Too few specialised nurses

2016-05-31 12:47
Ward operational manager, Alexia Ndlovu, staff nurse Nonhlanhla Dladla, and nursing manager Matron Joyce Webster are pictured in Northdale Hospital in Pietermaritzburg. (Jonathan Burton, The Witness)

Ward operational manager, Alexia Ndlovu, staff nurse Nonhlanhla Dladla, and nursing manager Matron Joyce Webster are pictured in Northdale Hospital in Pietermaritzburg. (Jonathan Burton, The Witness)

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Pietermaritzburg - KwaZulu-Natal's public hospitals are suffering a “nursing crisis” with a shortage of general and specialist nurses at public hospitals and clinics.

The Democratic Nursing Organisation of South Africa (Denosa) said they have raised concerns about overworked and ­underpaid nurses in the public sector.

Nurses were taking early retirement as a result of the tremendous workload, they claimed.

Provincial spokesperson Cassim ­Lekhoathi said, “posts at hospitals and clinics are not being filled and this had added ­pressure onto the limited staff at hospitals”.

“We believe the failure to employ more nurses has contributed to the large amount of malpractice cases against the state, ­especially in maternity,” said Lekhoathi.

KZN Health Department spokesperson Samuel Mkhwanazi said there is a surplus of nurses in certain categories within the department.

“Although it has been alleged that there is a shortage of nurses in certain specialised categories, the department is not aware of a study that shows or proves this,” he said.

Mkhwanazi did not respond to questions on the general shortage of nurses in the province and Denosa’s claim that nursing shortages had led to nurses being attacked.

Lekhoathi said Denosa had reports of one nursing sister having to run two wards because of the shortage of nursing staff.

“We have raised this with the ­department but it seems our pleas fall on deaf ears.”

Lekhoathi said the shortage of nursing staff has in some cases resulted in nurses being assaulted by “frustrated patients”.

“We have had numerous cases of assaults on nurses reported to us; several incidents occurred at the Polyclinic in KwaMashu.

“We have seen many nurses taking their pension packages early and staying at home because work has become too much for them to bear.”

He said the department needed to ­“tighten their belts” and attend to the ­problem immediately.

A statement by North-West University nursing professor and South African ­Nursing Council (SANC) education ­committee chairperson Abel Pienaar said nurses make up the largest group of healthcare providers in South Africa. “The performance of any healthcare system is directly dependent on the quality of care afforded by these healthcare professionals,” he said.

His statement quoted a 2015 report by Wits University, which revealed that over 60% of nurses admitted they felt too tired to work while on duty.

“According to this study, this could be linked to the 70% of South African nurses who admitted to ‘moonlighting’ or ­working overtime due to a massive skills shortage in this under-resourced sector.

“These statistics depict a profession in crisis and have alarming implications for the level of patient care provided,” said ­Pienaar.

He said if the country is to achieve ­universal healthcare, it first needs to address the skills shortage and the resulting ­casualisation of nurses.

Casualisation refers to the employment of workers on short-term contracts, ­without the rights and benefits associated with the standard contract of employment.

He said the private and public sector faced major challenges to produce, recruit, and retain skilled nurses.

“In a bid to keep bright medical professionals, young nurses are often fast tracked into senior positions by management.

“However, this practice often deprives these capable nurses of clinical expertise and the opportunity to specialise.”

He said the current trend, especially in universities, was to retain talented young graduates for teaching and learning.

Pienaar added that the national health budget for nursing had not been adjusted for two consecutive years.

“Budget constraints lead to a skills ­shortage,” he said.

“The lack of investment in clinical ­specialisation, both in the public and ­private sector, puts additional pressure on an already shrinking pool of expertise.

“If we don’t train and educate these health professionals, we run the risk of ­producing nurses with mediocre ­competency inevitably resulting in sub- ­optimal patient care.”

A Durban nurse who could not be named said the shortage of staff in the public sector had put pressure on the nurses currently working at clinics and hospitals.

“Nursing sisters are having to beg ­student nurses to help out at the hospitals, that is how severe the shortage is.”


In the University of Witwatersrand study, nurses reported high rates of ­unauthorised absences leading to ­further understaffing, overwork, and health worker exhaustion.

North West University nursing professor Abel Pienaar said that the Eastern Cape and KZN suffered the most from the nurse shortage with the least amount of nurses absorbed into hospitals from nurse colleges in the country.

Read more on:    pietermaritzburg  |  health  |  nurses

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