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Browsing by Subject "nurses"

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  • Valkohaapa, Anna-Mari (2014)
    In Finland the elderly residents of long-term care facilities are often prescribed a lot of medications, especially psychotropic drugs. It also happens that a patient or a resident has to be physically or chemically restrained. Chemical restraining can be defined in many ways, for example as using a drug - usually an antipsychotic - to restrict the freedom or movement of a patient and to control his or her behavior. In nursing homes the staff is in a key position when it comes to deciding on the use of chemical restraining or PRN medication. A legislation to guarantee the self-determination of a patient and to define how physical restraining can be used is now being prepared in Finland. Only a few studies on chemical restraining from a nurses' point of view have been made so far. Thus, the aim of this study is to provide more information on the level of knowledge, the attitudes and perceptions of nurses regarding chemical restraining and the effect of those on deciding whether to use chemical restraints or not. Three focus groups with nurses were conducted in Hyvinkää nursing homes (n=13). The groups were recruited both by e-mail and directly from the wards. The focus group discussions were digitally audiotaped and transcribed verbatim. The content of the transcripts was then analyzed using a constant comparative method. According to the study most of the antipsychotics used in long-term care were used daily. However, it is not uncommon for the nurses to be unsure about their knowledge on the use of medicines. It is thus important to help the nursing staff to increase their knowledge and skills in pharmacology. The nurses also wished to get extra training for treating people with dementia. The concept of chemical restraining is quite ambiguous, and the use of chemical restraints is a complex ethical issue because the reasons for and effects of administering it vary depending on the situation. The study shows that the chemical restraining is most often considered justified when it is used to ensure the safety of a patient, relieve anxiety or to keep the working conditions of the staff tolerable. Also a shortage of manpower and a request by the family can influence the decision on using chemical restraints. The lack of proper common guidelines causes confusion and wide variation in the use of chemical restraints. Many interviewees were hoping for more open discussion and cooperation on using chemical restraining. The nurses also mentioned many alternatives to rely on instead of using chemical restraints, such as soothing, comforting and creating a safe feeling for the patients, daily routines and stimulus. One of the key factors for taking to these instead of chemical restraints are the manpower resources in the facilities. Educating the staff can also help them to find more options for chemical restraining and make staff members recognize new or remember forgotten routines for caring for the patients without using psychotropic drugs.
  • Pihlaja, Ulla-Kaisa (2017)
    Namibia has gone through great changes since its independence in 1990. The new constitution illegalized the apartheid rule and racial discrimination, but the history has left its marks on the contemporary society. The class inequalities are one the biggest in the world, and they still intertwine with the racial and tribal memberships. Although any kind of discrimination is strictly forbidden in the society, the prejudices still remain. Furthermore, the gender roles are in transition and women encounter multiple, sometimes conflicting expectations. In this context, the thesis studies multidimensional identity from the perspective of decency. More specifically, it explores how decency is conceived among black female nurses of Katutura township in Windhoek. The study investigates how the racial, tribal, gender, class and professional identities intersect and contribute to the perceptions of a ‘decent person’. The study also discovers how young women try to answer simultaneously to the traditional and modern female ideals. Lastly, the thesis illustrates how the class dominance, traditional gender roles and the ethnic and racial prejudices are resisted and reproduced through the perceptions on decency. In terms of class-related decency was demonstrated by diving the ‘indecent them’ to the upper and lower classes. The whites and the majority tribe of Owambos were accused of being discriminatory and having better opportunities in life. The lower classes were instead stigmatized as lazy and immoral individuals, who did not deserve the higher socio-economic positions. Thus, both the better and worse-off were claimed being less respectable than the interviewed nurses, who represented the middle class. However, the interviewees also identified with the lower class and admitted that the societal structures hindered their class mobility. To summarize, they simultaneously maintained and resisted the class dominance. Class also had a strong link to the female respectability. On the other hand, the modern woman was expected to be independent, to take care of herself and not to rely on the assistance of men. As the interviewees had succeeded in this, they achieved the dignity of a modern working woman. Still, on the other hand, the traditions expected them to follow the old gender roles. The conflicting expectations became apparent, for example when discussing the ‘ideal nurse’. The decent nurse was supposed to be a feminine mother-type of a figure, who put herself last in order to help others. Still, also the high professional expertise made the ‘proper nurse’. In this way, the nursing profession both strengthened and faded the women’s femininity and simultaneously rejected and reproduced the traditional gender ideals. However, it was the co-existence of the traditional and modern decency that enabled the nurses to maintain their respectability in the changing society. Regarding the racial and tribal relations, any kind of discrimination was condemned. Nevertheless, the condemnation was also an issue of differentiating those who had a good sense of morals and those who did not. The interviewees argued that the whites were still racist, but that they themselves promoted equality like a decent person should do. Considering this, it is controversial that they seemed to forget the principles of the universal equality when talking about the ethnic difference. They reproduced the same prejudices they judged in regard to racial discrimination. Moreover, they underlined their old and new identities as they draw strong lines between the racial and tribal groups, but also claimed for absolute equity. In this light, it is possible to argue that the societal transformation has a great impact on the decency perceptions of the Namibians. The historical stances remain side by side the ideologies of the post-apartheid era, although the attitudinal change is taking place. The class inequalities and discrimination clash with the aspirations of equality, the traditional gender roles are challenged by the modern female respectabilities and the group relations are defined by both reconciliation and boundary making.
