DENOSA in solidarity with 14 000 Zimbabwean nurses fired by government...

Media statement 

Thursday, 19 April 2018  

The Democratic Nursing Organisation of South Africa (DENOSA) throws its weight behind and in solidarity with the more than 14000 Zimbabwean nurses who were fired by government on Tuesday for protesting following many unfulfilled promises by government to pay them outstanding allowances and demanding review of their salaries.

This decision poses a serious danger to the stability of healthcare service in our neighbouring country, when it has not more than 18000 in total in the country.  

We encourage government to resolve challenges by sitting around negotiation tables with the nurses’ union in Zimbabwe rather than opting to dismiss almost all nurses of the country. 

DENOSA is particularly concerned with the potential long-term deprivation of Zimbabweans access to quality healthcare, as nurses are the conduit to such which is a human right globally. This is because an outbreak of cholera has just broken out in some parts of the country, where four people have already succumbed to it.    

That the Zimbabwean government think it can just replace the experienced nurses with newly-qualified inexperienced and retired nurses may inflict more suffering to the Zimbabweans’ quality healthcare needs, something that has been caused by government’s endless delays in paying nurses outstanding allowances, in a trying economic condition like Zimbabwean, given the recent socio-economic troubles the country has had to face. 

“Zimbabwean nurses earn on average 284 US Dollars per month, which is equivalent to roughly R3 400 in South African Rands. Some nurses are owed around 1000 US Dollars by Zimbabwean government,” says DENOSA Acting General Secretary, Cassim Lekhoathi.  

“It’s quite egoistic of Deputy President of Zimbabwe to just dismiss so many workers for merely exercising their right as workers, when the very same government has not paid nurses for far longer periods while nurses have been patient while feeling the thorn of harsh economic conditions. It’s arrogance and bossy attitude that may demoralize many health workers.” 

End 

Issued by the Democratic Nursing Organisation of South Africa (DENOSA)

For more information, contact: 

Cassim Lekhoathi, DENOSA Acting General Secretary  

Mobile: 082 328 9671    

Or 

Sibongiseni Delihlazo, DENOSA Communications Manager 

Mobile:  072 584 4175 

 

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DENOSA KZN draws community’s attention to the worsening crisis at King Edward VIII Hospital ...

Media statement  

Monday, 16 April 2018 

The Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal would like to draw the attention of the community to the worsening crisis of bed shortage at King Edward VIII Hospital in Durban after heavy weather conditions damaged some wards last year in October which have not been fixed and made available for admission of patients since then.

As a result, many patients who are waiting for beds stay at the hospital’s trauma unit for more than four days waiting for beds’ availability. “What concerns DENOSA is that while patients are waiting at trauma unit after they have been stabilized, they don’t get food because there is no food allocation at trauma as patients are not meant to stay there – they are stabilized and referred to the relevant unit for admission,” explains DENOSA Provincial Secretary, Mandla Shabangu. 

Because of the overpopulation, nurses are getting professionally compromised because it is the responsibility of nurses to ensure good nutritional status of patients. But where will they get food in trauma? And now relatives of patients are angry at nurses for “depriving” their relatives some food. This could easily lead to litigation against nurses, for something that is not of their doing. “This problem is a Department issue and they must address it so that nurses can do their job without any impediment.” 

Another ethical dilemma that nurses are faced with is that, because of the dire situation, patients that should be admitted at surgical ward end up at TB ward because that’s where the first bed became available! This is a great potential for litigation because patients will acquire illnesses that they were not admitted for, and the Department could be forced to pay millions in damages.  

When the heavy weather damaged some wards like maternity and others, patients were transferred to King Dinizulu Hospital. But patients keep on flocking to King Edward VIII Hospital in large numbers that the facility is not able to accommodate, because the damaged wards are still not ready for admission of patients.

“The situation is also pitting health professionals against each other now. When nurses inform doctors that there are no beds available when patients are booked in by doctor, the doctor, in protecting themselves of course, simply writes on the file ‘nurse so and so says there is no bed available’.” 

Once again, DENOSA urges the National Department of Health to look into the situation and intervene before two patients are forced by circumstances to share one bed. 

