commsStudio – Page 14

Press Rel 7/2018

FOR ATTENTION:	News Editors
SUBJECT:	SANC Virtual Office to assist nurse in nine provinces
	31 August 2018

The South African Nursing Council’s (SANC) virtual office for nurses will be operating again in nine provinces, starting on 3 September 2018.

Says Ms Sizeni Mchunu, Acting Registrar of the SANC: “The purpose of the SANC Virtual Office is to bring limited walk-in services such as payment of annual fees, selling of distinguishing devices, providing information related to the SANC, etc. to the nurses’ doorstep and thus eliminating the need for them to travel to Pretoria.”

The services that will be offered at the Virtual Office include:

PAYMENT OF ANNUAL FEES OTHER SERVICES

•	Nurses are requested to provide the SANC officials with their SANC reference numbers rather than ID numbers for the processing of annual fees payments.
•	There is no limitation for the number of people you can pay for. However, one must ensure that the daily limit is increased with their respective banks.
•	The SANC further requests nurses to avoid using more than one bank card for payments because that delays the process. It would be appreciated / better if they deposit the money into one person’s account to save time.
•	If a person has paid at the bank already, the outreach staff cannot print their Annual Practising Certificates (APCs) as these will be sent to the nurses through the post. They will only be processing payments done on the day of the outreach.
•	Restorations cannot be processed immediately and any payment received for restoration will only be processed by the SANC head office after the visit. Proof of payment in the form of a white receipt will be provided and the original Annual Practising Certificate will follow later.

SELLING OF DISTINGUISHING DEVICES

•	The quantity of distinguishing devices will be limited to ONE pair per person. Nurses are also requested to bring their original green identity books/smart cards for verification.
•	If a nurse is buying on behalf of his or her colleague, he/she must also bring his/her original green identity book.
•	If a nurse is buying on behalf of his or her colleague, the distinguishing devices form must be completed, on both sides, and signed by the owner. Please note that if the form is incorrectly completed, the request WILL NOT be processed.
•	The owner must attach the certified copy of his or her ID and the quantity will be limited to one pair only if buying for someone else.
•	If a person has ordered the distinguishing devices through the bank, Outreach staff cannot issue that order, it will be sent through the post.

The provincial outreach plan for 2018 is published below – be sure to diarise the dates!

Provinces	Kwa Zulu- Natal	North West	Eastern Cape	Northern Cape	Western Cape	Free State	Limpopo	Mpumalanga	Gauteng
Days allocated	10	5	8	5	8	5	8	5	8
Week 1	3-7 Sept	10-14 Sept	26-28 Sept	8-12 Oct	15-19 Oct	22-26 Oct	5-7 Nov	12-16 Nov	28-30 Nov
Week 2	17-21 Srpt	N/A	1-5 Oct	N/A	31 Oct-2 Nov	N/A	19-23 Nov	N/A	3-7 Dec

Says Ms Mchunu: “Nursing practitioners are afforded six (6) months to pay their annual fee (from 1 July to 31 December every year). It is important to note that this annual fee is due by 31 December. If you pay it electronically into the SANC bank account on 31 December, the chances are it will not reflect in time – please keep this in mind when making payments, as failure to meet this deadline will mean that nurses will have to pay a restoration fee as promulgated by law. The SANC would like to reiterate that its eRegister is and remains sufficient proof for an employer to check if nursing practitioners are registered for the relevant year.”

ENDS

Official Spokesperson and person to be quoted:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on email: [email protected]

Press Rel 6/2018

FOR ATTENTION:	News Editors
SUBJECT:	2018 World Hepatitis Day
	25 July 2018

Hepatitis causes more than one million deaths a year and is one of the largest global health threats of our time.

Hepatitis is an inflammation of the liver and causes two in every three liver cancer deaths. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. Types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Typical symptoms of Hepatitis can include fatigue, flu-like symptoms, dark urine, pale stool, abdominal pain, loss of appetite, unexplained weight loss and yellow skin and eyes.

World hepatitis day is on 28 July 2018 and aims to create awareness about Hepatitis and the importance of being tested and treated. There are over 300 million people that are living with viral hepatitis in the world, yet up to 290 million of these are unaware that they have this virus.

