DENOSA KZN invites all healthcare workers to take initiative in the prevention of the rise in numbers of heal...

Media Statement
 
Wednesday, 08 July 2020
 
Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal notes with grave concern the increasing rate of healthcare workers who contract COVID-19 lately and others becoming very sick and others passing away after being diagnosed with COVID-19.
 
This is very saddening, demotivating and at the same time poses a threat to the healthcare system which is already on its knees with shortage of healthcare workers.
 
It is clear that our government does not put lives of healthcare workers as a priority. Apart from being healthcare providers, nurses are human too and are not immune from this deadly pandemic. This is evident in the Government's personnel at an operational level refusing and failing to provide proper PPE to front line workers, thus putting their lives in danger and also refusing to accomodate their views in the management of COVID-19.
 
It has been also evident through the behaviour of some managers hiding information regarding the incidents where there are identified positive cases in the workplace and healthcare workers continue to provide their services in a contaminated area, risking their lives, patients' lives and lives of their colleagues.
 
It is for these reasons that DENOSA KZN  sees the need to invite healthcare workers to rise to the occassion and take initiative in the care of their own lives while caring for the patients, community and the public.
 
This will be achieved through participative communication between healthcare workers, their professional organisation DENOSA through available platfotms including social media and direct conversations.
 
The basic principles of keeping social distancing, washing of hands with soap and water, use of sanitiser, correct use and wearing of masks, avoidance of touching mouth, nose and eyes remain critical and cannot be over-emphasised as they form pillars of safety precautions in the prevention of COVID-19.
 
DENOSA is on a mission to establish the root cause of these increasing infections among healthcare workers and this can only be achieved if every member shares their views, opinions and experiences.
 
These are testing times that require all of us to remain united, focused and vigilant in our everyday lives, in the workplace, at home and in public spaces. Let us lead by example in the communities where we live and in the workplace, because good role modelling can play a remarkable role during this period.
 
Let us stand together to curb the scourge of COVID-19. 
 
End
 
Issued by the Democratic Nursing Organisation of South Africa
 
(DENOSA) in KwaZulu-Natal 
 
For more information, contact:
 
Mandla Shabangu, DENOSA KZN Provincial Secretary 
 
Cell: 0716433369/031 305 1417

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DENOSA Student Movement Limpopo statement on the reopening of the Limpopo College of Nursing. ...

MEDIA STATEMENT
 
Friday, 03 July 2020
 
DENOSA Student Movement in Limpopo welcomes the reopening of the Limpopo College of Nursing to operate under strict COVID-19 regulations. It is in this era that the country and the province are in need of health professionals.
 
Reopening of the college will assist in the production of more nurses who are needed the most in fighting this pandemic. 
 
We urge all students to adhere to lockdown regulations which includes social distancing, washing of hands regularly with clean water and soap or sanitizer and wearing of facemasks. They must refrain from situations which can expose them to the virus.
 
We call upon the Department of Health to provide Personal Protective Equipment (PPE) to students and adhere to the lockdown regulations when they provide training.
 
 Students should never be allowed to attend to COVID-19 cases without supervision. 
 
We welcome extension of programme as remedy to save this academic year to ensure that students get sufficient and quality training that will enable them to provide nursing care. 
 
We call on the Department of Health to continue funding students even beyond the contractual agreement, because the programme extension is as a results of a natural disaster.
 
We condemn in the strongest term possible the inequality and the persistent abuse of students by the Department of health perpetuated by bursary system as a funding model. 
 
Throughout this pandemic, only students on PERSAL system received their stipend while students on bursary system were neglected and left to starve during lockdown. We also note that students received paucity allowances, and the worse part is that amounts are not consistent amongst the campuses. 
 
We demand that all the students on bursary system be paid what is due to them and be backdated from March 2020.
 
Book allowance must be paid to these students to enable them to fulfil their academic commitments.
 
END
 
Issued by Denosa students Movement Limpopo
For more information, contact:
 
Rebotile Maphothoma, Provincial Chairperson
Cell: 082 955 8010

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DENOSA warns of more crisis for the country as more healthcare workers have become patients who need care bec...

