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"Crisis as SA steadily loses qualified nursing"

January 14, 2005 -- Today South Africa's Star ran a good piece by Bruce Ventner describing the magnitude of that nation's "critical" nursing shortage. The piece reports that South Africa is "steadily losing" its best trained nurses, especially in rural areas, even as the growing population and expected increases in communicable diseases will mean a greater demand for skilled care.

Ventner cites 2002 data from Statistics SA indicating that the nation then had about 155,000 practicing nurses, for a nurse/population ratio of about 343 per 100,000, above the apparent 200 per 100,000 World Health Organization minimum. However, the adequacy of this minimum is far from clear; many developed nations with serious nursing shortages have nurse/population ratios of closer to 1,000 per 100,000 (see the ICN report). Indeed, the piece reports that there are currently 32,000 vacant nursing posts in South Africa's public hospitals alone--a figure that is more than 20% of the 2002 practicing nurse total. Meanwhile, the piece reports that a recent study by the Human Sciences Research Council (HRSC) shows that the nation is steadily losing trained nurses, with a reported 18% of the nurses registered with the SA Nursing Council no longer practicing there. Of course, though the piece does not say so, this 18% figure is remarkably similar to the apparent number of public hospital vacancies, suggesting that--as elsewhere--a significant part of the "shortage" is in fact due to existing nurses' unwillingness to work under current conditions. The study also suggests that nursing school enrollments actually decreased between 1990 and 2000, though the piece does not indicate what has been happening in the last few years.

The article notes that the HRSC study cites emigration, "work pressure, and work environment-related factors" as being among the main reasons for the decline in practicing nurses. A 2003 HRSC study reportedly found that 60% of nurses surveyed were dissatisfied with their work environments, with almost 80% reporting increased workloads. The piece also notes that rural areas are especially likely to experience a shortage of nurses.

The piece reports that the Democratic Nursing Organization believes that the crisis is actually "far worse" than the recent HRSC report indicates. Spokesperson Nelouise Geyer is quoted as saying that the nurse/population ratios reflect nurses "currently available," rather than those actually at the bedside; it's not clear exactly what this means. Geyer also suggests that South Africa is running especially low on "specialised" and "experienced" nurses, and notes that the "practising nurse" figures include nurses who are actually overseas, since they tend to keep their licenses current for a possible return.

The piece, which is of moderate length, deserves credit for providing a significant amount of relevant data, briefly exploring potential reasons for the crisis, and including several quotes from a nursing organization representative. It might also have included some input on current conditions from a nurse practicing at the bedside in South Africa--and from a nurse who has chosen to do something else.

See "Crisis as SA steadily loses qualified nursing: Fewer showing interest in the profession" by Bruce Ventner in the South Africa's Star.