The World Health Assembly has declared 2020 as the international year of the nurse and midwife in order to highlight the vital roles that nurses and midwives play in the healthcare system and in transforming it. This year also marks the implementation of the new nursing curriculum in South Africa.

The World Health Assembly has declared 2020 as the international year of the nurse and midwife in order to highlight the vital roles that nurses and midwives play in the healthcare system and in transforming it. This year also marks the implementation of the new nursing curriculum in South Africa.

In light of this, RHAP hosted a nursing webinar in order to discuss the Future of Nursing in South Africa- exploring challenges, opportunities, and social accountability in nursing education. The coupled question was ‘ are nursing education reforms responsive to rural communities ‘?

The webinar gave those who haven’t had the chance to voice their thoughts by encouraging the conversation about the current and future state of nursing in South Africa.

DR. Guin Lourens highlighted the need for strong leadership, management and communication.
Dr. Sipho Mkhize focused on the current transformation of the nursing curriculum.

Professor Laetitia Rispel, South African Professor of Public Health at the University of Witswatersrand, and keynote speaker for the webinar took the time to answer all the questions that were raised but left unanswered on the day.

  1. Why does the lack of HR alignment continue to take place in the face of the demand for nurses and the challenges that they face?
    This sounds like a rhetorical question, but the lack of alignment reflects the under-investment in human resources for health. Unfortunately, this happens in many countries around the world. It is incumbent on all of us to continue to demand greater investment in human resources and nurses, as they are the largest group of health workers.

  2. Education of nurses is very much based on face to face classroom teaching whilst in other disciplines, much is linked to technological advancement. How can we improve the utilization of technology to advance nursing education?
    COVID-19 presents an opportunity for hybrid teaching and learning. There are good practices of using technology to support educational activities in South Africa, despite resource constraints. Kenya, which is a poorer country compared to SA, used digital platforms to upskill enrolled nurses, even in the remote parts of the country. But sometimes it requires courage to embrace change, experiment with digital technologies, and to be open to learning from the experience. Careful planning is needed, but even small changes introduced could make a big difference.

  3. Prof Rispel is so spot on … we keep wanting to make changes and try and justify how and what we do…but if the SYSTEM does not recognize our voice, where are we going?
    We have to keep on speaking truth to power, advocate for change until someone listens.

  4. How do we ensure that our rights as nurses are protected in the workplace because honestly as a student, I feel like our profession is like a doormat, patients abuse us, doctors abuse us and the use of hierarchical power is also playing a role which leaves us with almost nowhere to run to? We are looking into the best interest of the profession but seems like no one cares about us.
    The first step is to know your rights as an employee, bring problems to the attention of management, ensure careful documentation, use your membership of representative organisations (whether DENOSA or a trade union).

  5. Educators are blamed for the poor training, but yet WHERE do we go as nurses to resolve the “abuse”?
    See response above

  6. Is it possible to have another Council that regulates the nursing profession?
    From an objective point of view, South Africa’s regulation of the nursing profession is a strength, as nursing is not regulated in many parts of the world (and the profession is the poorer for that). We need to separate the principle of having a regulator, from the problem of sub-optimal or poor governance and poor or lack of implementation of relevant legislation, and demand greater accountability from the SANC. So the question should be how do we ensure that we have a Nursing Council that is empowering and enabling, yet protects the interests of the public in an ethical and accountable manner.

  7. The education of our students is as much a responsibility of the educational institutions as it is of the clinical platform. The severe shortages and struggles in practice greatly hampers the development of our students. As an educator, I cannot affect the negative attitude of the RN or UM in the ward or clinic. Ultimately, it is the RN at the bedside that sways the conduct to not really care as was instructed. Clinics close, sending patients away when they decide they have worked enough for the day… How does that teach our students that we care?
    One strategy is to build closer relationships between the clinical teaching platforms (hospitals and clinics) and the relevant nursing education institution. Good relationships go a long way in ensuring mutual respect and understanding of the challenges faced but also building a common vision, as students are the future professionals and leaders (and even the “worst” RN knows that).
    Another strategy is to ensure that students are aware of the likely problems (whether ethics or attitudes) that they could face in the clinical setting, doing role plays with them, and engaging them in how they exercise leadership and catalyze change in public health facilities.

  8. How do we foster a culture of advocacy amongst practicing and student nurses?
    Advocacy in all its forms seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voice heard on issues that are important to them, defend and safeguard their rights, have their views and wishes genuinely considered when decisions are being made about their lives.
    It begins with teaching self-reflection, practicing self-reflection, participatory educational approaches, openness to new ideas, and partnerships with civil society, questioning ways of doing, and working. It will not happen overnight but requires constant attention and perseverance.

  9. What are the most effective ways for ordinary nurses to join advocacy efforts in a national and local way?
    There are no “one-size fits all”, but define your passion and ask yourself what difference you want to make. Once you know your passion, reach out to an organisation that is doing work in that area, volunteer, or meet with the relevant person to find out if there is something that you can assist with. Don’t be despondent if it is not the right fit, or does not meet your expectations, or does not work out the first time. It is the desire to make a difference and the perseverance that counts.

  10. Having resigned as a Dental Assistant, now in 3rd year of nursing and I already don’t see myself as a nurse in the next coming 5 years because of the treatment I got from the health institutions and the NEI I am registered at… What can any of the panelists say to me and possibly to any of the fellow or aspiring nursing students out there who may be feeling the way I feel about nursing now?
    I am sorry that you have had such a difficult time, and the many negative experiences, have clouded your views about nursing. At the same time, the nursing profession provides many opportunities for both personal and professional growth. I suggest that you use your experiences as a springboard for further study in nursing or in health. Perhaps you can define a vision of what you want to do or what difference you want to make in the next five years, and then ask what is needed to achieve that vision. I also suggest that you approach someone to mentor you in line with your personal and professional vision.

  11. I understand the new curriculum is already being taught in some private institutions. How will this work if the Scope of Practice is currently under revision? How/Why was accreditation given to these private institutions?
    I am unable to answer this question, but transforming some aspects of a curriculum can be done, until such time that the scope of practice is finalized. Ideally, it would be preferable to align the curriculum to the scope of practice.

Professor Laetitia Rispel, also shared her thoughts on the future of nursing in the daily maverick, ” Reflections on the future of nursing in South Africa”, she states that ” Education also involves advocacy for women’s rights, for human rights, for equity and social justice in ensuring access to quality care for those most vulnerable in society – poor people, rural communities, vulnerability on the basis of illness or disease, citizenship, and “the other”.

You can find the full recording of the webinar on our YouTube page:
RHAP Nursing Seminar: The Future of Nursing in South Africa

The Rural Health Advocacy Project would like to thank our esteemed panelists; Professor Laetitia Rispel, Dr. Sipho Wellington Mkhize, Dr. Guin Lourens, Sr. Lerato Madumo, Sr. Sanele Lukhele and Mrs. Meghan Botes for their participation and for their contributions to this important matter.