With the prevalence of HIV and various forms of drug-resistant TB as well as the rise of non-communicable diseases (NCDs) among South Africans, such as lung cancer, hypertension and diabetes, the advance stages of these illnesses result in patients needing palliative care, and most of patients are taken care of in their homes.
Because the country is short of doctors even at the country’s healthcare centres, as they are the ones who can assess and prescribe medication for such patients, nurses who supervise home-based care workers can’t prescribe morphine for such patients, a pain killer, even if their assessment of the pain-suffering patients shows the patients deserves a change to morphine.
In Africa, it is only in Uganda where nurses are empowered to prescribe morphine, and that has come to the assistance of patients most of whom suffer pain as a result of their illnesses. Nurses who are trained in palliative care are far better positioned to assess a patient and identify any need for a change in the pain medication. Because they can’t change the mediation, they have no option but to leave patients in pain and suffering.
As the regulatory body for nursing in South Africa, SANC issues of prescriptions by nurses fall under the radar of the Council as enshrined in the Nursing Act 33 of 2005.
DENOSA believes this move will be a milestone that would lead to better management of patients who are in need of palliative care either in their homes or health centres. With the continuing rise in the number of patients suffering from advanced-stage complications of non-communicable diseases such as strokes and other disabilities, giving nurses the powers to prescribe morphine would alleviate the great body pain that palliative care patients suffer from at the moment.
The great example is the manner in which nurses carried out the management of ART, through the Nurse-initiated Management of Anti-Retroviral Therapy (NIMART), and DENOSA believes this should convince the regulatory body for nursing as well as the Department of Health to place the majority health professionals, nurses, at the forefront of fighting the end-product of NCDs.
In its 67th sitting in May this year, the World Health Assembly (WHA) recognised that more than 40 million people currently require palliative care every year, foreseeing the increased need for palliative care with ageing populations and the rise of non-communicable and other chronic diseases worldwide. It also called for Member States, of which SA is one, to have estimates of the quantities of the internationally controlled medicines needed, including medicines in paediatric formulations.