Bachelor of Nursing and Midwifery

Purpose

The Bachelor of Nursing and Midwifery is comprehensive, and the training seeks to produce competent professional nurse and midwife practitioners within a wide range of health service settings. This qualification will provide qualifying learners with a wide range of skills, knowledge and attributes that will enable them to make a meaningful and sustained contribution to health services.

The qualification will equip learners with a developed sense of equality, justice and service ethics that will ensure that they work in a responsible and accountable manner, irrespective of their chosen workplace.

Qualifying learners also receive a wide range of transferable skills for application in other professions, disciplines and general life, including:

• A systematic solution-based approach to problem-solving.
• An empowerment-based approach to the development of self and others.
• Competence in written and oral communication.
• Capacity to assess and implement health and other policies.
• Ability to plan and implement and manage projects of a varied nature.
• Research capacity.

Rationale

The qualification seeks to combine nursing care that provides for curative aspects of nursing care, prevention of diseases, promotion of health for individuals, families and communities in hospitals and the community, urban and rural to effect strong primary health care.

The qualification will

• Enable the learner to render comprehensive care across all spheres of health and life, and function as a clinically focused, service-oriented and independent registered professional nurse.
• Provide the learner with a comprehensive view in the field of nursing and the necessary skills to screen and refer patients as required.
• Enable work with all patients, stabilised or nor, take responsibility for health care in any context, and take responsibility for managing nursing care in a health care facility.
• Allow for a variety of learners from all spheres of life (provided they meet the admission criteria and are healthy enough), to carry out the duties required of them. The qualification is grounded in practice and intends to provide access to further academic routes, specialisation and research. The qualifying learner will be a nurse and can provide care in the maternity area, general nursing science, community and mental health.
• Prepare nurses who will be able to meet the service delivery needs of the country, especially the burden of disease as experienced currently, using cost-effective measures in line with the stipulations of the primary health care approach.

Recognition of Prior Learning (RPL)

At the institution, Recognition of Prior Learning processes are used to increase access to qualifications by individuals through experience at the workplace, experiences through daily life or credit-bearing exemption.

The institution considers RPL where a learner gains entry into a qualification through non-traditional means, e.g., learners who do not meet the academic requirements for admission into a qualification may access that qualification based on their work experience. Learners may need to compile a portfolio of evidence detailing their experience, or they may challenge an examination on that module that they require recognition. The outcome may determine admission or an award of credits toward the module.

Admission through RPL must not reflect on the learners' record, but a detailed record of the assessment conducted and all the documentation about such an assessment activity must be kept in the archives of the institution and must be available when required.

Entry Requirements

The minimum entry requirement for this qualification is

• Senior Certificate, NQF Level 4 with endorsement and a pass in Mathematics, Physical Science and Biology.

Or

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

This qualification consists of the following compulsory modules at NQF Level 5, 6, 7 and 8 totalling 480 Credits.

Compulsory Modules, Level 5,120 Credits

• Human Anatomy A, 20 Credits.
• Biophysics, 12 Credits.
• Chemistry 1C, 16 Credits.
• Psychology 1, 16 Credits.
• English, 8 Credits.
• Nursing Science Theory 1, 20 credits.
• Nursing Science Practice, 28 Credits.

Compulsory Modules, Level 6,120 Credits

• Physiology, 20 Credits.
• Microbiology, 16 Credits.
• Psychology II, 16 Credits.
• Ethos and professional practice, 8 Credits.
• Nursing Science Theory II, 20 Credits.
• Nursing Science Practice II, 40 Credits.

Compulsory Modules, Level 7,120 Credits

• Nursing Science Theory III, 12 Credits.
• Nursing Science Practice III, 12 Credits.
• Midwifery I, 20 Credits.
• Midwifery I Practice, 36 Credits.
• Pharmacology and Prescribing and dispensing, 16 Credits.
• Sociology, 12 Credits.
• Health Service Management and Leadership I, 12 Credits.

