Fight or Flight

Fight or Flight: Survey Shows Mounting Workplace Challenges Require
Attention to Keep Nurses from Leaving

Global survey of nurses highlights views of profession, health care environments

July 1, 2009 – DURBAN, SOUTH AFRICA – South Africa’s nurses are less likely to stay in the profession over the next five years compared to their counterparts in other parts of the world, according to research presented today at the International Council of Nurses (ICN) 24th Quadrennial Congress.

The results, part of an extensive global attitudinal survey that asked more than 2,000 nurses around the world, including 200 in South Africa, about the challenges and opportunities facing nurses, found that when asked to rate the likelihood they will still be in nursing in five years, only 33% of nurses in South Africa say they are very likely to do so.

“Despite advances made so far in our democracy, significant challenges for South Africa’s nurses remain at crossroads with regards to adequate and equitable distribution of healthcare infrastructure and health human resources,” said DENOSA General Secretary Thembeka Gwagwa. “In a country like South Africa, with staggering disease rates and high patient to nurse ratios, it comes down fight or flight.  Do we allow the continued flight of nurses out of South Africa, or do we fight as a nation to address nurses’ concerns and protect the healthcare system so we can provide quality care to our patients?”

An estimated 13 million nurses form the backbone of health care systems, working in hospitals, clinics, communities and other settings around the world. ICN and Pfizer Inc. External Medical Affairs collaborated on a global representative survey of 2,203 nurses in eleven countries, including Brazil, Canada, Colombia, Japan, Kenya, Portugal, South Africa, Taiwan, Uganda, the UK, and the U.S.  The survey was conducted by APCO Insight.  Collated global results and methodology can be viewed at

“Nurses represent the largest group of healthcare providers in the world,” said ICN Chief Executive Officer, David Benton. “We are keen to better understand nurses’ views of their work and the environments in which they practice across the world. These results will inform the Positive Practice Environment campaign ICN and partners are implementing to improve the practice environment and with it the quality of care.”

“Nurses are key patient advocates and have always been patient-focused. The research shows that for nurses, the most favourable aspect of their profession is indeed patient contact,” said Paula DeCola, R.N., M.Sc., from the office of the Chief Medical Officer at Pfizer, Inc. External Medical Affairs. “This survey supports the research of Dr. Linda Aiken at the University of Pennsylvania – nurses perceive that inadequate staffing and high workloads are having a negative impact on the quality of care patients receive.”

Key findings from the research provide a glimpse into the challenges South Africa’s nurses face, and opportunities for improvements:

  • More than half of nurses (53%) in South Africa say their workload is worse today compared to five years ago, potentially impacting the quality of patient care and nurses’ commitment to remain in the profession.
  • The survey finds that in South Africa, as in other countries surveyed, most nurses (85%) say that they face time constraints that prevent them spending as much time with individual patients as they think necessary. A large majority of the nurses surveyed in South Africa (87%) say that spending more time with individual patients would have a significant impact on patient health.
  • Nurses in South Africa view overwhelming workloads (32%), insufficient pay and benefits (22%), lack of recognition (11%), budget cuts and inadequate healthcare systems (11%) as the least favorable aspects of their profession. Nurses are most likely to say that patient contact (39%) is the most favorable aspect of their work experience.
  • Nurses in South Africa see their professional associations as effective in advancing their interests (86%) and supportive of their needs (87%).  In fact, nurses in South Africa are much more likely than nurses in the other countries surveyed to say their professional associations are “very” effective – 42% in South Africa say their associations are very effective vs. the global average of 17%.
  • South Africa’s nurses also favor expanding their healthcare responsibilities, including the authority to prescribe medicines to patients. Fifty percent of the nurses surveyed in South Africa say they currently have the authority to prescribe medicines to patients. Additionally, eight in ten (83%) say they favour nurses having this authority.
  • The country’s nurses indicated there are now better opportunities for professional training and career advancement (59%) and increased recognition for their contributions as nurses (53%) than there were five years ago.  Additionally, 63% of nurses in South Africa perceive the nation’s healthcare system as better than it was five years ago.

“Nurses in South Africa, like nurses worldwide, play a critical role in the delivery of care and the quality of healthcare. We trust that this research will assist in providing necessary guidance for South African policy makers in the designing of intervention strategies as part of the government’s ongoing efforts to improve our healthcare system,” said Pfizer South Africa Country Manager, Brian Daniel.

“Nurses globally are thinking about leaving the profession, which will further impact already burdened healthcare systems, including in countries such as Kenya, Uganda and South Africa.  It is urgent to respond to their needs with adequate staffing, greater independence and greater involvement in decision-making.  Nurses must be involved in crucial policy conversations as healthcare systems are growing, developing and changing,” added Mr. Benton

About the Survey
More information about the survey and the methodology can be found at

DENOSA is a vigorous, dynamic, responsive member driven organisation that understands the unique dynamics of nurses, midwives/accoucheurs and provides specialised expertise to address individual and collective professional and union issues. Our professional and union solidarity impacts beyond the borders of South Africa into Africa and the rest of the world. In representing the majority of health professionals, DENOSA has a powerful impact on health care and health policy development and monitoring in South Africa.

About the International Council of Nurses
The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations representing the millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality nursing care for all and sound health policies globally.

About Pfizer, Inc.
Pfizer is committed to working together with various stakeholders to improve healthcare.  In recognition of the important role of nurses, Pfizer has established a platform to engage nurses. Pfizer has commissioned global research on nurse perceptions over the last few years in order to identify nurses’ key concerns and to identify areas in which Pfizer might support nurses and, by doing so, strengthen healthcare systems, globally.

About APCO Insight®
APCO Insight, a global opinion research and strategic communication consultancy, works with many of the world’s leading companies, associations, nonprofits and public-sector organizations on a diverse range of communication, reputation and issue management challenges.

Última actualización el Miércoles 13 de Abril de 2011 09:24