SA Health Minister Motsoaledi’s ‘devils in white’ – an ‘angel in white’ replies

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NurseWhat an unfortunate turn of phrase Health Minister Dr Aaron Motsoaledi chose when addressing nurses on International Nurses Day,  a day that was intended to celebrate our great profession. Criticising from a comfortable seat in a plush government office is easy. Working regular hours and being driven to meetings and lunches by a chauffeur, shields one from the lives of the people you’re criticising.

Minister Motsoaled, put on a nurse’s uniform and work on a ward for a day. Just one day. That will be enough to make you appreciate what we nurses do in our 12-hour shifts, for appalling pay and scant respect.

It’s not the first time I’ve heard of a totally inappropriate speech made on nurses’ day. At consecutive celebratory nurses day lunches, the mayor of my city, selected to extol our virtues, arrived with a swathe of security guards. He spent a great deal of his speech telling us what a wonderful local government we have and what great work they do around our city. Hardly on topic, but I suppose if you’re desperate to get the political word out, it’s any port in a storm.

I do acknowledge, though, that nursing these days is worlds apart from days gone by, when nursing was a more respected profession.

Back in the 1970s and 80s becoming a nurse was very much like joining the army. It was very structured. Very disciplined. A day on the ward was determined by the sister-in-charge, as she was known then. She compiled a daily list in which each staff member was assigned tasks, sometimes even dividing these into a task for each hour of the day.

One nurse would do dressings. One would do medications. One would cleaning the beds and lockers, not once but twice a day. One nurse would soak and scrub the bedpans. Another for washing the soiled linen (without gloves I must add). Another for setting trays and serving meals. And the deputy would do the doctors’ rounds. It worked like clockwork. Extremely efficient with excellent nursing care, and nary a muttering of: “it’s not my job,” or the other one  that one now hears so often, “it’s not in my scope of practice”.

Sadly the regimented structure has now gone.

The 6.45am start to the day begins with a handover. After handover it’s somewhat akin to Easter Sunday morning when children are released into the garden in search of hidden Easter eggs. The staff scatter to start their day: making beds and doing the morning rounds. One never, ever, is able to complete this task undisturbed. The interruptions are diverse and demanding: admit a patient; get a patient ready for theatre; receive a patient back from theatre; deal with a vomiting patient; give medicines; remove catheters,;put up drips; do doctors’ rounds; and order medicines from the pharmacy, only often to find two or three hours later that the meds haven’t arrived . The patient’s regimen is now out of kilter and isn’t the doctor going to be mad! And so he should be.

Into this melee is thrown another curved ball. In private hospitals, there has been a long process of cutting staff quotas to the bare minimum, so as to exponentially grow profits. In many instances when nurses resign, they are not replaced. Increasing use is made of agency staff. Such outsourcing is profitable for the mother company: there are no costly contributions to medical aid or provident funds, and disciplinary action is no longer their problem either.

Human nature being what it is, those employed on a temporary basis have very little sense of belonging. Commitment, too, is often missing unless they are regularly employed in the same ward. It seems that the policy of the nursing agencies is to remunerate a nurse with say, 15 years experience, at the same rate as a nursing newcomer. So all in all, it’s a win for the “big boys” and the profession is damaged, not forgetting the care that the patients should be receiving.

Small wonder that for those nurses with ambition and talent, their profession isn’t highly regarded as a viable lifetime career.

So why DO we do it? Nursing I mean. I can only speak for myself, but the reasons go deeper than money: it’s a fast-paced environment, where thinking on your feet is paramount. It’s exceedingly satisfying when you know you’ve made a difference to the lives of your patient and their families. It feeds the soul to know that without your actions, a patient could have died – literally.

And it’s the teamwork, also. The member of the team that you’re with for those 12 hours rely on each other for emotional and physical support. We’ve got each other’s backs. We laugh together, cry together, swear together and care together. That’s a lot of plusses for anyone with a caring disposition.

What a tragedy though, that commerce takes such huge advantage of our profession. It keeps the nursing profession (and it is a profession) firmly positioned close to the bottom of the food chain. If nurses were accorded the respect they deserve. If the social status of this vital profession were restored. If recognition and appreciation were given

If nurses were accorded the respect they deserve. If the social status of this vital profession were restored. If recognition and appreciation were given for the very hard work put in and if remuneration were raised to levels that allow nurses to live with dignity, it would attract abundant new talent into the hospitals.

And you, Honourable Minister would be willing, indeed compelled, to label the fraternity “angels in white”.

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