DENOSA to lead Free State student nurses and nurses on a march to Bophelo House on collapsing health system ...

    Media statement 
    Thursday, 11 February 2016   
    DENOSA Learner Movement in Free State and all student nurses have decided to take their fight to the streets and march to the provincial department offices (Bophelo House) on 15 February to voice their grievances on the dysfunctional and severely understaffed health facilities in the province, and the bad consequences this is having on community members.  Marching and protests seem to be the only language that Free State Department of Health (FSDoH) understands. 
    Students have tried to engage FSDoH for several years and couldn’t reach an agreement on the issues that they have as student nurses in the province.     
    It is high time that student nurses across the province, from different Nursing Education Institutions, stand together and fight for their rights. Nursing is seen as a submissive career in which the government can suppress us as much as they want. 
    There is a severe shortage of nurses around health institutions across Free State, and yet FSDoH introduced and implemented Circular 57 of 2013 and Circular 02 of 2014, which prohibit newly-qualified health professional from doing community service without being registered with their relevant regulatory bodies, which is not a problem for other health professions because their relevant regulatory bodies are quick to register them as community service health professionals. But with newly-qualified professional nurses it’s a different story, because South African Nursing Council (regulatory body for nurses) takes up to six months to register Community Service Professional Nurses. This cause further strain on the already burdened nurses in the province.  
    “The situation in the province’s hospitals is so bad that only three Nurses (1 Professional Nurse, 1 Enrolled/Staff Nurse, 1 Nursing Assistant) nursing 30 patients in a ward. This is highly unacceptable because those nurses will miss some of the important areas in nursing such patients.  Our nurses are fatigued because of this shortage of nurses. FSDoH must employ nurses because there are a lot of nurses who are without permanent jobs in the province. This will reduce the mortality rate in the province because each and every nurse will work within their scope of practice and this will improve patient care,” says DENOSA Provincial Learner Movement Secretary in Free State, Gift Mnyamane. 
    “We also demand a total overhaul of Free State School of Nursing (FSSoN) management structure, because the current one is grossly incompetent. For instance, some student stipends have not been paid up to now and there is no clarity on when these stipends are going to be paid. Student Nurses at Free State School of Nursing depend on these stipends and this means majority of students will have to study and do their practicals in our hospitals and clinics on empty stomachs.”  
    The community of Free State needs to know that student nurses at FSSoN have not even received meals for the past three to four months without stipends. This is highly unacceptable because this department will be producing sick nurses due to malnutrition. 
    We are also calling on the Free State Department of Health to fund all nurses on study leave for their tuition fees, books and accommodation in accordance with the Skills Development Act. We call for their absorption upon completion of their studies and their salaries to be adjusted to meet their qualifications according to Occupation Specific Dispensation (OSD). 
    We call on all student nurses, nurses and the Free State community to join us in a March to Bophelo House which will be held as follows:  
    Date: 15th February 2016 
    Time: 08:00 Place: Bloemfontein 
    Route: From Free State School of Nursing, Southern Campus Next to National Hospital to Bophelo House 
    Issued by the Democratic Nursing Organisation of South Africa (DENOSA) Free State Provincial Learner Movement  
    For more information, contact: 
    Gift Mnyamane, DENOSA Free State Provincial Learner Movement Secretary 
    Mobile: 083 567 1556  

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    DENOSA Eastern Cape appalled by zero intake of student nurses by provincial Health Department for 2016 at Li...

