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Auxiliary Nurse Training CPSI

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					      AUXILIARY NURSE TRAINING
    A MULTIPRONGED INNOVATION
                     LIMPOPO CASE STUDY




Presentation at the 4th Public Sector Innovation Conference
                   The Emperors Palace


                Dr Molepo M C
              1st September 2010


                                                              2
     Outline of the presentation
1.BACKROUND
2. PROGRAMME OVERVIEW
3.PROGRAMME BENEFITS
4. DAWN OF REALITY
5.PROGRAMME LIMITATIONS
6. LESSONS LEARNED
7. WHAT NEXT?
8. CONCLUSSION
                     1.Background
•   HEALTH FACILITIES
•   40 hospitals, 416 clinics 29 CHC
•   9800 Beds. UBUR 77%
•   13750 Nurses, 6 600 Prof nurses
•   1:2:4 =165 480 Nurses

Pushing back the frontiers of poverty”
• Department's response
SOCIAL DEVELOPMENT
 Consumers of food parcel's for poverty relief educated
  to Matric level
 Dependent of food parcel's
          Background cont..
HEALTH
Vacancy rate ( 57%)
Moratorium of direct entry into
Basic nursing care nurses upgraded
programme
Basic nursing care deteriorated
Optimal functioning of nursing schools
 running subcategory programmes
       2.Programme overview
• Purpose
• Guidelines developed
• District committees
• Selection
• Verification
• Post allocation for candidates
• Arbitration
• Sanctions
       2 Programme overview
• DISTRICT COMMITTEES
Social workers, Primary Health Care
 nurses, Communication liaison officers,
 Councilors responsible for the Health,
 Traditional and church leaders &
 Nurse educators
Hospital Board members where the
 Nursing Education Institution for
 training is located
    2 Programme overview
Selection of candidates
• Capacity of Nursing School
• Inclusive of residence
• Availability of post
• Allocation within district ( nearest to
  home)
• Identification
    2 Programme overview
• Selection Criteria
 Poverty is the core criteria
 Matric, orphaned & needy
food parcels, age
• Verification process
District delegates across municipalities
Compliance to the selection criteria
Consensus on poverty status
                  Programme overview
     • List of candidates for training
     • Sworn affidavits by candidates
District   Name   Gender   Facility Post   Sub-       Village   Criteria
                                    no     district




Approval for training and appointment
South African Nursing Council Course (R2176)
• “An Enrolled Auxiliary nurse is a person
 who has followed and satisfied the
 requirements of the South African Nursing
 Council course leading to enrollement as
 an Enrolled Auxiliary nurse”
               Programme intake and
                     graduates
                           AUXILIARY NURSE TRAINING


400



350



300



250


                                                                        intake
200
                                                                        output


150



100



50



  0
      2003/4     2004/5   2005/6            2006/7    2007/8   2008/9
           Programme progress   percentage




.                 2008/9, 97%                2003/4, 97%




                                                                         2003/4
                                                                         2004/5
                                                                         2005/6
    2007/8, 95%                                            2004/5, 96%
                                                                         2006/7
                                                                         2007/8
                                                                         2008/9




                  2006/7, 95%                2005/6, 95%
            3 Programme benefits
Professional Nursing Career path ( Diploma in Nursing)

 Intake   Number of   Pass at record Level   Level   Level 1
          students    time           111     11

 2005          7            6        1

 2006         12            9        0       1       1

 2007         15            8        1       2       3

 2008         21      -              10      10      1
 2009         18                             16      2
           3 Programme benefits
•   Reduced vacancy rate
•   Nursing category Upgrade
•   Improved service delivery
•   Continuous development
•   Bursary opportunities
•   Reduce burden for SASSA & relatives
•   Increased buying rate
•   Revenue generation
                 4 Dawn of reality
• Underestimated poverty ( emotional drain)
• In the absence of nothing, what is choice?
• Culture shock for nursing professions &
    managers
•   Self security, confidence, esteem
•   Social unintended neglect ( siblings)
•   Silent expectation
•   Poor coping with medically ill patients
•   Poor life skills
•   The “next of kin” drama
               4 Dawn of reality
• Stigma
• Academic progress (Matric subjects)
• Resistance by support personnel
• Inappropriate delegations, throwing them into
  the deep
• . English language proficiency
• Realities of nursing
4 Evidence of poverty alleviation
    from Nursing education

• Testimonies from candidates in
  certificate ceremony
• Letters of gratitude's writing to the
  Executing Authority
• Better life for siblings
• Candidates value things we take for
  granted
                 Social pressure
•   Losses ( neonates & students )
•   Depressive symptoms ( refer)
•   Abandon programme
•   8 deregistered and converted to support
    personnel ( SANC circular 6/2007)
•   Candidates trapped within family
•   Opportunistic social relationship
•   Pregnancy
•   Debilitating illnesses
         5 Programme limitations
• Initially restricted to E/N/A
• Level of education allowed them to do
    other programme
•   Poor communication with other
    departments
•   Disadvantaged for being poor
•   Pain of Excelling students
•   Ownership Health, Social development or
    Municipalities
             7 Lessons learned
• Poverty affects “you”
• Process not for the faint hearted
• Need to authentic certificate
• Reluctance to intervene where committee
  members are not departmental officials
• Committee members taking advantage of the
  vulnerable
• What about the person to whom nursing is a
  1st career of choice ?
         Reduced Vacancy rate
        Poverty alleviation ( 2452)

2003 2004 2005 2006 2007 2008 2009 201
                                   0
57,6 47.7 37.7 35.6 27% 19.9 10% 14.
               %                   3%
                     What next?
• Basic Nursing Care Package
• Assessment for impact on Basic Nursing care
• Material Support for candidates for health
    professions ( university)
•   Process was applied for Auxiliary Social work
•   Path followed for Health profession’s bursaries
•   Following evaluation report ( CPSI & GTZ)
          LASTLY
• THANK YOU

				
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