First Advisor

Parker, Carlo

Document Type

Dissertation

Date Created

5-2023

Abstract

At the beginning of the 20th century, St. Kitts and Nevis had one of the highest infant mortality rates in the Caribbean. However, unlike some Caribbean nations with similar historical and socioeconomic factors that continue to suffer from significant health disparities, St. Kitts and Nevis implemented strategic health reforms that have led to dramatic improvements in maternal and neonatal health outcomes. One of the strategic reforms designed to address these poor health outcomes was to mandate that all registered nurses in St. Kitts and Nevis pursue certification in the post-basic midwifery program. The purpose of this study was to examine the lived experience of registered nurses and registered midwives in St. Kitts and Nevis. No research has been conducted on the central role these registered nurses and registered midwives have performed in St. Kitts and Nevis’ highly successful healthcare system. To address this significant gap in the scholarly literature, a qualitative, hermeneutic interpretive phenomenological study was conducted to gain insight into the everyday lived experiences of the registered nurses and registered midwives in St. Kitts and Nevis. After receiving approval to conduct this research from the Institutional Review Board of the University of Northern Colorado and the Ethics Board of the Ministry of Health in the Federation of St. Kitts and Nevis, practicing registered nurses and registered midwives in St. Kitts and Nevis were recruited using purposive sampling and snowball techniques. Once verbal consent was obtained from the participants, data were collected on-site by audiotaping in-depth interviews until data saturation occurred. Semi- structured, open-ended interview questions derived from the model for upscaling nurse and midwifery partnerships were used to guide the interview process, which provided the theoretical framework for this study. The data were then transcribed verbatim onto NVivo software. Recurrent themes that emerged from the meanings these registered nurses and registered midwives constructed from their experiences were synthesized using Colaizzi’s (Abalos et al., 2016) rigorous qualitative data analysis process. Measures to ensure the trustworthiness of the data were implemented including peer review, member checking, triangulation of data, transparency, reflection on bias, and an audit trail. An analysis of historical, published and unpublished books and pamphlets relevant to the research question was integrated into and further supported the trustworthiness of the findings. Implications for nursing and midwife practice, education, policy, and research were discussed. Findings from this never-studied population might increase understanding of the strengths and challenges nurses and midwives in St. Kitts and Nevis face in providing care. This research contributed to the body of knowledge supporting registered nurse and registered midwife practice, education, research, and policy on St. Kitts and Nevis, and similar geographically isolated islands with limited resources.

Extent

257 pages

Local Identifiers

Gaul_unco_0161D_11116.pdf

Rights Statement

Copyright is held by the author.

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