Date: 08/03/2007

Source: Gauteng Provincial Government

Title: Hlongwa: Second Nursing Lekgotla

Speech by MEC for Health, Mr Brian Hlongwa at the second Nursing Lekgotla, Turffontein, Johannesburg

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