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SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED QUALIFICATION: 

Bachelor of Nursing 
SAQA QUAL ID QUALIFICATION TITLE
59257  Bachelor of Nursing 
ORIGINATOR
SGB Nursing 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY NQF SUB-FRAMEWORK
The individual Primary or Delegated Quality Assurance Functionary for each Learning Programme recorded against this qualification is shown in the table at the end of this report.  HEQSF - Higher Education Qualifications Sub-framework 
QUALIFICATION TYPE FIELD SUBFIELD
National First Degree(Min 480)  Field 09 - Health Sciences and Social Services  Curative Health 
ABET BAND MINIMUM CREDITS PRE-2009 NQF LEVEL NQF LEVEL QUAL CLASS
Undefined  508  Level 7  NQF Level 08  Regular-Unit Stds Based 
REGISTRATION STATUS SAQA DECISION NUMBER REGISTRATION START DATE REGISTRATION END DATE
Reregistered  SAQA 06120/18  2018-07-01  2021-06-30 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2022-06-30   2028-06-30  

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.  

This qualification does not replace any other qualification and is not replaced by any other qualification. 

PURPOSE AND RATIONALE OF THE QUALIFICATION 
Purpose:

Nursing is an essential skill in any community and country, and the profession in South Africa has enjoyed an enviable reputation for quality and competence, and the comprehensive nature of training provided. There is concern to maintain this quality and comprehensiveness going forward as the country works to transform health care provision. The identified needs of South Africa's various communities are for comprehensively trained nurses.

Planning for the development of nurses in response to these needs has indicated two key categories of nurses: The Staff Nurse and the Professional Nurse clearly distinguished in terms of their required competence and scope of practice.

There is a need for skilled professionals with highly developed critical thinking, analytical, and problem-solving skills that will be able to use evidence-based practice to evaluate nursing practice in the interests of quality and continuous improvement. If the profession is to develop, it will need to be based on sound research, which demands that professional nurses be able to carry out research and write up results, as well as put in quality standards.

The focus on more academic aspects of nursing will position professional nurses to look at new knowledge and new approaches to nursing care, which they will be able to monitor and evaluate. In this way they will be able to assess the impact of interventions.

This qualification will also prepare nurses for further specialisation as they move from general nursing practice to specialisation in particular areas, with a change in focus from practice to consultancy roles and clinical nurse specialists in their field. The focus will also shift from regional and institutional concerns to national and international issues.

On successful completion of this qualification, the learner is eligible for registration with the relevant statutory body (currently the South African Nursing Council) as a Professional Nurse. Successful registration will license nurses to practice as a professional nurse as defined in the Nursing Act No.33 of 2005. [The Act defines a Professional Nurse as one who: "is educated and competent to practise comprehensive nursing, assumes responsibility and accountability for independent decision making in such practice, and is registered and licensed as a professional nurse under the Nursing Act"].

More specifically, the qualification aims to:
  • Produce high quality graduates who are competent nursing practitioners in a range of health service settings.
  • Provide graduates with a range of skills, knowledge and attitudes that will enable them to make a meaningful and sustained contribution to health services.
  • Equip graduates with a developed sense of equity, justice and service ethics that will ensure that they work in an accountable manner irrespective of their chosen work place.
  • Offer a wide range of transferable skills for application in other professions, disciplines and general life. These include:
    > A methodical solution based approach to problem solving.
    > An empowerment strengths based approach to personal development.
    > Competence in written and oral communication.
    > Capacity to assess and implement health and other policy.
    > Ability to plan and implement and manage projects of a varied nature.
    > An ability to work independently and as part of a team.

    As such, the qualification will also be valuable for those in the profession who may have been practising within the field, but without formal recognition for registration purposes.

    This qualification will be useful for:
  • Staff nurses who wish to progress into nursing as a career.
  • Persons at a commensurate level in Health and Allied Health Sciences who wish to change direction and move into nursing.
  • Those wishing to progress towards qualification as a Master or Doctor of Nursing and beyond.

    This qualification articulates:
  • All competency requirements and outcomes (academic, specialist theory and practical/workplace experience) that are necessary to achieve professional registration.
  • The requirements and provisions of the Professional Body for professional registration.
  • Designation/s that may be achieved.
  • The ongoing requirements (including the Code of Ethics and the requirement for Continuing Professional Development) for retention of registration as stipulated by SANC, and the implications of non-compliance on use of the Professional Designation and right to practice and/or licence to practice.

    Recipients of this qualification will be able to:
  • Apply knowledge of biomedical, biotechnological and psychosocial sciences to the practice of nursing.
  • Develop, implement and evaluate population based health care.
  • Assess, plan, implement and evaluate nursing care for individuals and groups based on thorough assessment.
  • Deliver nursing care to sick or disabled individuals and groups.
  • Promote rehabilitation of individuals and groups with disabilities.
  • Diagnose and treat minor and common ailments.
  • Maintain professionalism in nursing practice.
  • Manage a health care unit and facility.
  • Deliver safe obstetric care.
  • Utilise principles of science and methodology in investigating nursing and health related problems.

    Learners will function within the current scope of practice of the professional nurse as formulated by the South African Nursing Council, in conjunction with the policies of the institutions of employment.

    Professionals carry out their duties:
  • As a member, or leader of a team.
  • In accordance with the Professional Code of Ethics for Nurses.
  • In accordance with the provisions of the norms and standards for nursing.
  • Taking full responsibility for basic health care.

    Rationale:

    This qualification will enable the learner to function as a clinically focused, service orientated, independent registered professional nurse, who is able to render comprehensive care across all spheres of health, as determined by the appropriate legislative framework. Comprehensive nursing in this context is defined in legislation as: "Nursing interventions that integrate and apply the scientific process of the full range of nursing that is general, community, obstetric, mental health that promote and maintain the health status of health care users in all contexts of health care delivery".

