Nursing Lekgotla, Turffontein, Johannesburg
8 March 2007
Head of Department
Chief directors
Senior managers from the national and Gauteng Departments of Health
Nursing managers from different hospitals and clinics
At the annual Health Summit that was held in 2004 it was resolved that
issues that affect the nursing profession should be addressed separately from
general health issues in order to avoid having them getting lost in a myriad of
broad health challenges that face us as a country and also as a province.
This Nursing Lekgotla is a direct result of a carefully considered
resolution to elevate issues that affect nursing in our province to a level
where they dealt with the importance and urgency they deserve.
Programme Director
It is fitting that this lekgotla is held four months after the Nursing
Education Conference was held at the same venue. Nurses make up more than 50
percent of health professionals and in our province we have approximately a
total of 18 854 nurses.
Therefore, it is clear that nurses are the bedrock of healthcare delivery in
our province. The Nursing Education Conference I have just referred to enjoined
the Department to consider the following:
* giving nurses a voice in the management of health services
* making nurses feel important and valued
* caring for nurses in order to maximise availability and retention
* creating a safer working environment for nurses
* providing career paths with incentives for levels and degrees of
responsibility
* review of salary packages
* management of the workload of nurses
* improving working relationships with other groups of healthcare workers
* providing good management support
* management of nurses that are affected by HIV and AIDS.
Programme Director
While we acknowledge the scientific advances that have been made in the
discovery of medicines and design of high tech equipment that is used in
medical care, it would be a mistake on our part not to acknowledge the fact
that healthcare is an intensely human activity and a labour intensive service
industry.
Healthcare is more than sophisticated machines and high tech laboratories.
It is, essentially, about human interaction and dedicated care for patients by
committed professionals and volunteers.
At the centre of this human activity are nurses who do not only care for
patients when they present themselves at our hospitals and clinics when they
are at their most vulnerable state, the same nurses also ensure that those that
are healthy remain healthy.
Programme Director
The health status of each country in the world is heavily dependent on the
quality of nursing care that is provided within the healthcare system.
As most of you who are attending this lekgotla are nurse managers, you are
fully aware of the contribution of your fellow professionals to an improved
health status of our country as well as of our province.
The fact that our society is still afflicted by illnesses of poverty, your
role as healthcare providers becomes even more pronounced because often
patients have to be attended to by yourselves instead or before they are seen
by medical doctors. In other words nurses are our first line of defence against
the burden of disease.
Programme Director
We have to acknowledge, however, that with the increase in the burden of
disease and the challenge that is posed by shortage of staff, nurses are
finding themselves under pressure from all angles.
An authority no less than the late former Director-General of the World
Health Organisation (WHO), Dr Lee Jong-Wook, referred to the shortage of health
professionals as a "global crisis" and one of the greatest challenges facing
healthcare delivery across the world. This challenge is even more acute when it
comes to nurses.
Programme Director
As you are aware this challenge is worsened by the fact hat countries with
stronger currencies have made conscious decisions to recruit nurses from among
those with weaker currencies, thus directly impacting on delivery of basic
healthcare among poor or developing countries.
We cannot wallow in the unfortunate situation we find ourselves in, hence we
all have a responsibility to ensure that we retain those that have decided not
to leave our shores.
Programme Director
In the hospital visits that I have undertaken I have been given hope by the
dedication of the nurses who work under trying conditions, where the demand for
health services has increased yet these nurses have chosen to remain in the
country and serve their communities.
The dedication of these nurses brings confidence and hope that all is not
lost. It is therefore my hope that this lekgotla will not deteriorate into a
session of moaning and wailing about challenges that you encounter, but I trust
that you will engage in discussions that challenge us who make policy to
communicate a vision of healthcare delivery that resonates with your
experiences as frontline healthcare workers.
In other words you need to challenge us through such forums to ensure that
our plans and programmes of action also capture your imagination as frontline
health workers.
Programme Director
As most of you are gathered here as nurse managers you need to address the
issue of a perception that nurses in the public sector have a poor attitude
towards their patients. I refuse to believe that the majority of our nurses are
less caring.
The minority of those nurses who sully the proud name of our dedicated
nurses tend to receive more publicity when compared to those who serve our
communities with distinction.
As nurse managers I also trust that you will address the issue of
accountability for quality of care at ward level. This accountability also
includes safety of patients while they are in your care.
Programme Director
The issue of uniforms for nurses also needs to be addressed if we are
serious about the perceptions regarding the standard of nursing care in our
province. While it is not widespread in our province, I have encountered nurses
whom I was not sure as to whether they worked for a certain chain store or are
public healthcare givers.
Identification of nurses as indeed nurses instils confidence among patients,
hence we need to address this matter and put it to rest. This is closely
related to the quality of candidates we recruit and train as new cadres of the
nursing profession.
There was a time when nursing was referred to as a "noble profession." It
was a time when young women and also men embarked on a nursing career in a
spirit of community service and commitment to serving the interests of the ill
and the weak in our society. Sadly this spirit of community participation has
largely been lost upon the current generation. The vocation aspect of nursing
needs to be re-instilled.
Programme Director
Career paths in the nursing profession should be informed by a well
researched disease profile of the province, in order to ensure that continuity
of professional development is meant to advance knowledge and development of
new health worker cadres.
This should take into consideration the fact that most of the patients who
present themselves at our health facilities seek treatment for illnesses that
are a direct result of inadequate basic health education. The pressures that
are being experienced by our nurses at all levels of care are a direct result
of this inadequate basic health education.
It is therefore logical that there should be a synergy between public health
programmes at community level with services that are rendered at all levels of
care. We can continue recruiting more nurses but in the long run this will not
alleviate the pressure they are faced with as long as we do not address the
basic causes of ill health most which are related to poor nutrition, lifestyle
and social conditions.
Programme Director
One of the primary issues we have to address is to expand the career paths
and widen the horizons of people involved in the nursing profession. For
instance, how do we get them involved in other challenging aspects in the
broader medical field such as primary research and even managed healthcare
within the public health sector. In this way we can retain the vital skills and
experience that we have nurtured and developed over many years instead of
losing them to other markets or career options.
But as managers within the Gauteng healthcare system at both head office
level and at hospitals and facilities we should also not neglect doing the
little things that can easily improve the working conditions of nurses at
relatively little expense.
Issues such as adequate rest and recreation facilities, clean washrooms,
safer working environments or a reduction in the workload may appear to be
petty within the big scheme of things but they all contribute towards creating
a work environment that can both attract and retain staff within the nursing
profession.
While we pay tribute to the thousands of nurses in our province who work
double or even triple shifts, we will have to take steps to improve the quality
of their working environments.
Programme Director
While I will not be prescriptive in terms of the outcomes of your
deliberations during this lekgotla you have to ensure that Gauteng has:
"The suitable nurses, with appropriate skills, deployed appropriately, doing
the right things!"
I thank you!
Issued by: Department of Health, Gauteng Provincial Government
8 March 2007
