1 November 2022

TO:     National Department of Health

Provincial Departments of Health

Nursing Education Institutions

All Stakeholders

SOUTH AFRICAN NURSING COUNCIL – YEAR-END CLOSURE

The office of the South African Nursing Council will be closed for the year-end from Friday, 23 December 2022 at 12:00 midday, and re-open on Tuesday, 03 January 2023 at 08:00. Kindly note that on 23 December 2022, for operational reasons the gates will be closed at 11: 00 already.

Annual fees must be paid into the Council’s bank account on or before 31 December 2022 to avoid restoration fees – note that banks take up to three (3) days to clear payments and thus all bank electronic transfers need to be made by 23 December 2022 to ensure it reaches the SANC by 31 December 2022.

The SANC banking details are:

Name of bank:              First National Bank

Account number:        514 211 86 193

Branch code:                253145

Reference:         Person’s own SANC Reference Number followed by ANLFEES

Whilst waiting for the Annual Practising Certificate to be distributed by the SANC, the employer can verify the registration status of the practitioner through the SANC website by logging into the SANC eRegister at https://www.sanc.co.za/eRegister.htm. To do this, they will require the practitioner’s SANC reference number or Identity Number (ID No).

We wish you all the best over the holiday season, please stay safe and we look forward to working with you in 2023.

Kind regards

(Signed)

Ms SJ Nxumalo
Acting Registrar and CEO
South African Nursing Council

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27 October 2022

To:      NATIONAL DEPARTMENT OF HEALTH

PROVINCIAL DEPARTMENTS OF HEALTH

NURSING EDUCATION INSTITUTIONS (NEIs)

ALL STAKEHOLDERS

SUBJECT: POSITION OF SANC ON ARTICULATION FROM LEGACY TO THE HIGHER EDUCATION QUALIFICATIONS SUB-FRAMEWORK (HEQSF)-ALIGNED NURSING QUALIFICATIONS

1. PURPOSE

1.1     To share information with the National Department of Health, Provincial Departments of Health, Nursing Education Institutions (NEIs) and other relevant stakeholders on the following:

1.1.1   Process followed by the South African Nursing Council (SANC) in determining the recommendations submitted to the Council on Higher Education (CHE) about articulation pathways for Nurses who trained under legacy qualifications;

1.1.2   Position of the SANC on Communiqué 1 of 2022 issued by the CHE; and

1.1.3   Position of the SANC on Communiqué 10 of 2022 issued by the CHE.

2. BACKGROUND

2.1    Process followed by the South African Nursing Council (SANC) in determining the recommendations submitted to the Council on Higher Education (CHE) on articulation pathways for Nurses who trained under legacy qualifications.

2.1.1    The legacy qualifications offered by the public and private Nursing colleges/schools were arbitrarily assigned on the NQF, based on the institutional type. When the new NQF Act No. 67 of 2008 was implemented, there was a need for alignment of higher educational qualifications nationally which happened between 2011 and 2015.  This includes Nursing qualifications acquired through universities. However, the public and private Nursing colleges/schools were left out of this process because they were not part of Higher Education at that time. This created a challenge for the Nurses who trained under legacy qualifications in terms of articulation to the new HEQSF-aligned Nursing qualifications. The SANC expressed concern about this omission through engagement with the CHE.

2.1.2   It is on the basis that the SANC initiated a gap analysis process to identify the similarities and differences between the legacy and HEQSF-aligned Nursing qualifications. The purpose of the exercise was to determine if there were gaps in learning content and programme outcomes of these Nursing qualifications, and if there were, how the gap would be bridged. The SANC conducted a three-day workshop from 3-5 March 2020. Nursing Education and Training stakeholders were represented at the workshop, namely, Forum of University Nursing Deans of South Africa (FUNDISA); the College Principals and Academic Staff of South Africa (CPASSA) and Hospital Association of South Africa (HASA). The findings of the workshop were to assist the SANC in mapping out articulation pathways for the Nurses who underwent the legacy qualifications.

2.1.3   The proposed recommendations emanating from the workshop on articulation pathways for the Nurses who trained under the legacy qualifications were approved by the Council of the SANC and submitted to the CHE for further consideration. The copy of the recommendations is available on request from the SANC.