“The 2018 theme petitions us to test for the virus to eliminate the millions of people living unknowingly with Hepatitis, and reminds those that are on treatment to adhere to their treatment plans. The South African Nursing Council would like to encourage the public to go for hepatitis testing even if they have do not have any of the symptoms mentioned as testing is the only means of knowing if you are infected.
We also urge nurses to continue with their efforts in combating the spread of this deadly disease and exercise the necessary caution when treating infected patients,” says Ms Sizeni Mchunu, SANC Registrar.

Remember: Testing is the only way to know if you are infected – Test, then Treat.

ENDS

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

Official Spokesperson and person to be quoted:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on Tel (012) 426 -9542 or email: [email protected]

Press Rel 5/2018

FOR ATTENTION:	News Editors
SUBJECT:	2018 International Nurse Day – Nurses also have a right to health
	7 May 2018

The global nursing community would be celebrating the birthday of the nursing pioneer, Florence Nightingale on 12 May as part of International Nurse day under a universal theme of ”Right to Health” for the 2018 commemoration.The global nursing community would be celebrating the birthday of the nursing pioneer, Florence Nightingale on 12 May as part of International Nurse day under a universal theme of ”Right to Health” for the 2018 commemoration.

The South African Nursing Council, as the voice of the nursing profession is in full support of this celebration and has added its own spin on the day with the theme “Nurses also have a right to health”. The focus will be on stress and its related condition, hypertension. This is in support of the international theme while underscoring the fact that nurses’ right to health is sometimes forgotten.

The SANC is aware of the challenges faced by nurses in their line of duty, often at the cost of themselves and their own health. Nursing is a noble profession which requires the highest degree of professionalism, dedication and care. The health system will never function without nursing as its backbone. But the stress that nurses work under daily cannot be under-estimated.

”We acknowledge the efforts from nurses in the healthcare environment. However, it has been noted that nurses tend to forget they also have a right to health. That is the reason we have decided to emphasize the importance of nurses’ health in this year’s International Nurses Day by putting more focus on stress and hypertension” says Ms Sizeni Mchunu, SANC Registrar & CEO.

We wish the nurses in South Africa a memorable International Nurse Day. Let us keep alive the words by the late Florence Nightingale: “For the sick it is important to have the best”.

ENDS

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on Tel (012) 426-9542 or email: [email protected]

Official Spokesperson and person to be quoted:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

Circular 4/2018

9 July 2018

TO:	National Department of Health
	Provincial Departments of Health
	Nursing Education Institutions
	All Stakeholders

Annual Fees for 2019

This circular serves as affirmation of the South African Nursing Council’s fees and fines as stipulated on the government gazette published on 28 June 2018.

1. ANNUAL FEES FOR 2019
1.1 NORMAL ANNUAL FEES
The annual fees for the calendar year 2019 for the different categories of practitioners are given in the following table.

CATEGORY	ANNUAL FEE FOR 2019
Registered Nurses and Midwives	R640.00
Enrolled Nurses and Midwives	R380.00
Enrolled Nursing Auxiliaries	R270.00

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 2019 (25% REDUCTION)

CATEGORY	ANNUAL FEE FOR 2019
Registered Nurses and Midwives	R480.00
Enrolled Nurses and Midwives	R290.00
Enrolled Nursing Auxiliaries	R200.00

1.2.2 65 YEARS OF AGE AND OLDER ON 1 JANUARY 2019 (50% REDUCTION)

CATEGORY	ANNUAL FEE FOR 2019
Registered Nurses and Midwives	R320.00
Enrolled Nurses and Midwives	R190.00
Enrolled Nursing Auxiliaries	R140.00

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

Notes:
The annual fees for 2019 must be received by SANC on or before 31 December 2018.
The amounts in the tables above all include 15% VAT.

2. RESTORATION FEES FOR 2019
The restoration fees for the different categories applicable from 1 January 2019 are shown in the following table.