    Media statement 
    Thursday, 11 February 2016
    Eastern Cape health crisis is deepening 
    The Democratic Nursing Organisation of South Africa in Eastern Cape is concerned that Eastern Cape health services are facing a bleak future after the department has stopped training nurses. DENOSA has learned with disbelief that there will be no intake of nursing students by the government nursing college, Lilitha Nursing College in 2016. 
    It has been a practice that, annually, the college will take about 350 new intakes for the nursing course. The annual intake of students ensures the constant supply of nurses into the health system. Every year, nurses are leaving the department through natural attrition and resignations for various reasons. When nurses leave the department, this leaves a big void. The annual intake ensures that these gaps will be closed. 
    DENOSA issued a media statement on 5 February 2016 that it will lead a nurses’ march to Bhisho to hand over a memorandum for the appalling working conditions and shortage of staff. The stoppage of annual intake is sending a strong signal that the provincial health services are heading for disaster. This irresponsible action by the Head of Department (HoD) is further depriving the people of Eastern Cape the quality nursing care that is already under severe strain. This recent development will form a strong part of our march.  
    What is worse is that this happens after the 2016 intake candidates were interviewed and accepted to start the training. These young people are now idling at home not knowing what the future holds for them. 
    DENOSA fears that this is the beginning of the end of nursing career in the province. The college tutors are also facing a bleak future because soon they will be told that they are redundant due to absence of training students. This is an insult to the profession. While we are crying foul about the shortage of staff, the department decides to stop the training of nurses. 
    This zero intake is also counter-productive to the undertaking by the national government to revitilise nursing colleges so that enough health professionals are produced in preparing the ground for the re-engineering of primary healthcare in line with the National Health Insurance (NHI). 
    DENOSA is mobilizing nurses, tutors, student nurses and community members to participate in the provincial march to Bhisho on 18 February 2016.
    Issued by the Democratic Nursing Organisation of South Africa (DENOSA) Eastern Cape 
    For more information, contact:
    Khaya Sodidi, Acting Provincial Secretary
    Mobile: 082 775 7734
    Land Line: 041 484 7323/4
    Facebook: DENOSA Eastern Cape

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    DENOSA Eastern Cape to lead nurses’ march to provincial health offices in Bhisho ...

    Media statement  
    Friday, 5 February 2016 
    The Democratic Nursing Organisation of South Africa (DENOSA) in Eastern Cape will be leading a march by nurses of the province to the provincial department of health office in Bhisho on 18 February to hand over a memorandum of demands in improving the health services in the provinces’ facilities and to object to the Department’s plan to further reduce nurses in facilities. 
    DENOSA held a meeting of all its shop stewards in the province who represent nurses in the facilities on 28 January 2016 and resolved that the only remaining avenue is for nurses and students to hold a march to the department. DENOSA is appalled by the working conditions of nurses and other health workers and the incompetence of the department in dealing with urgent nursing matters in the province. 
    “Nurses of Eastern Cape are making headlines for all the wrong reasons. It is reported daily that nurses commit professional misconduct and no one cares to know the root causes of this. DENOSA has done thorough investigation and concluded that it is wrong and misleading to put the blame squarely on the shoulders of nurses about these incidents. The working conditions are so bad to such that nurses become prone to committing the professional misconducts,” says DENOSA Acting Provincial Secretary in Eastern Cape, Khaya Sodidi. 
    The department had failed dismally in addressing the working conditions of nurses. The chronic shortage of staff and working equipment remain unattended and this compromises the quality of nursing care to patients. The nurses are working under dire conditions which expose them to medico-legal hazards. Once there is a patient incident, the department moves swiftly to discipline a nurse, disregarding the plight that nurses are facing. DENOSA is condemning in the strongest terms the negligence and bad behaviour by those few nurses who disobey the Nurses’ Pledge in serving the patients. 
    But the fact remains that due to severe shortage of staff, nurses work beyond their capacity and they become exhausted which leads to patient incidents.  
    The poor nursing education is also contributing to the patient incidents. The nursing education has deteriorated over the years. The infrastructure of the colleges is so poor that students are unable to focus fully on their studies. Students today are more worried about accommodation than focusing on their studies due to poor or non-existence of nurses’ home. The students are forced to rent outside hospitals, making them easy targets to thugs and exploitation. This is surely affecting the academic performance of the students negatively. After completion of the course, students get allocated to various health institutions to do community service for a year without any supporting programme. Due to shortage of staff, these community service practitioners are left alone to run the healthcare services as inexperienced as they are. They lack proper guidance in order to make them competent nurses. This surely, contributes to the patient incidents during their professional career
    While the health institutions are faced with the shortage of staff, some managers force nurses to carry out non-nursing duties that are supposed to be done by the support staff. The nurses are forced to sweep and mop, dish out for patients and become porters. Some institutions are forcing midwives that are not trained to do theatre procedures to scrub for caesarian sections. Nurses are bearing the brunt of the shortage of staff and there are no signs that the department is willing to address this any time soon. It has become a norm that one midwife looks after four mothers that are in progressive labour which results to poor management of the mothers and that may result to incidents. The department is refusing to release nurses to go and further their studies in order to improve their nursing skills due to shortage of staff.
    “The relationship between the Department and nurses has reached an all-time low level. The department created a social distance by unilaterally implementing policies that have adverse effects to nurses without consulting them. The nursing managers [institutional] are also complaining that most of the big decisions are imposed on them and those who dare to challenge these decisions are easily targeted for victimization. The issue at hand now is the Migration Plan that goes with Review of Organogram. While DENOSA is complaining that there was no consultation on this organogram, the department is arrogantly continuing to implement it. Senior nursing managers are complaining that this organogram is not addressing the shortage of staff but it is rather reducing the already lean current staff,” explains Sodidi.
    This means that once this organogram is fully implemented, we will see less nurses being employed while the rate of burden of diseases is escalating at an alarming rate. It is therefore impossible to expect nurses to perform optimally under these conditions. The department is not only undermining the collective agreements it signed with organised labour, but it is also defiant in implementing the decisions taken by Health Portfolio Committee in addressing some of the challenges faced by the health institutions. So we are dealing with arrogant senior managers and we are therefore calling for national department of health to intervene and put the province under administration, section 100, for the sake of patients and community members.   
    Issued By Democratic Nursing Organisation of South Africa (DENOSA) Eastern Cape
    For more information, contact:
    Khaya Sodidi, Acting Provincial Secretary
    Mobile: 082 775 7734
    Land Line: 041 484 7323/4
    Facebook: DENOSA Eastern Cape