2.1.4   A CHE Advisory Task Team was formed to deal with the SANC recommendations about articulation pathways for the Nurses who underwent the legacy qualifications. The SANC was represented at the CHE Advisory Task Team. The task team met several times and finally the CHE Advisory Task Team recommendations were presented to the Higher Education Quality Committee. After approval, the CHE issued Communiqué 1 of 2022.  

NB.     It must be emphasized that Communiqué 1 of 2022 didn’t include articulation pathways for Nurses who underwent the four-year comprehensive Diploma in line with Regulations Relating to the Approval of and the Minimum Requirements for the Education Training of a Nurse (General, Psychiatric and Community) and Midwife leading to Registration (Government Notice Regulation No.425 of February 1985 as amended).

                                                                                                NOR

For Nurses with a Diploma in Nursing with a one-year Midwifery qualification in line with Regulations for the course for the Diploma in Midwifery for registration as a Midwife (Government Notice Regulation No.22 of February 1975 as amended).

This was because the matter was still under discussion.

3. POSITION OF THE SANC ON COMMUNIQUE 1 OF 2022 ISSUED BY THE CHE

3.1       Much as the CHE has replaced Communiqué 1 of 2022 with Communiqué 10 of 2022, for the purpose of this circular, the position of the SANC will be articulated separately for Communiqué 1 and Communiqué 10.

3.2       The SANC is agreeable with the content of Communiqué 1 of 2022 because the SANC participated in the Advisory Task Team and the content of the Communiqué was in line with the SANC recommendations.

4. POSITION OF SANC ON COMMUNIQUÉ 10 OF 2022 ISSUED BY CHE

4.1       The SANC is agreeable with the decisions 1, 2, 3, and 4 of Communiqué 10 of 2022 because it is based on the content of Communiqué 1 of 2022.

4.2   The South African Nursing Council distances itself from the CHE Communiqué 10 of 2022 on articulation pathways (i.e. decisions 5, 6 and 7) as presented for Nurses who have graduated from the four-year comprehensive Diploma course and the General Nurses with one-year Midwifery qualification.

4.3       The SANC was not part of the discussions leading to decision 5, 6 and 7 of Communiqué 10 of 2022 after noticing that the discussions were derailed from the SANC recommendations and were not in the best interest of the Nursing profession.

5. IMPLICATIONS OF DECISIONS 5, 6 AND 7 OF COMMUNIQUÉ 10 OF 2022 ISSUED BY THE CHE

5.1       The larger pool of Registered Nurses who are eligible to access the postgraduate Diploma programmes are those that are affected by decisions 5, 6 and 7 of the CHE Communiqué 10 of 2022.

5.2       There will be a narrow pool of Nurses who are eligible to access postgraduate Diploma programmes directly.

5.3       There is currently an outcry on the shortage of Nurse Specialists and Midwife Specialists in South Africa. Should the Nursing Education Institutions not be able to train adequate Nurse Specialists and Midwife Specialists, it will exacerbate the shortage of this category.

6. WAY FORWARD

6.1     The Council of SANC ordinary meeting held on 22-23 September 2022 resolved that the matter should be escalated to the Executive Authority responsible for Health in South Africa for intervention. Feedback will be provided subsequently.

For further information in respect of this Circular, you are advised to contact Ms M Mzolo, Acting Senior Manager: Provider Affairs at (012) 420 1047 or on e-mail at: [email protected]

Yours Sincerely

(Signed)

MS SJ NXUMALO                                                                                                             

ACTING REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

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18 October 2022

To:          Nursing Education Institutions

                 Nursing stakeholders

SOUTH AFRICAN NURSING COUNCIL (SANC) EXAMINATION SCHEDULE – 2023

Attached is the Examination Schedule for 2023

Kindly take note of the following requirements applicable to the SANC examinations:

1. The closing date for the examinations should be strictly adhered to and no exceptions or allowances will be made to extend these dates.

2. Only registered learners will be eligible for an examination: The Head of the Nursing Education Institution (NEI) must ensure that all learners are registered with the SANC within the prescribed period. Foreign applicants apply as individuals but will have to adhere to the prescribed period.