    In addition, the qualifying learner will apply evidence-based research to enhance nursing practice.

    A significant report by Pick, Nevhutalu, Cornwall, and Masuku (2001, July) on the current situation of human resources in health in South Africa outlines a background of extreme economic and health inequalities of the past and describes the current landscape still characterised by complex distortions of supply, production, distribution, and development of health personnel.

    Pick et al (2001) found that there was considerable overlap of services in the primary health care package, seen as normal, but that some of the professional categories were not available at all points of Primary Health Care delivery. Nurses who had undergone no curative clinical care training provide primary clinical care for large sections of the population, while many health personnel currently provide many service components contained in the PHC package in contravention of their scopes of practice. Scopes often overlap, are too general, are not clearly defined, or are restrictive. The report strongly recommended that scopes of practice of different professionals be revised.

    The Report further identified a shortage of professionals e.g. doctors, professional nurses, and therapists - mostly in the rural areas. To address these shortages the Report proposed that the scopes of practice of upper- and mid-level workers be redesigned to allow some tasks traditionally assigned to upper-level professionals to be given, with training and associated controls, to workers at a lower level. Given the shortage of doctors, it would seem likely that professional nurses will be required to undertake tasks formerly excluded from their scope of practice, with consequent implications for developing and recognising competence. The potential inability to hold professionals accountable for their actions can be addressed by building a hierarchy of skills in which, as professionals advance up the hierarchy, they fulfil their roles at the highest level but are not excluded from assisting in roles at lower levels.

    Striking inequalities were found between urban and rural facilities in the staffing of nurses. The Report further recommended that the scopes of practice of all categories of nurses be revised to ensure that all categories are able to progress to the next level in the nursing skill hierarchy.

    Based on the above findings, Pick et al (2001) then recommended that some of the tasks, traditionally provided by highly specialised professionals, be reassigned, with training and supervision, to workers at a different professional level. These proposals are likely to see an increased demand for staff and professional nurses, newly skilled in terms of the revised scope of practice for nursing in South Africa.

    In practice, supply falls short of demand, and the gap is growing. According to the statistics published by the South African Nursing Council, in 1996, 2 259 learners graduated as professional nurses, with the qualification: Nursing Science (General, Community and Psychiatry) and Midwifery. In 2005, the number had dropped to 1 533.

    The decline of learners entering the nursing profession has been a matter of great concern to the South African Nursing Council and to the Ministry of Health. The problem is discussed in the Human Resources Plan for Health, which the Minister of Health launched in April 2006 and emphasis is given to recruitment of more learners into professional nursing. The registration of a Professional Degree: Nursing is seen as imperative to promote the uptake of graduate and postgraduate qualifications.

    The Act No.33 2005, passed in May 2006, makes reference to 4 categories of nurses and also outlines the scope of practice.

    On successful completion of this qualification, the learner is eligible for registration with the South African Nursing Council as a Professional Nurse. [The definition of a Professional Nurse in the Nursing Act is: "a person who is qualified and competent to independently practice comprehensive nursing in the manner and to the level prescribed, and who is capable of assuming responsibility and accountability for such practice"].

    Of importance in this proposed qualification is the scope. The graduate will be more comprehensively qualified than before, with a scope that includes obstetric skills, mental health, and primary health care (1st level contact and provision of health services with a referral system in operation when cases are beyond their scope). A person with this qualification will work with all patients, stabilised or not, and take responsibility for health care in any context. In addition, they will take responsibility for managing nursing care in a health care facility. The qualification will provide them with a comprehensive view of the field, and the necessary skills to screen patients and refer as required.

    There is a strong need for professional nurses to be equipped to promote the quality of health care in South Africa. They are expected to initiate quality measures, and take full responsibility for all nursing practice. There is recognition in the health care field of the need to benchmark practices and work towards quality improvement, and to this end the qualification makes provision for a strong research component. Professional Nurses will act as professional team leaders, after having developed their practical skills, typically deployed as unit and/or zone managers. They are both the providers of health care, and managers; there is a strong coordination role for care provided by other caregivers. Professional nurses will look at developing the capacity of other team members.

    The qualification, while solidly grounded in practice, is intended to provide access to further academic routes and provides for high quality learning opportunities with a focus on specialisation and research.

    The qualification is unit standard based so as to provide clear indications of ways in which the new qualification links to the revised scope of practice for the profession, and to facilitate the upgrade of existing practitioners. It is further intended to assist in bringing coherence to training provision by providing clearly defined outcomes of learning, and a single standard for the sector. This will make it possible for quality assurance bodies to challenge to quality of training provision, and assist training providers in their re-curriculation processes towards the new requirements. The unit standards will also allow for recognition of incremental learning through RPL processes where the scope has changed, it is easy for currently professional nurses to identify new requirements. The qualification and its unit standards will further facilitate ongoing professional development.

    The qualification is intended to promote higher-level cognitive thinking skills. Unit standards assist in clearly demarcating areas for experiential learning (vs. theoretical) to meet requirements for registration. 

  • LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
  • Successful completion of a Grade 12 certificate or recognised equivalent qualification.
  • Communication skills at NQF Level 4.
  • Mathematical literacy at NQF Level 4.
  • Computer literacy at NQF Level 3.

    Recognition of Prior Learning:

    Learners may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios, other forms of appropriate evidence and/or challenge examinations, as agreed to between the relevant provider and relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.

    RPL is particularly important, as there are people in the profession with a variety of qualifications of differing quality and scope. It is important that an RPL process be available to assist in making sense of existing qualifications, and helping to standardise qualifications around a common standard. A related issue is that the nursing profession is facing a new scope of practice, based on international standards. It is essential that existing qualifications and all new provision is aligned to the new scope of practice, and the vision for health care in South Africa.

