Democratic Nursing Organisation of South Africa

By Audrey Chiduku

In commemoration of Human Rights month, it is of relevance that we reflect on nurses’ rights. Nurses’ rights are governed by different Acts. As citizens of the country, nurses have human rights which are governed by the Constitution of the Republic of South Africa, Act 108 of 1996; employee rights of nurses are contained in the labour laws of the country including the Labour Relations Act 66 of 1995 and the Basic Conditions of Employment Act 75 of 1997. Professional rights of nurses are set out specifically in the Nursing Act 33 of 2005.

In their everyday lives as professionals and while executing their duties; nurses observe, uphold and protect patients’ rights in many ways. They advocate for patients’ rights by making sure that necessary and relevant care is rendered at all times. However, nurses rights are often times overlooked. There seem to be some confusion around the concepts of rights, duties and responsibilities of nurses.

The South African Nursing Council (SANC) lists the following nurses’ rights on their website:

Nurses have the right to:

• Practise in accordance with the scope which is legally permissible for his/her specific practice;
• A safe working environment which is compatible with efficient patient care and which is equipped with at least the minimum physical, material and personnel requirements;
• Proper orientation and goal- directed in-service education in respect of the modes and the methods of treatment and procedures relevant to his/her working situation;
• Negotiation with the employer for such continuing professional education as may be directly or indirectly related to his/her responsibilities;
• n the case of a registered person, equal and full participation in such policy determination, planning and decision-making as may concern the treatment and care of the patient;
• Advocacy and protection of patients and personnel for whom he/she has accepted responsibility;
• Conscientious objection provided that :
• he employer has been timeously informed in writing;
• it does not interfere with the safety of the patient and/or interrupt his/her treatment and nursing;
• Refuse to carry out a task reasonably regarded as outside the scope of his/her practice and for which he/she has insufficient knowledge or skill;
• Not participate in unethical or incompetent practice;
• Written policy guidelines and prescriptions concerning the management of his/her working environment;
• Refuse to implement a prescription or to participate in activities which according to his/her professional knowledge and judgement , are not in the interest of the patient;
• Have disclosed to him/ her the diagnosis of patients for whom he/she accepts responsibility;
• A working environment which is free of threats, intimidation and/or interference;
• A medical support or referral system to handle emergency situations responsibly.

These rights are associated with responsibilities, liabilities and accountability. Nurses cannot exercise their rights without accepting the corresponding duties and responsibilities. According to Nursing Regulation R387, nurses are responsible for their Acts and Omissions. This implies that as nurses we have to exercise our rights responsibly because we are answerable for all our actions.

As members of a caring profession, nurses are expected to be humble and somewhat meek. Society has a lot of expectations and tends to forget that nurses are also human with associated emotions. In some cases nurses become soft targets from frustrated patients, stressed family members as well as frustrated members of the multi-disciplinary team. At times nurses’ rights are overlooked at the expense of patients who happen to be at the core of the very same nurses’ attention. Nurses find themselves in an unequal relationship with their patients whereby the patient is ill and dependent on the nurse for care and assistance while the nurse is empowered with skill and knowledge and is in charge of the situation.

Sometimes there is a clash between the nurses’ rights and patients’ rights. As an example, a patient has a right to withhold their HIV status while on the other hand a nurse has the right to have disclosed to him/ her the diagnosis of patients for whom he/she accepts responsibility.

According to the World Health Organisation (WHO), health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. An environment where human rights are protected is an environment where the health of employees is upheld and promoted. For nurses to function effectively, the working environment must be therapeutic, stress-free and conducive to working. Protecting nurses’ rights can be an effective way to ensure positive health for nurses as well as patients in their care. Human rights violations can have serious consequences physically and psychosocially. The happier the nurses, the more pleasant the hospital environment will be and the more positive the impact will be on patients’ recovery.

Nurses must stand up for their rights without compromising the rights of their patients and their professional image. It is the nurses’ responsibility to protect their rights and not to infringe upon other people’s rights. The nurse has responsibilities towards the patient, the employer, society, the nursing profession, and above all, to self.

When nurses feel that their rights have been violated, they must follow the correct channels of communication to address the issues without aggression or fear. There are always better ways of resolving conflict amicably. Remember that in most cases it is not what you say but how you say it that matters. Let us celebrate, preserve and protect our rights as nursing professionals.