DENOSA to take government to CCMA if it fails to adjust salaries of public servants from 1 April as agreed an...

Media statement 

Friday, 20 March 2020

 

The Democratic Nursing Organisation of South Africa (DENOSA) would like to advise both Treasury and Department of Public Services and Administration of the anger of public servants on reports that government will not be honouring its side of the collective bargaining agreement come 1 April this year while they continue to do the work of 3 or more workers who are not hired by the same government.

 

DENOSA further advises government that it will take it to CCMA if it fails to implement the last leg of the collective bargaining agreement of adjusting salaries of public servants from the 1st of April 2020.   

 

Maybe both ministers of the two departments have not come to witness the anger and low morale of public servants upon these threats to renege from its undertaking. 

 

DENOSA is concerned that the commitment levels that many nurses have shown since the outbreak of COVID-19 will collapse because of this lack of appreciation. 

 

It is disappointing that government, as the promulgater of laws in the country, is the first to break the same laws while it expects others to be abided by the same laws. 

 

The public must remember this day as the day when chaos and labour unrest was started by government. There is nothing that will be stopping workers from fighting for their hard-earned rights when it is the same government that threatens to take away such rights.

 

All nurses in the public sector are willing to down tools if government shows its middle finger and disdain to public servants by refusing to adjust their salaries as if they are the ones responsible for the collapse of this country's economy.

End 

 

Issued by DENOSA

For more information, contact:

 

Cassim Lekhoathi, DENOSA Acting General Secretary

Mobile: 0823289671

 

Simon Hlungwani, DENOSA President

Mobile: 0823289635

 

Website: www.denosa.org.za

Facebook: DENOSA National Page

Twitter:@DENOSAORG

Read more
DENOSA Limpopo statement on shortage of water and personal protective equipment for health workers in some fa...

Media Statement
 
Thursday ,18 March 2020
 
 
The Democratic Nursing Organisation of South Africa (DENOSA) in Limpopo Provincial Office is inundated with calls from members and nurses reporting that some clinics do not have Personal Protective Equipments(PPE) and clean running water, which pose a serious threat to the management of and control of COVID-19.
 
In the meeting between the Department of Health and Organised Labour held on the 17 March 2020, a concern was raised about 72 clinics that are without running water and shortage of PPE in many of the clinics in the Province. The Deparment of Health made a committment to provide running water and PPE to affected facilities and also to rollout training on COVID-19 to all clinical and non-clinical staff members.
 
Due to high volume of patients who visit health facilities, DENOSA Limpopo reiterates its call for Department of Health to beef up the number of nurses in the facilities by employing all nurses who were trained through bursary system (post comserves) who are currently available and hunting for job as well as all other readily available nurses. 
 
Employment of around 600 Post-Community Service Registered Nurses will assist in curbing the spread of this pandemic. DENOSA is concerned about shortage of basic necessities in the workplace such as gloves, masks, hand washing soaps, sanitizers and running water which will make it diffult for nurses and other employees to provide quality patient care to the communities.
 
Safety of nurses, other employees and patients in health facilities is our major concern which was already registered with the Department of Health in our meeting held on the 17th of March.
 
To ensure safety of our members in the workplace, DENOSA requests shopstewards and members to monitor availability of PPEs in their Workplace as per above checklist.
 
This exercise will also assist the organisation to navigate the Department of Health to areas were the above items are needed urgently. Exposure to infection for health workers poses even wider risk of widening the spread of COVID-19 further to other patients and communities.
 
DENOSA Limpopo condems the continous attacks of our members like the recent incidents at Probeering and Setlaboswane clinics in Makhuduthamaga Sub-district in Sekhukhune Region whereby Computers and consumable stock were taken. 
 
DENOSA Limpopo continues to remind members of the community to take extra caution and ensure that they are fully protected at all times by washing their hands with soap or sanitizers frequently and to self isolate whenever they  show signs and symptoms similar to those of the COVID-19.
 
End
 
Issued by the Demogratic Nursing Organisation of South Africa(DENOSA) Limpopo
 
For information, contact: 
 
Jacob Molepo,DENOSA Provincial Secretary 
 
Mobile : 0725764979
 
Lesiba Monyaki ,DENOSA Provincial Chairperson
 
Mobile : 0725782753

Read more
DENOSA National Student Movement statement on the COVID-19 and suspension of classes in higher learning inst...

Media statement

For media release

Amidst all the uncertainty and panic regarding the Corona Virus in South Africa, the DENOSA Student Movement is certain about one thing; the Safety and Wellbeing of student nurses in South Africa is our number one priority.

We, therefore, call for all cooperation of all concerned bodies in ensuring the safety of all students throughout the country.

We would like to commend all institutions who have recognised the importance of ensuring that nursing students and all students at large are not at risk of exposure by suspending academic programmes.

We acknowledge that nursing is an essential service and we recognise and commend all nurses holding the fort and those directly and fearlessly responsible for the care and nursing of those infected with the Corona Virus.

It’s an unfortunate event what we are seeing and we have to act with precise caution to guard and protect the lives and wellbeing of our upcoming workforce. Let them not be subjected to this risky and overwhelming environment at this stage like the readily qualified.

This is a national crisis and no institution should be defiant of any protocols put in place to ensure the safety of the Nation. Especially if this defiance poses a risk to all parties concerned.

We should be reminded that students are expected to be in clinical areas and some even reside in residences in the same premises as healthcare institutions, we, therefore, cannot deny the direct threat that this poses upon them. Should a student contract the virus whilst at work or in the institution's residence, there are no protocols in place to not only protect other student's but to ensure that this student is safe from academic exclusion resulting from ill-health.

We would like to call upon all institutions to strategize contingency plans to ensure that students are not forced to forfeit the academic year and clinical hours due to this National disaster. More-so The South African nursing council as the regulatory body should be the one to champion these strategies amidst this unforeseen crisis.

We are greatly disappointed by the notice released by the SANC at this time, we believe that this is not the time for SANC to be closing its doors on nurses. Instead, they should be standing hand-in-hand, or rather elbow to elbow, with Nurses of all ranks in keeping the nursing profession functional amidst this disaster.

They should ensure that nurses and nursing students are not left compromised by this disruption. This includes timeous issuing of Community service certificates to community service nurses, ensuring that Suspension of Academic programmes is not at the expense of the students, amongst others.

We would also like to encourage all nursing institutions to suspend academic and clinical programmes to ensure the safety of Students and to mitigate the spread of this Coronavirus. We will engage with the SANC, institutions of higher learning and all stakeholders on plans to be put in place.

We are more than ready to be actively involved with our nurses and communities on awareness programmes and Education.

 

End

 

Issued by DENOSA National Student Movement

For enquiries:

Sphumelele Zime Blose
National secretary
DENOSA student movement
Cell: 079 300 4409

Nathaniel Mabelebele
National chairperson
DENOSA student movement
Cell: 071 684 1646

Read more
View More

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


 

Read more

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.

Read more

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

Read more
View More

Publications

Nursing Update

         
August 2019

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