From the above challenges, DENOSA hereby informs the communities that it is giving the Department of Health in the province until Wednesday 18 April to normalize the situation at King Edward VIII Hospital by providing conducive working environment for health professionals. Failure to fix the problem, DENOSA will on Thursday instruct its members to just report for duty at the facility but not touch any work under an environment that is not conducive and that is compromising the quality healthcare to patients. 

We believe this is in best interest of quality patient care for communities that utilize King Edward Hospital as they deserve. We also believe this time-frame is reasonable and will give the Department sufficient time to make preparations if it really cares about those communities.  

End 

Issued by the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal 

For more information and comment, contact:

Mandla Shabangu, DENOSA Provincial Secretary

Mobile: 072 151 5874 

Tel: 031 305 1417

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DENOSA Gauteng student Movement in solidarity with protesting students over non-delivery of books  ...

Media statement

Wednesday, 11 April 2018

The Democratic Nursing Organisation of South Africa (DENOSA) wishes to declare solidarity with the 'Bursary Students' 1st and 2nd year in all three public nursing colleges and universities on the issues that they are raising regarding the disastrous bursary system and lack of study material to the Gauteng Department of Health in a form of a protest within the college premises. 

It is disappointing that the department that is supposed to give a basic human service and protect the basic human rights of the community in Gauteng is prepared to fail to provide nursing students with material required to provide quality education and make the environment conducive for learning at both clinical and theoretical placements all in the name of budget.  

DENOSA commends the SRC of all nursing colleges for leading the students in the right direction into resolving these issues and the students themselves for deciding that it is time they became united and vocal with all the challenges that they are experiencing. 

It is for these reasons that as student movement we sought to find a solution for the situation through seeking the attention of the MEC and the SRC, as there was not much that could've been done through the other offices in the Gauteng Department of Health other than of the MEC. SRC had already lost hope after they were deceived by the other key officials within the GDoH on many occasions. 

The meeting with the MEC took place yesterday at the Department office at 17:00. In this very meeting it was noted that there has been some misleading and deceiving that took place in the department and that the MEC was not aware of the challenges raised in the meeting. Therefore it was concluded that the MEC will arrange for the required material and will give progress report with definite solution (due to weighing preference of hardcopy and the notepad and availability from different service providers) by Thursday the 12 April 2018. 

Quoting the word of MEC Gwen Ramokgopa: "It can't be correct in 2018 that students don't have study material whereas it was budgeted for", meaning she is willing to correct the injustice. We have to ensure that we give the executive authority time to dispose of the matter as she has requested only one working day to work on this matter decisively and close it off. 

Therefore GPSM supports the intensification of the protest by our fellow students, by mobilising other forces and rallying for more support up until the final report by MEC where, if no solution is found, a decision will be taken by SRC of colleges and students to strike and march to the offices of the Gauteng Department of Health. 

End

Issued by DENOSA Gauteng Student Movement

For more information, contact: 

Markos Ndlovu, chairperson of DENOSA Gauteng Student Movement 

Mobile: 071 683 8460

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Trauma Nursing Matters...

Evidence based practice: Is cricoid pressure effective in preventing gastric aspiration during rapid sequence intubation in the emergency department?

By Ntombifuthi Jennet Ngiba (BN) (UKZN).

There is on-going change within trauma nursing due to increased research in the area. Practices have been routinely adopted as the norm, but subsequently on further examination proven to be useless and more of a risk to the patient (Moore & Lexington, 2012). Research has brought into question practices or techniques such as the application of cricoid pressure during rapid sequence tracheal intubation. This practise was goaled at preventing the regurgitation of gastric content into the pharynx and subsequent aspiration into the pulmonary tree, but now questioned.

