“The dilemma around Nurse Education and Training in South Africa has been going on for years” says Sr.Teresa Basson, Director of The Exceptional Nurse Campaign – TEN Campaign. “Blaming the South African Nursing Council – SANC – and the Council of Higher Education – CHE – for stalling the training of nurses is in my opinion, the typical red herring. Challenges have most certainly arisen with the accreditation of nursing colleges and the phasing in of new nursing qualifications, but the main cause for the drastic decrease in the number of student nurses currently being trained in South Africa is the lack of FINANCE: and Government holds the trump card!”
Articles in the media have suggested a growing shortage of over 30 000 professional nurses in South Africa’s public healthcare sector alone. Should the Minister of Health decide to immediately open 30 000 professional nurse posts in public hospitals, community clinics and nursing colleges, the estimated cost to the Department of Health, for employing a vast number of nurses, even at entry level salaries, will amount to an extra 8 billion rand annually – a mere 3% increase on the current Annual Health Budget. What then is the real problem?
THE SERIOUS CHALLENGE WE FACE AS A COUNTRY:
50% of the nurses registered with SANC are nearing retirement age. We are losing 9,000 nurses each year due to retirement, emigration and death, but currently only have capacity as a country to train 3,000 nurses annually. This growing shortage of nurses is a deep concern which, if not urgently addressed by Government, will have devastating consequences for public health service delivery in the near future.
At this point I need to say that every cloud has a silver lining! In a country with such a high percentage of youth unemployment The Exceptional Nurse Campaign sees this as an open door, a great opportunity to address this systemic unemployment problem in South Africa. We have been hosting NIGHT RUNs to honour NURSES in 5 main cities during the month of September each year, to raise awareness for the nursing crisis, to raise funding for bursaries and encourage exceptional young people to choose a career in Professional Nursing. Please support us and book your ticket online at www.theexceptionalnurse.co.za
I’m extremely hopeful because our President has promised to raise billions over the next few years from National Treasury and private enterprise for youth job creation and skills development. We remind Government: hospitals and schools are excellent job creation factories. With such a critical shortage of nurses and teachers in South Africa, we do not need to create jobs! The responsibility rests with Government, firstly to open frozen posts, to release the necessary funding, to train, employ and pay exceptional young people to fill the posts of nurses and teachers in South Africa.
BACKGROUND TO THE DECLINE IN THE NUMBERS OF NURSES BEING TRAINED EACH YEAR:
Up until 1995 nursing was considered a critical skill in South Africa, the training of which was fully funded by Government. In an effort to professionalise the nursing career, decisions were then made to move the training of professional nurses to universities for a 4-year Nursing Science degree. 70% of these university students were then required to personally finance their studies which created new problems. The Nursing Colleges continued to offer the 3-year diploma in general nursing which was attractive as 70% of these students were funded by the Provincial Departments of Health. Whereas only 30% of the university student nurses received funding. Just recently the Minister of Home Affairs has added Professional Nurses to South Africa’s critical skill list.
The media have recently quoted key nursing leaders and educators who mention the following factors as the main causes for the serious drop in the annual quota of student nurse graduates:
South Africa currently does not have enough qualified and skilled Nurse Educators.
As a result, some private and public nursing colleges did not meet the necessary requirements for accreditation by the South African Nursing Council to train professional nurses.
Public hospitals do not have enough student nurse posts to accommodate all the students who need to complete their clinical nursing practice hours.
Public hospitals do not have enough clinical nurse educator posts to supervise and train large numbers of students in nursing practice.
Again we ask the question: why aren’t there enough student nurse posts/positions available in public hospitals and clinics for nurses to complete their clinical practice hours? Why doesn’t the Department of Health open more posts and employ more nurse educators to train and supervise student nurses? The truth is: nurse educators, professional and specialist nurses – are expensive! We suspect the lack of finance is the real problem.
THE VISION OF THE EXCEPTIONAL NURSE CAMPAIGN:
The Exceptional Nurse Campaign – TEN Campaign’s vision is to see exceptional nursing care practised at every hospital and clinic in SA by highly competent and deeply compassionate nurses. We promote zero tolerance for poor nursing practice. Our mission is to identify, raise up, mobilise and multiply exceptional nurses to serve future generations. We aim for South Africa to gain the reputation of training and producing the most exceptional nurses in the world. Why should we settle for anything less?
The World Health Organization currently estimates a critical shortage of 9 million professional nurses internationally. Sadly, first world countries are attracting qualified nurses from their under-resourced neighbours. The Royal College of Nursing in the United Kingdom boasts a membership of 465 000 professional nurses, midwives and auxiliary nurses. Together these nurses serve a population of just under 67 million people in the UK. As of 31 December 2021, the South African Nursing Council reported a paid-up membership of 276 000 nurses. 144 000 of these nurses are currently employed in the public sector serving a growing population of 51 million people. The balance of 9 million people in SA enjoy private healthcare through Medical Aid funding. We leave the reader to draw a conclusion.