Media statement 

Thursday, 02 July 2020 

Given the sharp rise in COVID-19 infections in the country and the rising number of healthcare workers who are infected, the Democratic Nursing Organisation of South Africa (DENOSA) would like to forewarn the country, especially the National Department of Health and provincial governments of the next wave of crisis – the shortage of healthcare workers who will be desperately needed to care for the many patients who are admitted in facilities due to rising infection rate among healthcare workers who are now in quarantine and some are in self-isolation needing care.    

DENOSA reiterates its earlier call to its members not to risk their lives if they are not provided with sufficient PPE. DENOSA has its members, shop stewards and leaders in self-isolation due to contracting COVID-19 while some have passed away. 

More concerning is that this daily sharp increase of infections is at the time when the country relaxes the national lockdown regulations and prepares to allow even more people back to work as various sections of the economy are reopened.  

What will breed more crisis is that the government has abandoned the policing of its own regulations under level 3: taxi operators have forced their way and are loading passengers 100% and resumed with cross-border transportation and there are no reports of enforcement of regulations by law enforcement agencies. Many of these taxi passengers will fall sick and will add to the already overstretched healthcare system, and will be cared for by no one in facilities due to the existing shortage of staff. 

Patients won’t have healthcare workers to look after them as more and more healthcare workers themselves get infected at an alarming rate despite the many calls from labour unions for provision of sufficient personal protective equipment (PPE) to healthcare workers. Healthcare workers themselves now have become patients that need care, and this will leave thousands of patients in facilities without caregivers. 

And the field hospitals that provinces are busy preparing will not have enough healthcare workers because there is a serious shortage of staff even in the existing healthcare facilities, something that we have raised many times and way before this crisis. 

With this crisis still engulfing the country, DENOSA warns of a further crisis that is likely to hit the country hard for years to come: migration of healthcare workers to better working environments overseas as soon as our borders are reopened.  

While they are working their socks off in fighting COVID19 and risking their families, healthcare workers in the public sector have not had their salary adjustments for the 2020 financial year effected by the same unresponsive government four months later. They are demotivated and will leave the country as soon as recruitment for overseas work begins. And countries like the UK, UAE, Saudi Arabia and many others have seen the low death and high recovery rates of COVID-19 cases in South Africa, which speak volumes about the skills of local healthcare workers. Soon this skill will be lost to the nation in large numbers because the only shred that government is clinging on its healthcare workforce is their patriotism and nothing more.

End 

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

For more information, contact:

Cassim Lekhoathi, DENOSA Acting General Secretary

Cell: 082 328 9671 

Simon Hlungwani, DENOSA President 

Cell: 082 328 9635 

Tel: 012-343-2315

Website: www.denosa.org.za

Facebook: DENOSA National Page

Twitter: @DENOSAORG 

 

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Trauma Nursing Matters...

Evidence based practice: Is cricoid pressure effective in preventing gastric aspiration during rapid sequence intubation in the emergency department?

By Ntombifuthi Jennet Ngiba (BN) (UKZN).

There is on-going change within trauma nursing due to increased research in the area. Practices have been routinely adopted as the norm, but subsequently on further examination proven to be useless and more of a risk to the patient (Moore & Lexington, 2012). Research has brought into question practices or techniques such as the application of cricoid pressure during rapid sequence tracheal intubation. This practise was goaled at preventing the regurgitation of gastric content into the pharynx and subsequent aspiration into the pulmonary tree, but now questioned.

Cricoid pressure was briefly defined by Sellick in 1961 as a method used to reduce the risk of aspiration during the induction phase of anaesthesia. Sellick`s technique was to apply backwards pressure to the cricoid cartilage, compressing the oesophagus against the underlying vertebral body (Ellis, Harris & Zideman 2007; Priebe 2005). In this application of pressure the oesophageal lumen is occluded, preventing the passage of regurgitated gastric content into the pharynx and subsequent aspiration into the pulmonary tree (Stewart et al, 2014). Cricoid pressure is incorporated into the overall approach in reducing the chances of aspiration through rapid sequence induction of anaesthesia (Ellis et al., 2007; Priebe 2005). Over the years rapid sequence induction has been adapted by emergency physicians to allow ventilation as required to prevent hypoxia and subsequently termed “rapid sequence tracheal intubation”. Rapid sequence tracheal intubation (RSTI) is now the most widely used technique for tracheal intubation in the emergency department (ED) and cricoid pressure is taught as a standard component of emergency airway management (Ellis et al., 2007).