Cricoid pressure was briefly defined by Sellick in 1961 as a method used to reduce the risk of aspiration during the induction phase of anaesthesia. Sellick`s technique was to apply backwards pressure to the cricoid cartilage, compressing the oesophagus against the underlying vertebral body (Ellis, Harris & Zideman 2007; Priebe 2005). In this application of pressure the oesophageal lumen is occluded, preventing the passage of regurgitated gastric content into the pharynx and subsequent aspiration into the pulmonary tree (Stewart et al, 2014). Cricoid pressure is incorporated into the overall approach in reducing the chances of aspiration through rapid sequence induction of anaesthesia (Ellis et al., 2007; Priebe 2005). Over the years rapid sequence induction has been adapted by emergency physicians to allow ventilation as required to prevent hypoxia and subsequently termed “rapid sequence tracheal intubation”. Rapid sequence tracheal intubation (RSTI) is now the most widely used technique for tracheal intubation in the emergency department (ED) and cricoid pressure is taught as a standard component of emergency airway management (Ellis et al., 2007).

Despite inadequate scientific evaluation of the risks and benefits of cricoid pressure it is adopted as an integral component of rapid sequence intubation in EDs. No randomised controlled trials have shown any benefit of its use during rapid sequence intubation (Trethewy, Burrows, Clausen & Doherty, 2012). Furthermore, the application of cricoid pressure may be linked to increased risks to the patient such as  impeding airway management, prolonging intubation time by concealing laryngeal view, inducing nausea/vomiting and oesophageal rupture with excessive force (Ellis et al., 2007; Priebe 2005;Trethewy, et al, 2012). Paradoxically, cricoid pressure may promote aspiration by relaxing the lower part of the oesophagus (Ellis et al., 2007). Some case reports note that tracheal intubation was impeded by cricoid pressure and regurgitation occurred despite application of cricoid pressure, possibly due to its improper application (Trethewy, et al, 2012). According to Bhatia, Bhagat and Sen (2014) the application of cricoid pressure increases the incidence of lateral displacement of the oesophagus from 53% to 91%.

However despite this evidence and the outcome of Trethwy’s (2012) RCT the judicial system appears guided in its judgement by outdated practises. A judge in UK ruled against an anaesthesiologist for failing to apply cricoid pressure to a patient with irreducible hernia who had regurgitated and aspirated. The judge argued that “We cannot assert that cricoid pressure is not effective until trials have been performed, especially as it is an integral part of anaesthetic technique that has been associated with a reduced maternal death rate from aspiration since the 1960's” (Bhatia et al. 2014). Therefore one may say that despite cricoid pressure entering medical practice on limited evidence and only supported by common sense, it somehow remains the practice of choice (Bhatia et al., 2014).

Thus it is about time nurses and doctors embrace evidence-based practice within the emergency department and let go of traditional practice that are proven to do more harm than good. There is still a great need for further evidence-based practice within the emergency department, to investigate the validity of the notion that cricoid pressure prevents regurgitation.

Ntombifuthi Jennet Ngiba is a Professional Nurse at Greytown Hospital.

REFERENCES

Bhatia N, Bhagat H & Sen I. (2014). Cricoid pressure: Where do we stand? J Anaesthesiol Clin Pharmacol, Vol 30 pp 3 – 6.

Ellis D.Y, Harris T & Zideman D. (2007). Cricoid pressure in the emergency department rapid sequence tracheal intubations: a risk-benefit analysis. American College of emergency physicians.Vol 50, pp 653 – 665. 

Moore K & Lexington K.Y (2012). Evidence-based practise guidelines for trauma care. Journal of emergency nursing. Vol 38, pp 401-402.

Priebe H.J, (2005). Cricoid pressure: an alternative view. Elsevier. Germany.

Stewart J.C, Bhananker S, & Ramaiah R. (2014). Rapid-sequence intubation and cricoid pressure. J Crit Illn Inj Sci, Vol 4, pp 42 - 49.

Trethewy C.E, Burrows J.M, Clausen D & Doherty S.R. (2012). Effectiveness of cricoid pressure in preventing gastric aspiration during rapid sequence intubation in the emergency department: study protocol for a randomised controlled trial. BioMedCentral. Australia. Retrieved 04 August 2016: http://www.trialsjournal.com/content/13/1/17


 

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National changes in nursing training: South African perspectives 2015...

