The Democratic Nursing Organisation of South Africa (Denosa) and the Health and Other Services Personnel Trade Union of South Africa (Hospersa) agree with a Unisa study that found that the threat of litigation negatively impacts the quality of patient care offered by theatre nurses to patients living with HIV.
The study was conducted at a South African hospital that has 12 operating theatres with different areas of speciality. The objective was to establish how theatre nurses are affected when rendering peri-operative care to patients living with HIV.
The study found that these nurses were affected in their professional capacity as they feared making mistakes which could lead to dismissal.
Apart from fear of being dismissed, the study revealed that they were also afraid of potential lawsuits from a patient or a relative of a patient who received inadequate care.
‘Theatre nurses’ fears were that if they were sued, they would end up forfeiting their pension as the state would take their money to pay the aggrieved litigant.”
According to the study, theatre nurses worked under stressful conditions, and the patients they dealt with were mostly HIV-positive. “Patients living with HIV needed constant monitoring which was difficult to do as there were many patients to look after.”
The data revealed that most of the participants were also worried about the risk of contracting HIV while being at the workplace and this affected the quality of patient care.
“They said they were being exposed to touching patients’ body fluids because of limited PPE (personal protective equipment) and impaired concentration due to exhaustion.”
A Hospersa spokesperson said being a theatre nurse is a specialist field that comes with various challenges, including performing procedures that come with risks.
“It remains the responsibility of the nurse to only act within their scope. This becomes extremely challenging with the current state of the system with staff shortages, equipment failures and various other challenges,” said the union.
The union said evidence shows that the threat of litigation is often a burden on the nurses.
“We have seen a mass exodus from the midwifery category as the risk of litigation is high and many midwives have found themselves in hot water.”
Denosa spokesperson Sibongiseni Delihlazo said the study followed others which echoed the same findings.
He said the areas that cause nurses anxiety are not new.
“The pressures caused by a shortage of staff in health-care settings are messing with the care and safety protocols that are in place in facilities, thus compromising nurses hugely.”
Delihlazo agreed that the threat of litigation does impact the care of patients.
“Alertness forms a great part of patient care. Anxiety, on the other hand, brings about hindrances to that alertness because a health-care professional has to think more about whether they are safe instead of thinking about the safety of the patient,” he said.
He added that nurses in the public sector do have liability cover, which ordinarily covers the employer in the cases where there is litigation, but for the instances where they were found to have been grossly negligent they would be personally liable.
Delihlazo called on nurses to never compromise themselves by going against the protocols and to inform union representatives immediately when adequate PPE is not available, which is at the core of infection control measures and poses a real threat to both their career and safety.
Both unions said that union members get indemnity cover.
When the DA’s Madeleine Hicklin put questions to the Minister of Health, Joe Phaahla, about the issue of litigation, he said all nurses, whether undergraduate or post graduate students or qualified, enjoy vicarious liability cover by working in public health establishments.
He said vicarious liability was a legal principle that holds employers responsible for the wrongful actions of their employees.
“The deciding factor is whether or not the individual acted in the course of and within the scope of their employment.
“While indemnity cover is not required as a prerequisite for employment, nurses are advised to take indemnity cover to protect them in the event they are sued in their personal capacity.
This can be obtained by way of associations, unions and or private.”
The Mercury