3. Candidates will not be registered for an examination with only an identity number. SANC reference numbers are needed in all cases. Please follow up with the SANC Registration Section first, if learners are registered for the course before registering them for an examination.

4. The SANC will only process applications for entry into the South African Nursing Council examination that meet the following requirements:

• The Examination Application Form is completed in full, accurately and signed by the relevant person/s. The surname and given names must be those appearing in the identity document/ passport number.

• All the required documentation to be included.

• There is proof of payment of prescribed examination fees into the SANC bank account, such payment must be done by the NEI (group payment) and not by learners, except for foreign candidates.

Banking details are as follows:

Name of Bank:            First National Bank

Account number:        51425166282 (Current Account)

Branch:                        Corporate Core Banking – Pretoria

Branch code:               210-554

Reference:                  NEI S-number followed by the type of fee code ‘EXAMFEE’

The correct reference must appear on all deposits to expedite the processing of your payment. The code ‘EXAMFEE’ must only be used for payment in respect of examination fee. This code must not be used for any other types of payment. Here is an example of what a correct reference will look like for an NEI with S-number S12345:  S12345EXAMFEE

NB:      The Head of the NEI must ensure that payment of fees by their Provincial Department of Health or Head Office is made separately for each NEI and for each specific examination.

Provincial bulk payments without specifications create administrative challenges and cause a delay in processing of the applications.

5. Only those candidates that have been issued an examination timetable/number will be eligible to write the SANC examination.

6. All practical MARK SHEETS must be submitted to the SANC by registered mail/courier by the end of the month in which the examination is written. If the PRACTICAL MARK SHEETS in a SANC format are not submitted on time, the examination results will be published without the practical marks, hence qualification certificate will not be issued to the affected candidates.

7. The SANC requests invigilators not to enclose the practical mark sheet or any other documents with the examination package.

8. The SANC reserves the right to cancel an examination reflected on the schedule if there are insufficient candidates for such an examination.

9. The SANC requests the NEIs to inform all their candidates of the outcome of the examination results once published. No examination results will be given out telephonically by the office of the SANC. However, candidates will receive results via text messages (SMS).

NB: Examination fees are non-refundable according to Regulations regarding fees and fines payable to the South African Nursing Council (Government Notice No.R.170 of 8 March 2013)

 ___________________________

Ms S.J Nxumalo

Acting Registrar and CEO

The South African Nursing Council

SOUTH AFRICAN NURSING COUNCIL

EXAMINATION SCHEDULE FOR 2023

The following examination will be held during the year 2023 if there are candidates.

For further information, please contact the Assessment Section, South African Nursing Council.

Contact Professional Advisors:

Ms N Ndlovu Telephone 012 420 1078/ [email protected]

Ms M Tshabalala Telephone 012 426 9534/ [email protected]

Manager: Assessment Section

Ms E Magagula Telephone 012 426 9596/ [email protected]

Fax: 012 343-5400

Address Private Bag X132, Pretoria, 0001

Email: [email protected]

Final Examination for the Bridging Course for Enrolled Nurses leading to Registration as General Nurse or Psychiatric Nurse

Regulation: R.683 of 14 April 1989 (as amended)

Paper 1 = Integrated General Nursing Science II

OR

Integrated Psychiatric Nursing Science II

Paper 2 = Ethos and Professional Practice (including Ward Administration

And Clinical Teaching) and Social Science II

Professional Entrance Examination for Registration as a Professional Nurse and Midwife

Regulations: R.174 of 08 March 2013

Paper 1 = Comprehensive Nursing care

Paper 2 = Midwifery component

Professional Entrance Examination for Registration as a General Nurse

(Also written by Foreign Nurses as admission examination)

Regulations: R.171 of 08 March 2013

Professional Entrance Examination for Registration as an Auxiliary Nurse (Also written by Foreign Nurses as admission examination)

Regulations: R.169 of 08 March 2013

Admission Examination for Foreign Applicants for Enrolment as a Nurse

• International Nurses should contact the Foreign Registrations Desk, South African Nursing Council for additional information.