Despite inadequate scientific evaluation of the risks and benefits of cricoid pressure it is adopted as an integral component of rapid sequence intubation in EDs. No randomised controlled trials have shown any benefit of its use during rapid sequence intubation (Trethewy, Burrows, Clausen & Doherty, 2012). Furthermore, the application of cricoid pressure may be linked to increased risks to the patient such as  impeding airway management, prolonging intubation time by concealing laryngeal view, inducing nausea/vomiting and oesophageal rupture with excessive force (Ellis et al., 2007; Priebe 2005;Trethewy, et al, 2012). Paradoxically, cricoid pressure may promote aspiration by relaxing the lower part of the oesophagus (Ellis et al., 2007). Some case reports note that tracheal intubation was impeded by cricoid pressure and regurgitation occurred despite application of cricoid pressure, possibly due to its improper application (Trethewy, et al, 2012). According to Bhatia, Bhagat and Sen (2014) the application of cricoid pressure increases the incidence of lateral displacement of the oesophagus from 53% to 91%.

However despite this evidence and the outcome of Trethwy’s (2012) RCT the judicial system appears guided in its judgement by outdated practises. A judge in UK ruled against an anaesthesiologist for failing to apply cricoid pressure to a patient with irreducible hernia who had regurgitated and aspirated. The judge argued that “We cannot assert that cricoid pressure is not effective until trials have been performed, especially as it is an integral part of anaesthetic technique that has been associated with a reduced maternal death rate from aspiration since the 1960's” (Bhatia et al. 2014). Therefore one may say that despite cricoid pressure entering medical practice on limited evidence and only supported by common sense, it somehow remains the practice of choice (Bhatia et al., 2014).

Thus it is about time nurses and doctors embrace evidence-based practice within the emergency department and let go of traditional practice that are proven to do more harm than good. There is still a great need for further evidence-based practice within the emergency department, to investigate the validity of the notion that cricoid pressure prevents regurgitation.

Ntombifuthi Jennet Ngiba is a Professional Nurse at Greytown Hospital.

REFERENCES

Bhatia N, Bhagat H & Sen I. (2014). Cricoid pressure: Where do we stand? J Anaesthesiol Clin Pharmacol, Vol 30 pp 3 – 6.

Ellis D.Y, Harris T & Zideman D. (2007). Cricoid pressure in the emergency department rapid sequence tracheal intubations: a risk-benefit analysis. American College of emergency physicians.Vol 50, pp 653 – 665. 

Moore K & Lexington K.Y (2012). Evidence-based practise guidelines for trauma care. Journal of emergency nursing. Vol 38, pp 401-402.

Priebe H.J, (2005). Cricoid pressure: an alternative view. Elsevier. Germany.

Stewart J.C, Bhananker S, & Ramaiah R. (2014). Rapid-sequence intubation and cricoid pressure. J Crit Illn Inj Sci, Vol 4, pp 42 - 49.

Trethewy C.E, Burrows J.M, Clausen D & Doherty S.R. (2012). Effectiveness of cricoid pressure in preventing gastric aspiration during rapid sequence intubation in the emergency department: study protocol for a randomised controlled trial. BioMedCentral. Australia. Retrieved 04 August 2016: http://www.trialsjournal.com/content/13/1/17


 

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National changes in nursing training: South African perspectives 2015...

Dr. Respect Mondli Miya,(D.Lit et Phil)

Senior Lecturer: Psychiatry at Durban University of Technology, Department of Nursing Science

 

Nursing is a career of love rooted in rich and fertile soil governed by caring ideologies and philosophies. Individuals within the profession have strong and inexplicable desires to serve and preserve humanity at all cost. The nursing profession drives the health care system and is forever in the forefront of preventing, promoting and management of various diseases.  Nurses have always been there and have survived trials and tribulations. Nursing demands not only the brain for cognitive purposes but a humble heart, selflessness in daily duty execution. An individual without passion for the sick will never survive a minute of nursing’s demanding tasks.

