were found instead of the expected 39 percent. Sixty three percent lived in rural areas and thirty-seven percent lived in Kingston and St. Andrew, while most of the dock workers lived in Kingston and St. Andrew. The majority owned a house. The perceived health status of the groups was good and they are all mentally and physically self-supporting. The three main diseases affecting them, were hypertension, arthritis and diabetes. However, the incidence of these diseases among the groups was slightly lower than the national figures with the exception of arthritis which was more common among dock workers (30 percent) and was higher than in the nurses (25 percent) and the national population of elderly (40 percent). The majority of them said they had no difficulty acessing health care and more than 50 percent got most of their health care from private practitioners, while an average of twenty percent said that they were unable to finance their health care. More than 70 percent of both groups said that their pensions were inadequate to meet financial needs. They therefore depend on other sources of income such as : present employment, investment and support from family. Hence 70 percent of the nurses and 5 percent of the dock-workers were presently employed. The main coping strategies employed were close links with family and friends and active involvement in church and community groups. The nurses expressed a high level of satisfaction about themselves and life, more so than dock workers. These findings raise questions such as "how will the retired nurses and dock-workers of the future cope with retirement?" It is therefore necessary for their employers and professional associations to develop and implement retirement plans for them with urgency. (AU)

The knowledge attitudes and practices of nursing personnel with regards to caring for HIV/AIDS patients at selected hospitals in Kingston and St Andrew Jamaica

Nursing personnel who are regarded as a high risk occupation group, continue to work in the front line providing care for HIV/AIDS patients. A comparitive study was conducted to examine the knowledge, attitude and practices of nursing personnel with regards to caring for HIV/AIDS patients. Information was obtained from a sample of ninety nursing personnel who worked at the Kingston Public Hospital, Victoria Jubilee Hospital, Bustamante Hospital for Children and National Chest Hospital. The group was comprised of registered nurses, midwives, enrolled assistant nurses, ward assistants, operating-room technicians and community health aides. A self administered questionnaire was used to collect data on various aspects of HIV/AIDS. For overall knowledge on HIV/AIDS 22 nursing persons received high scores of 38-52 of a posssible 52 scores, while 59 received medium scores of 23-37 and low scores of 8-22 were received by 9 respondents, registered nurses received the highest scores. As compared to the other groups e.g. children, adults, heterosexual male and females who are not prostitutes attitude towards the homosexuals and prostitutes was negative. Although most nursing personnel (70 percent) had knowledge of universal precautions these precautions were not practised on a continuous basis. Fear of contagion was expressed by all respondents. There is therefore an urgent need to strenghten these areas of weakness such as knowledge of HIV/AIDS and practices with regards to universal precautions, so as to reduce their risk of contracting HIV/AIDS. (AU)

Coping with retirement: a comparitive study among retired dockworkers and retired nurses

Populations across the world are ageing in terms of life after age 60 and the section of the population referred to as the elderly is growing at a rapid rate. This study seeks to examine the strategies adopted for coping with the phenomena of retirement among a sample of retired dockworkers and retired nurses; and to compare the findings of the two groups. The population comprised of 62 dockworkers between the ages 65 years to over 75 years from urban and rural areas. Overall they were relatively healthy. The chronic diseases suffered in this population was arthritis, hypertension and diabetes as the leading three. The study substantiated the view that pensioners were the ones who felt the pressures of inflation because they were not productive employees and that the money needed to purchase necessary foods was never enough since they needed to purchase at the same prices as the rest of the population; hence the importance for persons to begin preparing for retirement long ahead of the scheduled time. It is therefore necessary for employers to take the initiative and introduce seminars which will inform their employees as to retirement plans that will enable them to invest wisely during their working life and so earn from those investments during retirement. This study is part of a comparative study done simultaneously with one done among retired nurses by fellow Masters in Public Health student Marjorie Ming. (AU)

Grenada, Carriacou and Petite Martinique: country report

The report covers the activities of the Grenada Nursing Services for the period June 1994 to May 1995. States that the Nursing Services continue to provide quality care to patients/clients despite limited working conditions in relation to physical facilities, equipment, supplies and staff. An update is provided on human resource developments, nursing evaluation and statistical data on the nursing service island-wide