Dr. Respect Mondli Miya,(D.Lit et Phil)

Senior Lecturer: Psychiatry at Durban University of Technology, Department of Nursing Science

 

Nursing is a career of love rooted in rich and fertile soil governed by caring ideologies and philosophies. Individuals within the profession have strong and inexplicable desires to serve and preserve humanity at all cost. The nursing profession drives the health care system and is forever in the forefront of preventing, promoting and management of various diseases.  Nurses have always been there and have survived trials and tribulations. Nursing demands not only the brain for cognitive purposes but a humble heart, selflessness in daily duty execution. An individual without passion for the sick will never survive a minute of nursing’s demanding tasks.

Nursing novices are professionally socialized and groomed on their first day of training. Noble traditions of nursing are gradually unpacked and monitored up to graduation to enhance relevance and dignity of nursing profession. Nursing demands the utmost respect for humanity even after death itself. Most professions have minimum set of working hours yet nursing philosophy calls and promotes dedication beyond duty. Nursing is a way of living not just mere qualification written on papers but lived and experienced charisma. 

Historically, nursing was viewed as a religious vocation and was predominantly religious in nature which explains chapels, and meditation designated facilities utilized for prayers before commencing daily duties in old hospitals. Nursing training in South Africa before 1976 was hospital-based hence the notion of viewing nursing as a “hands-on” career has been accepted nationally and acknowledged by most prolific nursing scholars who remain sceptical to have nursing pitched at a degree level and offered in higher training of education in South Africa.   

Such training exposed and subjected nurses to poor recognition as a career.  Nurses were abused and viewed as medical officers’ hand maids who were good for nothing but to offer a bed pan, bathing the sick, and carry orders as prescribed without being objective. The training at that time was strict and limiting, even the scope of practice was limited and nobody could imagine a degree in nursing or university based nursing teaching and learning. Hospitals mostly trained nurses in general nursing and later midwifery.

Around 1987, nursing in South Africa was gradually introduced in tertiary education system and scope of practice and curriculum were amended. Nursing graduates were introduced to a 4-year degree obtaining general, psychiatry, midwifery and community health nursing. That made older nurses to feel bitter and never fully accepted university graduates as satisfactorily trained. Even medical officers were threatened and witness role change from nurses as hand maids into fully recognized members of the multidisciplinary health team with independent roles and functionality. These changes failed to bridge the gap of scope of practice and remuneration packages. Even to this date, the university and hospital trained nurses earn the same salary and follow same stream of training regulated by the same nursing Act 50 of 1978 as amended with specification stipulated in Regulation 425 (R.425).

The nursing act 33 of 2005 introduced community service of one year post- training for both hospital- and university-trained individuals. Errors still exist within the nursing education such as same recognition of a hospital and university trained graduate have similar scope of practice, universities are allowed to implement R425 differently. For example, some South African universities train students for six months in midwifery while others dedicate two full years for midwifery and three years for community health nursing which is offered for six months in colleges and some universities. The problem in South Africa is that there is one R.425 and implemented differently from one university to the other.

The current health ministry is proposing nursing training restructurization. In the proposal dated 23 July 2015, it recommends reintroduction of the old nursing training system with a hope of extending the nursing training duration and to phase out the R.425 of Act 50 (1978). The current proposal overlooks scope of practice and remuneration packages of such graduates irrespective of their qualification which is an error not even Occupational Specific Dispensation (OSD) could resolve in 2007. OSD failed to address issues of salaries in the nursing fraternity; an obvious error is that a nursing lecturer is graded as a nursing specialist.

The unresolved question here is: Who teaches the other? And why do they earn same salary if the other is a teacher? Up to the very same date, the public health system continues to fail to distinguish university graduates from hospital nursing graduates yet continues to differentiate auxiliary social worker from a University graduate Social Worker, and experienced Medical Officer from a Master of Medicine graduate. Why not with nursing in South Africa? 

The proposed training changes are as follows: general nursing and midwifery be done in a college over a period of four years without indicating whether that shall be Bachelor of nursing offered in a college which can never materialize as colleges do not offer degrees but universities do. If agreed upon, this will mean degrading the dignity of nursing as a profession over medicine which continues to be offered in the university without interruptions.

According to the proposed plan, nursing training is extended to 9 years (four year of midwifery and general, 18 months of psychiatry and one year of community health) which is unnecessary waste of time for an undergraduate qualification yet medicines years of training have been reduced to 5 years (MBCHB).