    A further consideration is that there is a big change in the needs of the community that nurses have to serve; this partly explains the 'migration' amongst practitioners to other qualifications. Nurses are finding that their existing qualifications do not meet emerging needs or requirements, and they move to another to meet those needs. Historically, Nursing has provided an access to learning for people without higher education. People have gained entry into nursing through different routes (usually via auxiliary and ancillary health). There are increased numbers of people wanting to access higher education, and RPL will assist in formalising what exists and providing access to learning pathways.

    Existing registered nurses (single qualified registered nurses), as well as currently enrolled nurses, and the staff nurse qualified under the new National Diploma may wish to obtain this qualification.

    There are gaps between old qualifications and the requirements of the new scope of practice, and a consequent need to upgrade qualifications. RPL is seen as vitally important in every case to give recognition to learning already in place, make sense of the plethora of different levels and standards in the field, and provide a means for all to gain access to, and progress within, a common learning pathway for the profession.

    There is a strong need to bring about alignment to the profession, with one nationally recognized qualification providing for the comprehensive approach. The focus is on the integration of the various components of nursing, to ensure that these are allied in an integrated manner to provide comprehensive care. Professional Nurses are the managers of health care in all settings for health care delivery. They are independent practitioners, exercising judgement and make decisions around nursing care, and there is a strong need for critical and analytical thinkers to build the scientific knowledge base of nursing.

    Access to the Qualification:

    Successful completion of the National Diploma: Nursing, NQF Level 5, or through recognition of prior learning. Learners may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios, other forms of appropriate evidence and/or challenge examinations, as agreed to between the relevant provider and relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.

    The National Diploma: Nursing will provide credits towards the professional degree through an RPL process. This will be verifiable evidence, and will allow candidates access to formal assessment of their competence.

    In terms of current relevant legislation:
  • Learners are required to be registered with the relevant statutory health council as learners for the duration of the period of learning.
  • Learners must have access to clinical facilities of health service providers that are accredited by the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA for the practical component.
  • Clinical and work-based experiences must comply with the current regulations of the relevant statutory health council. 

  • RECOGNISE PREVIOUS LEARNING? 

    QUALIFICATION RULES 
    Nursing training is based on an assumption of 1560 hours of learning per annum (35 hours per week for a duration of 44 weeks).

    The Professional Degree: Nursing at NQF Level 7 incorporates the whole of the National Diploma: Nursing at NQF Level 5. Typical learning routes will be entirely different for both qualifications:
  • Nursing Colleges are likely to provide learning resulting in the National Diploma, while the Professional Degree will be offered at accredited Universities. It cannot be assumed that learners will achieve the Diploma (either through service and RPL, or the College route) before moving into a Degree programme at a University. In fact, this would be a rare exception to the rule, and the typical target populations for each category will almost certainly be quite different.
  • There are likely to be large numbers of persons studying for the National Diploma, with no immediate intention to progress beyond that, although the two qualifications provide for the necessary articulation. Persons wishing to be recognised as Professional Nurses are likely to start out in a degree study programme, enrolled at a university.

    In order to be credited with this qualification, learners are required to achieve a minimum of 508 credits to be compiled as follows:
  • Fundamental: all 121 Fundamental component credits are compulsory.
  • These credits are all included in the National Diploma: Nursing at NQF Level 6. They are essential learning for the Professional Degree. For reasons stated above, they must be registered as part of the Professional Degree.
  • Core: all 377 Core component credits are compulsory.
  • Of these credits, 272 are new to the Professional Degree (are not included in the Diploma).
  • Elective: at least 10 Elective component credits must be attained to complete the qualification. 

  • EXIT LEVEL OUTCOMES 
    1. Support and/or protect the rights of others in a health care context.

    2. Maintain professionalism in own practice of nursing.

    3. Apply knowledge of biomedical, biotechnological and psychosocial sciences to the practice of nursing.

    4. Develop, implement and evaluate population-based health care.

    5. Assess, plan, implement and evaluate nursing care for individuals and groups with stable uncomplicated health problems based on thorough assessment.

    6. Deliver nursing care to sick or disabled individuals and groups.

    7. Promote rehabilitation of individuals and groups with disabilities.

    8. Deliver safe obstetric care.

    9. Manage a health care unit and facility.

    10. Utilise principles of science and methodology in investigating nursing and health related problems.

    Critical Cross-Field Outcomes:

    This qualification addresses the following critical cross-field outcomes, as detailed in the associated unit standards:
  • Identifying and solving problems in which responses indicate that responsible decisions using critical and creative thinking have been made.
  • Working effectively with others as a member of a team, group, organisation or community.
  • Organising and managing oneself and one's activities responsibly and effectively.
  • Collecting, analysing, organising and critically evaluating information.
  • Communicating effectively using visual, mathematical and/or language skills in the modes of oral/written persuasion.
  • Using science and technology effectively and critically, showing responsibility towards the environment and health of others.
  • Demonstrating and understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation.

    Learning programmes directed towards this qualification will also contribute to the full personal development of each learner and the social and economic development of the society at large, by making individuals aware of the importance of:
  • Reflecting on and exploring a variety of strategies to learn more effectively.
  • Participating as responsible citizens in the life of local, national and global communities.
  • Being culturally and aesthetically sensitive across a range of social contexts.
  • Exploring education and career opportunities; and developing entrepreneurial opportunities. 

  • ASSOCIATED ASSESSMENT CRITERIA 
    Associated Assessment Criteria for Exit Level Outcome 1:

    1.1 Advocacy activities promote individual, group and community rights with respect to law and health care provision.
    1.2 Organisation, presentation and communication of professional information in court settings meets requirements of expert testimony, is consistent with professional expectations, and enhances perceptions of the professions.

