DENOSA KZN reports provincial health department to SA Human Rights Commission and Public Service Commission ...

Media statement 

Wednesday, 12 February 2020     

The Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal has reported the provincial Department of Health to both the South African Human Rights Commission and the Public Service Commission over the poor state of safety in health facilities in the province which has led to unnecessary attacks and killings of health workers and patients recently as well as over the years. 

This poor safety has brought low morale to health workers as they are constantly worried about their own safety while performing their work inside health facilities, and rightfully so.    

“After several incidences of attacks and killings inside facilities, where we do not see the Department taking drastic steps to protect patients and nurses in healthcare institutions, DENOSA took a decision to report all these incidents to the two commissions with view that they investigate. We did so on the 4th of February,” says DENOSA KwaZulu-Natal Provincial Secretary, Mandla Shabangu.

“We hope that they will see the root cause of the problem for themselves, as we have been complaining for years about the poor state of security in health facilities in the province.” 

The South African Human Rights Commission has acknowledged DENOSA’s complaint and assured that the matter will be processed according to the commission’s complaints’ handling procedures. The Public Service Commission, however, has not acknowledged receipt of our complaint and we hope they will do so and, most importantly, do their own assessment of the state of safety in health facilities. 

DENOSA is not going to keep quiet in the face of this continuing injustice, and feel that the department must be taken to task for failing to provide safe working environment for our members and communities out there who use public facilities. 

End   

Issued by DENOSA in KwaZulu-Natal   

For more information, contact: 

Mandla Shabangu, DENOSA Provincial Secretary

Mobile: 071 643 3369

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DENOSA warns nurses of a scam to extort money from job-seeking nurses under pretext of securing employment fo...

Media statement   

Wednesday, 12 February 2020

 

The Democratic Nursing Organisation of South Africa (DENOSA) would like to warn all nurses out there, especially those who are unemployed and desperately looking for work, to be careful of the new scam where a person targets those who are desperate and offer them employment at a fee of R5000, because there are no such opportunities. 

A person purporting to be a professional nurse on Facebook is enticing nurses who are looking for work desperately and promise them employment at Northdale Hospital in Pietermaritzburg. Some nurses from as far as Eastern Cape have been enquiring from the same person who requires a payment of a R5000 deposit before the nurses can be employed under the pretext that they will pay a further R5000 upon employment, which is a strategy to bring a moment of lull upon her victims as this employment never materialize. She would then disappear without any trace.    

DENOSA would like to reiterate that in any legitimate employment application process, there is not a single cent that is required from the applicant in order to get the post. This ruthless person is taking advantage of the fact that thousands of nurses are sitting at home looking for work. And government is creating this opportunity for nurses to be robbed because of its lethargy in employing qualifying nurses at the time when shortage of nurses in facilities is at its highest.

DENOSA would like to call on those who suspect that they are being recruited into a position on condition that they pay a certain fee to contact the DENOSA provincial office in KwaZulu-Natal. 

DENOSA shop stewards have been made aware of this and regional leaders are busy tracking the suspect. Any nurse who can assist in identifying the person is requested to contact DENOSA office urgently so that law enforcement agencies can be involved. The Telephone number is: 031 305 1417 

Furthermore, DENOSA calls on government once again to speed up the process of employing unemployed nurses because rogue individuals are making use of this malaise on government’s part by robbing innocent and desperate nurses – which is double victimization. 

From DENOSA KwaZulu-Natal 

For any information, contact:

Mandla Shabangu, DENOSA KwaZulu-Natal Provincial Secretary

Mobile: 071 643 3369  

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DENOSA KZN to obtain court order against Department of Health over stabbing of a nurse ...

Media statement

Monday, 03 February 2020

DENOSA KZN to obtain court order against Department of Health over stabbing of a nurse, a patient and security at King Edward Hospital, and closure of all health services in the ILembe District due to unpaid salaries of security personnel

The Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal woke up to the sad news where a nurse, a patient and a security officer were stabbed by a patient at King Edward Hospital in Durban as well as the closure of health facilities and district offices in the ILembe District due to a protest by security personnel over unpaid salaries.

These are disturbing developments because it is not long ago that a patient was shot and killed at Clairwood Hospital, south of Durban, which clearly shows the lack of will to deal with this ongoing challenge in our facilities.

As a result of these latest developments, DENOSA has taken, as a last resort, a decision to approach the court with the view to obtain an order forcing the department to adhere to the National Health Act by providing a safe environment for our members working in its facilities as well as to ensure the safety of patients under its care. Attacks of workers and patients have been occurring without any stoppage.

Nurses and other health workers and patients at King Edward Hospital are traumatized and demoralized at the same time because they have been experiencing this issue of poor security at the facility. The hospital is a high risk zone where, constantly, workers feel unsafe.

Last week on Thursday in the morning, criminals dressed in white coats broke into the nursery locker area and they broke padlocks of many lockers and took all the valuables that they could get. Money, cellphones and wallets were taken while nurses were on duty. Security and management were all informed. And two hours later, they went to the top floor where they robbed other wards of the same and nothing was done to catch them while there is security in each and every floor. No police came to investigate.
In the ILembe District, all health facilities in the district are closed, including the district offices of health, because security personnel are aggrieved over unpaid salaries. This is a threat to both nurses and patients, and nurses cannot work in facilities where their safety is not guaranteed.

It is over a decade since DENOSA has been complaining about security in health facilities and contracts of security companies get renewed and new one get contracts and yet the results are the same. We have long advocated for the in-sourcing of security in government which we believe strongly that it will be cost effective to government while accountability of security will rest with CEOs and Managers of health facilities.

End

Issued by DENOSA in KwaZulu-Natal

For more information, contact:

Mandla Shabangu, DENOSA KZN Provincial Secretary

Mobile: 071 643 3369

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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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Publications

Nursing Update

         
August 2019

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