Experiences of nurses caring for youth victims of violence at a community health centre in Khayelitsha
Ekole-Chabanga, Harrite Achu
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The introduction of primary health care in South Africa in 1994 marks a new beginning for the majority of the marginalised population in South Africa during the apartheid era. This introduction has improved access to health care in most communities. Health services are now more decentralised with community health centres that are primarily run by nurses. Violence continues to take its toll in post-apartheid South Africa and the youth remain the most affected group of most communities. It often leaves the youth shattered and traumatised with alarming psychological effects, including poor self-esteem. There is a steady increase of youths who are visiting community health centres to seek health care from nurses with a subsequent increased workload for the nurses at these centres. Previous research has dwelt more on either violence on its own, or the youth affected by violence but very little is known about the nurses caring for these youth victims of violence. It is unclear how nurses who are working at a community health centre experience caring for youth victims of violence. The purpose of this study was to explore and describe the experiences of nurses caring for youth victims of violence at a community health centre in Khayelitsha and to develop guidelines for supporting nurses caring for youth victims. A qualitative, exploratory, descriptive, and contextual design was used. The accessible population (N = 40) included all nurses who are registered under Section 31(1) of the Nursing Act No 33 of 2005 in order to practice nursing or midwifery, and who were working at a community health centre in Khayelisha. Purposive and snowball sampling were used. The data collection method comprised an individual unstructured interview while using an audio recorder and documenting field notes. Tesch's descriptive method of open coding was used for data analysis. Trustworthiness was ensured by means of applicability, dependability, transferability and confirmability. The findings from this study indicated that the experience of nurses who were caring for youth victims of violence was particularly related to a number of factors. These factors included challenges faced by the youth in the community, their socio-economic situation, violence and abuse, gangs, substance abuse, illiteracy, teenage pregnancy; as well as challenges face by nurses, under-preparedness, staff shortage, increase workload, rudeness, and verbal and physical abuse of the nurses. They also emphasised some rewarding experiences. There were some psychological effects on nurses and their emotional responses reported by these nurses. The study also revealed the different coping mechanism these nurses were using and their need for support. Guidelines were developed to support nurses. Recommendations for future implementation are presented in the last chapter.