    Associated Assessment Criteria for Exit Level Outcome 2:

    2.1 Practice is applied consistently in a manner that reflects a clear understanding and interpretation of the requirements of SA Nursing and Health Care legislation.
    2.2 Ethical codes, professional accountability and responsibility, and standards for the practice of nursing are interpreted and applied consistently in line with their spirit and intent.
    2.3 Own personal development and management maintains emotional balance, and promotes effective and professional service delivery of self and the health care unit as a whole.
    2.4 Engagement in professional development activities contributes significantly to the professional growth of nurses in sphere of influence, and to the standing of the nursing profession.

    Associated Assessment Criteria for Exit Level Outcome 3:

    3.1 Knowledge of applied psychology and sociology is applied in ways, which benefit the level and quality of health care delivery to patients.
    3.2 Knowledge of anatomy, micro-organisms and physiology meets requirements for professional health care, and promotes effective health care delivery.

    Associated Assessment Criteria for Exit Level Outcome 4:

    4.1 Health care provided is appropriate to the particular context, and based on proper health assessment.
    4.2 Community involvement in health care is promoted through information sharing, and contact, which promotes ongoing collaboration with the community or group.
    4.3 Community health assessments assist in prioritising community needs and reporting findings for effective health care delivery.
    4.4 Strategies and/or programmes developed are appropriate to the findings of comprehensive health assessments, and based on sound epidemiological principles.
    4.5 Counselling, where required, is supportive of a range of different needs, including needs of those affected by abuse, neglect, or violence.

    Associated Assessment Criteria for Exit Level Outcome 5:

    5.1 Planning and provision for health care is based on sound assessment, and informed decision making. Planning is inclusive of the patient and other key stakeholders.
    5.2 Nursing care is implemented in an integrated manner, according to plans. Health care status of individuals, groups and/or communities identifies changes in general status in time to implement preventative or corrective measures in the interests of general well being.
    5.3 Childhood illnesses, minor and common ailments are accurately diagnosed and managed according to generally accepted treatment guidelines.
    5.4 Interventions with mentally ill persons are consistent with generally accepted psychosocial techniques, and contribute to the therapeutic management of these patients.

    Associated Assessment Criteria for Exit Level Outcome 6:

    6.1 Nursing care delivered provides the necessary physical and psychological care and support for long term and or terminally ill patients, in line with the accepted scope of practice for nursing.
    6.2 Interventions with acutely ill patients contribute to identification and management of physical and psychiatric illnesses, maintenance of physiological homeostasis, the physical and psychological comfort of patient and significant others, and the prevention and/or management of complications.
    6.3 Support provided to patients recovering from acute illness prepares them for discharge in ways that enable the patient, family and significant others to cope with the management of the patient at home.

    Associated Assessment Criteria for Exit Level Outcome 7:

    7.1 Goals set are realistic in terms of functional ability and possible barriers to rehabilitation.
    7.2 Assistance provided to the client identifies indicators of relapse or complications and ways of preventing these.

    Associated Assessment Criteria for Exit Level Outcome 8:

    8.1 Care delivered is integrated and provides for the long-term wellbeing of mother and child, in line with the accepted scope of practice for nursing.
    8.2 Intra-labour care delivered to the mother and baby complies with generally accepted treatment guidelines, manages potential and actual emergencies, and promotes the safety of both.

    Associated Assessment Criteria for Exit Level Outcome 9:

    9.1 Unit philosophy, vision, mission, goals, policy and procedures developed for nursing care provision and personnel management within a health care unit comply with current legislation, SANC requirements, and international best practice for the profession.
    9.2 Systems established promote cost effective and efficient service delivery within a health care unit.
    9.3 Management and leadership activities are directed towards the establishment of a team approach to health care, and the effective delivery of services within a physically safe and emotionally supportive environment.
    9.4 Pharmacological preparations and treatment are managed in ways that ensure the correct storage of drugs, and the correct preparation and administration of pharmacological treatment.
    9.5 Assessment, planning, implementation and evaluation is documented accurately and timeously, and promotes effective service delivery as well as security and confidentiality of information.
    9.6 Standards set for unit health care delivery are monitored regularly, and information gathered identified areas for improvement on an ongoing basis.

    Associated Assessment Criteria for Exit Level Outcome 10:

    10.1 Technology is used in ways that facilitate the effective diagnosis and treatment of hearing and breathing related conditions.
    10.2 Research activities develop own professional knowledge and expertise, and contribute to the development of nursing practice and the profession as a whole.

    Integrated Assessment:

    The South African Nursing Council (SANC) guidelines for assessment, and the competency framework are used as a reference for assessing clinical competence.

    Formative:

    A variety of assessment strategies and approaches must be used. This could include tests, assignments, projects, demonstrations or clinical assessments and/or any applicable method. There must be evidence of involvement in a research project. Formative assessments can include a mix of simulated and actual (real) clinical practice or care settings.

    Summative:

    Summative assessment can take the form of oral, written and practical examinations as agreed to by the relevant ETQA. All summative practical assessments must be conducted in actual clinical practice or care settings. 

    INTERNATIONAL COMPARABILITY 
    Attempts to benchmark South African nursing practice have seen a review of international best practice, as well as best practice on the African continent. Countries regarded as leaders, such as New Zealand and Canada, do not provide the comprehensive training that South Africa has done for the professional nurses. South Africa provides comprehensive training as basic whereas other countries provide it by way of additional courses. The reason is South Africa's emphasis on primary health care, nursing in the health care system, and our particular system and range of contexts. The scope of practice for nurses in South Africa is necessarily much broader.

    The quality and scope of South African qualifications is endorsed by the fact that most 1st world countries readily accept South African nursing qualifications, and the UK, USA, New Zealand, Australia, Canada, Holland, and the UAE are keen to employ South African nurses. South African nursing standards exceed those in comparable economies such as Brazil, Indonesia, and India. In Africa, South Africa accepts nursing qualifications from Botswana, Swaziland, Tanzania, Namibia (which has only a diploma at present, although they are moving towards a degree in nursing), Zimbabwe and Zambia. These nations, in turn, accept South African qualifications.