CATEGORY	NORMAL RESTORATION FEE	REDUCED RESTORATION FEE
Registered Nurses and Midwives	R1 920.00	R130.00
Enrolled Nurses and Midwives	R1 160.00	R130.00
Enrolled Nursing Auxiliaries	R810.00	R130.00

Notes:
The reduced restoration fee only applies to:

	Practitioners who were voluntarily removed from the register
	Practitioners who are or will be 60 years of age or older on 1 January 2019 are legible to pay reduced annual fees however this must be confirmed with the Council before paying the reduced amount.

3. VOLUNTARY REMOVAL
Nurse practitioners who are no longer willing to practice in South Africa or those who are unemployed may request voluntary removal of their names from the register in writing, on the form available from the SANC. If voluntary removal is granted by SANC, the nurse practitioner’s name will be removed accordingly on the 31 December of the year in which the application is received. Once removed from the register, the nurse practitioner will no longer be required to pay any future annual fees.

If those practitioners who were voluntarily removed from the register require their names to be restored to the register they will need to pay reduced restoration fee. It must be noted that practicing while not registered is illegal.

4. CLOSING DATE FOR PAYMENT OF ANNUAL FEES
Please note that for the calendar year 2019, the closing date for the payment of Annual Fees is 31 December 2018. Payment must reach the SANC bank account on or before the closing date. You are therefore urged to pay as soon as possible in order to avoid the last minute rush. Remember: Bank transfers from non-FNB banks take up to 3 working days – pay well in advance to meet 31 December 2018 deadline.

5. OTHER FEES
Please note that other fees and fees payable by institutions will be applicable with effect from 1 January 2019.

6. E REGISTER
The SANC has made an e Register facility available on the SANC website which can be utilized 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.

7. 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. 12345678 REGFPRA).

(Signed)

Ms SA Mchunu
Registrar & CEO
South African Nursing Council

Press Rel 4/2018

FOR ATTENTION:	News Editors
SUBJECT:	2018 World Malaria Day
	23 April 2018

The South African Nursing Council (SANC) is supporting the global community in the commemoration of World Malaria Day on 25 April 2018. This year’s theme is “Ready to Beat Malaria” and it emphasizes the global efforts in malaria prevention and control.

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. According to the World Health Organization (WHO) in 2016, there were an estimated 216 million cases of malaria in 91 countries, an increase of 5 million cases over 2015. The current pace is insufficient to achieve the 2020 milestones of the WHO that targets a 40% reduction in malaria case incidence and death rates.

The available drugs against malaria do not offer complete protection against the disease. The most important method of prevention is to avoid being bitten by mosquitoes by following these rules:

•	Wear protective clothing
•	Use insect repellents that contain diethyltoluamide (DEET). Repellents should be applied to all exposed skin as per instructions on the can.
•	Approved insecticides that can be sprayed on to clothing
•	Sleep under a treated mosquito net
•	Use mosquito-repelling vaporizers.

“The 2018 theme “Ready to beat malaria” instigates hope that this deadly disease would be beaten. In infected individuals malaria symptoms usually appear 10–15 days after the mosquito bite. The first symptoms are normally fever, headache and chills – almost like cold and flu symptoms -and it may be difficult to recognize it as malaria. To be safe, healthcare providers should suspect malaria in patients with unexplained fever who have returned from areas known as a risk for malaria as little as 7 days prior. ” says Ms Sizo Mchunu, SANC Registrar & CEO.

ENDS

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

Official Spokesperson and person to be quoted:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on Tel (012) 426-9542 or email: [email protected]

Pres Rel 3/2018

Press Rel 3/2018

FOR ATTENTION:	News Editors
SUBJECT:	SANC warning against “pre-nursing” programme
	5 April 2018

The South African Nursing Council (SANC) issued a warning today regarding certain institutions that are offering the Community Health Work programme purporting that it is an entry requirement into nursing education programmes.

These institutions lure students, who do not meet the minimum entry requirements into nursing education programmes, into their programmes with promises that it will provide them with an opportunity to bridge into nursing education. Says Ms Sizo Mchunu, Registrar of the SANC: “We should make it clear that this is not true. Entry requirements into nursing education programmes are legislated and the Community Health Work programme or any “pre-nursing” programme will not assist students to bridge the gap. They will be paying a lot of money for the programme only to find out at the end of their studies that the SANC cannot allow them, according to legislation, to register as student nurses.”