Changing attitudes of nurses - abstract

It is believed that the attitudes of nurses have changed over the years from the orientation of 'ideal service to the public' (altruism) to self interest as a primary goal. The study aimed at investigating if there is in fact a change of attitude and the reasons for change. The convenient sample included Registered Nurses, other health care workers and members of the public. The findings revealed that there is a change in the attitude of nurses towards patients and that dissatisfaction with salary and inadequacy factors contributed to this change. The demands imposed by society influence to some extent the change in the orientation of the nurses. Members of the public are concerned and express some degree of sympathy with the nurses in view of their adverse working condition and economic deprivation. The information gained from this study can serve at least two purposes: 1. To sensitize nurses to the importance of examining our attitudes towards clients and seek to bring some improvement. 2. To provide information to make recommendation for improvement in the social and economic welfare of nurses. (AU)

A preliminary examination of indicators of fear of success (ios) of a selected sample of registered nurses at the University Hospital of West Indies - abstract

METHODOLOGY: The research instrument was a questionnaire comprising of eighteen questions which focused on questions prompted by the literature which may be considered to indicate a fear of success. Fear of success (positive indicators) was considered to be present if answers to those questions indicated a tendancy for the "feelings' exerienced regardingconsequences of the success to be negative or there was no evidence of non-acceptance of professional mobility and success. A coded questionnaire comprising eighteen questions was administered to a sample of seventy nurses who had specialized or held managerial/teaching positions within the hospital. MAJOR FINDINGS: Major findings revealed that there were minimal indicators of fear of success. Where there were expresions of negativism, it focused on issues of socioeconomic, job satisfaction and interpersonal problems. DISCUSSION: The results revealed by this preliminary study indicated that in a particular sample of registered nurses at the UHWI there was minimal evidence of fear of success. Caution must be exercised however in any attempt to generalize from such a limited sample. (au)

Nursing needs assessment

The Ministry of Health and Environment, through the office of the Director of Nursing, saw the need to conduct a study to determine the number of nurses needed to provide an accecptable level of care to the people of the Commonwealth of the Bahamas. The aim of the study was two fold, to: (a) Determine the number of position of nurses, registered midwives and enrolled nurses needed to deliver an "acceptable level of care" to the people of the Commonwealth of the Bahamas: (b) Esablish the number of candidates who should be educated/trained over the next five (5) years with the aim of maintaining an adequate number of nursing personnel within the health care system. The study was conducted during the months of May, June, July and August of 1994 within the institutions and areas of the Ministry of Health and Environment. These institutions and areas included, Princess Margaret Hospital and Sandilands Rehabilitation Centre both in New Providence; the Community Health Services which serves New Providence as well as the Family Islands and Rand Memorial Hospital which serves the Freeport and Grand Bahama area. Methodology for this survey was that of a comparative nature. The original plan included the comparison of four (4) sets of data. However, due to unforeseeable constraints, only the following three (3) sets were utilized and compared. Data on sick and study leave was incomplete, therefore, was not included in the study. (1) Data from previous surveys as far back as the early 1980's focussing on nursing needs as well as working conditions of nurses. (2) Data indicating the present nursing positions as well as the projected required nursing positions as indicated by the institutions. (3) Calculated number of positions determined by number of beds, occupancy rates, met demand for services and the average time taken to complete nursing task as indicated by nursing personnel through discussions. The fourth set of data was collected by way of self administered questionnaire containing 49 variables and distributed to a sample of 210 participants, selected by the stratified systematic method of sampling. (AU)

Grenada, Carriacou and Petit Martinique

Reports on the administrative aspects of the nursing service. Outlines local action on resolutions issued from the Thirteenth Meeting of the Conference of Ministers Responsible for Health. Technical assistance received from external agencies is summarised, followed by an update of development in nursing administration and training. Some of the current problems faced is as a result of inadequate trained staff, sub-standard working conditions and the absence of a hospital policy. There is need for improved top and middle management personnel and educational opportunities in the form of scholarships for nurses, among others