Incorrect published Regulations regarding Scope of Practice for Nurses and Midwives

Incorrect published Regulations regarding Scope of Practice for Nurses and Midwives

27 May 2020

The National Department of Health published the above Regulations in Government Gazette No. 43305 published on 12 May 2020 for public comments for a period of one month. It was discovered after publication that an incorrect version of the Regulations was published. The National Department of Health regrets this error. The correct version of the Regulations will be published in due course to enable the public to comment.


Factual informaton on R425 Registered Nurse, R174 Professional Nurse and Midwife, and R171 General Nurse

Factual informaton on R425 Registered Nurse, R174 Professional Nurse and Midwife, and R171 General Nurse

25 May 2020

The South African Nursing Council has become aware through various media platforms that there is misinformation regarding the status of the current and future status of the four(4)- year degree/diploma nursing programme (Regulations Relating to the Approval of and the Minimum Requirements for the Education and Training of a Nurse (General, Psychiatric and Community) and Midwife leading to Registration-Government Notice No. R. 425 of 22 February 1985 as amended) and possibly other qualifications. This has caused confusion to the profession and the public at large.


  1. Current status of the Four year (4) Degree and Diploma programme.(R.425)
    This is a legacy nursing qualification that is being phased out like all other legacy qualifications in the country, in line with the requirements of the Higher Education Qualifications Sub-Framework and as supported by the Board Notice published in the Government Gazette by the Minister of Higher Education, Science and Innovation in July 2016. The last intake for this programme was 2019. It must be noted however that the programme leading to this qualification continues and is going to continue being offered for pipeline students for the next four (4) to six (6) academic years including 2 years teach-out period.


This programme will for some years run concurrently with the new four-year Bachelor programme. These two qualifications are mutually exclusive qualifications and none is a replacement of the other.


Any person that completed the R. 425 programme leading to Registration with the SANC as a Nurse (General, Psychiatric and Community) and Midwife shall retain this title and qualification and shall not be “degraded” or “demoted” in any way.


On completion of the R. 425 programme, graduates and diplomats from the four-year programme will be registered by the South African Nursing Council as Nurse (General, Community & Psychiatric) and Midwife. This programme will not under any circumstances be downgraded or changed in any way. It will run its course until it is naturally phased out in about 6 years.

No downgrading of the four-year R425 Course
The profession needs to note that the Registered Nurse qualifying from this programme will not be downgraded in anyway whatsoever. Section 31 (1) (c) of the Nursing Act, 2005 (Act no. 33 OF 2005), prescribed a category Staff Nurse. Following various changes in legislation, particularly the National Qualifications Framework Act, it became necessary that the nursing qualifications fit within the country’s qualification framework.
As a result, the Category “General Nurse” was created through a board notice published in Government Gazette R.939 of 28 June 2019 by the Minister of Health. This programme will have a duration of three years and is not a replacement of any other qualification.

  1. Future four- year programme(R.174)

This is a new four-year programme governed by Regulations Relating to the Approval of and the Minimum Requirements for the Education and Training of a Learner leading to Registration in the Categories Professional Nurse and Midwife (Government Notice No. R174 of 8 March 2013).

Several Universities and Public Nursing Colleges were accredited by the Council to offer the programme. The SANC is aware that they have opted to commence with the offering of this programme in 2021.

Further information for students:
Students that are currently undergoing the R 425 programme should therefore not panic due to misinformation and disinformation from informal sources. They are encouraged to enquire and seek clarity from their principals regarding the uncertainties. The Heads of Nursing Education Institutions can if necessary enquire and be duly and formally advised by the SANC.

On behalf of the CEO& Registrar:
Ms S Mchunu

SANC Professional Conduct Hearings

SANC Professional Conduct Hearings

May 2020

Dear Nurses, Clients and Stakeholders

Kindly note that due to the COVID-19 pandemic the Professional Conduct Hearings that were scheduled to be held at the offices of the South African Nursing Council from the 11th to the 13th of May 2020 is hereby formally postponed until further notice.

If you have received a summons or a subpoena to appear at these hearings, please note, we will be in contact with you in due course to inform you of the new arrangements.