Contact: Mr S Shezi- Professional Advisor

Telephone: National:012 420 1040

International: +2712 420 1040

Fax: National: 012 426 9516

International: +2712 426 9516

Address Private Bag X132, Pretoria, 0001

Republic of South Africa

E-mail:[email protected]

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1 October 2022

To:          National Department of Health

                 Provincial Departments of Health

                 Private Health Providers

                 All stakeholders

This Circular serves to inform Stakeholders that Ms SJ Nxumalo has been appointed as the Acting Registrar and Chief Executive Officer of the South African Nursing Council (SANC) by the Minister of Health with effect from 01 October 2022.

The appointment is in terms of Section 18 of the Nursing Act, 2005 (Act No. 33 of 2005) and in terms of conditions as provided in the Policy on the Secondment of Employees in the Public Sector.

Kind regards

(Signed)

Dr M MOLEPO                                                                                         

CHAIRPERSON: SOUTH AFRICAN NURSING COUNCIL

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11 August 2022

To:          National Department of Health

                 Provincial Departments of Health

                 Private Health Providers

                 All stakeholders

SUBJECT: UNIDENTIFIED DEPOSITS: 2022 ANNUAL FEES PAYMENTS

1. PURPOSE

1.1. The purpose of this circular is to address a growing concern that the South African Nursing Council (SANC) is currently experiencing regarding the payments which are made by the Nurse Practitioners without including their SANC reference number together with the service they are paying for.

1.2. This circular also seeks to outline the process which should be followed for tracing and reallocation of incorrectly referenced payments or payments that are made without any reference whatsoever.

2. BACKGROUND

2.1 During the 2022 Annual Practising Certificate season, the SANC received a high number of payments for annual fees which were not properly referenced, therefore, many of these payments could not be allocated to the Nurse Practitioners’ SANC membership accounts. As a result, the Nurse Practitioners could not be issued with their Annual Practising Certificates and were removed from the Register for non-payment of annual fees.

2.2 We urge the Nurse Practitioners who know that they have made payments for their 2022 annual fees but are removed from the register for non-payment of 2022 annual fees to urgently contact the SANC so that we can assist them in tracing their payments, and where successful, allocate the payments to their SANC membership account.

2.3 The South African Nursing Council uses the Reference Deposit Account for payment of Fees and Fines payable by our stakeholders. The reference consists of two parts:

2.3.1 Your SANC reference number (8 digits) – which is used to identify who the payment is for.

2.3.2 A payment type code (7 CAPITAL LETTERS) written immediately after the SANC reference number – which is used for identifying what the payment is for.

The following line is an example of what a correct reference will look like when making annual fee payment:

12345678ANLFEES

In the above example, ‘12345678‘ is the Nurse practitioner’s SANC reference  number and ‘ANLFEES‘ is the payment type code.  You will notice that the payment reference number is always 15 characters long.

PLEASE NOTE that the above reference is only an example, and you should not use the    above details for making any payment.  You must use your own SANC reference number as the reference followed by an appropriate payment type code.

2.4 Listed in the tables below are all the PAYMENT TYPE CODES that are in use at the South African Nursing Council:

TO BE USED BY INDIVIDUALS 

TO BE USED BY INSTITUTIONS/ORGANISATIONS/COMPANIES 

3. UNIDENTIFIED DEPOSITS

3.1 Affected Nurse Practitioners are required to send their proof of payment (not bank statement) and SANC reference number to [email protected] or [email protected].

To enable successful tracing the proof of payment should at least have the following information:

3.1.1 Beneficiary/Recipient Account Number

3.1.2 Beneficiary/Recipient Reference

3.1.3     Date of payment

                     3.1.4     Amount Paid

3.2 The contents of this communique should be brought to the attention of all Nurse Practitioners in all health establishments.

3.3 The Nurse Practitioners are also reminded that according to Section 44 (2)(b) of the Nursing Act, a person whose name has been removed from the register must cease to practise as a Nurse Practitioner and is precluded from performing any act which he or she, in his or her capacity as a registered person, was entitled to perform.

3.4 For further information in respect of this communique, kindly contact Mr B Manganyi, Acting Manager: Revenue Collections and Sales at [email protected] or Tel: 012 420 1081.