    South Africa is an active member of the Internal Council for Nursing (ICN) as well as the Internal Labour Organisation (ILO), member of the African Union (AU), formerly the Organisation of African Unity (AOU), Southern African Development Community (SADC) and the Commonwealth. The proposed qualification would meet recognition requirements in most of the member countries of these organisations and throughout Sub-Saharan Africa.

    Comparison of qualifications:

    In recognition of the reality of globalisation of nursing and nursing personnel, the International Council of Nurses (ICN) (2001) recommended "global" competencies for the generalist nurse. The ICN defined the generalist nurse as:

    "A person who has completed a programme of basic nursing education and is qualified in her/his country to practice nursing. The educational programme prepares the nurse, through study of behavioural, life and nursing sciences and clinical experience, for effective practice and direction of nursing care, and for the leadership role. The first level (generalist) nurse is responsible for planning, providing and evaluating nursing care in all settings for the promotion of health, prevention of illness, care of the sick and rehabilitation; and functions as a member of a health team" (ICN, 200, p. 2).

    The ICN further differentiates between what they refer to as a first and a second level nurse. The first level nurse refers to the generalist nurse or the equivalent of a professional nurse in current SA terms. The second level nurse on the other hand refers to a nurse who has completed a programme of study including "nursing theory and clinical practice" (p. 2) in preparation for practising nursing under the supervision of the first level nurse. This would be the equivalent of either the enrolled and nurse or the enrolled nursing assistant in SA terms.

    The Role of the Generalist Nurse:

    The role includes: "Promotion of health, and prevention of illness of individuals of all ages, families and communities, planning and management of care if individuals of all ages, families and communities with physical or mental illness, disabilities or rehabilitation needs in institutional and community settings and care at the end-stage of life" (p. 3).

    Competencies of the Generalist Nurse:

    The ICN defined competence as: "a level of performance demonstrating the effective application of knowledge, skill and judgment" (1997, 44; 2001, p. 3). Three broad categories of competencies are identified.

    These include:
  • Professional, ethical and legal competence.
  • Care provision and management.
  • Professional development.

    The World Health Organisation (1987) on the other hand has placed emphasis on the issues surrounding the relevance of the education of health professionals. The basic premise on which the WHO's recommendations are based is that effective education of health professionals must produce health professionals who are "responsive to needs to the needs of the populations they serve, in order to achieve the goal of health for all" (WHO, 1987, p. 5), and that such an education should be "based largely in the community, or in any of a variety of health service settings" (p. 5). In this regard, the WHO recommends that education of health professionals be community-based. The WHO views community-based education as "consisting of learning activities that use the community extensively as a learning environment".

    Required Competencies of Graduates of Community Based Education Programmes:

    The WHO work study group on community-based education classifies competencies of graduates of CBE programmes into:

    General competencies for all Health Professionals.

    All health professionals should be able to:
  • Respond to health needs and expressed demands of the community by working with the community, in order to stimulate self-care and a healthy life-style.
  • Educate both the community and their co-workers.
  • Solve or stimulate action for the solution of both individual and community health problems.
  • Direct their own and community efforts towards the promotion of health and the prevention of disease, unnecessary suffering, disability and avoidance of death.
  • Work as members of health teams and with other health other health teams.
  • Act as leaders of such teams when necessary.
  • Continue to learn throughout their working experience, in order to maintain and improve personal competence.

    Professional functions.

    Include the following:
  • Provision of preventive care.
  • Provision of curative care.
  • Health education of the population.
  • Management of services.
  • Participation in health teamwork.
  • Training other members of the health team.
  • Participation in research activities.
  • Collaboration with other sectors involved in community development.
  • Finding solutions to unfamiliar problems.
  • Self-assessment and the continuous development of personal professional skills.

    The proposed Professional Degree: Nursing NQF Level 7 compares with the ICN requirements in the relevant categories of professional nurses.

    Scope of Practice:

    The work of the task team, which compiled the revised scope of practice for nursing, was informed by a review of:
  • Health care delivery needs within the context of the South African Health care system.
  • Existing legislation.
  • Policy documents.
  • Human resource reports (Pick Report).
  • Norms of Standards (PHC, District Hospitals).
  • Regulatory frameworks & Scope of nursing practice documents of other countries:
    > UK, Canada, New Mexico, Australian, New Zealand.
    > African Countries (ECSACON Professional Regulatory Framework).
    > ICN competency framework for nursing.

    The scope of practice for nurses in South Africa is based on guidelines produced by the International Council of Nurses (which provides the guidelines and/or competency framework for most countries), as well as the results of research into the countries and regions described above.

    The Review:

    The Review of the Scope of Practice of Nursing and the profession of nursing began in 1999 when the South African Nursing Council prioritised the need to revise the scope of practice. The factors that influenced the review of the scope of practice was a changing health care system identified in the White Paper for the Transformation of Health and the changes in education system brought about by the National Qualifications Framework and the South African Qualifications Act.

    The purpose of the review is to align the practice of nursing to the changes in the national health policy and the legislative framework.

    Purpose includes:
  • Ensure that nursing practice is in keeping with and is responsive to a changing health care delivery system.
  • Develop a scope for nursing practice that is informed by the core competencies required for nursing practice.
  • Review the scope applicable to different categories of nurse to ensure that each category of nurse is enabled to practice independently within their scope.
  • The new scope of practice and the competencies required for nursing practice will then inform the education and training of nurses required for such practice. This will assist in facilitating the development of a framework for a single unitary education pathway for nursing qualifications that is in line with the principles of the National Qualifications Framework.

