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SA's nurses: Poorly trained, in poor health, and living in fear

Most of South Africa's nurses lack confidence in their training, more than 40% have poor health, and a quarter are experiencing severe psychological distress, reports a health care workers study led by the Human Sciences Research Council.

City Press reports that the country's health care workers, particularly nurses, are also living in fear of contracting a deadly virus and then passing it on to their families.

The survey, says City Press, shows that nurses, often described as the backbone of the healthcare system, appear to be the Cinderellas of the health sector – lagging behind in critical training regarding COVID-19 treatment guidelines. And they have little confidence in their own knowledge about the many moving parts of the virus and its progression.

The study was led by the Human Sciences Research Council in collaboration with the University of KwaZulu-Natal’s College of Health Sciences and the Edendale Hospital in Pietermaritzburg, KwaZulu-Natal. It surveyed 7 808 healthcare professionals – 36.7% of whom were nurses. Nurses make up 65% of the country’s healthcare workforce, and the majority of them are women.

The report says the survey was conducted as the pandemic started gaining ground locally – between 11 April and 7 May. At the time, there were only 2,003 confirmed cases in the country. “The survey has given us confirmation of what we knew and what we’ve been raising (as concerns) as far back as April. We asked for training (on COVID-19) in April, as it was our foresight from complaints from our members (that it would be a problem),” said Simon Hlungwani, president of the Democratic Nursing Organisation of SA (Denosa).

During the release of The State of the World’s Nursing in April, Dr Tedros Adhanom Ghebreyesus, the director-general of the World Health Organisation, said: “Nurses are the backbone of any health system. Today, many nurses find themselves on the frontline in the battle against COVID-19. This report is a stark reminder of the unique role they play, and a wake-up call to ensure they get the support they need to keep the world healthy.”

But, City Press says, this latest report shows that nurses have not had nearly enough support. “This issue of confidence in healthcare workers in overall knowledge about COVID-19 is important. About 54.7% of medical professionals demonstrated confidence in their knowledge, and the lowest percentage was with nurse practitioners (only 41.7% said they were confident in their knowledge). The number of those who didn’t have confidence in their knowledge was quite high (35%),” said Professor Mosa Moshabela, dean and head of school for the School of Nursing and Public Health at the University of KwaZulu-Natal.

They survey also found that healthcare professionals in the country were mostly concerned about passing on the infection to their families. “It’s because we hear these stories, but generally we often don’t pay attention to them. At least 70.8% feared for their family members and their own health, and 72.2% feared passing the infection on to their family members. At least two in five nurses were concerned about the risk of transmitting COVID-19 to their families.

“There were high levels of psychological distress among healthcare workers. For the nurses, severe distress was high at 25%. That means one in four nurses experienced severe psychological distress. In terms of wellbeing, 44% of the nurses had poor health compared with other healthcare professional groups, which was at 25%,” Moshabela said.

 

Priscilla Reddy, extraordinary professor at the HSRC, said that health workers are another group of very important foot soldiers in the face of the pandemic. She is quoted in Skills Portal as saying: “They’re the most important people in the response to COVID-19, infrastructure is one important part. But the frontline workers, health workers, nurses, doctors and all other health workers are important.”

Meanwhile, the research focuses on the nurses who form 65% of the healthcare workforce in South Africa – the majority of which are women. Reddy said there are several concerns including the fact that the knowledge was not as high as it should have been.

“But I think the most important findings are at a personal level and how they perceive themselves at risk or didn’t perceive themselves at risk,” she said. “Therefore, it affected their health and wellbeing. In the same context, the issue of healthcare workers taking infections from wherever they are working and back to the family.”

According to Reddy, risk perception is an important concept from different angles. “If a person perceives them at risk, whether it’s high, medium, moderate or low risk, it’s for a reason,” she explained. “If you understand the disease, if you have good knowledge of the disease, then you’ll know exactly what to do prevent the risk. Because it’s taking that risk that’s going to infect you.”

Skills Portal reports that she added that, if you grasp the infection control procedures and have a good knowledge of it and able to do it, you will perceive yourself as lower risk. “What shocked me which is not on our data is the number of healthcare workers who have become infected and that’s the hard part and how they’re going to heal from it.”

 

The National Education Health and Allied Workers’ Union (Nehawu) has, meanwhile, called on the Health Department to necessitate more stringent and effective plans to combat the spread of the COVID-19 urgently as the pandemic shows no sign of slowing down, reports The Citizen.

Nehawu noted the Health Minister Zweli Mkhize’s address signalling that the country had the 5th highest numbers of infections in the world. With over 521,318 positive cases alongside 8,884 mortalities, Nehawu said it was disappointed by the timid response by the minister on the rising numbers of frontline workers who are testing positive for the pandemic.

The union questions why if personal protective equipment (PPE) was available, it hasn’t been provided to workers who had been complaining about the lack of sufficient PPE in their workplaces.

 

[link url="https://www.news24.com/citypress/news/nurses-battling-to-cope-with-covid-19-20200808"]Full City Press report[/link]
[link url="http://www.hsrc.ac.za/en/media-briefs/general/hcw-survey-launch"]HSRC survey[/link]

 

[link url="https://www.skillsportal.co.za/COVID-19-among-nurses"]Full Skills Portal report[/link]

 

[link url="https://citizen.co.za/news/south-africa/health/2336250/covid-19-shows-no-sign-of-slowing-down-stop-paying-lip-service-nehawu-warns-mkhize/"]Full report in The Citizen[/link]

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