Wednesday, 17 April, 2024
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Bureaucracy strangles specialist nurse supply in SA

South Africa has a shortage of 62 000 nurses, with about 50% of them being specialised nurses, and the crisis is worsening, the government’s botched transition to new qualifications all but cutting off the pipeline for training these vitally-needed healthcare workers.

The situation highlights a massive problem for public and private hospitals, which for more than a decade have battled to recruit specialist nurses for intensive/emergency care and oncology.

According to BusinessLIVE, the issue is so bad that the government has finally included specialist nurses on its critical skills list, which is intended to smooth the way for employers to hire foreign nationals.

Universities and public nursing colleges have been given the green light to train only 70 nurses seeking postgraduate qualifications in emergency care this year, along with 80 for oncology, fewer than 200 for critical care, and just 265 for midwifery, show SA Nursing Council (SANC) data.

This is despite SA’s massive trauma burden and high maternal and infant mortality rates. Only 15 places are available to train nurses wanting to specialise in critical care for children, 46 for nephrology and 80 for mental health. No nurses at all will receive specialist postgraduate training in the Eastern Cape this year.

These low numbers come after a two-year hiatus in the training of specialist nurses under the new qualifications, a plan that was supposed to begin in 2020.

“We have a drastic shortage of nurses in all categories, and 50% of these shortages are in the professional nursing category. If the capacity to train is not increased, we will produce less than half the shortfall by 2030,” said Wits professor of nursing Judith Bruce, citing data from a report commissioned by the health department from the Hospital Association of SA and McKinsey.

She warned that the number of specialist nurses produced by nursing education institutions would be less than the number of approved places for 2023, as not all spots are taken up and the attrition rate can be as high as 20%. “This crisis will be felt for years to come if not addressed decisively and urgently.”

The government’s decision to introduce new qualifications in 2020 meant nursing education institutions had to acquire fresh accreditation from multiple bodies — the Department of Higher Education & Training, the Council for Higher Education, the SA Qualifications Authority and the SANC — before they could begin training specialist nurses on the new curriculum.

But red tape stymied their plans to such an extent that no new students could begin specialist nursing training in 2020 and 2021, said Nursing Education CEO Nelouise Geyer.

Education for nurses is provided by universities, public colleges run by provinces, and private colleges like those operated by hospital groups Netcare, Life Healthcare and Mediclinic. However, only universities and public colleges have been permitted to offer postgraduate qualifications in specialist nursing fields.

Apart from the Higher Education & Training Department’s delays in declaring public nursing colleges higher education institutions, the Health Department promulgated the regulations required by nursing education institutions to develop their curricula for the new specialist qualifications only in June 2020, six months after they were supposed to begin teaching, said Geyer.

Nursing education institutions had to obtain approval first from SANC and then from the Council for Higher Education.

“Despite the commitments made by these two authorities to work together to speed up the accreditation process on many occasions, this has not happened,” said Geyer.


BusinessLIVE article – Red tape chokes off supply of specialist nurses (Restricted access)


See more from MedicalBrief archives:


Netcare again warns of SA’s critical nursing shortage


SA nursing under threat as UK, Canada lure staff to address crippling shortages


Amended Critical Skills List a short-term fix to shortages, say health institutions


Critical staff shortage affects East London’s Frere Hospital surgeries


Surgery catch-up stymied by South Africa’s shortage of ICU nurses






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