    Challenges facing Nursing Education:

    The changes in both the health care system and the education system has created numerous challenges for nursing education and training and some of these challenges are:
  • Promoting and maintaining a caring ethos within the nursing profession.
  • Ensuring National Health Priorities are addressed in all nursing education programmes.
  • Creation of a cadre of nurses who are lifelong learners and critical thinkers.
  • Promote the ability in every nurse to evaluate and assure quality in his/her practice.
  • Access to Nursing Education by learners is limited due to the slow implementation of the National Qualifications Framework in the Health Sector.
  • Selection and recruitment criteria in many instances remain restrictive limiting access to nursing qualifications.
  • The distinct nursing qualifications for each category of nurse is not in keeping with the NQF principles and thereby limiting access to higher education training opportunities for existing enrolled & auxiliary nurses.
  • Recognition of Prior Learning (RPL) as a selection criterion is not widely applied because RPL assessment is complex, costly and there is a general lack of knowledge on how to give recognition to prior learning.

    Challenges facing the profession:

    South Africa requires nurses that are comprehensively trained to provide nursing care in various contexts (Primary health care, institutional/hospitals, midwifery and mental health settings) and in both rural and urban setting. Comprehensive training does not imply or focus on attaining separate qualifications but rather on the ability to integrate knowledge and skills for the provision of comprehensive nursing care. Each category of nurse will be an independent practitioner in accordance with their scope of practice and the level of training and competence attained.

    The Scope, and a Competency Framework:

    The revised scope of practice focuses on outlining the practice of the three basic categories of nurses. Education and training of nurses will be informed by the scope of practice and the competencies required for nursing practice, as defined in this qualification (and three others). Where the scope of practice for current categories of nurses is expanded, training to upgrade the skills and competencies will be required.

    Each category of nurse is defined and a clear distinction in terms of the practice is made. The scope distinguishes between different areas of practice viz. clinical, ethical and professional and quality of practice. A competency framework for the profession of nursing supports the scope of practice. The competency framework provides details for and supports an outcomes based approach to nursing education and training.

    Definitions:

    A professional nurse is a person who:
  • Is educated and competent to practise comprehensive nursing.
  • Assumes responsibility and accountability for independent decision making in such practice.
  • Is registered and licensed as a professional nurse under the Nursing Act.

    Scope of Practice:

    The scope of the professional nurse is to provide comprehensive nursing, which entails:
  • The provision of comprehensive treatment and care of persons in all health care settings.
  • Emergency care.
  • Taking responsibility and accountability for the management of nursing care of individuals, groups and communities.
  • Ensuring safe implementation of nursing care.
  • Taking responsibility and accountability for the care of persons who have unstable and complicated health conditions.
  • Ensuring that nursing care is only delegated to competent practitioners.

    Scope of Professional and Ethical Practice:

    The Professional and Ethical practice of a Professional Nurse & Midwife requires a practitioner to:
  • Demonstrate an in depth understanding of laws and regulations relevant to nursing, midwifery and health care in South Africa.
  • Practise nursing and midwifery in accordance with the laws and regulations relevant to nursing and health care in South Africa.
  • Practice nursing and midwifery in an ethically justifiable manner.
  • Create and maintain an enabling environment for ethical nursing and midwifery practice.
  • Promote and protect the rights of individuals and groups in relation to health care.
  • Practise nursing and midwifery in accordance with the standards set for the profession.
  • Accept and assume accountability and responsibility for nursing and midwifery actions and omissions within the legal and ethical parameters of a dynamic health care environment.
  • Ensure safe implementation of all nursing care.

    Scope of Clinical Practice:

    The clinical practice of a professional nurse is to provide comprehensive nursing care and management for the treatment and rehabilitation for all health problems of individuals, groups and communities as an independent practitioner. Such practice requires a practitioner to:
  • Screen the health status and assess nursing needs through comprehensive observation, interaction and measurement.
  • Assess the health care information needs of clients and plan for and respond accordingly.
  • Analyse, interpret data and diagnose nursing needs.
  • Formulate and prescribe a comprehensive nursing and care plan.
  • Take full responsibility for the total management and implementation of the overall nursing plan of care to achieve identified outcomes.
  • Manage nursing care and co-ordinate health care to ensure continuity of care within the health care team.
  • Delegate nursing care and tasks to competent persons and provide supervision for all nursing care.
  • Appropriately and timeously refer a health care user.
  • Facilitate continuity of care through reporting and communication to care givers and members of the health care team.
  • Evaluate health care user's progress towards expected outcomes and revise nursing care plans in accordance with evaluation data.
  • Create and maintain a complete and accurate nursing record.
  • Initiate and maintains a therapeutic relationship.
  • Establish and maintains an environment in which health care can be provided safely and optimally.
  • Create and maintain an environment in which health care users feel safe, secure and respected.
  • Advocate for the rights of health care users.
  • Promote health care user participation in health care and empowers them towards self reliance.
  • Demonstrate and maintain clinical competence in all required areas of nursing to practice as a safe practitioner.
  • Continuously review nursing practice against professional standards.

    Quality of Practice:

    The quality of nursing practice of a professional nurse and midwife is to:
  • Actively engage in the development of standards, criteria and indicators for quality nursing, midwifery and health care.
  • Participate in the development and maintenance of a plan to improve the quality of nursing, midwifery and health care.
  • Implement and manage of a quality improvement plan for his/her own area of practice.
  • Participate in the auditing of quality of nursing, midwifery and health care.
  • Assist with the development of nursing and midwifery and improvement of standards of care through research.
  • Incorporate appropriate research findings into practice.
  • Create an environment and learning opportunities that foster professional growth and improvement in nursing and midwifery practise.
  • Commit to the development, maintenance and facilitation of life long learning for self and others.
  • Actively engage in the education and training of learners in the health care system.
  • Identify own learning needs and maintain knowledge and skills required for competent and independent nursing and midwifery practice.

    Conclusion:

    An examination of the Scope of Practice, as well as those in operation in ICN signatory countries, clearly indicates the alignment of this proposed qualification with international practice. 

