Public sector nurses have submitted a petition to President Ian Khama requesting to be allowed to venture into private practice. The petition was submitted by the Botswana Nurses Union (BONU) late last year.
The document titled “meeting between nurses and His Excellency the President of the Republic of Botswana” states that the nurses intend to share with the President their main concerns of nursing and midwifery care to the public and to make suggestions and recommendations on how to balance public employer and nurses’ expectations.
The union states that in many countries in the region and abroad, nurses have formed important partnerships in the health sector and made significant contribution in the care agenda.
The union observes that over the years, the awarding of private practice licenses for nurses and midwives has been a challenge.
This they said is a direct opposite to what obtains in other health professions.
“Upon realisation of gaps in the regulation of private practice for nurses and midwives, the Nursing and Midwifery Council of Botswana, in 2011, proposed an amendment of the Nursing and Midwifery Act, to incorporate private practice for nurses and midwives. To date the change has not been incorporated,” said BONU.
The union recommended that the proposed amendment of the Act to incorporate private practice for nurses and midwives be expedited to enable nurses to engage in private practice.
BONU suggested that private practice for nurses must be supported so that nurses can participate in public-private partnerships in the health care system and operate nurse homes, maternity centres and step-down or half-way homes to admit patients who do not require specialised medical services in hospital setting. This, they say can reduce current challenges such as congestion in public health facilities.
The Union also decried what it described as the diminishing of continuing professional education for nurses.
“The University of Botswana offers a bachelors degree completion program for registered nurses. However, their release from service and financial support to enrol into the program has diminished significantly,” said the union.
It states that advanced preparation at degree level and above enables a nurse to be well grounded in decision making for safer client care and to participate fully in health care deliberations in policy and decision making that improve practice.
“Furthermore, nurses work with highly qualified health care professionals, including medical specialists and other allied health professionals specialists. Nurses are expected to match up the level of expertise of these colleagues team players in the health care system,” the nurses further stated.
BONU recommended that they should be accorded chances to undertake higher degrees; institutes of Health Sciences should speedily be strengthened to offer degree courses.
While appreciating the merging of Primary Health Care Services from the Ministry of Local Government Under the Ministry of Health, BONU faulted the process saying it was “very sudden and lacked orientation plans for staff from hospitals and clinics such that they will be transferrable across all levels of health care service delivery.”
According to the union, a nurse who has worked in a health post for 10 years or more being transferred to a referral hospital unit has implications for public safety, the professionals (fitness to practice, frustrations, early retirement), litigation for government and declining quality care.
The union also called on Khama to ensure that the Ministry of Health develops a high quality task-shifting and tasks-sharing framework that will recognise the ever-expanding roles shifted to nurses and provide appropriate education and remuneration.
The union also suggested to Khama that nurses should be compensated for rest; shift work, public holidays, on-call and weekends as they work on weekends, night shifts and public holidays and calls on rest periods which in other countries are compensated separately.
The union also demand that nurses should benefit from structures available in government with equal chance of progression to E scale and above like other civil servants.
There is need to speedily review security measures at health facilities, both human and electronic (CCTV) and access cards, the nurses said.