Bachelor of Nursing

Purpose

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 and Midwife. Successful registration will license nurses to practise as a professional nurse and Midwife 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 1) produce competent professional nurse practitioners within a wide range of health service settings; 2) provide learners with a wide range of skills, knowledge, and attitudes that will enable them to make a meaningful and sustained contribution to health services; 3) equip learners with a developed sense of equity, justice and service ethics that will ensure that they work in a responsible and accountable manner, irrespective of their chosen workplace; and 4) offer a wide range of transferable skills for application in other professions, disciplines and general life, including:

• A methodical solution-based approach to problem-solving.
• An empowerment-based approach to development of self and others.
• 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.
• Research capacity.

The learner who completes this qualification will be able to apply knowledge of theory of biological and natural sciences, psycho-social sciences and pharmacology in the provision of comprehensive nursing and midwifery care; Develop, implement and evaluate population-based health care; assess, plan, implement and evaluate nursing care for individuals and groups throughout the lifespan; promote health, prevent ill-health, provide nursing care and promote rehabilitation of individuals and groups independently; utilise research in nursing and health-related problems to improve health care outcomes; manage health care facilities; demonstrate professional and clinical leadership; promote the professional development of self and others; demonstrate clinical judgment and critical thinking; and register as a Professional Nurse with the South African Nursing Council.

Rationale

This qualification will enable the learners to function as a clinically focused, service-orientated, independent registered professional nurse and midwife 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 i.e. general, community, obstetric, mental health that promote and maintain the health status of health care users in all contexts of health care delivery" (Department of Health, Regulation 786 of 2013).

Reports on the status of nursing in the country indicate a growing gap between the demand and supply of professional nurses and midwives, the decline in learners entering the nursing profession and the ageing population of professional nurses. The decline of learners 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 updated in the Strategic Plan 2014/15-2018/19, 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 (Department of Health Strategic Plan 2014/15-2018/19).

Of importance in this qualification is the scope. The learners will be more comprehensively qualified than before, with a scope that includes obstetric skills, mental health, and primary health care (first 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, he/she will take responsibility for managing nursing care in a health care facility. The qualification will provide him/her with a comprehensive view of the field and the necessary skills to screen patients and refer as required (Department of Health, Regulation 786 of 2013).

There is a strong need for nurses and midwives 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 and midwifery practice. There is recognition in the health care field of the need to benchmark practices and work towards quality improvement; to this end, the qualification makes provision for a strong research component. After having developed their practical skills, Professional Nurses will act as professional team leaders, typically deployed as unit and/or zone managers.

They are both the providers and managers of health care; there is a strong coordination role for care provided by other caregivers. Professional nurses and midwives 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 (Postgraduate Diplomas and Master's Degrees).

Recognition of Prior Learning (RPL)

Registered Auxiliary and General Nurses who are at NQF Level 5 and 6, will be allowed to apply for Recognition of Prior Learning. They might access the qualification based on their certificate of conditional exemption by virtue of mature age attained at the age of 23 years (Higher Education Act, Act 101 of 1997) if approved by the Committee of Principals, based on the requirements and conditions for matriculation endorsement and issuing of certificates of exemption for admission to Bachelor's Studies. They might be allowed to enrol for the qualification from the first academic year.

Entry Requirements

The minimum entry requirement is

• National Senior Certificate, NQF Level 4 granting access to bachelor studies (with Life Sciences, Mathematics, and Physical Sciences).

Or

• Senior Certificate, NQF Level 4 with endorsement (With the following subjects are compulsory: Biology or Physiology, Mathematics and Physical Science).

This qualification comprises of compulsory modules at NQF Levels 5, 6, 7 and 8 totalling 540 Credits.

Compulsory Modules, NQF Level 5, 136 Credits

• Anatomy, 24 Credits.
• Medical terminology, 12 Credits.
• Academic English for Health Sciences; 12 Credits.
• Academic Information Management, 6 Credits.
• African language: Sepedi/isiZulu, 12 Credits.
• Physiology, 12 Credits.
• Nursing studies, 8 Credits.
• Integrated health care leadership, 14 Credits.
• Nursing practice Education, 24 Credits.