  • ARTICULATION OPTIONS 
    This qualification The Professional Degree: Nursing articulates vertically with the National Diploma: Nursing at NQF Level 6 and the Masters Degree in nursing at NQF Level 8 or Masters Degree in the health and social sciences, as determined by the provider. Horizontal articulation would include any other Professional Degree.

    The following shows the location of this qualification in terms of other possible qualifications within the field:

    Represented in categories:
  • Level 1: GETC: Ancillary Health.
  • Level 2: NC: Fundamental Ancillary Health.
  • Level 3: NC: Auxiliary Nursing; NC: Community Health Work; NC: Health Sciences and Social Services.
  • Level 4: FETC: Nursing; FETC: Community Health Work; NC: Health Sciences and Social Services.
  • Level 5: Diploma: Nursing: Mental Health; Diploma: Nursing: Community Health; NC: Community Health Facilitator Training.
  • Level 6: National Diploma: Nursing (leads to PD); Various: health/allied heath sciences; Various: research/teaching/education/management.
  • Level 7: B: Nursing; Social sciences (social work; health/social services; C&YCW; Probation).
  • Level 8: Masters: Nursing (PD prepares learners for Masters).
  • Level 8 and above: PhD: Nursing.

    Horizontal articulation:

    Learners might move into a number of related areas in health and allied health sciences as these qualifications are developed, as well as research, education and nursing management, by achieving the credits specified in each qualification, mainly related to specialisation areas particular to each sub-field.

    Vertical articulation:

    Learners can move vertically by using this qualification as the basis for any of the qualifications indicated above Level 7. 

  • MODERATION OPTIONS 
  • Providers must be accredited to provide this qualification in terms of the current relevant nursing legislation by the relevant ETQA or ETQA that has a Memorandum of understanding in place with the relevant ETQA.
  • Moderation of assessment must be overseen by the relevant ETQA or ETQA that has a Memorandum of understanding in place with the relevant ETQA according to moderation principles and the agreed ETQA procedures.
  • Internal and external moderation must be conducted by moderators appointed by the provider in agreement with the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.
  • Moderators must be trained and registered as Moderators with the relevant ETQA. Competence in Design of Assessments is a further requirement. 

  • CRITERIA FOR THE REGISTRATION OF ASSESSORS 
  • Assessors must be accredited by the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.
  • Both internal and external moderators must be in possession of an appropriate qualification at a NQF Level above this qualification, as well as relevant clinical expertise and current experience. In addition they must be in possession of a qualification as an educator or administrator or clinical specialist. External moderation will be conducted by the relevant ETQA for nursing and midwifery.
  • An Assessor must be accredited by the relevant ETQA and also be currently registered with the relevant statutory health council as a professional nurse and midwife, as determined by the particular exit level outcome being assessed. In addition, Assessors must have appropriate clinical expertise and/or a relevant qualification at an NQF Level above this qualification. 

  • REREGISTRATION HISTORY 
    As per the SAQA Board decision/s at that time, this qualification was Reregistered in 2012; 2015. 

    NOTES 
    Provision of this Qualification:
  • This qualification can only be offered by a higher education and training provider as determined by the current legislation pertaining to Higher Education, in agreement with the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.
  • The provider must have the required clinical facilities to meet the clinical requirements for the qualification in terms of the current legislation for nursing.
  • In order to be registered to practice as a Nurse, the learner will have to comply with the requirements set by the relevant statutory health council and the legislative framework. 

