Important changes are being implemented in the nursing profession that aim to equip nurses with the competencies and support they need to fulfil their role as the foundation of the country's health care system.
"Nurses fulfil an essential role. They are the first point of contact, and in many rural areas they are the only point of contact for patients," said Prof Anita van der Merwe, head of the Division of Nursing at Stellenbosch University's Faculty of Medicine and Health Sciences, ahead of International Nurses Day celebrated on 12 May. This year's theme is "Nurses: A force for change - cost effective and care effective".
"The escalating cost of health care globally requires that measures be taken to contain costs to levels that countries and governments can afford and sustain," the International Council of Nurses (ICN) said in a statement.
An effective and popular measure of cost saving in health care is task shifting. Through this measure, tasks and responsibilities that traditionally would have been performed by for example doctors, such as the prescribing of medicines, are being shifted to nurses, especially in the primary care context. "Nurses have been able to prescribe ART [antiretroviral treatment] for some time and currently there are processes underway to extend it to other medicines in a well-regulated fashion," said Van der Merwe.
However, she warns that task shifting has to be carefully planned and managed in order to prevent the overburdening of nurses, particularly in South Africa, which is plagued by health care staff shortages.
"Burnout among nurses and midwifes is of great concern. Having too much to do causes stress and depression. They become despondent and stop caring about their work and develop an attitude of 'I'll just do the minimum of what I have to do', and this in turn impacts on patient care," she says
This touches on the second goal of the Nurses Day theme, namely "Being care effective", which relates to the extent to which health problems are solved. The basis for effective nursing is the competence and education of nurses - an area that is currently undergoing transformation.
The South African Nursing Council and higher education institutions are redesigning the curricula of nursing programmes to be in line with the national higher education framework. In future nurses will obtain a Bachelor's degree in general nursing and midwifery. Specialisation in areas such as psychiatry, critical care, or primary health care, will be obtained through additional postgraduate studies. The current dispensation of a fourfold basic nursing programme is being phased out. In coming years, nurses will also have to meet continuous professional development (CPD) requirements in order to practice, as doctors have to do now.
