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Nursing

I solemnly pledge myself to the service of humanity
and will endeavour to practise my profession with conscience and with dignity.
I will maintain, by all the means in my power, the honour and noble tradition of my profession.
The total health of my patients will be my first consideration.
I will hold in confidence all personal matters coming
to my knowledge.
I will not permit consideration of religion, nationality, race or social standing to intervene between my duty and my patient.
I will maintain the utmost respect for human life.
I make these promises solemnly, freely and upon my honour.

This is the version, as currently used in South Africa,1 of the original ‘Nightingale Pledge’. Although not composed by Florence Nightingale, that ‘Lady with the Lamp’2 is recognised as the founder of nursing as we know it today.

The Nursing Act 20053 regulates all matters concerning the nursing profession. It falls under the authority of the Minister of Health, but for all intents and purposes its administration is in the tender, loving, caring hands of the South African Nursing Council.4

There are different specialities in the nursing profession – midwives, theatre nurse, ICU, and so on. Unfortunately (as is recorded in the Council’s explanatory memorandum on the rationale for the Bachelor’s Degree in Nursing and Midwifery5) reports on “the status of nursing in the country indicate a growing gap between the demand and supply of professional nurses and midwives, the decline of learners entering the nursing profession and the aging population of professional nurses and midwives.

This is a general provision that ‘any person who contravenes or fails to comply with any provision of the Act’ is guilty of an offence.6 In what follows, the specified provisions have been addressed.

A. Registration

  1. No one may practise as a professional nurse, midwife, staff nurse, auxiliary nurse or auxiliary midwife unless she is registered in that category with the Council.7 It is an offence to contravene this directive.8

  2. An employer must not employ (or retain in employment) a person to perform nursing functions, unless that person holds the necessary qualification and is registered with the Council,9 and commits an offence if it does.10

  3. No person may use, as a title, any of the categories mentioned above unless she is registered as such.11 It is an offence to do otherwise.12

  4. It is an offence to represent that:
    • you are competent to practise nursing if this is not the case.13
    • you are registered to practice nursing, if this is not the case.14
  5. It is an offence to practice in a capacity in which he is not registered.15

  6. It is a crime to use or publish any name, title, description or symbol which indicates, or is likely to lead people to think, that you hold a registered professional qualification, if that is not shown in the register.16

  7. Any person who, by means of a false representation, procures (or attempts to procure) for herself or for any other person registration (or any certificate or decision referred to in the Act) is guilty of an offence.17

  8. It is also an offence to make (or cause to be made) any unauthorised entry in, alteration to, or removal from:
    • a register; or
    • a certified copy of or extract from any certificate issued under the Act.18
  9. If you wilfully destroy, damage or render illegible any entry in the register, you commit an offence, without the permission of the holder.19

  10. It is a criminal offence to omit any information, or give false information to the effect that no professional misconduct proceedings are being (or are likely to be) held in relation to you.20

  11. If you forge any document or, knowing it to be forged, use any forged document it is an offence.21

  12. You commit a crime if you impersonate any person registered in terms of the Act.22

B. Limited registration

  1. The Council may provide limited registration to a person who holds a qualification but not the qualification required to practise as a nurse. That person may only be entitled to practise for such period as the Council may determine (but not exceeding three years), and under conditions determined by the Council, and any person who practices in contravention of this entitlement is guilty of an offence.23

C. Education

  1. An institution intending to conduct a nursing education and training programme must first:24
    • apply to the Council in writing for accreditation;
    • submit information on:
      • the education and training programme to be provided; and
      • how it will meet the prescribed standards and conditions for education and training;
    • furnish the Council with any additional information required by the Council for purposes of accreditation or approval of the education and training programme; and
    • pay the prescribed fee.

    It is an offence to fail to comply with these requirements.25

  2. The person in charge of a nursing education institution must notify, and furnish to the Council the prescribed information in respect of each learner nurse who has commenced, completed, transferred to or abandoned a nursing education and training programme. It is a crime not to do so.26

  3. A health establishment must not allow access to clinical facilities for training purposes to anyone who is not registered in terms of the Act.27 It commits an offence if it does.28

  4. Any person authorised by the Council may, in the presence of a police officer, enter any institution or premises where learners are trained; and confiscate any document or object relevant to such education and training, for purposes of inspection or investigation relating to its education and training.29 It is an offence to hinder or prevent any such person from doing so.30

D. Disciplinary hearings and corporate governance

The Council can appoint a disciplinary tribunal to hear and determine charges of improper conduct against any registered nurse.31 The tribunal has a wide variety of powers relative to such a hearing.

  1. It is an offence for any person who has been subpoenaed:
    • to fail to attend the hearing at the time and place specified in the subpoena;32
    • to refuse to be sworn in (or to be affirmed) as a witness;33
    • to refuse or fail to give evidence relevant to the inquiry;34
    • to fail to answer, fully and satisfactorily, all questions lawfully put to him;35 and
    • to fail to produce any book, document or object in her possession, custody or under his control which he has been required to produce.36
  2. A person who has been subpoenaed commits a criminal offence if she misleads the Council or any professional conduct committee.37

  3. Any person who obstructs the Registrar in fulfilling his corporate governance obligations in terms of the Act38 commits an offence.39

  4. The Council must ensure that the Registrar complies with such corporate governance obligations.40 Any person who obstructs the Council in its obligations in this regard commits an offence.41
  1. See: www.sanc.co.za/aboutpledge.htm 

  2. She earned this nickname amongst the wounded British soldiers during the Crimean War, in 1854, because she did her rounds at night. 

  3. As amended; the latest amendment was effected by Act 33 of 2005. 

  4. The head office of the Council is in Pretoria, at 602 Pretorius Street, Arcadia. Contact SANC at 012 343 5400. 

  5. www.sanc.co.za s.v. ‘Details of New Nursing Qualifications’ and see the PDF document: ‘Bachelors Degree in Nursing and Midwifery’, page 2. 

  6. See Section 55(2). 

  7. Section 31(1). 

  8. Section 31(11). 

  9. Section 31(3). 

  10. Section 31(11). 

  11. Section 31(4). 

  12. Section 34(11). 

  13. Section 53(1). 

  14. Section 53(1). 

  15. Section 53(1). 

  16. Section 55(1). 

  17. Section 54(1)(a). 

  18. Section 55(1)(b). 

  19. Section 54(1)(c). 

  20. Section 54(1)(d). 

  21. Section 54(1)(e). 

  22. Section 54(1)(f). 

  23. Section 33. 

  24. Section 42(1). 

  25. Section 42(4). 

  26. Section 32(4). 

  27. Section 32(5). 

  28. Section 32(4). 

  29. Section 52(1). 

  30. Section 52(2). 

  31. Section 46. 

  32. Section 47(10)(c)(i). 

  33. Section 47(10)(c)(ii). 

  34. Section 47(10(c)(i). 

  35. Section 47(10)(c)(v). 

  36. Section 47(10)(c)(iii). 

  37. Section 47(10)(c)(iv). 

  38. See Section 29(2) for these obligations. 

  39. Section 29(4) read with section 29(2). 

  40. See Section 29(3). 

  41. Section 29(4).