COSATU Public Service Unions Strongly Disapprove the Hypocrisy of the Public Servants Association (PSA)...

Media statement 

Wednesday 16 May 2018 

The COSATU unions in the public sector under Joint Mandating Committee (JMC) representing SADTU, POPCRU, NEHAWU, DENOSA, PAWUSA and SAMA wish to express their compelling disapproval of what we believe as PSA’s double standards and crude misleading public posturing as the public sector wage negotiations unfold in the Public Service Co-ordinating Bargaining Council (PSCBC). 

We believe the PSA has taken a decision to lie to both its members and the public and this was further made clear through its statement published on the 15th of May 2018 regarding the ongoing negotiations.

We can place it on record that the PSA as a matter of fact has already declared a dispute and received its certificate of non-resolve. The receipt of the certificate of none-resolve post a conciliation intervention simply means that the PSA had effectively declared its loss of confidence in the process unfolding at the level of the PSCBC. Furthermore, this means that the PSA was now exploring other methods to unlock the stalemate outside of the ongoing negotiations.

To our astonishment, the very PSA continued to form part of and fully participate in the negotiations after declaring and publicly communicating its loss of confidence in the ongoing process at the level of the PSCBC. In a statement released on the 15th of May, the PSA went further to communicate that it was now balloting its members for what we suppose will be some form of an industrial action. We also believe it’s mischievous for the PSA to single out one of the COSATU Unions in their statement insinuating that others have signed the agreement whilst negotiations are ongoing.

It is our very strong view that the PSA is now playing to the gallery and its sole intention is to give the false public impression of having ultimately being the catalyst to unlocking the stalemate. We believe the PSA is performing a form of public relations gymnastics based on its double standards and hypocrisy which is where our disapproval emanates from. If it was to be honest to its members and the public, the PSA should have immediately halted its participation in the PSCBC after declaring a dispute.

An uncomfortable reality however which is where the PSA finds itself is that inherently, it does not have the organisational capacity to mount a significant industrial action in the public service on its own. It has never done so in history and prospects of it doing so on its own in the current discourse are extremely limited to non-existent. It’s common course that COSATU unions have embarked on impeccable strikes in the past that benefited members of the PSA who were not on strike and it is regrettable that the PSA would like to blackmail other unions that are fighting for a solution inside the chamber. 

What is clear is that in the eventuality that a dispute is declared by the other public sector unions as well which are still in negotiations, the PSA will in all probability “hide everything from the public servants, tell lies and claim easy victories” to paraphrase Amilcar Cabral’s famous quote.  

This is an extremely sensitive stage of the negotiations and we are of the view that honesty and integrity must be what guides them as a matter of principle. Very few can argue that there is any molecule of honesty in an organisation that formally declares the loss of confidence in a process and yet continues to opportunistically participate in it and even release statements about it in public. We encourage the PSA to choose a struggle and in this case it is a process outside of the current negotiations in the PSCBC instead of blatantly lying to the public in general and its members in particular.      

COSATU public service unions spoke out strongly against the delaying tactics of the employer and its generally intransigent behaviour during the current phase of the negations. We have engaged our members extensively as worker-controlled unions and we would be the first if the need arises to go on a head- on-collision against the employer. We would do this without any fear or favour because a strong and decisive posture against the employer forms the very essence of our existence as red unions in the Public Service. 

We are committed to the process of negotiations and remaining locked to the cause whilst the PSA is enjoying the game of “running with the fox and hunting with the hounds.” If they (PSA) had the will and clout, why play to the gallery instead of seriously mobilising their members and take it to the streets without posturing on media seeking public sympathy? 

We as COSATU unions remain confident that we are still advocating for the rights of our members by remaining in the bargaining and exhausting all available avenues to a negotiated settlement. The adjournment of the Council yesterday is a normal process for any party to go and seek mandate when new demands of offer is tabled.

We are therefore calling for maximum unity amongst all our members during this phase of negotiations. Let us not be divided by self-serving public stunts and rather focus on the bigger picture, and that picture consists of a better deal for all the public servants. 


Issued on behalf of the COSATU JMC

Nkosinathi Theledi 082 567 7803

Mugwena Maluleke 082 783 2968

Mike Shingange 082 455 2485

Thandeka Msibi 060 998 3288

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DENOSA condemns the brutal killing of over 50 Palestinians by Israeli forces in Gaza  ...

Media statement 

Tuesday, 15 May 2018 

The Democratic Nursing Organisation of South Africa (DENOSA) would like to condemn the killing of more than 50 Palestinians and injuring more than 2000 civilians by Israeli forces in Gaza yesterday and commend South African government for withdrawing the South African ambassador from Israel.

