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KZN nurses get their Uniform Allowance...
Thursday 20 July 2017
After almost two weeks of embarking on a passive protest by not wearing the torn uniform in demand of payment of Uniform Allowance that should have been paid in April this year, the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal is relieved that nurses in public hospitals in the province were finally paid their uniform allowance on Thursday 20 July 2017 although a quarter of a year later!
DENOSA implemented the resolutions of the provincial chamber on 10 July, which declared that nurses won’t wear any uniform if they are not paid by the 10th of July 2017 by the employer. DENOSA provincial office sent a courtesy letter to the provincial department on 5 July, informing it of DENOSA’s intention to instruct nurses not to wear uniform on the 10th of July if they are not paid Uniform Allowance, which was way long overdue already. On 10 July, nurses led by DENOSA shop stewards came to work on time, and had their identification and put their distinguishing devices on casual clothing as they could no longer wear the torn uniform.
“DENOSA at the provincial bargaining chamber meeting in February urged the Department of Health in the province to ensure that payment of Uniform Allowance does not get delayed this year as it had been the case over the last three years,” explains DENOSA Provincial Organiser in KwaZulu-Natal, Mandla Shabangu. “But April came and went by without any movement and without any explanation as to what the cause of the delay was. In June in our bargaining meeting in the province, we demanded answers from the Department as to what the cause of the delay was, but still we could not get any satisfactorily answer. It was in that meeting at the chamber that we gave the Department an ultimatum to pay nurses Uniform Allowance before 10 July, or face a revolt from nurses.”
Nurses heeded the call by DENOSA and supported the cause. More and more nurses joined in. Initially the Department said nurses were to be paid by end of July. DENOSA’s response to that was that nurses will continue not to wear their uniform until Uniform Allowance is paid then. It took some pushing from the higher office in the province to get nurses to be paid their Uniform Allowance on 20 July, something that DENOSA does believe it should have dragged that long before if nurses are respected and appreciated as the frontline workforce in the healthcare.
Some nurses were charged by their employers at institutions for not wearing uniform, as if the Department had paid them Uniform Allowance already. “We are currently dealing with those cases as the union. Some nurses were given written warnings while others were charged. We also call on other DENOSA members to alert DENOSA about their letters of warnings and charges so that we could deal with those. It was an intimidation by the managers of institutions. Where were they going to find money to buy uniform when the Department had failed to honour its responsibility? Where do they get the courage to charge nurses for not wearing uniform whereas they are not paid? It’s clear sign of abuse of power and super exploitation of workers which DENOSA will not tolerate. What baffles us is that institutions are charging nurses over a provincial matter. But we will deal with each and every one of those,” adds Shabangu.
DENOSA calls on nurses to contact the provincial office immediately on 031 305 1417 if they have been issued with either warnings of charges. DENOSA also urges nurses not to make any statement without a union representative.
Issued by the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal
For more information, contact:
Mandla Shabangu, DENOSA Provincial Organiser in KwaZulu-Natal
Mobile: 071 643 3369
Tel: 031 305 1417
DENOSA KZN implements Chamber decision due to non-payment of Uniform Allowance by KZN Department of Health ...
Tuesday, 11 July 2017
The Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal commenced with its implementation of provincial bargaining chamber decision for nurses not to wear anything that resembles uniform from 10 July 2017 if the Department of Health in the province has not paid Uniform Allowance that it should have paid to nurses by 1 April already. Nurses will not wear any torn uniform until the Department pays Uniform Allowance.
DENOSA wrote a courtesy letter to the Department on 5 July, informing it of its intention not to wear ‘uniform’ if Uniform Allowance is not paid to nurses by 10 July 2017. By Friday 7 July, there was no sign of payment of Uniform Allowance.
The bargaining chamber in the province which met in June resolved that if the employer is not paying Uniform Allowance to nurses by the 9th of July 2017, no nurse must wear uniform when coming to work on 10 July 2017 until the Uniform Allowance is paid.
As organized labour we have taken this decision out of frustration by endless delays by the employer in paying the Uniform Allowance to nurses, which should have been paid on 1 April 2017 so that nurses could buy the uniform.
In our meeting with the employer in the chamber in February this year, we urged the employer to ensure that Uniform Allowance is paid timeously this time around, unlike the past four to five years where it was paid late. The employer committed to paying on time. But in our meeting in June 2017 when we wanted to find out what the cause of the delay was, the employer could not provide any reasons.
As per the resolution of the chamber, we have written a courtesy letter to the employer (attached here), informing it of our intention on 10 July 2017 if no Uniform Allowance is paid before 10 July 2017.
DENOSA says nurses are not done any favours by being paid Uniform Allowance – it’s not even enough to cover the so-called uniform even for one day.
If there is any intimidation directed at nurses, DENOSA members must please inform their DENOSA shop stewards as their union representatives immediately.
We say #NoUniformAllowance_NoUniform
Issued by the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal
For more information, contact:
Mandla Shabangu, DENOSA KZN Provincial Organiser
Mobile: 072 151 5874
Tel: 031 305 1417
DENOSA notes the ruling by Pretoria High Court on the cancelled SANC exams ...
Friday 30 June 2017
The Democratic Nursing Organisation of South Africa (DENOSA) notes the ruling by the Pretoria High Court today, which dismissed our application to have Circular 2 of 2017 by the South African Nursing Council (SANC) nullified.
The circular orders that the May examinations by bridging student nurses across the country be rewritten due to reports of leakages, which SANC accepted to make an amendment on the dates of rewriting exams to the 19th and 21st of July respectively. This acceptance is an indication that SANC was unreasonable in setting dates for rewriting in a short space of time (they were set for 28 and 30 June respectively).
While DENOSA is still studying today’s judgement, we would like to make it clear that the matter is far from over, and our reasons are the following:
- We have already received reports claiming that the June Exams were already leaked, and to that effect even seen photo evidence circulating on social media currently which proves that leakages are out control at SANC.
- The Acting Registrar failed to ensure that safety measures are improved after the May leakage of Exam papers as means to protect further leakages.
- We still feel strongly as an organisation that SANC must investigate the leakages thoroughly to identify and address areas of weaknesses in its own ranks and ensure that its own internal controls are water-tight first and do not allow for any chance of leakages now and in future.
- The investigation must not be prejudicial to any of students who often get punished for something that the Council shouldn’t have allowed in the first place.
If DENOSA does not challenge the internal controls systems at SANC, another likelihood is that even the exams rescheduled for July can be leaked again.
We feel it is of public interest that SANC expedites the investigation because these continuous leakages undermine the integrity of SANC and by effect the Nursing profession.
After studying the judgment, DENOSA will announce its way forward in this regard. Our way forward will be with the sole interest to protect the nursing profession and that justice, procedural fairness and reasonableness prevail in every action taken by the SANC as enshrined in Section 33 of the Constitution of South Africa.
We challenge SANC to accept our request for a meeting as we have always tried as our first option to resolving matters within the profession.
Issued by the Democratic Nursing Organisation of South Africa (DENOSA)
For interviews, contact:
DENOSA General Secretary, Oscar Phaka.
Mobile: 082 328 9771
For more information, contact:
DENOSA Communications Manager, Sibongiseni Delihlazo.
Mobile: 072 584 41775
Facebook: DENOSA National Page
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: http://www.trialsjournal.com/content/13/1/17
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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