The Mandoza ambulance ordeal is a daily reality for many patients who often die unnecessarily...

    Media statement 
    Tuesday, 20 September 2016   
    The Democratic Nursing Organisation of South Africa (DENOSA) notes with sadness the passing of Kwaito star, Mduduzi ‘Mandoza’ Tshabalala, and sends its sincere heartfelt condolences to his family and his music fans.   
    However, DENOSA would like to point out a serious concern in relation to media reports that he had to wait for an ambulance for three hours, to no avail. If these reports are true in the case of Mandoza, this highlights an embarrassingly grey area and a glaring weakness in our healthcare system – poor resource allocation in health. The stories of delayed ambulances get told in most funerals of patients, which unfortunately hardly get the media attention.   
    Many patients have long given up from calling ambulances in cases of emergencies because of bad previous experiences of delays. The shortage of resources in our facilities often leads to unnecessary deaths of patients, and DENOSA has been crying about this issue for years. Patients in rural areas are the worst hard hit by this and, regrettably, most have lost their lives because of this very shortage whereas they could have easily received attention at the point of care and, probably, would still be with us today. 
    DENOSA once again highlights this serious issue for communities to take note of. Similar to the shortage of nurses in facilities, the shortage of ambulances, and poor administration thereof, confront the vulnerable at the greatest time of need.  
    Simply put, if communities do not realise the seriousness of this matter and call for it to be addressed, there may be very few people left to raise the red flag when you are the one needing this help of an ambulance, because most would have passed away already!  It is the same issue with the shortage of health workers such as nurses. Patients may pitch at their nearest facility one day and find that there are no nurses, because they got sick because of heavy workload and depression. Who will take care of patients?    
    Issued by the Democratic Nursing Organisation of South Africa (DENOSA) 
    For more information, contact: 
    Oscar Phaka, DENOSA Acting General Secretary
    Mobile: 060 583 4691 
    Sibongiseni Delihlazo, DENOSA Communications Manager
    Mobile: 079 875 2663 
    Tel: 012 343 2315 
    Facebook: DENOSA National Page 
    Twitter: @DENOSAORG  

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    DENOSA in Eastern Cape commends the move made by the provincial department of health in the province to advertise 180 nursing positions across the province to help boost primary healthcare ahead of the National Health Insurance Scheme (NHI). DENOSA is in full support of implementation of NHI, so any little move made in realizing NHI is highly commendable. 

    Given the number of posts advertised, it is obvious that this is a drop in an ocean due to chronic shortage of nurses. However, we take this as a step towards the right direction. We notice that the posts advertised are for Operational Managers (OMs) which is not good enough to run a facility. This means that each clinic will receive one additional nurse (operational manager). For any clinic to render effective primary healthcare needs support staff services, good infrastructure and security. Most of the posts advertised are in the periphery of the province where it is difficult to retain clinicians due to poor infrastructure and lack of safety.  

    It is therefore disappointing that the department is not revealing its plan as how it is going to capacitate primary health facilities in realizing the implementation of NHI in those rural areas. The advertised posts have been vacant for more than 5 years and nurses have been acting in those posts. We are very pleased that finally the department is heeding our call of filling the vacant funded posts. We are hopeful that more nursing posts will be advertised within this financial year to ease the burden of work the nurses are subjected to on a daily basis.

    It is noted with disappointment, however, that the department is not involving organized labour in the processes towards the implementation of NHI. However, DENOSA remain resolute and committed in realizing NHI.


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

    For more information, contact:

    Khaya Sodidi, DENOSA Acting Provincial Secretary in Eastern Cape

    Mobile: 082 775 7734

    Facebook: DENOSA National Page

    Twitter: @DENOSAORG  

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    DENOSA KZN not accepting provincial health department’s unilateral withdrawal of agreement with student nur...

    Media statement
    Wednesday, 07 September 2016   
    The Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal is refusing to accept the mischievous act by the KZN Health Department of unilaterally withdrawing itself from the agreement it has entered into with student nurses in the province, by unilaterally issuing a circular last week (circular 54 of 2016) withdrawing all previous circulars that bind it to the existing agreement.  
    DENOSA calls on the department to formalize the circular and consult broadly with stakeholders first by next week, or else DENOSA will mobilise all students from all 12 campuses and pay the department a courtesy visit at its offices if it fails to do so. 
    The agreement between student nurses and the department is that the department is to take full responsibility for the employment of 300 students upon completion of their four-year course each year in the province or to absorb the close to 250 enrolled nurses the  department has taken to bridging course into professional nurses this year. This agreement also applies to those nurses that do specialty courses, as well those who are bridging from being enrolled nursing assistants to enrolled nurses, and those bridging from being enrolled nurses to professional nurses. 
    The new circular, which was issued without consulting labour unions, states that the department will no longer offer students employment upon completion of their studies, and that they will sit at home at the end of this year and wait for job adverts to appear on papers and only apply when adverts are placed. DENOSA says, not so easy. 
    At the time when shortage of nurses is gross in the province, DENOSA finds this unilateral decision irresponsible and inconsiderate of the compromised quality of care that patients are currently subjected to in facilities as a result of severe shortage. 
    Students must not be the sacrificial lambs for the improper financial planning by the department’s HR. Vacancies are not coming out and now students are made to sit at home forever upon completion of their community service. 
    As if there is no shortage of nurses already, the circular says students are free to look for employment elsewhere, even in the private sector, whereas taxpayers’ money was used to enroll the students. Now the private sector must benefit from intake meant for public facilities?  
    What is worse, and which DENOSA takes great exception to, is that those lower category nurses who have completed their bridging courses to become professionals nurses are being used by managers to perform the work of professional nurses and yet they are not paid for that. DENOSA warns managers against such abusive practice and calls on those affected nurses to come forward and expose this brutal practice. 
    Issued by the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal.
    For more information, contact:
    Mandla Shabangu, DENOSA Provincial Organiser, KZN 
    Mobile: 082 443 4170 
    Facebook: DENOSA National Page 
    Twitter: @DENOSAORG  

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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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    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