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Statement by DENOSA on the subsequent developments of the incident at Mamelodi Hospital recently
Statement
Wednesday, 05 June 2019
As the Democratic Nursing Organization of South Africa (DENOSA) in Gauteng, the biggest nurses’ organization in the country, we have seen it fit and proper to convene this media briefing in order to respond to the many speculations that have been making rounds following last week’s incident at Mamelodi Hospital in Tshwane in which the video of a patient, 76-year-old Martha Marais, circulated on social networks.
By now, it has since become common knowledge that accusations have been leveled towards nurses over this incident. Furthermore, it has also become common knowledge that whenever there is an incident in health facilities, nurses have always come under fire, sometimes rightly and sometimes wrongly. But very often nurses have been falsely accused and blamed wrongly.
Because nurses are the face of a healthcare system, it has become a discomforting norm that they are the ones to be blamed even before investigations are done and concluded on incidents in which they are alleged to have caused. But often, when investigations exonerate nurses there has never been a single apology. As DENOSA, we say this is unfair to nurses and it needs to stop.
It is for this reason, therefore, that we have come to a decision to add the voice of nurses on this matter, because the only laud voice that has been making noise has been that of the Ministry. We would like to highlight what we deem as three key areas:
- The overview of conditions of service and patient care at Mamelodi Hospital leading to the incident;
- The short synopsis of the nurse cadre who has since been implicated in the incident; and
- The way forward
Coming to the incident itself at Mamelodi Hospital, in which we are made to believe that an investigation is underway, we would like to highlight the following:
Contrary to the verdict of the court of public opinion, four staff members at the hospital have been issued with letters of intention to suspend, namely:
- Two doctors;
- A security guard; and
- A nurse
But the circumstances surrounding the announcement by the MEC of Health to place theses officials on special with immediate effect leaves our spine cold, and for the following reasons:
- Because the MEC announced to the media that they have been placed on special leave on Sunday, and yet they only got their letters of intent to suspend on Monday and they were not placed on special leave
- In the case of a nurse who has been implicated in this, she submitted her responding letter on why she should not be suspended on Tuesday 04 June 2019.
As the processes of investigations are underway, we may not dwell much on the specifications of the incident nor attempt to expose the condition of the patient, but it is only fair to highlight the following areas of concern for nurses and other health workers working at Mamelodi Hospital:
v Mamelodi Hospital is an abnormal facility where health strategies or guidelines and infection control reports’ recommendations are hardly complied with;
v Patients do not have privacy nor are there sufficient resources to cater for their health needs while under the care of the facility: there are not enough beds or seclusions and many areas are open plans;
v Casualty section at the hospital does not have ventilators and Infection Control team had come to the hospital and they instructed that no one should go or be stationed at the Casualty because the area is highly infectious; yet patients are still cared for there and there have been no changes from the time the Infection Control issued the directive.
v Shortage of beds for patients is a daily occurrence, and often patients are left to sleep on the floor at the Casualty Section for up to a week while waiting for beds;
v Psychiatric Patients that are under 72-hour observation stay well beyond this stipulated time at the facility without being referred, and often under the care of nurses at Mamelodi Hospital who are not trained on caring for psychiatric patients;
v By the time of the incident at hand, there were more than 71 patients at Casualty Section in various wards (trauma, medical, emergency, and resuscitation rooms) including 10 psychiatric patients. These were looked after by a mere 8 nurses.
Out of these continuing poor conditions, nurses are still expected to perform to the best of their ability and play their advocacy role. As DENOSA, we must say that it has become extremely difficult to fulfill this role under the current circumstances.
Making it more difficult for nurses to become effective in their work is the lack of speedy intervention from the South African Nursing Council (SANC) as a regulatory body for nurses in the country on systemic and structural challenges that hinder nurses from performing their duties effectively after they have satisfied and passed competency assessments that are set and overseen by the Council. The view of the Council is always that once a nurse agrees to take care of a patient, such a nurse will be held responsible if anything goes wrong with the patient. This is in line with the ethos of total commitment to patient care, which is perfect in a normal environment where nurse-to-patient ratios are set. But it becomes unreasonably punitive to nurses if only eight nurses are allowed to care for over 100 patients at any given time.
The country produces good quality nurses that are well sought-after by developed countries all over the world.
Coming to the implicated nurse, we can say the following about her:
- She has been a nurse since 1991 (28 years of public service under her belt);
- She is a mother of two;
- Throughout her career spanning 28 years, she has never been charged with either negligence or dereliction of duty and she is passionate about nursing and patient care;
- She has grown into the profession through the ranks into becoming a specialist nurse in trauma care;
- She has done courses in Midwifery, Management, Community Education, and she did an Advanced course in Trauma Care;
As a nurses’ organization, we are concerned that, if conditions of service do not improve so that positive patient experience is realized, more and more of the hardworking nurses like this one are going to be charged.
Way forward
The investigation into this matter must be done by the office of the Health Standard Compliance (OHSC), where the Health Ombudsman is located, because this is the only neutral body that as DENOSA Gauteng we have full confidence in. The investigation by the Gauteng Department of Health in our view is already compromised by the posture taken since the matter came out. They have already prejudiced the nurse through their actions like misinforming the public about placing the officials on special leave whilst that did not happen and in fact as we speak there is no special leave given to our member.
We are calling for the report of the Health Ombudsman to be used for remedial action not that of the Gauteng Department of health.
As a way forward in this regard, all that we are asking for as a nursing fraternity is a commitment from the MEC of Health that, if the implicated nurse is exonerated by the investigation, he comes out and pronounce on the outcomes of such processes. This is because, often, nurses have been lambasted by the public for its bad experiences in facilities for things that are not of nurses’ doing and responsibility.
We also call on hospital boards to be vocal enough about the poor conditions in hospitals so that these are addressed. These wrongs have been at Mamelodi Hospital for years.
We also appeal for support from members of the media in the form of their daily work. We believe there is a lot that can be solved if members of the media visited our facilities and assess for themselves the conditions that both patients and nurses are cared for and care under.
End
Issued by the Democratic Nursing Organization of South Africa (DENOSA) in Gauteng
For more information, contact:
Simphiwe Gada, DENOSA Gauteng Provincial Chairperson
Mobile: 072 563 1923