DENOSA further calls on South African government to remove the Israeli ambassador from South Africa with immediate effect. 

More concerning to DENOSA is the fact that the injured civilians will be taken care of in the Palestine’s already stretched healthcare facilities while Israel will not incur any costs in this regard but they are the main cause of this tragedy.  

While we condemn what the Israeli forces have done, unfortunately we cannot take away our eyes off the US for ruffling the feathers by relocating its embassy offices from Tel Aviv to the contended Jerusalem while it claims to be intervening in the Palestine/Israel stand-off over Jerusalem. 

Jerusalem is the main is the bone of contention between both Israel and Palestine, and for Israel to use armed forces and live ammunition towards peaceful protesters on Palestinian land is just unacceptable and downright bullying.    

DENOSA hopes that the US will come forward and defuse the situation that has emerged as a direct result of its opening of embassy offices in Jerusalem, thus siding with Israel. 

DENOSA hopes the United Nations will see the need to intervene urgently before more Palestinians lose their lives in what is surely becoming a genocide. 

DENOSA Central Executive Committee (CEC) held in February this year resolved that South Africa should withdraw its ambassador from Israel and that South Africa should expel the Israel ambassador from South Africa until the Gaza Strip matter is handled responsibly by Israel. 

DENOSA joins forces with the international community in condemning the heavy-handedness of Israel and its suppression of peaceful protests by Palestinians. 


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

For more information and comment, contact:

Cassim Lekhoathi, DENOSA Acting General Secretary

Mobile: 082 328 9671 


Simon Hlungwani, DENOSA President

Mobile: 082 328 9635 


Facebook: DENOSA National Page

Twitter: DENOSAORG   

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DENOSA statement on the continuing state of paralysis in North West  ...

Media statement 

Tuesday, 15 May 2018  

The Democratic Nursing Organisation of South Africa (DENOSA) in North West would like to express itself on the continuing dire situation in North West as a consequence of maladministration which continues to have crippling effects on healthcare services for both patients and nurses in the province.  


The situation has reached a point of no return for nurses who have been abused, exploited, neglected and deserted. The poor working conditions have seriously rendered the profession sub- standard service due to system failures aggravated by the corrupt government officials in the province.  


Lack of accountability and selfishness have completely consumed the province which has now compromised health care services. Some of the major challenges are the following:  


-       Patients are exposed to non-conducive environment whereby beds are shared because of congestion. 

-       In terms of nutrition, patients are eating bread and mince-meat. 

-       There is no water in some of the sub districts which affects maternity patients severely. 

-       No medication supplies for chronic patients. 

-       Non functionality of backup generators when electricity goes off as an extreme measure according to national core standards which exposes patients’ lives to danger.  


Nurses are salvaging the situation by using their cell-phones and torches to deliver babies in some of the provincial hospitals in the province. 


The linen crisis is so prevalent that patients are utilizing their own linen and blankets from home and infection control measures are not observed. Non functionality of mortuary fridges whereby deceased families are not receiving proper care. Smelling mortuaries with bodies of more than 150 days in some district hospital has become the norm while mortuary attendants and nurses are supposed to wheel the deceased patients to such areas. This is total cruelty to humankind. 


Government’s patients’ transports are so old and not roadworthy that nurses are supposed to escort patients in those transport including ambulances that are not fully equipped.


DENOSA strongly condemns these developments and wants to urge the ANC-led government, especially in the North West, that nurses will no longer tolerate such treatment and this is where it ends. They have compromised a lot because of the oath that they took but now they have been taken for a ride. They are human beings before they are nurses. They deserve better. As they celebrate nurses month with the theme: “Nurses: A Force for Change – Health is a Human Right”, nurses are also advocating for provision of adequate human and material resources to promote quality nursing care.


DENOSA is currently exploring all legal options to put a stop to this situation.


With the above issues, and many others, DENOSA fully understands and sympathise with the call by COSATU in North West for a total shut down of services in the province. The reality is that the situation has become untenable, and the harsh effects are still felt post- the decision by national government to place the provincial administration under Section 100(a).


DENOSA would like to warn national government about its failure to safeguard communities in possible times of service shut down, especially in the so-called essential service category because of its failure to sign the Minimum Service Level Agreement, which will stipulate the minimum staffing levels for this group of workers. This failure to sign the agreement simply means every workers can easily embark on a total shut down. That is how patients’ lives are exposed.     




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


For more information, contact:

Motlalepule Ramafoko, DENOSA Acting Provincial Secretary

Mobile: 071 643 7980 


Motlalepule Maikepa, DENOSA Provincial Chairperson

Mobile: 076 673 1172

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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.


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:


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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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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   

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Nursing Update

January 2018

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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