The SANC requests all students to be mindful of institutions that are recruiting and promising them that if they don’t meet requirements for entry into the nursing profession, they must do the community health course as a bridging programme. Of even bigger concern is that apparently these institutions are expecting the students to deposit huge sums of money into their accounts as an entry fee.

The SANC strongly warns students and potential students against these institutions that offer the so-called ‘’pre-nursing”-programme, purporting that it is an entry requirement for any nursing programme.

ENDS

Official Spokesperson:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on Tel (012) 426-9542 or email: [email protected]

Circular 3/2018

23 March 2018

TO:	Health Regulation and Compliance (National Department of Health)
	Office of the Chief Nursing Officer (National Department of Health)
	Directors on Nursing Education (Provincial Department of Health)
	Directors on Nursing Services/Practice (Provincial Department of Health)
	Nursing Education Institutions
	All Relevant Stakeholders

CPD

1. PURPOSE OF THE CIRCULAR
The purpose of this document is to update the Nursing profession and relevant Stakeholders about the Council’s Continuing Professional Development (CPD) and specifically the planning and implementation progress thereof.

2. BACKGROUND AND PURPOSE OF CPD
The South African Nursing Council (SANC), in line with the provisions of the Nursing Act, 2005 (Act No. 33 of 2005), is in the process of developing a Continuing Professional Development (CPD) System. This process commenced in 2013. To ensure reasonable participation in this process, the SANC established a CPD Technical Working Group (TWG) to assist it to drive the project.
The development of the CPD System is a response to the need expressed by the profession and the process of CPD seeks to ensure that Nurse Practitioners remain up-to-date with the required competencies for their specific areas of practice in Nursing. It is also seen as a mechanism that will provide opportunities to practitioners to pursue and achieve professional growth throughout their careers in order to benefit the people of South Africa.

The SANC is indebted to the funders of this project, namely The Atlantic Philanthropies initially and International Training and Education Centre for Health (I-TECH) from 2013 to date.

3. LESSONS LEARNT
Lessons learnt from research, literature as well as national and international benchmarking included:

•	A need for gradual and ‘staggered’ implementation;
•	The development of clear guidelines regarding types of CPD activities and the weighting of activities
•	The need to perform auditing of ‘Portfolios of Evidence’ of at least 10% per annum once the full roll-out has been implemented;
•	Establishing verification and validation strategies to prevent fraud and forgery;
•	Establishing a communication strategy with Stakeholders;
•	Establishing a dedicated business unit for CPD within the structure of the SANC;
•	Establishing a CPD Committee, which will be accountable to Council; and
•	The requirement for a “fit for purpose” technology solution.

4. CPD REQUIREMENTS
It is proposed that each practitioner will be required to accrue a minimum of fifteen (15) CPD points over a twelve (12) month period that will eventually be linked to the renewal of the Annual Practice Certificate (APC). It is envisaged that the cycle of accrual will commence in July of each year and end in June of the following year.

The required CPD points will be accrued through activities and events that are offered by CPD Service Providers who are recognised by the SANC. The criteria that will be used to recognise potential CPD Service Providers will be finalised and will be communicated widely, once approved by the Council.

Table 1: PROPOSED THEMES OF CPD DELIVERY

CONTINUING PROFESSIONAL DEVELOPMENT GRID
NURSING CATEGORY	THEMES FOR DELIVERY AND REQUIRED CPD POINTS
	Ethical and Legal domains EL	Area of Practice AoP	Leadership and Management LM	Teaching T	Research R	Total CPD Points
Registered/ Professional Nurse	4	6	3	1	1	15
Midwife	4	6	3	1	1	15
General Nurse	4	6	3	1	1	15
Enrolled Nurse	3	9	1	2	Nil	15
Auxiliary Nurse	3	10	1	1	Nil	15

5. PROGRESS TO DATE
5.1 Development of a CPD Framework
A CPD Framework was initiated and developed to the current Version 3. This was possible through national and international benchmarking as well as engagement with stakeholders who provided valuable comments and input.