Yours sincerely,

(Signed)

MS SA MCHUNU                                                                                               

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

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3 June 2022

To:          National Department of Health

                 Provincial Departments of Health

                 Nursing Education Institutions

                 All stakeholders

This Circular serves as confirmation of the South African Nursing Council’s fees and fines as stipulated in the Government Gazette published on 27 May 2022.  

1. ANNUAL FEES FOR 2023

1.1 NORMAL ANNUAL FEES

The annual fees for the calendar year 2023 for different categories of practitioners are provided in the table below:

1.2 REDUCTIONS IN ANNUAL FEES FOR AGE 60 AND OVER

The Council has resolved to introduce reduced fees for nurses 60 years of age and over as per the table below:

1.2.1 60 TO 64 YEARS OF AGE ON 1 JANUARY 2023 (25% REDUCTION)

1.2.2 65 YEARS OF AGE AND OLDER ON 01 JANUARY 2023 (50% REDUCTION)

NB: To qualify for the discount amounts, practitioners may be required to submit a certified copy of their identity document in order to confirm their age.

Notes:

• The annual fees for 2023 must be received by the SANC on or before 31 December 2022.
• The amounts in the tables above all include 15% VAT.

2. RESTORATION FEES FOR 2023

The restoration fees for different categories applicable from 1 January 2023 are shown in the following table.

Notes:

The reduced restoration fee only applies to a practitioner:

• Who must have been removed from the register at his/her own request; or
• Who must be 60 years of age or older on 1 January 2023. However, this must be confirmed with the Council before paying the reduced amount.

3. VOLUNTARY REMOVAL

A Nurse Practitioner who no longer wishes to practise in South Africa or who is unemployed, may request, in writing, for a voluntary removal of his/her name from the register, by completing the form available from the SANC. If a voluntary removal is granted by the SANC, the nurse practitioner’s name will be removed accordingly on the 31^st of December of the year in which the application is received. Once removed, the nurse practitioner will no longer be required to pay annual fees while he/she is removed from the register.

If the nurse practitioner requires reinstatement onto the register, he/she will, in addition to paying the reduced restoration fee, be required to complete a Restoration Form which can be accessed from the SANC website, www.sanc.co.za. It must be noted that practising while not being registered is illegal.

4. CLOSING DATE FOR PAYMENT OF ANNUAL FEES

Please note that for the calendar year 2023, the closing date for the payment of annual fees is 31 December 2022. Payments must reach the SANC bank account on or before the closing date. You are, therefore, urged not to leave payment for the last minute to avoid problems associated with making payments at year end.

Remember: Bank transfers from non-FNB banks may take up to 3 working days and you are therefore advised to pay well in advance to meet the 31 December 2022 deadline.

5. OTHER FEES

Please note that other fees and fees payable by institutions will be applicable with effect from 01 January 2023.

6. PERSAL DEDUCTIONS

The signing of Resolution 3 of 2019 in September 2019 by the National Department of Health together with major trade unions in Public Health and Social Development Sectoral Bargaining Council (PHSDSBC), brought into effect the implementation of PERSAL deductions from the 2020 APC season for all employees falling under the scope of the PHSDSBC.

As a result of this agreement, affected Nurse Practitioners are urged not to pay the annual fees on their own as the employers are required to pay on their behalf in terms of Resolution 3 of 2019.  

7. eREGISTER

The SANC has made an eRegister facility available on the SANC website which can be utilised by employers to verify the registration status of all Nurse Practitioners in their employment. Employers are urged to utilise this facility in the absence of a physical Annual Practising Certificate (APC).

Visit: https://www.sanc.co.za/eRegister.aspx for more details.

8. COMMUNITY SERVICE PRACTITIONERS

Community Service Practitioners are not eligible to be issued with an APC, and therefore, should NOT pay annual fees. They MUST pay a conversion fee on completion of their Community Service in order to be registered as Nurse Practitioners using the REGFPRA registration fee code instead of ANLFEES (e.g. 12345678REGFPRA).