WORKING TOGETHER TO TRANSFORM THE NURSING PROFESSION IN SOUTH AFRICA:
TEN Campaign supports the South African Nursing Council and the Council of Higher Education in their efforts to raise the bar of Nurse Education and Training in SA. The rapid advancement in medical science and technology over the past decade has highlighted the need for major development in nurse education and training. Nurses are at the patient’s bedside 24/7. The current nursing science syllabus and the clinical nursing practice demonstrated must adequately equip the professional nurse to manage computerised medical equipment, medical technology and advanced nursing care. Digital advancements are already transforming the way nursing care is delivered. Every nurse needs training and support to become an e-nurse.
As with any other degree, nursing lecturers are required to have a masters in Nurse Education to train nurses. Why should the Nursing Professional settle for anything less? It has been suggested that previous nurse educators who were lecturing without a masters in Nurse Education are not interested in studying further. They prefer to go back to practical nursing in hospitals or working for pharmaceutical companies. If teaching young nurses is not their passion, let us release them with joy! At the same time TEN Campaign urges all professional nurses with a compassionate heart and a gift to teach to enrol at your nearest university to complete your masters in Nurse Education. This country needs YOU!
Ms. Sizwe Mchunu, Registrar of SANC has clarified the fact that the Department of Higher Education has not taken the responsibility of nurse education and training away from the organization. SANC is still the professional body that regulates nursing practice and education in South Africa. An explanation of the Higher Education Qualification Sub-Framework = HEQSF.
SANC has stipulated that accredited public and private Nursing Colleges may now only offer:
HEQSF Level 5: A 1 year course for nursing students to obtain a certificate in auxiliary nursing.
HEQSF Level 6: A 3 year course for nursing students to obtain a diploma in general nursing, followed by 1 year of community service to qualify as a registered nurse.
Some Nursing Colleges are still permitted to offer post graduate specialist courses.
Accredited universities may offer:
HEQSF Level 8: A 4 year degree in Nursing Science followed by 1 year of community service to qualify as a professional nurse.
Most universities with a Health Science Faculty offer post graduate specialist nursing courses, up to honours, masters and doctorate level. Another bone of contention as mentioned by Dr. Sue Armstrong, lecturer at Wits university and Chairperson of the Nursing Education Association, is the South Africa Council’s recent decision to only permit nurses with a 4-year Nursing Science degree to specialise. Before, the diploma nurses were permitted to specialise once they had completed a qualification in midwifery. There is now an urgent need for a solution whereby general nurses above a specified age, with at least 2-3 years of experience in practical nursing should be permitted to specialise. TEN Campaign promotes this solution and is confident that bright, innovative nursing leaders will design a new framework to prevent a growing shortage of specialist nurses.
THE CAUSE FOR A CURRENT REDUCTION IN THE STUDENT NURSE QUOTA:
SANC also regulates/stipulates the exact quota of students each nursing college may accept at the start of the academic year. For many of the Nursing Colleges, this number has been drastically reduced. This again has been the cause of ongoing discouragement, dissatisfaction and frustration experienced by the colleges who desperately need the required student registrations and fees. As with every business, colleges are required to pay nursing college staff, lecturers and private colleges have monthly facility rentals. In the past some colleges depended on an intake of 250 students annually: how do they now pay their staff and survive financially on an intake of 50 students? Understandably these college principals and staff are extremely discouraged and frustrated with SANC and the status quo.
SANC’s argument: We cannot permit the training of thousands of nurses in South Africa if Government and the Department of Health cannot guarantee these graduates with jobs. Funding community service posts for the existing number of 3,000 nursing graduates remains a massive challenge. Again, funding is the main problem!
PATIENCE AND PERSEVERANCE IS NEEDED AT THIS CRITICAL TIME:
Instead of blaming and shaming one another as nurses, let us join hands with the South African Nursing Council, the Department of Higher Education, the Nursing Education Associations, the Democratic Nursing Organization of South Africa, the Young Nurses Indaba Trade Union and the Exceptional Nurse Campaign to intentionally RAISE THE BAR on Nursing Education and Training in this country. We all agree that Government must give urgent attention to the training and development of an adequate and sustainable workforce to serve our nation. We want South Africa to gain the reputation of equipping and producing the most exceptional nurses in the world!
While we wait for those who have the trump card to act, let us as nurse leaders, refrain from being negative and critical. Let us choose to encourage one another and make positive decisions to do the best we can with what we have. Let us join with TEN Campaign in this EXCEPTIONAL MISSION to transform the heart of public healthcare in South African. SAVE LIVES – BE A NURSE!
Sr. Teresa Basson: Director – The Exceptional Nurse Campaign
