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NMCH Family: Ncediwe Stemela, Lead Nurse for Clinical services

NMCH chatted to Ncediwe Stemela, the lead nurse who is currently overseeing the specialist training of nurses who will be working at the Nelson Mandela Children’s Hospital from the first day it opens doors in 2016.

Hi, Ncediswe, can you please tell us more about your involvement with NMCH?

My role in the NMCH Project started 8 years ago when I was part of the feasibility study of the hospital to determine the project’s potential for success. At the end of the study, when it was established that there is a definite need for a children’s hospital with valuable data to support it, the role changed to Lead Nurse for Clinical services.

Seeing that there was still no hospital operational at that stage, my major role was to advise on nursing requirements in preparation of a stand-alone, tertiary/quaternary specialist children’s hospital. With the help of other nurses that I chose, we drafted a nursing strategy that will see to the quantity and quality of nurses needed to be able to staff the NMCH.

I’m now currently overseeing the specialist nursing training of nurses to ensure their efficiency in caring for sick children.

How were you chosen?

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It was such a coincidence that I approached the CEO of the hospital project at the time when she was engaging with the human resources needed to carry out the feasibility study. I’m always grateful of the opportunity to be part of a team that strives to see the existence of another children’s hospital in this country.  I always look back at the humble beginnings of this endeavor (from the days of 5 people around the table as the staff) to where it is today with a large team of physicians, architects, engineers, administrators, fundraisers, etc with various offices to operate from.

We believe nursing is a calling… Based on your experience, what makes a good nurse?

A good nurse is someone that becomes passionate about helping sick people and always seeks to develop skills in the profession. After all, best outcomes depend on nurses with expert caring practices, skilled clinical judgment and astute awareness of a patient’s changing needs.

Nursing is a profession in a health sector, except that it is a very demanding one, so much so that when one chooses it you need to realise what it entails: patience to deal with sick people, long working hours, stressful and traumatic situations encountered etc. It does have its emotionally rewarding or heartwarming moments, such as when you help a patient recover, reuniting families, or bonding with fellow nurses. Just don’t come to expect it.  Leave the happy endings for Grey’s Anatomy.

How will the NMCH change perceptions about South African health services and nurses in general?

The gift from the NMCH Trust of a second children’s hospital in the country, a first one in this province, and a third or fourth one in the continent, is a huge contribution to the paediatric health services of this country and the continent as a whole. NMCH is about to change South African child health (which is currently in a poor state and should be addressed by focusing on the healthcare needs of all children) by providing much-needed beds for sick children and also by becoming a training center and producing paediatric healthcare specialists such as doctors, nurses, allied health specialists and the like.

What can parents and children expect from NMCH nursing staff?

NMCH will be a tertiary/quaternary hospital with areas of specialty, focusing on disciplines such as cardiology (heart); oncology (cancer); nephrology (kidney), etc.  We’re striving to get nurses to specialise in these areas even before the hospital opening, so that they can provide exceptional care to the sick children in NMCH.

Currently, only about 2% of qualified nurses in South Africa are trained as specialised paediatric nurses.  This does not reflect well on the care of sick children in the country. Parents of sick children are assured to see the level of knowledge and expertise of the caregivers. The rating of any healthcare institution is based on the standard of care by nurses and not by a good security guard at the gate.

What’s your take on the current state of healthcare in South Africa?

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South Africa has made significant progress in certain aspects of the healthcare system, for example it has developed sound and public health legislation and policies, established a unified national health system, increased infrastructure at primary care level, removed user fees for maternal and child health services and introduced a system of social support grants. We have ensured the steady increase of immunization coverage and supported the world’s largest HIV/AIDS treatment programme.

Despite these major achievements, though, the country has made insufficient progress towards Millennium Development Goal 5 (neonatal & infant mortality) and 6 (on HIV/AIDS, TB and malaria), and progress towards MDG 4 (on maternal health) has even reversed.  The NMCH will play a huge role in the achievement of MDG 5 as it will reduce the load of the existing facilities and improve on childcare dramatically.

The health sector continues to face significant challenges, which include a quadruple burden of disease, economic and social inequity, barriers to accessing health services, inequitable distribution of health resources and continuing human resource capacity needs. Other weaknesses in the areas of human resources and leadership are also cause for concern.

What do you think can be done to improve this?

High population growth should be matched by an increase in the healthcare facilities so that there’s adequate access to good quality health services for all. In 2004, the South African population was estimated at 46.6million, compared to 54million in 2014 – a 16% population increase in 10 years, which is not necessarily followed by a matching increase in healthcare facilities and human resources to render the care.

Community education about the most common causes of death in children under 5 years old, such as diarrhoea, pneumonia, AIDS, measles, tetanus and malaria is also essential, as is the need to seek urgent healthcare at the earliest stages of presentation.

Promotion of antenatal care for pregnant women for monitoring; early identification of pregnancy problems, which also helps to prevent maternal mortality, and the promotion of breast feeding are the good practices that would go a long way in helping South Africa achieve some of the MDG goals and let its people live a better life.