Yours sincerely,

(signed)

MS SA MCHUNU                                                                                               

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

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24 May 2022

To:          National Department of Health

                 Provincial Departments of Health

                 Nursing Education Institutions (NEIs) 

                 All stakeholders

SUBJECT: COMMUNITY SERVICE FOR NURSES WHO HAVE COMPLETED THE BACHELOR OF NURSING PROGRAMME

For further information in respect of this Circular, you are advised to contact Ms SJ Nxumalo, Acting Deputy Registrar: Professional Affairs at (012) 420 1022 or on e-mail at: [email protected]

Yours sincerely,

(signed)

MS SA MCHUNU                                                                                               

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

24 May 2022

To:          National Department of Health

                 Provincial Departments of Health

                 Nursing Education Institutions (NEIs) 

                 All stakeholders

SUBJECT: INTERIM MEASURES ON DISTINGUISHING DEVICES TO BE WORN BY AUXILIARY NURSES WHO HAVE COMPLETED THE HIGHER CERTIFICATE PROGRAMME IN NURSING

1. PURPOSE
   • The purpose of this circular is to update the National Department of Health, Provincial Departments of Health, Nursing Education Institutions (NEIs) and other relevant stakeholders about the interim measures on distinguishing devices to be worn by Auxiliary Nurses who have completed the Higher Certificate programme in Nursing.

2. BACKGROUND
   • In terms of the Regulations Regarding the Distinguishing Devices and Uniforms for Enrolled Nursing Assistants and Enrolled Pupil Nursing Assistants (Government Notice Regulations No. 1747 of 29 September 1972 as amended), Enrolled Nursing Auxiliaries wear a Metal Brooch with the wording “South African Nursing Council” in blue coloured lettering around the edge.
   • The nursing profession was engaged on the matter of distinguishing devices through a survey. Recommendations were provided on the range of distinguishing devices, which included the dark turquoise epaulettes being recommended for Auxiliary Nurses who will complete the Higher Certificate programme in Nursing.
   • The findings of the survey informed the review of distinguishing devices for Nurses and Midwives.
   • The reviewed Regulations on distinguishing devices for Nurses and Midwives were developed, approved by Council and submitted to the National Department of Health for consideration and publication for public comments.

3. INTERIM MEASURE
   • In the meantime, the first cohort of Student Nurses have completed the Higher Certificate programme in Nursing, passed the Professional Entrance Examination in May 2021 and were subsequently registered with the South African Nursing Council in the category “Registered Auxiliary Nurses”.
   • It is a statutory requirement that practitioners should be correctly identified through the prescribed distinguishing devices.
   • The Council at the virtual special meeting held on 30-31 March approved that, whilst still awaiting the promulgation of the new Regulations on Distinguishing Devices for Nurses and Midwives, the Registered Auxiliary Nurses who underwent the Higher Certificate programme in Nursing be permitted to wear the brooch, same as the distinguishing devices worn by Nursing Auxiliaries who completed the course leading to enrolment as a Nursing Auxiliary (Government Notice Regulations No.2176 of 19 November 1993 as amended)

For further information in respect of this Circular, you are advised to contact Ms SJ Nxumalo, Acting Deputy Registrar: Professional Affairs at (012) 420 1022 or on e-mail at: [email protected]

Yours sincerely,

(signed)

MS SA MCHUNU                                                                                               

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

7 April 2022

To:          National Department of Health

Provincial Departments of Health

Nursing Education Institutions    

All stakeholders

SOUTH AFRICAN NURSING COUNCIL – EASTER HOLIDAYS CLOSURE

Please be informed that the South African Nursing Council (SANC) offices will be closed from Thursday, 14 April 2022 at 12:00 and will re-open on Tuesday, 19 April 2022 at 8:00.

We would appreciate it if you could kindly inform all persons in your institutions.

Wishing you safe travels over the Easter holidays.

Yours sincerely,

(signed)

MS SA MCHUNU                                                                                               

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL

28 March 2022

To:          National Department of Health

Provincial Departments of Health

Private Health Care Providers     

All stakeholders

SUBJECT:      IMPAIRMENT COMMITTEE FINDINGS: POOR MANAGEMENT OF SCHEDULED SUBSTANCES/     MEDICINES IN HEALTH ESTABLISHMENTS

1. PURPOSE

• Share the findings/trends of the Impairment Committee (IC) regarding mismanagement of scheduled substances/medicines with the National Department of Health, Provincial Departments of Health, Private Health Care Providers and other relevant stakeholders.
• To remind Registered Nurses and/or Midwives of their role in managing scheduled substances/ medicines in health establishments in line with relevant policies and protocols.

