OurHealth interviewed three nurses in the Eastern Cape’s rural OR Tambo District about what it is like to work under often challenging conditions – and why some nurses struggle to keep a smile on their faces. They asked not to be named for fear of being victimised at work.

One nurse reported that the lack of nurses places an unfair burden on existing nurses. This workload takes it toll and leads to burn out and bad attitudes among nurses, she said.

“There are many obstacles that prevent us from providing proper quality service,” she told OurHealth. “One of those is the shortage of staff. (When nurses leave), personnel are not replaced.”

“All this results in nurses being exploited by having to do the work of the nurses that are not there,” she added. “The workload brings physical and emotional stress, which results in nurses having bad attitudes (in) the face of the patients”

Problems extend beyond OR Tambo

In a December 2013 letter to Eastern Cape Head of Health Dr Thobile Mbengashe, the Eastern Health Crisis Action Coalition reported nursing shortages affected at least seven clinics that the group of nongovernmental organisations was aware of. [quote float=”right”]“Security is not always provided, especially at night, in the clinics that have rooms for nurses”

The coalition also reported that nurses’ accommodation at the Holy Cross Hospital was in a deplorable condition with fungus growing on the walls and an unreliable supply of water. It also noted that some nurses paid out of pocket to, for instance, transport critical documents to Mthatha or call ambulances.

Another nurse who spoke to OurHealth in OR Tambo reported that there was also a lack of nursing accommodation in the rural areas.

“I would say there are also inequalities in how we, the nurses, in the rural areas and urban areas are treated,” she said. “The conditions we work under are much worse in the rural areas than those in the urban areas.”

“There is no running water, no homes for nurses, and the distances we travel from where we live to our places of work are very long,” said the nurse, who added that in the villages, where many clinics are located, transport options are limited.

“Security is not always provided, especially at night, in the clinics that have rooms for nurses,” she said. “This alone result in few nurses that are interested in working in the rural areas.”

With a lack of incentives to attract nurses to rural areas, one nurse said she expected problems to continue with grave consequences for patients.

“Government is not creating mechanisms to attract more nurses,” said one nurse with 36 years experience. “The shortage of staff and the lack of training may lead to death and (poor care) of the clients… especially when it comes to chronic diseases that need constant monitoring.”