The HPCSA brought out a ruling in March 2008 stating that anyone not “suitably qualified” and “duly registered” with the HPCSA (in terms of the Health Professions Act, Act 56 of 1974), may not respond to incidents involving patients and potential patients. Furthermore, “it is permissible that unregistered persons such as fire fighters, allied health professionals or non-medical lay persons accompany registered emergency care providers, paramedics or practitioners solely for purposes of observation on such vehicles subject to the following conditions: a) These observers are not entitled to assess or manage patients in any way whatsoever...”. (italics by the author)
Technically, this implies that Registered Nurses (RNs) (registered by the South African Nursing Council) are included in this stipulation.
ENSSA responded to this ruling in August 2010, stating its dissatisfaction with this ruling. There are situations when nurses should be able to practice in the EMS environment, including for example flight nurses and emergency nursing students gaining experiential learning experience on EMS vehicles. When the Act is analysed closely, no mention is made about the environment in which persons registered with the HPCSA may practice. Considering the RN’s scope of practice (Regulation 2598 of 1984), they may practice in the pre-hospital environment, should they be trained and competent to do so. The Nursing Act, Act 33 of 2005 also does not stipulate the exact environment in which nurses may practice.
HPCSA briefly responded to ENSSA’s communication, stating once again that “in terms of section 17 of the Health Professions Act, 1974 (Act 56 of 1974), persons who work within the scope of emergency care on ambulances have to be registered with the HPCSA.”
Interestingly, a recent Western Cape Services Act 2010, Act 33 of 2010 (published in a Provincial Government’s Gazette - number 6806 – in November 2010), describes “Ambulance Personnel” as including nurses registered under the Nursing Act, Act 33 of 2005 (section 31).... This contradicts the HPCSA’s ruling.
We at ENSSA would like to encourage the HPCSA to reconsider the 2008 ruling. Further communication with the HPCSA is still pending. Comments are welcome.