2. BACKGROUND

• The IC is one of the standing committees established by the South African Nursing Council (SANC) in terms of section 51 of the Nursing Act, 2005 (Act No.33 of 2005). The Committee is appointed to manage practitioners who are registered in terms of section 31 (1) of the Act, who are deemed unfit to practice nursing due to disability or impairment. Most of the cases received by IC relate to abuse of scheduled substances/medicines. In dealing with these cases, the Committee has noted with concern the deteriorating vigilance in the management of scheduled substances/medicines in healthcare establishments, both public and private, which leads to abuse of these substances/ medicines by Health Care Professionals.
• On analysis of the reported cases, the IC established that practitioners had access to these substances/ medicines in any of the following ways:
• When Registered Nurses and/or Midwives issue and administer prescribed scheduled substances/ medicines alone.
• Scheduled substances/ medicines cupboard keys not kept in line with applicable policies.
• Scheduled substances/ medicines not co-checked during hand over and in every shift change, leaving discrepancies to go unnoticed.
• Counting and recording of the quantities of scheduled substances/ medicines administered not done in line with applicable institutional policies or common best practices

• Prolonged use of prescribed scheduled substances/ medicines, which leads to dependency. For example, Registered Nurses and/or Midwives who were involved in car accidents or have had major operations which lead to addiction and abuse.

3. TELL-TALE SIGNS OF NURSE PRACTITIONERS WHO MAY BE ABUSING SCHEDULED SUBSTANCES/ MEDICINES

The following are some of the warning signs that the nurse may be using or addicted to scheduled Substances or medicines:

• Scheduled substances/ medicines to be discarded kept in a syringe for no apparent reason;
• Registered Nurse and/or Midwife frequently borrowing scheduled substances/ medicines from other wards or visiting the wards/ healthcare establishments at awkward times;
• Registered Nurse and/or Midwife requesting colleagues to countersign in the register for scheduled substances/ medicines which they did not witness being dispensed;
• Inaccurate recording and questionable entries;
• Erasing or ‘overwriting’ of drug book entries, instead of following standard operating procedures;
• Registered Nurse and/or Midwife often volunteering to administer scheduled medications; and
• Registered Nurse and/or Midwife frequently offering to count scheduled substances/ medicines, to make sure the count is correct.

4. ROLE OF PRACTITIONERS IN MANAGEMENT OF SCHEDULED SUBSTANCES/ MEDICATIONS

• It remains the obligation of the Registered Nurse and/or Midwife to ensure that all scheduled substances/medicines are ordered, controlled, administered and disposed of in terms of the given protocols, policies and procedures of the institution.
• Registered Nurses and/or Midwives must ensure that Enrolled Nurses/Nursing Auxiliaries ARE NOT allowed to keep the keys to the controlled medicines and substance cupboard and to check and administer scheduled medicines alone.
• Scheduled medicines must be prescribed by a doctor except in emergency situations as per institutional protocol.
• Registered Nurses and/or Midwives are personally liable for all unprofessional conduct while performing their duties.
• The person in charge of the ward or nursing unit will remain accountable for all nursing care provided.

5. ROLE OF NURSE MANAGERS IN MANAGEMENT OF SCHEDULED SUBSTANCES/ MEDICATIONS

• Nurse Managers must develop and implement policies and procedures with regards to the ordering, safe keeping and administration of scheduled substances/ medicines.
• There should be strict monitoring of compliance to policies and procedures to assist Nurse Managers to prevent possible addiction and/or abuse.
• Nurse Managers must report incidences of alleged addiction or abuse to the SANC, so that the alleged practitioner is managed under the Impairment Programme, failure of which, the Nurse Manager will be charged for unprofessional conduct.

6. The contents of this circular must be brought to the attention of all practitioners and all managers in all health establishments.

7. For further information in respect of this circular, kindly contact Dr NJ Muswede, Senior Manager: Professional Practice at [email protected] or Tel: 012 420 1008.

Yours sincerely,

(signed)

MS SA MCHUNU                                                                                                    DATE

REGISTRAR AND CEO

SOUTH AFRICAN NURSING COUNCIL