  • Pihlaja, Ulla-Kaisa (2017)
    Namibia has gone through great changes since its independence in 1990. The new constitution illegalized the apartheid rule and racial discrimination, but the history has left its marks on the contemporary society. The class inequalities are one the biggest in the world, and they still intertwine with the racial and tribal memberships. Although any kind of discrimination is strictly forbidden in the society, the prejudices still remain. Furthermore, the gender roles are in transition and women encounter multiple, sometimes conflicting expectations. In this context, the thesis studies multidimensional identity from the perspective of decency. More specifically, it explores how decency is conceived among black female nurses of Katutura township in Windhoek. The study investigates how the racial, tribal, gender, class and professional identities intersect and contribute to the perceptions of a ‘decent person’. The study also discovers how young women try to answer simultaneously to the traditional and modern female ideals. Lastly, the thesis illustrates how the class dominance, traditional gender roles and the ethnic and racial prejudices are resisted and reproduced through the perceptions on decency. In terms of class-related decency was demonstrated by diving the ‘indecent them’ to the upper and lower classes. The whites and the majority tribe of Owambos were accused of being discriminatory and having better opportunities in life. The lower classes were instead stigmatized as lazy and immoral individuals, who did not deserve the higher socio-economic positions. Thus, both the better and worse-off were claimed being less respectable than the interviewed nurses, who represented the middle class. However, the interviewees also identified with the lower class and admitted that the societal structures hindered their class mobility. To summarize, they simultaneously maintained and resisted the class dominance. Class also had a strong link to the female respectability. On the other hand, the modern woman was expected to be independent, to take care of herself and not to rely on the assistance of men. As the interviewees had succeeded in this, they achieved the dignity of a modern working woman. Still, on the other hand, the traditions expected them to follow the old gender roles. The conflicting expectations became apparent, for example when discussing the ‘ideal nurse’. The decent nurse was supposed to be a feminine mother-type of a figure, who put herself last in order to help others. Still, also the high professional expertise made the ‘proper nurse’. In this way, the nursing profession both strengthened and faded the women’s femininity and simultaneously rejected and reproduced the traditional gender ideals. However, it was the co-existence of the traditional and modern decency that enabled the nurses to maintain their respectability in the changing society. Regarding the racial and tribal relations, any kind of discrimination was condemned. Nevertheless, the condemnation was also an issue of differentiating those who had a good sense of morals and those who did not. The interviewees argued that the whites were still racist, but that they themselves promoted equality like a decent person should do. Considering this, it is controversial that they seemed to forget the principles of the universal equality when talking about the ethnic difference. They reproduced the same prejudices they judged in regard to racial discrimination. Moreover, they underlined their old and new identities as they draw strong lines between the racial and tribal groups, but also claimed for absolute equity. In this light, it is possible to argue that the societal transformation has a great impact on the decency perceptions of the Namibians. The historical stances remain side by side the ideologies of the post-apartheid era, although the attitudinal change is taking place. The class inequalities and discrimination clash with the aspirations of equality, the traditional gender roles are challenged by the modern female respectabilities and the group relations are defined by both reconciliation and boundary making.