  • UNIT STANDARDS: 
      ID UNIT STANDARD TITLE PRE-2009 NQF LEVEL NQF LEVEL CREDITS
    Core  252101  Create and maintain a safe physical and emotionally supportive environment in a health care unit  Level 6  Level TBA: Pre-2009 was L6 
    Core  252106  Demonstrate knowledge of applied psychology in the care of health care users  Level 6  Level TBA: Pre-2009 was L6  12 
    Core  252103  Demonstrate knowledge of applied sociology in the care of patients  Level 6  Level TBA: Pre-2009 was L6  12 
    Core  252109  Demonstrate knowledge of the physiology and biochemical functioning of all body systems  Level 6  Level TBA: Pre-2009 was L6  20 
    Core  252100  Develop a care plan in collaboration with patients and/or carers  Level 6  Level TBA: Pre-2009 was L6  10 
    Core  252091  Maintain optimum health of the pregnant woman and the family  Level 6  Level TBA: Pre-2009 was L6  12 
    Core  252081  Manage childhood illnesses in an integrated manner  Level 6  Level TBA: Pre-2009 was L6 
    Core  252097  Manage individuals and groups with communicable diseases  Level 6  Level TBA: Pre-2009 was L6  14 
    Core  252111  Manage minor ailments and common illnesses  Level 6  Level TBA: Pre-2009 was L6  16 
    Core  252087  Manage pharmacological preparations and treatment  Level 6  Level TBA: Pre-2009 was L6 
    Core  252096  Manage rehabilitation  Level 6  Level TBA: Pre-2009 was L6 
    Core  252108  Provide nursing care to individuals with long term illness  Level 6  Level TBA: Pre-2009 was L6 
    Core  252085  Provide postpartum care to the mother and neonate  Level 6  Level TBA: Pre-2009 was L6  12 
    Core  252083  Utilise relevant legislation, regulations and policy in planning in a health care unit  Level 6  Level TBA: Pre-2009 was L6 
    Core  252149  Advocate for the rights of individuals, families, groups or communities and health care providers  Level 7  Level TBA: Pre-2009 was L7  10 
    Core  252141  Apply epidemiological principles to health planning and monitoring  Level 7  Level TBA: Pre-2009 was L7 
    Core  117434  Conduct research  Level 7  Level TBA: Pre-2009 was L7  15 
    Core  252140  Deliver safe intra-partum care to mother and baby  Level 7  Level TBA: Pre-2009 was L7  24 
    Core  252148  Demonstrate professionalism in own practice and promote and maintain professionalism in a health care unit and facility  Level 7  Level TBA: Pre-2009 was L7 
    Core  252172  Develop and implement unit philosophy, vision, mission, goals, policy and procedures for nursing care provision and personnel management within a health care unit  Level 7  Level TBA: Pre-2009 was L7 
    Core  252086  Develop, maintain and manage an effective information management system for nursing practice  Level 7  Level TBA: Pre-2009 was L7 
    Core  252160  Diagnose and manage common ailments  Level 7  Level TBA: Pre-2009 was L7 
    Core  252152  Formulate appropriate population based health promotion strategies and/or programmes  Level 7  Level TBA: Pre-2009 was L7 
    Core  252159  Identify and manage acute physical and psychiatric illnesses  Level 7  Level TBA: Pre-2009 was L7  32 
    Core  252157  Improve or restore mental health of individuals or groups through psychosocial techniques  Level 7  Level TBA: Pre-2009 was L7  24 
    Core  252173  Lead and guide personnel allocated to a health care unit  Level 7  Level TBA: Pre-2009 was L7 
    Core  252090  Maintain physical and psychological comfort in acute and/or chronically ill patients, and significant others  Level 7  Level TBA: Pre-2009 was L7  11 
    Core  252161  Maintain physiological homeostasis in the acutely ill patient  Level 7  Level TBA: Pre-2009 was L7  10 
    Core  252154  Manage extreme emotions and behaviour of mentally ill patient therapeutically  Level 7  Level TBA: Pre-2009 was L7  24 
    Core  252084  Manage the provision of quality nursing care in a cost effective manner  Level 7  Level TBA: Pre-2009 was L7 
    Core  252094  Organise, co-ordinate and review the activities of a health care unit  Level 7  Level TBA: Pre-2009 was L7 
    Core  252104  Prepare the patient who has recovered from an acute illness for discharge  Level 7  Level TBA: Pre-2009 was L7 
    Core  252151  Provide a therapeutic environment for patients with mental illnesses  Level 7  Level TBA: Pre-2009 was L7 
    Core  252146  Take responsibility for own personal and professional development and contribute to the growth of the nursing profession  Level 7  Level TBA: Pre-2009 was L7 
    Fundamental  252082  Carry out a health assessment of an individual of any age group  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252112  Demonstrate knowledge of the anatomy and bio-physical functioning of the human body  Level 5  Level TBA: Pre-2009 was L5  20 
    Fundamental  252110  Demonstrate knowledge of the structure and biology of micro organisms as it applies to clinical practice  Level 5  Level TBA: Pre-2009 was L5  12 
    Fundamental  252113  Develop and apply strategies to cope with the emotional demands of nursing situations  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252089  Ensure child and adolescent-friendly health and nursing care  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252107  Facilitate community stakeholder involvement in promoting and maintaining health  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252093  Implement and evaluate planned nursing care to achieve identified patient outcomes  Level 5  Level TBA: Pre-2009 was L5  16 
    Fundamental  252105  Lead and participate in team approaches to health care  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252092  Manage a community health intervention  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252095  Monitor and stimulate the growth and development of a child and/or adolescent  Level 5  Level TBA: Pre-2009 was L5  10 
    Fundamental  252125  Perform a spirometry screening test in an occupational setting  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252126  Perform an audiometric screening test in an occupational setting  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252080  Practice in accordance with ethical and legal codes of nursing and the laws of the country  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252099  Provide nursing care to a terminally ill patient and support to the family  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252102  Share information to promote effective decision making in health care  Level 5  Level TBA: Pre-2009 was L5 
    Fundamental  252098  Use communication skills to establish and maintain supportive relationships  Level 5  Level TBA: Pre-2009 was L5 
    Elective  252167  Provide expert testimony in court  Level 6  Level TBA: Pre-2009 was L6 
    Elective  244225  Advocate for the rights of children and youth at risk  Level 7  Level TBA: Pre-2009 was L7  10 
    Elective  244237  Organise, manage and implement advanced behaviour management strategies and techniques  Level 7  Level TBA: Pre-2009 was L7  15 
    Elective  252150  Provide coherent responses to patients manifesting with seriously troubled/troublesome behaviour  Level 7  Level TBA: Pre-2009 was L7 
    Elective  244229  Provide counselling and intervention for people affected by abuse, neglect, or violence  Level 7  Level TBA: Pre-2009 was L7  15 
    Elective  244239  Provide workspace and consultative supervision and support for child and youth care workers  Level 7  Level TBA: Pre-2009 was L7  18 


    LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION: 
     
    LP ID Learning Programme Title Originator Pre-2009
    NQF Level
    NQF Level Min Credits Learning Prog End Date Quality
    Assurance
    Functionary
    NQF Sub-Framework
    74329  Bachelor of Nursing  Generic Provider - Field 09  Level 7  NQF Level 08  508       HEQSF 
    71713  Bachelor of Nursing  Mediclinic (Pty) Ltd - Corporate Office  Level 7  NQF Level 08  508     CHE  HEQSF 
    87259  Bachelor of Nursing  Nelson Mandela University  Level 7  NQF Level 08  508     CHE  HEQSF 
    87508  Bachelor of Nursing  Walter Sisulu University  Level 7  Level N/A: Pre-2009 was L7  480  2018-12-31  CHE  HEQSF 


    PROVIDERS CURRENTLY ACCREDITED TO OFFER THESE LEARNING PROGRAMMES: 
    This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.
     
    LP ID Learning Programme Title Accredited Provider
    71713  Bachelor of Nursing  Mediclinic (Pty) Ltd - Corporate Office  
    87259  Bachelor of Nursing  Nelson Mandela University  
    87508  Bachelor of Nursing  Walter Sisulu University  



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