Compulsory Modules, NQF Level 6, 112 Credits

• Microbiology, 18 Credits.
• Physiology, 12 Credits.
• Psychology, 12 Credits.
• Nursing studies, 14 Credits.
• Integrated health care leadership, 16 Credits.
• Nursing practice Education, 40 Credits.

Compulsory Modules, NQF Level 7, 148 Credits

• Midwifery theory, 16 Credits.
• Midwifery practice, 40 Credits.
• Integrated health care leadership, 12 Credits.
• Nursing studies, 8 Credits.
• Nursing practice Education, 6 Credits.
• Research in Healthcare sciences, 30 Credits.
• Pharmacology, 36 Credits.

Compulsory Modules, NQF Level 8, 144 Credits

• Midwifery theory, 24 Credits.
• Midwifery practice, 44 Credits.
• Integrated health care leadership, 20 Credits.
• Nursing practice Education, 30 Credits.
• Nursing studies, 16 Credits.
• Research in Healthcare sciences, 10 Credits.

1. Identify and address ethical and legal issues based on critical reflection on the suitability of different ethical value (and legal) systems to the nursing and midwifery practice within the legal framework.
2. Apply knowledge of biological and natural sciences, psycho-social sciences and pharmacology in the provision of safe nursing care, throughout the life span, in a variety of health care settings and communities in response to population needs.
3. Effectively manage the health care unit and health facility with the understanding of the roles and relationships within the multidisciplinary team.
4. Access, produce and manage information effectively to a range of audiences.
5. Utilise research in investigating nursing, midwifery, and health-related problems.
6. Apply learning strategies effectively to address own, and other's professional and personal ongoing learning needs in a self-critical manner.
7. Apply knowledge of theories, methods, and techniques in the practice of safe clinical nursing and midwifery that is responsive to the needs of the individual, the family, and the community, in accordance with national legislative and policy frameworks.
8. Provide safe and quality midwifery and neonatal care in a scientific, integrated, and evidence-based approach in all health care settings.

Associated Assessment Criteria for Exit Level Outcome 1

• Advocacy activities promote individual, group, and community rights with respect to law and health care provision.
• Practice is applied consistently in a manner that reflects a clear understanding and interpretation of the requirements of South African Nursing and Health Care legislation, including a Primary Health Care approach.
• Ethical codes, professional accountability and responsibility, and standards for the practice of nursing and midwifery are interpreted and applied consistently in line with their spirit and intent.

Associated Assessment Criteria for Exit Level Outcome 2

• Knowledge of psychology and sociology is applied in nursing and midwifery practice in ways which benefit the level and quality of health care delivery to patients.
• Knowledge of bio-natural sciences meets requirements for professional health care and promotes effective nursing and midwifery care delivery.
• Assistance provided to the client identifies indicators of relapse or complications and ways of preventing such.
• Technology is used in the practice of nursing and midwifery in ways that facilitate the effective diagnosis and treatment of illnesses and conditions.
• Treatment is initiated to manage common conditions (including prescribing and dispensing medication) in accordance with relevant legislation and protocols Understanding of pharmacokinetics and pharmacodynamics, as well as standard treatment protocols/guidelines, are evident in prescribing and administering drugs to women perinatal.
• Pharmacological principles are applied in the care and control of drugs used for neonates.

Associated Assessment Criteria for Exit Level Outcome 3

• Planning and provision for health care are based on sound assessment and informed decision-making. Planning is inclusive of the patient and other key stakeholders.
• Unit philosophy, vision, mission, goals, policy, and procedures developed for nursing and midwifery care provision and personnel management within a health care unit comply with current legislation, South African Nursing Council (SANC) requirements and international best practice for the profession.
• Systems established promote cost-effective and efficient service delivery within a health care unit.
• 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.
• Pharmacological preparations and treatment are managed in ways that ensure the correct storage of drugs and the correct preparation and administration of pharmacological treatment.
• Applies management processes strategically and systematically to manage resources effectively within a health care unit.
• Quality management systems are effectively implemented and monitored.

