KwaZulu-Natal Health MEC, Dr Sibongiseni Dhlomo, calls for the empowerment of nurses to dispense morphine
KwaZulu-Natal Health MEC, Dr Sibongiseni Dhlomo, has vowed to push for less stricter control of the pain management drug, morphine, which could allow nurses to dispense it – ensuring that more people with chronic ailments are spared unnecessary pain and suffering.
MEC Dhlomo was speaking today on the sidelines of the annual Hospice Palliative Care Association conference, which is underway at Elangeni Hotel in Durban. The three day meeting, which commenced yesterday (27 September 2015) and will end on Wednesday, is attended by delegates from countries such as the USA, UK, Uganda, Botswana and Nigeria, and from across South Africa.
In South Africa, only doctors are allowed by law to dispense morphine, which is a schedule 7 drug.
However, MEC Dhlomo said he is aware that nurses in Uganda are empowered to dispense morphine, with huge success, and he sees no reason why the approach cannot be replicated locally.
“I’m of the view that as South Africa we need to have a dialogue in order to establish why our nurses cannot do the same here. It is working very well in a country with limited resources like Uganda, I really don’t see why it can’t work here,” said Dr Dhlomo.
MEC Dhlomo also reiterated the call made by the World Health Organisation for the promotion and acceleration of Palliative Care, saying this would improve the quality of life of patients who face challenges associated with life-threatening and life-limiting illness from the point of diagnosis up to cure or death.
Advocating for professional nurses to prescribe and administer opiates to patients who need pain management in the community, MEC Dhlomo said: “The decision to embark on Nurse Initiated Management of Anti-Retroviral Therapy (NIMART), was the recognition that the cadre of health care professionals who are found almost in all corners of our country are nurses, and to improve access to ART.
This became the only vehicle to do this. We should in the same approach recognise that the practice of Palliative Care in our country will be augmented by realising that we need to empower professional nurses to be able to dispense and administer morphine. This approach has over years been practiced in Uganda and one feels that our patients with life threatening and life limiting conditions can benefit positively this way," said MEC Dhlomo.
The MEC said that nurses at South Africa health facilities are already able to prescribe Pethidine – a drug similar to morphine - in maternity wards. And, unlike with doctors, South Africa has a good supply of nurses, which means the country has more capacity to reach patients in need.
“Now, do you need a doctor to leave King Edward VIII Hospital for instance, and go to Inanda, Umlazi, Chatsworth, KwaMashu or KwaMakhutha to administer morphine? We just don’t have enough doctors to do that. Why don’t we train nurses in the same way patients are accessing ARVs through nurses. I really don’t see why we can’t have a nurse-driven approach for morphine.
“I now know it works, and I’m going to be pushing for it. It’s not that morphine is not available, I am arguing that there are few doctors, whereas patients need morphine. If you need morphine, you need to have access to a doctor. It therefore means, if you can’t access a doctor, you can’t access morphine. To me it’s not the right way,” MEC Dhlomo said.
MEC Dhlomo also re-iterated his call for undergraduate training in palliative for health care professionals, especially nurses and doctors.
“I am of the view that the majority, if not all, public health care facilities must offer palliative care. This will ensure that majority or all people who require palliative care do receive such care.”