Compulsory Modules, Level 8, 120 Credits

• Nursing Science Theory IV, 12 Credits.
• Nursing Science Practice IV, 12 Credits.
• Midwifery II, 24 Credits.
• Midwifery II Practice, 36 Credits.
• Research Methodology, 16 Credits.
• Health Services Management and Leadership, 20 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 and midwifery care, throughout the life span in a variety of health care settings and communities in response to population needs.
3. Effectively manage a health care unit and health facility based on the understanding of roles and relationships within the multidisciplinary team.
4. Access, produce and distribute information effectively to a range of audiences, including health information system.
5. Utilise research in investigating nursing, midwifery and health-related problems to improve quality of care.
6. Apply learning strategies effectively to address their own and other's professionals 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 that is responsive to the needs of the individual, the family and the community, following the national legislative and policy frameworks at all levels of health care.
8. Provide safe and quality midwifery and neonatal care in a scientific integrated and evidence-based approach in all health care setting.

Associated Assessment Criteria for Exit Level Outcome 1

• Discuss advocacy activities that promote individual, group and community rights concerning law and health care provision.
• Apply practice consistently in a manner that reflects a clear understanding and interpretation of the requirements of the South African Nursing Council (SANC) and Health Care legislation, a Primary Health Care approach.
• Interpret and apply ethical code, professional accountability and responsibility and standards for the practice of nursing and midwifery consistently in line with their spirit and intent.

Associated Assessment Criteria for Exit Level Outcome 2

• Apply knowledge of Psychology and Sociology in Nursing and Midwifery practice in ways which will benefit the level and the quality of health care delivery to patients.
• Apply knowledge of bio-natural sciences that meets requirements for professional health care and promotes practical nursing and midwifery care delivery.
• Assist clients that identify indicators of relapse or complications and ways of preventing such.
• Use technology in the practice of nursing and midwifery in ways that facilitate the effective diagnosis and treatment of illnesses and conditions.
• Initiate treatment to manage common conditions (including prescribing and dispensing medication) following relevant legislation and protocols.
• Show understanding of pharmacokinetics and pharmacodynamics as well as standard treatment protocols/guidelines in prescribing and administering drugs to women perinatally.
• Apply pharmacological principles in the care and control of drugs used for neonates and young children.

Associated Assessment Criteria for Exit Level Outcome 3

• Base planning and provision for health care on sound assessment and informed decision making. The plan 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, SANC requirements and international best practice for the profession.
• Direct systems established to promote cost-effective and efficient service delivery within a health care unit management and leadership activities towards the establishment of a team approach to health care, and the effective delivery of services within a physically safe and emotionally supportive environment.
• Manage pharmacological preparations and treatment in ways that ensure the correct storage of drugs and the proper preparations and administration of pharmacological treatment.
• Apply management processes strategically and systematically to manage resources effectively within the health care unit.
• Implement and monitor quality management systems.

Associated Assessment Criteria for Exit Level Outcome 4

• Organisation, presentation and communication of professional information is accurate and consistent with professional expectations.
• Promote community involvement in health care 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.
• Monitor standards sets for unit health care delivery regularly, and information gathered identifies areas for improvement on an ongoing basis.
• Use communication effectively using a variety of media and technology including computers
• Interpersonal skills effectively to establish supportive and therapeutic relationships.

Associated Assessment Criteria for Exit Level Outcome 5

• Conduct research of limited scope 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.
• Develop appropriate strategies and programmes to the findings of comprehensive health assessments and based on sound epidemiological principles.
• Provide care based on scientific evidence.

