The nursing profession in South Africa – are nurses adequately informed about the law and their legal responsibilities when administering health care?

• Jurisdiction: South Africa
• Author: A. Singh,M. Mathuray
• DOI: 10.10520/EJC-1070c28ca1
• Published date: 01 July 2018
• Date: 01 July 2018
• Record Number: dejure_v51_n1_a9
• Pages: 122-139
• Published By: University of Pretoria

122

The nursing profession in South Africa –

Are nurses adequately informed about the

law and their legal responsibilities when

administering health care?*

A Singh

LLM PhD

Lecturer, School of Law – Howard College Campus, University of KwaZulu-Natal

M Mathuray

BCur, BNHons, LLM

Clinical Training Specialist, Life Entabeni Hospital, Life Healthcare Group

OPSOMMING

Die verpleegprofessie in Suid-Afrika – Is verpleegkundiges op hoogte van die

reg en hul regsverantwoordelikhede in die gesondheidsorg?

Hierdie artikel focus daarop om te bepaal hoe ingelig verpleegsters is oor

die reg en die norme en standaarde wat die verpleegprofessie in Suid-

Afrika reguleer. Die doel van die artikel is tweeledig: Eerstens, poog dit om

vas te stel wat die internasionale norme en standaarde is wat in ander

jurisdiksies toegepas word. Om hierdie rede is ’n wye spekrum van eerste

wêreld, derede wêreld en outluikende ekonomiese jurisdiksies, waaronder

die Verenigde State, Nieu-Seeland, Australië, Spanje, Thailand, Singapoer,

Indië, Mexiko en Nigerië, geskies om vas te stel wat die internasionale

standaarde is wat deur verpleegkundiges in die uitvoer van gesondheid-

sorg toegepas word en of dit vergelykbaar is met die poeisie in Suid-Afika.

Wat voortspruit uit ’n oorsig van die internasionale, praktykregulasies, is

dat daar ’n noemenswaardige ooreenkoms is met betrekking tot die

uitdagings wat bestaan. Baie studies toon die gebrek aan kennis van die

reg en verantwoordlikhede as ’n algemene rede vir die bron van wan-

praktyk problem onder verpleegsters. Tweedens, ontleed die artikel ook

die bestaande wetgewing in Suid-Afika krities om vas te stel of dit by die

implementering daarvan voldoende is om vepleegkundiges die nodige

kennis te gee on hulle in staat te stel on hul rol te verstaan wanneer

gesondheidsorg aan pasiënte toegedien word. Alhoewel die bevindinge

getoon het dat die meerderheid verpleegkundiges in Suid-Afrika kennis dra

van die toepaslike wetgewing en hul regsverantwoordelikhede, is daar ook

’n beduidende aantal verpleegkundiges wat geen begrip van die reg het nie

en ook nie die omvang van hul diens en die verantwoordlikhede wat

daarmee verband hou ten volle verstaan nie. Waar skuiwergate

geïdentifiseer is, word strategieë voorgestel om die gehalte gesondheid

deur verpleegkundiges aan pasiënte wat aan hulle sorg toevertrou is te

verbeter.

How to cite: Singh & Mathuray ‘The nursing profession in South Africa – Are nurses adequately informed

about the law and their legal responsibilities when administering health care?’ 2018 De Jure 122-139

http://dx.doi.org/10.17159/2225-7160/2018/v51n1a8

* This paper was originally presented by M Mathuray as an LLM dissertation

entitled – ‘A Critical Evaluation of Nurse’s Legal Knowledge and Its Impact

in Preventing Nursing Malpractice in South Africa’ (2017).

The nursing profession in South Africa 123

1Introduction

Nursing is a vital part of the healthcare system and nurses1 are described

as the ‘heartbeat of healthcare.’2 They direct their energies towards the

prevention, promotion, maintenance and restoration of the individual’s

health. Expansive knowledge is required for nurses to perform their

duties and render holistic patient care competently, ethically and legally.

What is apparent is that the nurse’s role has changed significantly over

the past two decades and includes wider specialisation, greater

autonomy and more accountability.3 Nurses pledge to take responsibility

for the care they provide and to answer for their own decisions. They are

expected to perform their actions in accordance with the requirements

of the nursing professional bodies and the law. When nurses are aware

of their legal responsibilities and obligations, they would undoubtedly be

better prepared to care for persons in their care to achieve better

productivity and quality in their service delivery.4 This article focuses on

ascertaining how well informed nurses are about the law and their legal

obligations in the milieu in which they operate and administer services to

persons who are entrusted to their care. While, the first part of the article

seeks to establish what are the norms and standards that are employed

by nurses in administering health care in other international

jurisdictions, to assess whether this is comparable with the position in

South Africa, the latter part analyses the existing regulations in South

Africa. The thrust of the discussion here is to determine whether existing

legislation and policies are adequate to provide nurses with the required

knowledge to enable them to fully appreciate their role and

responsibilities when administering health care to patients.

2Background

In South Africa, there has been an alarming increase in medical

malpractice litigation in both the public and private healthcare sector.

According to Aon insurance company in South Africa, claims in excess of

1 The Nursing Act 33 of 2005 defines a ‘nurse’ as a person registered in a

category under section 31(1) in order to practice nursing or midwifery.

Professional nurse, practitioner, nurse auxillary, staff nurse means a person

registered in terms of section 31. Section 31 makes provision for a nurse to

be registered to practice as a professional nurse, midwife, staff nurse,

auxillary nurse and auxillary midwife. Section 43(1) stipulates the use of

titles as Registered Professional Nurse, Registered Midwife, Registered Staff

Nurse and Registered Auxillary nurse. The reference to ‘nurse’ in this article

will be used as a general term with reference to all of the categories

described in the Nursing Act.

2 Botha ‘Nurses are the Heartbeat of Healthcare’ (2014) The Gremlin,

available at http://www.thegremlin.co.za/2014/05/12/nurses-are-the-heart

beat-of-healthcare/ (accessed 2016-02-27).

3 Scivener ‘Accountability and Responsibility: Principle of Nursing practice B’

(2011) Art and Science, Nursing Standard 25(29) 35-36.

4 Mali & Mali ‘Effect of Self-Instructional Module on Knowledge Regarding

Medico Legal Responsibilities among Nurses’ (2014) 3 (3) IJSR, 617 -618.