Associated Assessment Criteria for Exit Level Outcome 4

• Organisation, presentation, and communication of professional information is accurate and consistent with professional expectations.
• Community involvement in health care is promoted through information sharing and contact, which promotes ongoing collaboration with the community or group.
• Assessment, planning, implementation, and evaluation is documented accurately and timeously and promotes effective service delivery as well as security and confidentiality of information.
• Standards set for unit health care delivery are monitored regularly, and information gathered identifies areas for improvement on an ongoing basis.
• Communicate effectively using a variety of media and technology, including computers.
• Interpersonal skills are used effectively to establish supportive and therapeutic relationships.

Associated Assessment Criteria for Exit Level Outcome 5

• Research of limited scope conducted is based on identified needs and takes into consideration the steps of the research process, as per standard research text.
• Research conducted is based on ethically sound research principles and methods.
• Strategies and/or programmes developed are appropriate to the findings of comprehensive health assessments, and based on sound epidemiological principles.
• Provision of care is based on scientific evidence.

Associated Assessment Criteria for Exit Level Outcome 6

• 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.
• Engagement in professional development activities contributes significantly to the professional growth of nurses in the sphere of influence, and to the standing of the nursing profession.
• Research activities develop own professional knowledge and expertise and contribute to the development of nursing practice and the profession as a whole.
• Learning activities are directed towards positive health outcomes and uses relevant teaching strategies.
• Mentoring activities are directed towards the development of others, according to their needs and their scope of practice.

Associated Assessment Criteria for Exit Level Outcome 7

• Health care status of individuals, groups, and/or communities identifies changes in general status in time to implement preventive or corrective measures in the interests of general wellbeing.
• Conditions are accurately diagnosed and managed according to generally accepted treatment guidelines.
• Nursing interventions are based on individualised plans that reflect comprehensive and integrated assessment of mentally ill persons, and understanding of common emotional and behavioural disorders, as well as major psychiatric disorders (perceptual and severe mood disorders.
• Interventions with mentally ill persons are consistent with generally accepted psycho-social techniques and contribute to the therapeutic management of these patients.
• Support provided to patients recovering from 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.
• 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.
• Interventions with patients contribute to the identification and management of conditions, maintenance of homeostasis, the comfort of patient and significant others, and the prevention and/or management of complications.
• Competent clinical skills are demonstrated at all times.
• Clinical decisions/judgements made are in accordance with the principles of clinical governance.
• Strategies used in problem-solving are scientific, systematic, and appropriate to addressing identified problems.

Associated Assessment Criteria for Exit Level Outcome 8

• The preparation of a woman and family for pregnancy, childbirth, and family changes is appropriate, takes into consideration the woman's context/background and is facilitated by means of antenatal classes and appropriate health education.
• Obstetric history-taking and physical examination of the mother is conducted in a comprehensive manner, using a variety of available technology.
• Observations of significant changes and laboratory results are accurately interpreted and appropriately referred where potential risk to mother and/or foetus exists.
• Monitoring of the wellbeing of the foetus is ensured by monitoring foetal movement, heart rates, and growth.
• Monitoring and management of the mother during labour and delivery is comprehensive, evidence understanding of the physiology of labour, technology used to monitor the mother and wellbeing of the foetus.
• Management of the new-born demonstrate understanding of changes taking place in a new-born baby.
• Potential and actual emergencies of the mother and/or foetus are timeously identified and accurately managed and referred.
• 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.

Integrated Assessment

Integrated Assessment will take place within the context of quality assurance policies, procedures, and processes, both in terms of formative and summative assessment. Different approaches and methods will be used in the modules with the focus on integration and application, which will be determined by the level of the module (according to the level descriptors) and the complexity of the content. The purpose of the assessment will be to ensure that the qualifying learner meets the standards of the educational programme and requirements for registration with the South African Nursing Council.