A Mighty Nurse in South Africa

betinaThere is just something fascinating about cultures other than our own. We travel to taste new food, hear a new language, and see new sights. What about different nursing cultures? Are they not equally fascinating? What kind of system do they work in? Do they face the same issues nurses in the U.S. face? Do they struggle with nursing shortages? In my travels I have had the privilege to meet some amazing foreign nurses and experience healthcare in different countries. My latest Mighty Nurse feature takes us to South Africa.

Meet Betina, a neonatal nurse from Johannesburg, South Africa. She became a nurse in a culture where according to her, nursing is “a profession that is looked down upon.” It sounds a little strange coming from a country where nursing is considered one of the most honorable professions. It is not to say that American nurses are without struggle for respect. We fight every day to be equals on our medical team.

Betina originally thought nursing would be the springboard to medical school. She planned to become a doctor, but her path led her to nursing where she realized what she was destined to be. She found her specialty in the Neonatal Intensive Care Unit where she still works 7 years later. When I caught up with her, she was on her first travel assignment-in Saudi Arabia. 

Describe what healthcare is like in your country?

The healthcare system in our country is divided into the government sector and the private sector. The government sector is financed through taxes, whereas the private sector is mainly financed through medical aids and – schemes. The healthcare system has proven to be a priority challenge in our country because most of the population can’t afford the private sector. This has caused a major influx of patients to the government hospitals, who are already short of staff, stock, equipment and other resources. Patients have very long waiting times and often poor service due to the above mentioned challenges in government-funded institutions

What is a normal nurse/patient ratio?

The Neonatal Intensive Care unit where I worked is a 10-bedded unit with an adjacent High-Care Unit that can occupy 19 patients, but due to the fact that we are a tertiary institution accepting all the referrals, we were almost always overcrowded. The ICU would have an average of 13 patients and the High-Care and average of 29 patients causing the nurse/patient ratio to increase. The usual ratio in ICU is 1:2 and in High-Care it would be 1:4, but there has been shifts where the agency nurses were not confirmed or a nurse phoned in sick, then we would end up with 1:3 in ICU and 1:5 in High Care. It made a shift extremely stressful and tiring for all the nurses involved. Luckily, we worked well as a team and helped each other as much as possible.

What kind of acuity (how sick)?

The hospital I worked in was an academic government institution, therefore we were a Level 3 referral hospital, meaning all the critically ill and complicated cases were sent to us. The patients in our unit ranged from medical to surgical to palliative care. Some of our patients’ stay was longer than three months, depending on their condition which contributed to the unit being overcrowded.

If there was one thing you could change about your healthcare system, what would it be?

Unfortunately, healthcare is not listed as a priority in our country. My wish would be that education and healthcare will become top priorities with the resources necessary to provide the best and most affordable care possible to every citizen or visitor.

Describe some of the stronger points of your healthcare system.

Our healthcare system has become more focused on prevention, rather than cure. More effort and resources have been put into primary care at the community level. This approach will hopefully ensure that the need for hospitalization and specialized care would decrease.

Wherever in the world we are; nurses share a common bond. The deep devotion to the profession as well as struggles are real. The issues are the same to one degree or another. Thanks so much Betina for sharing!

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