DENOSA commences legal action against SANC on cancelled exams for student nurses doing bridging course...

    Media statement 


    Wednesday, 21 June 2017   


    The Democratic Nursing Organisation of South Africa (DENOSA) had given South African Nursing Council until 10h00 today to retract its irrational and ill-conceived Circular 2 of 2017, failure of which DENOSA made it clear that it will take the legal route against the Council. 


    On 12 June, the Council, which is the regulatory body for Nursing in South Africa, issued Circular 2 of 2017 to all Nursing Education Institutions (NEIs), stating that it has come to its attention that some students had access to the exam papers prior to the day of the examination and that, while its investigation is still underway, it has decided to cancel the examinations and set the new date for all students to rewrite the examinations on 28 and 30 June 2017 respectively. 


    The Council has not responded to our letter by 10h00 today and until this hour. Consequently, DENOSA has briefed its lawyers to initiate the legal action against the Council. Through its legal representatives, DENOSA has written a letter of demand to the Council to immediately nullify their prejudicial circular and demand to see the following: 


    -          The resolution of the Council to issue the circular and cancel the May exams; and 

    -          The evidence as a basis for the decision to issue the circular by the Council. 


    Prior to this legal route, DENOSA made a request for an urgent physical meeting with the Council on Monday, but the Council through the office of the Acting CEO/registrar cited unavailability this whole week.  


    DENOSA is making it known that it won't allow student nurses to be subjected to an ill-considered and unfair decision to rewrite the exams and be the ones punished for SANC's loose internal controls. 


    DENOSA calls on all its structures to mobilise its members and student nurses and ensure that no student complies with this all-punishing and unfair circular by rewriting exams that thousands of students have already written as that would be covering up for SANC's inefficiencies as a regulatory body. SANC must first conclude its own investigation before jumping guns and concluding on new dates for rewriting and cancellation of the May examination. DENOSA fully supports the investigation by the Council, but believes that fairness, consideration and justice should be at the core of its functioning.  


    All the affected student nurses have absolutely nothing to be apologetic for if the investigation has not been done and concluded by the Council first. This decision is creating all inconvenience for institutions as they have to reschedule programmes and all students placed at health institutions must be recalled at the exam time and coordination of their study period will be severely interrupted for something that was not of their own doing.    


    Furthermore, DENOSA calls on SANC Acting Registrar to step down if she can't steer the profession towards the path of fairness. She has proven not to be helpful when it mattered the most for the matter concerning student nurses. We hope it is not due to bitterness because of our march on 22 February when we complained about the Council’s failing of the nursing profession.  


    All these students are extremely demoralized and feel that the nursing profession is increasingly becoming distasteful of them, and that’s unacceptably prejudicial treatment that they don’t deserve at any time of day considering their full commitment to and passion for the nursing profession. 


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

    For more information or interview with DENOSA General Secretary, Oscar Phaka, contact:

    Sibongiseni Delihlazo, DENOSA Communications Manager

    Mobile: 072 584 4175  


    Facebook: DENOSA National Page 

    Twitter: @DENOSAORG 

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    DENOSA congratulates Justice Ray Zondo for his appointment as Deputy Chief Justice...

    Media statement  


    Friday, 9 June 2017  


    The Democratic Nursing Organisation of South Africa (DENOSA) would like to congratulate Justice Ray Zondo for his appointment as Deputy Chief Justice of the Constitutional Court by President Jacob Zuma on 7 June. 


    DENOSA can vouch for Justice Zondo. Just after the dissolution of homelands nursing associations following negotiations by progressive nurses at the dawn of democracy in the 1990s, Justice Zondo became the legal adviser of the progressive nurses from all provinces that had dissolved in favour of one nursing organisation representing all nurses of the country on a voluntary basis. He assisted the nurses at the most critical time of their struggle, when it was South African Nursing Association (SANA) that was showing great reluctance to dissolve. 


    It was his sharp negotiation skills and legal mind that assisted progressive nurses in winning the battle to persuade SANA to finally dissolve. He was a lawyer well-versed on the broader struggle for democracy in South Africa. Soon after that victory, DENOSA was formed in 1996, after years of negotiations. 


    Coordinator of the dissolution process from progressive nurses at the time, and former General Secretary of DENOSA, Thembeka Gwagwa remembers Justice Zondo’s immense contribution. “Just after we had won the battle for all associations to dissolve, a new fight emerged over the name of the new organisation. Justice Zondo simply asked all of us: ‘What is in a name when all that core struggle which you had fought for had been achieved? The issue of the name must simply be taken to the congress for members to decide on.’ That’s what we did, and that’s how the name Democratic Nursing Organisation of South Africa (DENOSA) came about.”


    With his impeccable track record in the legal fraternity, DENOSA is confident that his appointment to the second-highest office in the country’s judicial system will only benefit South Africa greatly. 


    DENOSA wishes him all the best in his new responsibility. 




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


    For more information and for interviews with DENOSA General Secretary, Oscar Phaka, contact:


    Sibongiseni Delihlazo, DENOSA Communications Manager

    Mobile: 072 584 4175 or 079 875 2663 



    Facebook: DENOSA National Page 

    Twitter: @DENOSAORG

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    DENOSA Mpumalanga disappointed by inconsiderate and reckless act by community members who attacked nurses a...

    Media Statement

    Tuesday, 06 June 2017

    The Democratic Nursing Organisation of South Africa (DENOSA) is taken aback by the reckless and inconsiderate act of community members who gained entry at Delmas Hospital on Saturday night and attacked nurses because they are the ones who pay their salaries.

    What is more disappointing is that they claimed to represent civil organisation SANCO while some were wearing ANC T-shirts.

    "As an organisation, we are particularly disappointed that SANCO is showing complete disregard of the issues that nurses are faced with in communities where they work like Delmas," says DENOSA Mpumalanga Provincial Secretary, Mzwandile Shongwe.

    "In fact, this will only fuel the tensions. Nurses at the hospital are not touching work until the matter is resolved. They also feel that police never attended to the issue when they were called by nurses after hours of physical attacks by rogue community members at Casualty section, which further prevented nurses from caring for patients at the facility. Police way after the event, and when they arrived they never acted because perpetrators were people known to them."

    DENOSA once again highlights the issue of poor security in health facilities which remains unattended.

    There were only four securities deployed at the facility by the provincial department, and none of them is armed. The rogue community members forced their entry into the facility with full knowledge that the security is not armed.

    DENOSA hopes the community will understand why nurses don't want to touch work from yesterday until the matter of security is attended to and assurance is given that a similar event will not happen again.

    DENOSA further demands that the perpetrators get arrested because they are known to the police. DENOSA demands include that security personnel in government be in-sourced.

    "It would appear as though nurses must first make a drastic decision, like allowing death of patients, before their fair demand for a safe working environment is provided to them. Nurses are picketing outside the facility demanding security. They are not essential service anyway, and nothing shows that they are," concludes Shongwe.


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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 2017

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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