5.2 Feasibility study
A feasibility study was conducted in November and December 2013. The aim of the study was to evaluate the feasibility, acceptability and capacity to establish an effective and sustainable SANC CPD process for Nurses and Midwives within South Africa.

5.3 CPD Pilot study
A CPD Pilot study was conducted in the Gauteng and Mpumalanga provinces from August 2015 to February 2016. The aim of the Pilot study was to explore the feasibility of the CPD project in order to determine the adjustments/adaptations required to facilitate a national roll-out. The findings of the Pilot study confirmed that, although there were barriers that prevented some participants from succeeding in acquiring the required CPD points, nurses expressed their support for and recognised the value of CPD. The study further yielded valuable input as to the relevance of the proposed thematic areas (highlighted in Table 1 above) as well as equitable access to CPD activities and opportunities.

5.4 Consultative Road shows
Road shows were conducted by the Council in all nine provinces during June to December 2016 to disseminate information on the purpose, process and nature of CPD.

The information sessions were attended by representatives from the Public and Private hospitals, the South African Military Health Services, Correctional Services, South African National Blood Services, NGOs, School Health Services, Nursing Education Institutions, Community Healthcare Centres and Clinics, Occupational Health organizations, Hospice Association and Old Age homes; as well as MTN Mobile, Eskom, PIKIT-UP and the Road Accident Fund.

5.5 CPD Stakeholder Forum
SANC established a CPD Stakeholder Forum, comprising of leaders in Nursing and Midwifery from the Public and Private sector, South African Military Health Services, Correctional Services, Private and Public Nursing Education Institutions and Labour organisations. This forum meets twice per annum to share information regarding progress on CPD.

6. CPD IMPLEMENTATION/ROLL-OUT
For various reasons, including the need to purchase an ICT application which can be utilised for CPD, the SANC is not yet ready for a full roll-out of CPD. The draft CPD Framework shared at the Stakeholders’ meeting in October 2017 is a ‘baseline’ document that will be amended as necessary. Once all the necessary systems are in place, have been tested and are approved by the Council, the roll-out plan, including the implementation time frames and approach for the implementation of CPD, will be communicated to the profession and related stakeholders.

For further information in respect of this Circular, you are advised to contact The Manager: CPD – Ms A. Mnguni at (012) 426 9576 or on e-mail: [email protected]

Kind regards,

(Signed)

Ms SA Mchunu
Registrar and CEO
South African Nursing Council

Press Rel 2/2018

FOR ATTENTION:	News Editors
SUBJECT:	2018 World TB Day – SANC calls on all nurses to adhere to TB protocols
	22 March 2018

The South African Nursing Council will be joining the world in the commemoration of the World TB Day on 24 March 2018 with the THEME “Wanted: Leaders for a TB-free world”.

World TB day is commemorated each year to raise awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up the efforts to end the global TB epidemic. The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

A lot of effort that has been put in trying to empower the communities with preventative measures and to cure this deadly disease but despite these measures TB continues to be the top infectious killer worldwide, claiming over 4 500 lives a day. In 2017 the World Health Organisation (WHO) reported that 10.4 million people fell ill with TB and there were 1.8 million TB deaths in 2016. The emergence of multidrug-resistant TB (MDR-TB) poses a further major health risk that adversely influences the progress made in the fight against TB.

“The 2018 theme makes an appeal to all leaders in different spheres in the communities to play a positive role in trying to combat the spread of TB and also to ensure that all those that are on treatment adheres to their treatment plans. As the voice of the nursing profession the SANC pledges its support to educate nurses and the public who interact with people affected with TB, whether at work or in the community at large,” says Ms Sizo Mchunu, SANC Registrar & CEO.

The SANC acknowledges that the nursing profession is the backbone of the health system and as such nurses attend to people who are diagnosed with TB, who are already on treatment and those that are immune-compromised. Nurses are frequently the first professionals to have contact with infected people, which exposes them to the disease and increases the risk of occupational TB. The SANC therefore appeals to nurses as leaders in their communities and health facilities to ensure that they adhere to the TB management protocols in order to protect themselves and also ensure that any new TB infections decreases and patients take their medication properly and timeously.

