Democratic Nursing Organisation of South Africa

DENOSA warns Treasury to back off from inciting violence by wanting to renege on implementing salary increase...

Media statement

Wednesday, 26 February 2020   

The Democratic Nursing Organisation of South Africa (DENOSA) is disgusted by yet another act of mischief and undermining of the collective bargaining agreement by government which tabled a proposal to offer a zero increase for final year of the public sector salary agreement (2020/2021) at the bargaining chamber yesterday, which organised labour rejected outright.

This happens not long after the Independent Commission for the Remuneration of Public Office Bearers has recommended that public representatives at national, provincial, and local government levels, members of the judiciary and magistrates and traditional leaders, be remunerated from 3% to 4% more, backdated to 2019.  

In essence, government is becoming the first to break this collective agreement especially clause 3.3 of Resolution 1 of 2018 on salary adjustment which says the salary adjustment for the period 1 April 2020 to 31 March 2021, effective from 1 April 2020, for employees on salary levels 1-12 will be as follows: 

-          Level 1 to 7:   Projected CPI + 1.0%

-          Level 8 – 10:  Projected CPI + 0.5% 

-          Level 11 – 12: Projected CPI   

Government regards the collective bargaining platform as a joke. Organised labour is dealing with a government that has no respect for collective bargaining agreements. The meeting called at the bargaining chamber ended and organised labour rejected this nonsense and expects government to be respectful enough to honour this agreement come 1 April 2020. Government workers need no mobilization to strike as they were never happy with this agreement in the first place. 

We warn that once Finance Minister, Tito Mboweni, speaks untruth in today’s Budget Speech in Parliament about intending to offer no salary increase to public servants this year, as a means to please other people, he must know that he has declared war between government and labour. 

For too long, government has been flirting with labour unrest, which began with:

-          Threats to cut 30% of public servants personnel numbers; 

-          Followed by a threat to cut 10% of public servants’ salaries; and 

-          A threat to cut performance bonuses. 

DENOSA warns government not to start what it cannot finish. What about high vacancy rates of nurses and other public servants that remain unfilled in government hospitals and clinics?

End 

Issued the Democratic Nursing Organisation of South Africa (DENOSA) 

For more information, contact:

Cassim Lekhoathi, DENOSA Acting General Secretary

Mobile: 082 328 9671 

Simon Hlungwani, DENOSA President 

Mobile: 082 328 9635 

Website: www.denosa.org.za

Facebook: DENOSA National Page 

Twitter: @DENOSAORG   

DENOSA Gender structure congratulates DENOSA Student Movement for its congress outcomes and on addressing th...

Media statement   

Monday, 24 February 2020

The Democratic Nursing Organisation of South Africa (DENOSA) National Gender Committee (NGC) would like to congratulate the DENOSA Student Movement for concluding its 6^th National Congress which was held over the weekend in Ventersburg in the Free State from 21-23 February, and particularly for addressing the big elephant in the room, the gender question, as reflected in the outcomes of the election results which saw five women occupying five positions out of the six national office bearers (NOBs) positions. 

This speaks volumes and inspires hope even to the mother body that the issue of gender question needs to be addressed constantly within the organization’s structures. There has been a constant challenge in reaching acceptable and appropriate levels of gender equality within the structures of the organisation, which is not reflective of the make-up of the organisation’s membership that is more than 80% women-dominated. 

These outcomes have proven beyond reasonable doubt that the student movement have a big heart! We call on them to share their perspective constantly with the rest of the DENOSA structures.   

These election results prove that DENOSA Student Movement is indeed supposed to be the think-tank of the organisation even on sensitive matters and questions. We hope this historic achievement by the Student Movement breaks permanently what has become a strange and unfair ‘normal’ expectation – that men happen to make better leaders than women – which is far from the truth. 

The NGC appeals for more support to be provided to this first-in-a-lifetime generation of leaders so that their success speak the truth that all people are equal and no specific gender has superpowers of leadership over the other. 

There are many gender issues that affect students and society alike, and NGC will work closely with the National Student Movement to tackle these challenges head on. 

We wish these izimbokodo all the best in their term of office and may their ascendance inspire more women to take up positions of responsibility and leadership positions in the structures of the organisation.  

Malibongwe igama lamakhosikazi!  

End  

Issued by DENOSA National Gender Committee  

For more information, contact: 

Thandeka Msibi, DENOSA 2^nd Deputy President and Chairperson of DENOSA National Gender Committee  

Mobile: 082 328 9845 

Tel: 012 343 2315 

Website: www.denosa.org.za

Facebook: DENOSA National Page 

Twitter: @DENOSAORG 

DENOSA Student Movement to hold 6th National Congress in Ventersburg on 21-23 February...

MEDIA ALERT

Wednesday, 19 February 2020 

The Democratic Nursing Organisation of South Africa (DENOSA) Student Movement will hold its 6th National Congress at the Aldam Resort and Conference Centre in Ventersburg, Free State, from 21 to 23 February.

The congress, to be attended by over 200 delegates made up of student nurses from the country's institutions of higher learning, will be reflecting on the variety of challenges that confront nursing education and students. 

These challenges include:

-          Youth unemployment in the country;  

-          Poor safety in residences as well as in the clinical areas for student nurses and nurses alike; 

-          The horrible effects of the implementation of a bursary system at institutions; 

-          Exploitation of student nurses in the clinical areas due to unfilled vacancies of nurses; 

-          Poor student accompaniment of students in clinical practice areas; 

-          Non-absorption of post- community service nurses in many provinces; 

-          Non-placement of student nurses into community service positions in many provinces; and 

-          The New Nursing Curriculum;  

The congress will also reflect on the latest developments and trends in the health sector globally, including the outbreak of the Coronavirus that nurses are at the forefront of fighting as well as the declaration of the year 2020 as the International Year of the Nurse and Midwife. The students will also reflect on the country’s preparedness towards the implementation of the National Health Insurance (NHI) as means to achieve Universal Health Coverage for all South Africans. 

The congress will be addressed by various representatives from the youth formation, including South African Student Congress (SASCO), Young Communist League of South Africa (YCLSA), PSI Young Workers, and COSATU Young Workers Forum among others.  

The congress will elect new leaders to lead student matters for the next two years, which will be announced on the last day on Sunday. 

Members of the media are cordially invited to the Congress to report

End 

Issued by DENOSA National Student Movement  

For more information, contact:

Yomelela Mnqabashe, DENOSA National Student Movement Secretary

Mobile: 071 624 6423 / 076 613 8952 

Morgan Thabiso, DENOSA National Student Movement Chairperson

Mobile: 071 624 5490 

Website: www.denosa.org.za

Facebook: DENOSA National Page 

Twitter: @DENOSAORG  

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

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.

WHY DO WE SAY NURSING IS A CALLING? ...