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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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    From Ntandane Nyebe, a nurse in Cape Town. 

    As the backbone of any healthcare system in the world, it is my honest opinion that nurses deserve proper compensation for the hard work they put in in improving the health of South Africans. After all, nurses are the proverbial Alpha and Omega. The following 10 points are the reasons.    

    1. We are short staffed- one person does a work that should have been done by 4 people.

    2. We have gone through formal education, we have got degrees etc, we are accountable to a nurses' board, we got to be paid decent salaries like Pharmacists and doctors- YES.

    3. The health institutions do not have enough of the unskilled workers e.g. porters and cleaners- Nurses are then forced to work as unkilled workers-on top of their scope of practice, when the need arises.

    4. There are many instances where doctors go & do shopping at the malls when they are on call, or simply some institutions have shortage of doctors- when an emergency situation arises- a nurse does a work that was supposed to be done by the doctor to save the client. Same case when there no social workers- nurses must run around doing what was supposed to be done by a social worker.

    5. We do a risky job - I've heard of many nurses & docs who died from contagious diseases- especially trauma staff.

    6. The governing party admitted in 2011 that there is a dire shortage of nurses in SA, which means nursing is a scarce skill in SA and the last time I checked professionals with scarce skills were getting paid higher salaries in SA.

    7. We work under bad conditions- institutions with no proper security, lack of proper equipment etc. But we always try and do our best to improvise for the benefit of the clients.

    8. Nurses who go & work overseas they don't go there just for fun or to experience different culture- they leave because they feel they are being overlooked by Government in terms of salary- meanwhile SA loses specialised nurses with experience - Government who cares about its people would try and keep nurses by raising salaries.

    9. We deserve better. Our Government can afford to increase our salaries by 100%. There is money in SA- we have seen structural developments in SA & they have been built by companies who have been paid millions and billions.

    10. ANC Government promised to increase salary of Nurses when they were in Mangaung in 2012/13. 

    I Thank You


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    Nursing Update

    January 2016

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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