 

There is absolutely no need for such drastic changes in the nursing education.  It is alarming to witness MBCHB years of training have been reduced to five years and get paid a satisfactory remuneration package compared to Bachelor of Nursing graduates with stagnant remuneration. The introduction of Masters Degree in Medicines in South Africa is preparing sound clinical researchers and such projects (thesis and dissertations) are evaluated by nursing professors who in turn receive less recognition and degrading salaries compared to MMed graduates.

The South African health system requires the following:

1.     Strong and vocal task team of nursing professors who shall preserve the image and dignity of nursing as a profession and strongly oppose plans to change nursing training.

2.     No college shall be allowed to offer a bachelor of nursing, strictly universities only.

3.     Salary packages to be reviewed and sort clear distinction of a university graduate over a hospital trained graduate.

4.     Revised scope of practice, degree holders be given more opportunity to execute complex clinical procedures and be given better remuneration packages.

5.     Chief Nursing Officer to be more vocal and avoid external influences to disorganise nursing training.

6.     Hospitals to create portfolios and acceptable remuneration packages for all nursing qualifications from a diploma to PHD level.

7.     All South African universities to adopt and implement similar training structure  that is two years of midwifery, two years of psychiatry and two years of community health nursing

8.     Develop a Nursing Ministry by nurses with nurses and for nurses.

9.     MBCHB degree be afforded same status as B.Cur degree thereafter if need be.

10.  South African nursing council to be headed by prolific PHD holders and nursing qualifications be regulated and registered up to PHD level.

11.  Any qualification obtained outside university be regarded as either associate professional nurse and associated medical office until related exam has been endorsed by the regulating body.

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WHY DO WE SAY NURSING IS A CALLING? ...

 
We are professionals, and let us fight to be recognised as such… 
Vuyolwethu Mashamayite - 20150728_073623
By Vuyolwethu Mashamaite 
Ever since I joined nursing in 2005 I have heard nurses say nursing is a ‘calling’ and it's not about money. I couldn't understand why they said so and I still don't.   
I believe that everyone is called by God to be in the profession or job they are doing, unless nurses consider themselves in the same umbrella as ‘Sangomas’ and ‘Preachers’. Those are the people who will leave their profession or jobs and focus on their calling or do both, regardless of whether they are paid or not. 
Perhaps this could be the reason why nurses are under-paid and left to work in extreme unfavourablecircumstances ...because it’s a "Calling".
Don't get me wrong; I have passion and great respect for human life as a nurse. But I cannot keep quiet. Nurses are the most abused professionals by the employer because they consider themselves "called" instead of being employed professionals.
Nurses you are jack of all trades doing everyone's jobs from a cleaner to a doctor but come pay day you are the ones who cry the most because you are underpaid while doing everyone's jobs. I guess it's the consequences of having been “called" instead of being professional.
We feel so comfortable working out of our scope of practice to an extent that we run a risk of performing tasks that we are not equipped to do. When told it's not your scope of practice you tell us of how long you've been doing this and you didn't kill anyone. But the South African Nursing Counci (SANC) is out there nailing nurses and not considering your "calling" but rather your profession and scope of practice.
What hurts the most is the fact that you studied for four years and someone from another discipline who studied the same years is treated and paid better than you. I guess they are professionals and you are in a "calling". 
Nurses, let's STOP hiding behind "CALLING" and start taking our profession seriously. If you don't do it, no one will do it for you. Like it or not we are professionals and let us fight to be recognised as such. 
Vuyolwethu is a nurse based in Kimberley, Northern Cape   
End

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Nursing Update

         
January 2018

Nursing Update is jointly published by the Democratic Nursing Organisation of South Afr... More.

Curationis

         
January

Curationis provides a forum for cutting-edge theories and research models related to th... More

About us

The Democratic Nursing Organisation of South Africa (DENOSA) in its current form was established on 5 December 1996.

The organisation was formed through political consensus after the transition to democracy and was mandated by its membership to represent them and unite the nursing profession. Prior to this, the South African Nursing Council (SANC) and the South African Nurses Association (SANA) were statutory bodies which all nurses had to join. It was also important after the transition to democracy to incorp... Read more