The nursing profession’s standards of care include enabling patients to achieve an adequate level and quality of life and with TB nurses play a crucial role in control programs.

Ms Mchunu says: “The SANC, as the governing body in the nursing profession and nursing education, will continue to engage in programs contributing to the dream of a TB-free world.”

ENDS

Issued by:

Mrs. Adri van Eeden
Senior Manager: Marketing and Communications
South African Nursing Council
E-mail: [email protected]
Website: www.sanc.co.za
Tel: 012 426-9542

Official Spokesperson and person to be quoted:

Ms S Mchunu
Registrar and CEO: SA Nursing Council

For more information or to arrange for an interview with the Spokesperson, please contact Mrs. Adri van Eeden on Tel (012) 426-9542 or email: [email protected]

Circular 2/2018

14 March 2018

TO:	National Department of Health
	Provincial Department 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, 29 March 2018 at 12:00 and will re-open on Tuesday, 03 April 2018 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 S Mchunu
Registrar & CEO
South African Nursing Council

News 3/2018

19 February 2018

Impairment Committee Report: Management of controlled scheduled medicines/substances in healthcare establishments to minimize errors and abuse caused by improper control

1. Introduction
In healthcare establishments, registered nurses have a duty to control various medications, including controlled scheduled medicines and substances, i.e. those scheduled 5, 6 and 7.
The shortage of qualified professional nurses in wards has the implication that ‘other categories’ of nurses are expected to participate in the co-checking of these medicines or substances. This has at times led to a departure from the policies and procedures governing the control of medicines and as such, lower categories of nurses and unauthorised personnel are sometimes left to check and administer these drugs on their own, without supervision.

2. Purpose
This Impairment Committee Report serves to reaffirm that nursing management has a duty to ensure that controlled scheduled medicines are properly managed, from the time these are ordered until they are administered to patients as prescribed by a medical practitioner, following proper policies and procedures.

3. Background
The Impairment Committee of the South African Nursing Council (SANC) has noted with concern a degree of negligence in the manner in which controlled scheduled medicines are managed in some healthcare establishments (both public and private).
The Impairment Committee, which is one of the standing committees established in terms of section 51 of the Nursing Act, 2005 (Act No.33 of 2005), is appointed to manage nurse practitioners (registered in terms of section 31 (1)(a-e) of the Act) who are deemed unfit to practice nursing due to disability or impairment. Cases of medicine and substance abuse are referred to the Committee, and it is frequently established that nurse practitioners have had access to drugs in the following ways:

	Nurse practitioners being allowed to check and administer controlled scheduled medicines alone;
	The keys of cupboards containing controlled scheduled medicine were not kept in the appropriate manner;
	The amount of a medicine or injections remaining was supposed to be discarded, but the nurse in question appropriated it for her own use, because she handled the discarding process alone, and therefore had the opportunity
	Controlled scheduled medicines are not properly checked during every shift change, leaving discrepancies to go unnoticed;
	Prescribed medicines being administered recklessly, without counting/keeping record of the quantities of medicine having been administered to patients.

o This information was forthcoming from nurse practitioners who, for example, were involved in car accidents or have had major operations (including caesarean sections) and were prescribed Pethidine, which led them to or contributed to their addiction

4. Management of controlled medicines, schedules 5,6 and 7, in hospital departments and wards:

4.1 Hospitals must adhere to policies and procedures in place to:

• Prevent;
• Detect; and
• Report any diversion (such as stealing and falsifying of records) of controlled medicines.

