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Background: Emergency departments are regarded as stressful working environments, associated with staff shortages, increased patient numbers and long waiting times. Increased organisational demands for performance can compromise genuine interactions between families and healthcare providers working in emergency departments. A relational practice approach in caring for families can enhance the capability of healthcare providers to simultaneously overcome these difficulties and provide emergency healthcare of high quality.Objectives: The purpose of the study was to describe healthcare providers’ perceptions of relational practice with families in three emergency departments in KwaZulu-Natal, South Africa.Method: Using a qualitative descriptive approach data were collected through semi-structured interviews with healthcare providers working in emergency departments. The data were analysed and categorised using qualitative content analysis.Results: Four categories emerged from data analysis: (1) families and healthcare providers connecting; (2) recognising the uniqueness of families; (3) caring interactions; and (4) taking charge when necessary.Conclusion: The study elicited that healthcare providers working in emergency departments perceived that despite high patient volumes and resource constraints, collaborative relationships with families were important. However, these collaborative relationships cannot be willed into practice, instead training workshops are needed to develop relational skills of healthcare providers which can facilitate family and healthcare professional collaboration.

Background. Moral distress resulting from frequent and intense exposures to morally challenging encounters with critically ill patients, their families and other healthcare professionals negatively impacts on the personal and professional wellbeing of critical care nurses. Objective. To determine the frequency, intensity and overall severity of moral distress among critical care nurses working in the critical care environment of a private hospital in the eThekwini district of KwaZulu-Natal Province, South Africa. Methods. A descriptive survey was conducted using a 21-item moral distress scale revised questionnaire. We assessed the influence of sociodemographic variables of the respondents on the moral distress composite scores. Results. The moral distress composite scores of the 74 critical care nurses who completed the questionnaires ranged from 0-303 out of a possible 336. The mean (standard deviation (SD)) composite moral distress score was 112.12 (73.21). Analysis of the relationship between sociodemographic variables and the moral distress composite scores revealed that female respondents experienced higher distress scores than males (p=0.013). There was an inverse relationship between composite scores and an increase in age (p=0.009) and years of service (p=0.022). Conclusion. The mean composite score of the critical care nurses was suggestive of moderate levels of moral distress. Counselling services and empowerment skills training are advocated to support critical care nurses to manage moral distress. Keywords. moral distress; critical care nurse; critical care unit.

Background: Novice student nurses encounter challenges when making the transition to clinical learning because of the complex and unpredictable nature of clinical settings. A selected campus initiated a peer-mentoring programme based on research findings, which revealed that student nurses were inadequately mentored in clinical settings because of mentors experiencing work overload, time and resource constraints, staff shortage and patient-care demands.Aim: The aim of this study was to describe the perceptions of student nurses regarding barriers and benefits of a peer-mentorship programme in a clinical setting.Setting: The study was conducted in a clinical setting in KwaZulu-Natal.Methods: A quantitative, descriptive design was used, whereby data were collected through questionnaires. A total of 56 mentors (third- and fourth-year nursing diploma student nurses) and 94 mentees (first- and second-year nursing diploma students) participated in the study.Results: The mentors highlighted insufficient practice opportunities because of the short duration of the placement, time and resource constraints, and the simultaneous mentoring of too many students as barriers, while the mentees highlighted the reluctance of mentors to fulfil their roles and lack of dedication and unfriendliness as barriers to effective mentorship. The benefits of being a mentor were self-achievement, enhancement of skills and acquiring of positive work ethics, while the major mentee benefits included experiencing less anxiety, adapting to the clinical environment easily and being less intimidated in the clinical setting.Conclusions: This study revealed that both mentors and mentees perceived peer-mentoring programmes as important to their clinical growth. However, these programmes require formative evaluations to address negative perceptions of student mentees and mentors and to identify challenges faced by them.

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