Restoration of nurses to the SANC nursing register for National State of Disaster period: Private Hospitals

Restoration of nurses to the SANC nursing register for National State of Disaster period: Private Hospitals

1 May 2020

1 May 2020

Dear Stakeholder

Please note that the process for private hospitals is the same as for Provincial Departments of Health, with the following exceptions:

1. All Hospital Association of South Africa (HASA)- affiliated health establishments will be handled via HASA directly – the process has been communicated to and agreed upon by HASA. The contact person is Lauren Drysdale at email:

2. Private hospitals NOT affiliated to HASA will follow the process as set out below and submit the list per hospital. If you need clarity on this process kindly contact Mr Patrick Modiselle at email:

The process, in short:

Position/s are advertised by the Employer, who will do the screenings for the positions (nature of engagement agreed upon between practitioner and health establishment).
The form has been sent to HASA (The form is also on the SANC website as a backup).
Once an employment or engagement agreement is reached with the employing health establishment, HASA (or if a private hospital it can be sent to the SANC if not affiliated to HASA) sends a bulk pack of applications to the SANC for processing.
The SANC will issue the certificate letters to the Employer as proof of registration of a Nurse with the SANC.
The Employer then communicates to the Nurses as they issue letters of engagement.
No individual applications can be sent to the SANC for processing.

NB: Registration lapses immediately upon lifting of the National State of Disaster.

Restoration Form for Private Hospitals

News 4/2018

News 4/2018

26 October 2018

TO:All SANC Clients
FROM:Ms SA Mchunu
Registrar and CEO


SANC offices closed from 11:00 on 9 December 2017

The SANC offices will be closed for operational reasons from 11:00 am on Friday, 9 November 2018 and will reopen on Monday, 12 November 2018 at 08:00 am


News 3/2018

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.


Some SUBSTANCES are recreational, such as:

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 deliveryTel No. 27+12 420 1008/426 9547
The South African Nursing Council
602 Cecilia Makiwane Building
Arcadia, 0083
Email: or



‘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;; discipline/chemically-dependent-nurses/.

News 2/2018

News 2/2018

29 January 2018


Nurses now receive 10% discount when using the Greyhound bus service


Great news!

Nurses registered with the SANC now receive 10% off on all bus travel via Greyhound!

Contact Greyhound directly via their Facebook page: GreyhoundSA or on Twitter: @GreyhoundRSA


Special News Item 2/2013 Death of an icon

Special News Item 2/2013

South African Nursing Council Mourns the Death of an Icon: Dr. NELSON ROLIHLAHLA MANDELA

10 December 2013


The South African Nursing Council mourns the passing on of our leader, Dr. Nelson Rolihlahla Mandela. His passing on is a loss not only to his family but also to the country and the nursing fraternity as a whole.

We take cognisance of the values Dr. Mandela upheld so dearly – caring, respect, selflessness, and will work towards ensuring that all members of the profession emulate these values. We salute the nurses that took care of Dr. Mandela. They indeed distinguished themselves as true ambassadors of this noble profession as they could have been under pressure to breach privacy and confidentiality but maintained them.

The nursing profession benefited from the struggle Dr. Mandela waged against apartheid. The South African Nursing Council is today a transformed organization following the demise of apartheid. We feel highly privileged to have reaped the fruits of his struggle.

We convey our heartfelt condolences to the Mandela family.

Prof. Busisiwe Bhengu
South African Nursing Council


Special News Item 1/2013 National Strategic Plan

Special News Item 1/2013

The National Strategic Plan for Nurse Education, Training and Practice 2012/13 – 2016/17

23 Sepember 2013

On this day the Department of Health published the National Strategic Plan for Nurse Education, Training and Practice 2012/13 – 2016/17 on its website.

The development of the strategic plan has its roots firmly in the Nursing Summit which took place in 2011 and the Nursing Compact that was drawn up as a direct consequence of the Summit.

This link is published on the Nursing Council website in an effort to distribute this important information as widely as possible and particularly amongst the nursing profession and others involved in the health care sector.  Please download a copy of the strategy document and share it with your friends and colleagues.  To do so, click on the picture on the left or on the following link:

Pdf icon    The National Strategic Plan for Nurse Education, Training and Practice 2012/13 – 2016/17


Special News Item 3/2012 Nomination Process

Special News Item 3/2012

Nomination of members to serve on the 15th Council

This information was originally published on the Home Page of the SANC website.


Nomination and appointment of members to serve on the Council

A notice calling for nomination of persons to serve as members of the Nursing Council for the period June 2013 to 2018 has been published by the Minister of Health.

    Click here to see a copy of the notice published in the Sunday Times of 7 October 2012.

In terms of the arrangements in the notice, the following documents can be downloaded and printed from the Nursing Council website:-
    Nursing Act, 2005 (Act No. 33 of 2005)

    Regulations relating to the Nomination and Appointment of Members of the Council (Government Notice No. R.20 of 16 January 2008)

   Prescribed Nomination Form

   Charter of Good Practice for Councillors
  Covenant for Councillors

  Application for Certificate of Good Standing


NB: This process is now complete.