Exploring the working environment of enrolled nursing auxiliaries in private hospitals in the eThekwini District

Abstract

Background: The nursing professionals are recognised worldwide as being critical to the delivery of high quality, efficient nursing management and patient care in the healthcare services. However, shortage of skilled nurses in most countries, including South Africa, has led to an overburdened healthcare system with certain nursing categories doing much more than they are trained to do. The enrolled nursing auxiliaries (ENAs) are junior members of the nursing team who, on completion of a one-year basic nursing certificate programme, work either in public or private healthcare sectors. Aim of the study: The aim of the study was to explore the working environment of ENAs, in private hospitals in the eThekwini District, KwaZulu-Natal, South Africa. Methodology: An exploratory descriptive design was used. Data was collected by in-depth one-on-one interviews with ENAs, Registered Nurses (RNs) and Unit Managers (UMs) working in the medical and surgical units of the selected healthcare institutions and were analysed using Tesch’s method of data analysis. Findings: Three major themes that emerged from the data analysis were a) working experiences of the ENA, b) challenges experienced by the ENA, c) supervision of the ENA. This study found that due to the shortage of skilled nurses in the country, brain drain and cost containment in the private health sector, the dynamic healthcare environment resulted in ENAs endangering their professional status by functioning out of their scope of practice and performing a role for which they were never intended or academically prepared. The ENAs under study were dissatisfied by a lack of clear career development pathways from the private healthcare group to assist them with transitioning to the next level of qualification. They also felt that they were not recognised or rewarded for their contributions to nursing. Conclusion The private healthcare group under study should, as a priority, communicate to ENAs the plans for career development and funding which will allow ENAs to undertake training to the next level of qualification. The nursing agency utilisation should decrease from 40% to the benchmark of 25% to ensure sufficient numbers of skilled staff are working in the general nursing units. The emphasis by nursing leadership must be on teamwork to build a motivated workforce.