Nursing novices are professionally socialized and groomed on their first day of training. Noble traditions of nursing are gradually unpacked and monitored up to graduation to enhance relevance and dignity of nursing profession. Nursing demands the utmost respect for humanity even after death itself. Most professions have minimum set of working hours yet nursing philosophy calls and promotes dedication beyond duty. Nursing is a way of living not just mere qualification written on papers but lived and experienced charisma. 

Historically, nursing was viewed as a religious vocation and was predominantly religious in nature which explains chapels, and meditation designated facilities utilized for prayers before commencing daily duties in old hospitals. Nursing training in South Africa before 1976 was hospital-based hence the notion of viewing nursing as a “hands-on” career has been accepted nationally and acknowledged by most prolific nursing scholars who remain sceptical to have nursing pitched at a degree level and offered in higher training of education in South Africa.   

Such training exposed and subjected nurses to poor recognition as a career.  Nurses were abused and viewed as medical officers’ hand maids who were good for nothing but to offer a bed pan, bathing the sick, and carry orders as prescribed without being objective. The training at that time was strict and limiting, even the scope of practice was limited and nobody could imagine a degree in nursing or university based nursing teaching and learning. Hospitals mostly trained nurses in general nursing and later midwifery.

Around 1987, nursing in South Africa was gradually introduced in tertiary education system and scope of practice and curriculum were amended. Nursing graduates were introduced to a 4-year degree obtaining general, psychiatry, midwifery and community health nursing. That made older nurses to feel bitter and never fully accepted university graduates as satisfactorily trained. Even medical officers were threatened and witness role change from nurses as hand maids into fully recognized members of the multidisciplinary health team with independent roles and functionality. These changes failed to bridge the gap of scope of practice and remuneration packages. Even to this date, the university and hospital trained nurses earn the same salary and follow same stream of training regulated by the same nursing Act 50 of 1978 as amended with specification stipulated in Regulation 425 (R.425).

The nursing act 33 of 2005 introduced community service of one year post- training for both hospital- and university-trained individuals. Errors still exist within the nursing education such as same recognition of a hospital and university trained graduate have similar scope of practice, universities are allowed to implement R425 differently. For example, some South African universities train students for six months in midwifery while others dedicate two full years for midwifery and three years for community health nursing which is offered for six months in colleges and some universities. The problem in South Africa is that there is one R.425 and implemented differently from one university to the other.

The current health ministry is proposing nursing training restructurization. In the proposal dated 23 July 2015, it recommends reintroduction of the old nursing training system with a hope of extending the nursing training duration and to phase out the R.425 of Act 50 (1978). The current proposal overlooks scope of practice and remuneration packages of such graduates irrespective of their qualification which is an error not even Occupational Specific Dispensation (OSD) could resolve in 2007. OSD failed to address issues of salaries in the nursing fraternity; an obvious error is that a nursing lecturer is graded as a nursing specialist.

The unresolved question here is: Who teaches the other? And why do they earn same salary if the other is a teacher? Up to the very same date, the public health system continues to fail to distinguish university graduates from hospital nursing graduates yet continues to differentiate auxiliary social worker from a University graduate Social Worker, and experienced Medical Officer from a Master of Medicine graduate. Why not with nursing in South Africa? 

The proposed training changes are as follows: general nursing and midwifery be done in a college over a period of four years without indicating whether that shall be Bachelor of nursing offered in a college which can never materialize as colleges do not offer degrees but universities do. If agreed upon, this will mean degrading the dignity of nursing as a profession over medicine which continues to be offered in the university without interruptions.

According to the proposed plan, nursing training is extended to 9 years (four year of midwifery and general, 18 months of psychiatry and one year of community health) which is unnecessary waste of time for an undergraduate qualification yet medicines years of training have been reduced to 5 years (MBCHB).