Associated Assessment Criteria for Exit Level Outcome 6

• Develop own personal and management strategies to maintain emotional balance, and promote effective and professional service delivery of self and the health care unit as a whole.
• Engage in professional development activities to contribute to the professional growth of nurses in the sphere of influence, and the standing of the nursing.
• Develop research activities from own professional knowledge and expertise and contribute to the development of nursing practice and the profession as a whole.
• Direct learning activities towards positive health outcomes and uses relevant teaching strategies.
• Direct mentoring activities towards the development of others, according to their needs and their scope of practice.

Associated Assessment Criteria for Exit Level Outcome 7

• Provide appropriate health care to the particular context and based on comprehensive health assessment.
• Implement nursing care in an integrated manner according to plans. Health care status of groups and communities identifies changes in general condition in time to implement preventative or corrective measures in the interest of general wellbeing disorders.
• Accurately diagnose and manage conditions according to generally accepted treatment guidelines.
• Base nursing interventions on individualised plans that reflect a comprehensive and integrated assessment of mentally ill persons, and understanding of common emotional and behavioural disorders, as well as major psychiatric diseases (perceptual and severe mood disorders).
• Provide consistent interventions with mentally ill persons with generally accepted psycho-social techniques, and contribute to the therapeutic management of these patients.
• Provide support to patients recovering from illness prepares them for discharge in ways that enable the patients, family and significant others to cope with the management of the patients at home.
• Deliver nursing care to provide for the necessary physical and psychological care and support for the long term and terminally ill patients, in line with the accepted scope of practice for nursing interventions with patients contribute to, identification and management of conditions, maintenance of homeostasis, the comfort of the patient and significant others, and the prevention and control of complications.
• Demonstrate competent clinical skills at all times.
• Make clinical decisions/judgements following principles of clinical governance.
• Use strategies in problem-solving that are scientific, systematic and appropriate to address identified problems.

Associated Assessment Criteria for Exit Level Outcome 8

• Display understanding of the appropriate preparation of the woman for pregnancy, childbirth and family changes which takes into consideration the woman's context/background and facilitate using antenatal classes and proper health education.
• Conduct obstetric history taking and physical examination of the mother in a comprehensive manner, using a variety of available technology.
• Interpret observations of significant changes and laboratory results referred to where a potential risk to mother and foetus exists.
• Ensure monitoring of the wellbeing of the foetus by monitoring foetal movements, heart rate and growth.
• Ensure monitoring and management of the mother during labour and delivery is comprehensive and it evidences the understanding of the physiology of work, the technology used to monitor the mother and wellbeing of the foetus.
• Demonstrate understanding of the management of the new-born to ensure that changes that take place in the new-born baby.
• Identify, accurately manage and refer potential and actual emergencies of the mother and foetus.
• Ensure that 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.
• Integrate care delivered postnatally and provides for the long-term wellbeing of mother and child, in line with the accepted scope of practice for midwives.

Integrated Assessment

Registered assessors do both formative and summative assessment. The learner must be competent in all the Exit Level Outcomes.

Theoretical Formative assessment

Modules taught will be continuously assessed individually and with integration with the other modules to affect understanding and application. Remedial/ Academic support interventions will be incorporated to assist the learner in achieving the expected outcomes. Theoretical assessment methods include classroom question and answer (formal and informal written class tests), assignments, essays, interviews, case studies, projects, portfolios of evidence and Quizzes.

Clinical facilitators appointed by the institution will conduct formative clinical evaluations. Assessments integrate theory and practice. The clinical competency is assessable through practical performance in areas of care, record keeping and unit management activities. The professional nurse in the clinical area will periodically provide progress reports on learner performance. Learners whose performance is not satisfactory will receive remedial teaching and further coaching.

Learners must do a minimum of 60% of formative clinical assessment activities in a real-life situation.

Marks obtained during formative assessments in the classroom or clinical area (WIL) are recorded and used separately to determine entry into the summative assessment (Theory and Practice).

Summative assessment happens at the end of a section, a year, a qualification, the purpose of which is to decide on the progression of the learner. Much more than the formative assessment, a learner has to earn the summative assessment.