Welcome to the RHC 2017. We hope to see a growing contingent of nurses attending this annual event!
RuNurSA (Rural Nursing South Africa) aims to strengthen rural nursing leadership by harnessing the courageous commitment, inspiration and vision of nursing professionals in the face of rural health realities and challenges to influence the change required to improve rural health nursing care.
In South Africa a primary health care approach was adopted, as a social justice philosophy, and a combination of legislative, policy and resource allocation measures have been used to achieve transformation and improve population health.
However, these policies have not been enough to turn around the overall performance of the South African health system with around 84% of the population, who carry a far greater burden of disease, depending on the under-resourced public sector. South Africa is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal diseases, and injury-related disorders. NCDs, specifically cardiovascular diseases, type 2 diabetes, cancer, chronic lung disease and depression are on the rise in both rural and urban settings.
Three fault lines have been identified (Rispel, SAHR, 2016): tolerance of ineptitude as well as leadership, management and governance failures; lack of a fully functional district health system, which is the main vehicle for the delivery of primary health care; and inability or failure to deal decisively with the health workforce crisis.
The crisis of ineffective management, incompetence and failure of leadership and governance at all levels of the health system, is exacerbated by a general lack of accountability
These fault lines have negative consequences for patients, health professionals and policy implementation. Patients bear the brunt through negative experiences and sub-optimal care. Health care providers such as nurses on the front line and at the bottom of the hierarchy also suffer.
Faced with an unsupportive management environment, staff shortages and health system deficiencies, nurses find it difficult to uphold their professional code of ethics and provide good quality of care. The loss of trust and confidence in both our leaders and organizations is at the root of the workforce issues we face today.
A call for metaphorical ‘repair of fault lines’ to ensure success of the proposed national health insurance system includes addressing the leadership, management and governance failures. This requires political will; appointment of public service managers with the right skills, competencies, ethics and value systems; effective governance at all levels of the health system to enforce laws; appropriate management systems; and citizen involvement and advocacy to hold public officials accountable.
John Maxwell holds that good leadership changes lives, forms teams, builds organisations, and impacts communities .Leaders are always taking people somewhere. They aren’t static.
Nurses are called upon to proceed to lead, especially in rural environments by having the faith of their convictions-stepping forward and becoming a voice to lead and champion nursing issues which will positively affect health of communities in this country.
Nursing leaders have extraordinary responsibility, authority, and accountability. As a result, they also must have access to educational opportunities and the mentoring needed to develop and enhance their leadership skills. Supporting educational programs play an important role in developing leaders who are eager to engage colleagues and country on nursing issues and are adept at creating space for authenticity and mutual respect.
Healthcare is a partnership, so we embrace the rural health advocacy partners who are on the same trajectory. There is a lot of goodwill amongst rural health professionals and RuNurSA has to reach out more boldly to join forces. We must find a path to empower every direct care rural nurse to have a voice in decisions that affect their practice and the expectations of how that practice will be carried out. We salute our rural nurse of the year for doing just that!
We believe it is possible to create environments that allow nurse leaders to encourage and promote flourishing of the human spirit in the rural workplace. This ultimately creates space for positive returns on health investment and a healthcare culture shift that produces exceptional results to support the sustainable development goals. Join us as we find our way…..
Guin Lourens; RuNurSA