 

There is absolutely no need for such drastic changes in the nursing education.  It is alarming to witness MBCHB years of training have been reduced to five years and get paid a satisfactory remuneration package compared to Bachelor of Nursing graduates with stagnant remuneration. The introduction of Masters Degree in Medicines in South Africa is preparing sound clinical researchers and such projects (thesis and dissertations) are evaluated by nursing professors who in turn receive less recognition and degrading salaries compared to MMed graduates.

The South African health system requires the following:

1.     Strong and vocal task team of nursing professors who shall preserve the image and dignity of nursing as a profession and strongly oppose plans to change nursing training.

2.     No college shall be allowed to offer a bachelor of nursing, strictly universities only.

3.     Salary packages to be reviewed and sort clear distinction of a university graduate over a hospital trained graduate.

4.     Revised scope of practice, degree holders be given more opportunity to execute complex clinical procedures and be given better remuneration packages.

5.     Chief Nursing Officer to be more vocal and avoid external influences to disorganise nursing training.

6.     Hospitals to create portfolios and acceptable remuneration packages for all nursing qualifications from a diploma to PHD level.

7.     All South African universities to adopt and implement similar training structure  that is two years of midwifery, two years of psychiatry and two years of community health nursing

8.     Develop a Nursing Ministry by nurses with nurses and for nurses.

9.     MBCHB degree be afforded same status as B.Cur degree thereafter if need be.

10.  South African nursing council to be headed by prolific PHD holders and nursing qualifications be regulated and registered up to PHD level.

11.  Any qualification obtained outside university be regarded as either associate professional nurse and associated medical office until related exam has been endorsed by the regulating body.

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

 
We are professionals, and let us fight to be recognised as such… 
Vuyolwethu Mashamayite - 20150728_073623
By Vuyolwethu Mashamaite 
Ever since I joined nursing in 2005 I have heard nurses say nursing is a ‘calling’ and it's not about money. I couldn't understand why they said so and I still don't.   
I believe that everyone is called by God to be in the profession or job they are doing, unless nurses consider themselves in the same umbrella as ‘Sangomas’ and ‘Preachers’. Those are the people who will leave their profession or jobs and focus on their calling or do both, regardless of whether they are paid or not. 
Perhaps this could be the reason why nurses are under-paid and left to work in extreme unfavourablecircumstances ...because it’s a "Calling".
Don't get me wrong; I have passion and great respect for human life as a nurse. But I cannot keep quiet. Nurses are the most abused professionals by the employer because they consider themselves "called" instead of being employed professionals.
Nurses you are jack of all trades doing everyone's jobs from a cleaner to a doctor but come pay day you are the ones who cry the most because you are underpaid while doing everyone's jobs. I guess it's the consequences of having been “called" instead of being professional.
We feel so comfortable working out of our scope of practice to an extent that we run a risk of performing tasks that we are not equipped to do. When told it's not your scope of practice you tell us of how long you've been doing this and you didn't kill anyone. But the South African Nursing Counci (SANC) is out there nailing nurses and not considering your "calling" but rather your profession and scope of practice.
What hurts the most is the fact that you studied for four years and someone from another discipline who studied the same years is treated and paid better than you. I guess they are professionals and you are in a "calling". 
Nurses, let's STOP hiding behind "CALLING" and start taking our profession seriously. If you don't do it, no one will do it for you. Like it or not we are professionals and let us fight to be recognised as such. 
Vuyolwethu is a nurse based in Kimberley, Northern Cape   
End

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Publications

Nursing Update

         
February 2020

Nursing Update is jointly published by the Democratic Nursing Organisation of South Afr... More.

Curationis

         
January

Curationis provides a forum for cutting-edge theories and research models related to th... More

About us

The Democratic Nursing Organisation of South Africa (DENOSA) in its current form was established on 5 December 1996.

The organisation was formed through political consensus after the transition to democracy and was mandated by its membership to represent them and unite the nursing profession. Prior to this, the South African Nursing Council (SANC) and the South African Nurses Association (SANA) were statutory bodies which all nurses had to join. It was also important after the transition to democracy to incorp... Read more