	4.2 It remains the obligation of the registered nurse/midwife to ensure that all controlled scheduled medicines are ordered, controlled, administered and disposed of in terms of the given protocols, policies and procedures of the institution.
	4.3 The registered nurse in charge of a nursing unit and/or shift remains accountable and responsible.
	4.4 Enrolled nurses/nursing auxiliaries MUST NOT be allowed to keep the keys to the controlled medicines and substance cupboard and to check and administer scheduled medicines alone.
	4.5 Unregistered staff (care workers and general workers) should not be involved in the administration of controlled scheduled medicines, or any medication.
	4.6 Without a prescription by a doctor, there can be no administration of controlled scheduled medicines, except where a protocol is followed and in an emergency situation. The person in charge will remain accountable

Note that the following are warning signs of nurses who may be abusing medicines and substances:

	Health care users receiving the maximum prescribed dose of a pain injection (e.g. 100mg Pethidine), yet still experiencing increased pain;
	Scheduled medicine to be discarded being kept in a syringe for no apparent reason;
	A nurse frequently borrowing scheduled medicines from other wards or visiting the wards/healthcare establishments at awkward times;
	A nurse asking colleagues to countersign in the register for scheduled medicines which they did not witness being dispensed;
	Inaccurate recording and fraudulent entries;
	Erasing or ‘overwriting’ of drug book entries, instead of following standard operating procedures;
	Often volunteering to administer scheduled medications;
	Frequently offering to count scheduled medicines, to make sure the count is correct.

5. Legal obligations of the nursing service manager/ unit manager
Nursing service management must oversee the scheduled medicine control processes or procedures to ensure that all healthcare providers working in their healthcare establishment are strictly following these in terms of the given legislation.
It is therefore important that nursing management ensure adherence to the standards as laid down by:

	The Medicines Control Council;
	The National Drug Policy for South Africa;
	The rules relating to Good Pharmacy Practice in South Africa;
	The Medicines and Related Substances Act, 1965 (Act 101 of 1965).

Behaviours indicative of Controlled Medicine abuse

These may include, but are not limited to the following:

	A noticeable decrease in attendance at work, increased absence or reporting late for work
	A noticeable decrease or inconsistency regarding work performance.
	Mood swings.
	Deterioration in personal appearance.
	May be sleepy or dozing off while on duty.
	Not interested in interaction with others, or being withdrawn.
	Memory lapse or euphoric recall of events.
	May have ‘pin point’ pupils, shaky hands or tremors.
	Smelling of alcohol, or mouthwash/breath mints to mask the alcohol smell.

Common group of Controlled Scheduled Medicines abused by health practitioners

Like anyone, nurses can and do use many different types of medication. Some are legitimate prescriptions issued after consultation with medical doctors. Some, like pain or allergy medication can be bought over the counter.

Those used in health establishments fall within the following categories:

	Barbiturates, benzodiazepines and tranquilizers, such as Diazepam;
	Prescription painkillers, such as opiates;
	Sedatives, such as Propofol or Diprivan;
	Appetite suppressants and narcotic analgesics.

A LIST OF SCHEDULED SUSTANCES IS AVAILABLE IN THE MEDICINES AND RELATED SUBSTANCES ACT NO. 101 OF 1965.

Some SUBSTANCES are recreational, such as:

	Alcohol;
	Marijuana and other ‘street drugs’.

Getting Help

Most public and private health establishments have Employee Assisted Programs to support their staff, including assistance for nurses with substance abuse problems.
The South African Nursing Council, like other health statutory bodies, offers an alternative to discipline program for nurse practitioners who demonstrate signs of impairment in terms of section 51 of the Nursing Act, 2005 ( Act 33 of 2005).

To contact the SANC please use the following information

Postage or hand delivery	Tel No. 27+12 420 1008/426 9547
The South African Nursing Council 602 Cecilia Makiwane Building Arcadia, 0083	Email: [email protected] or [email protected]

References

	‘Scheduling of Medicine guidelines’– Medicine Control Council;
	Medicine and Related Substances Act, 1965 (Act No. 101 Of 1965);
	Nursing Act, 2005 (Act No. 33 of 2005);
	‘Good Pharmacy Practice Manual’ – South African Pharmacy Council;
	‘Safe Management of Controlled Drugs: A guide to good practice in secondary care (England)’ – British Department of Health;
	www.rehabcenterrankings.com/drug-addiction-in-healthcare-professionals;
	www.nevadanursingboard.org/ discipline/chemically-dependent-nurses/.