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Despite exposure to varied work-related hardships, participants in this study expressed satisfaction with regard to good patients` outcomes. One participant had this to say:

`Ah... it is basically when I see patients discharged. You know, after all that work...

you feel good about yourself.´

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Another participant expressed satisfaction at seeing the happiness of relatives regarding recovery of patients as described below:

`...., and of course you see the children recovering, I really feel good about this because I know that the recovery of these children also affects some other lives like the parents and relatives. So it really brings joy within seeing the joy of many others as well.´

Speciality training related to some aspects of burns care was also expressed as a source of motivation which created job satisfaction, although this was limited to very few individuals amongst the participants.

This is what one participant described:

`Mhh..., me, I was allocated to this unit when I only had general nursing you know and I was only oriented to all this on the job. However, at one point, I was privileged to go for ICU training and right now I am a trained ICU nurse`..., (participant continues)...., because I have ICU as a speciality, I do get monitory incentive package.., You know, with this money, I do feel somehow appreciated for the work I give in this unit and this to some extent is a motivation.´

It was noted that participants felt bad when treatment failed and patients died, as this participant expressed:

`Oh.. I mean some children die..., and it is not nice at all, you see... these kids pass through so much discomfort like pain and they just die like that.., this is really traumatic to us as well, considering all we do on the patients and nothing good really comes out.´

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From the expressions above, there is a reflection that participants` job satisfaction dwelt on good patient outcome. It was worth noting that participants aspired for intensification of burns prevention to reduce workload and therefore facilitate provision of intensive care to burns victims for good outcome, just as this participant expressed:

`Mhh..., I would wish to see burn nursing improving in the context of care we give but also in the area of prevention so we have few patients to give that intensive care, you see...´

Another participant aspired to having professional nurses in the unit with post-basic training in critical care nursing for successful burns care outcome, as this participant described:

`Mhh, (smiles)..Ahh, I think I would like to see the burns unit being manned by professional nurses only, of course with post-basic training in critical care nursing, you see, because once with the patient, the professional nurse would be giving nursing care in totality;´

However, another nurse had contrary views as described below:

`.., really we need to be more of us nurses here, it may not be specifically ICU trained nurses, but even the other cadres as well, that can really make a different to our patients, you see, a good number of nurses attending to these patients will make them feel well cared for as their needs will timely be attended to and that will be less overwhelming even to us nurses.´

These sentiments were expressed with the wish to improve patient outcome, which was perceived as a source of job satisfaction in the unit

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4.4.7 Mutual Bonding in Burns Nursing

In this study, unique bonds were observed to be established between the participants and patients based on elements of long contact and sympathy as this participant described:

`Ah... With this form of contact... you know, I really become fond of the patients, I even know them all by their names; you see, that kind of thing.´

Another participant had this to say:

`Unlike in other wards, here we stay with our patients for so long; we chat and get used to them- we just become like family members. When they recover and go home, we feel happy and satisfied as well. And when they don`t make it, we become affected. (expresses sadness) Oh! It is like losing someone you are fond of- you see..., you get worried and become affected as usual. Just the way you feel when you lose someone you know...., you see, the same applies here when we lose patients we become fond of.´

This nature of interaction helped to establish trust in the work environment which was fundamental for a caring relationship.

It was also noted that whilst engaging in establishing this nature of relationship, with regard to the element of sympathy, the participants were also conscious of their professional boundaries and responsibilities to keep work moving. With regard to feelings for patients` pain, this participant expressed:

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`But still there are times when others would really scream and so I become empathetic and not sympathetic because then I would not assist them anyway. As a care giver I just bear their pain and continue to assist them... you see, that`s how it works.´