Asanda Fongqo, +27 12 343 2315 , firstname.lastname@example.org (DENOSA)
Tsabeng Nthite, +27 11 685 1215, email@example.com (Pfizer, ICN)
Fight or Flight: Survey Shows Mounting Workplace Challenges Require
Attention to Keep Nurses from Leaving
Global survey of nurses highlights views of profession, health care environments
July 1, 2009 – DURBAN, SOUTH AFRICA – South Africa’s nurses are less likely to stay in the profession
over the next five years compared to their counterparts in other parts of the world, according to research
presented today at the International Council of Nurses (ICN) 24th Quadrennial Congress.
The results, part of an extensive global attitudinal survey that asked more than 2,000 nurses around the
world, including 200 in South Africa, about the challenges and opportunities facing nurses, found that when
asked to rate the likelihood they will still be in nursing in five years, only 33 percent of nurses in South
Africa say they are very likely to do so.
“Despite advances made so far in our democracy, significant challenges for South Africa’s nurses remain at
crossroads with regards to adequate and equitable distribution of healthcare infrastructure and health human
resources,” said DENOSA General Secretary Thembeka Gwagwa. “In a country like South Africa, with
staggering disease rates and high patient to nurse ratios, it comes down to fight or flight. Do we allow the
continued flight of nurses out of South Africa, or do we fight as a nation to address nurses’ concerns and
protect the healthcare system so we can provide quality care to our patients?”
An estimated 13 million nurses form the backbone of health care systems, working in hospitals, clinics,
communities, and other settings around the world. ICN and Pfizer Inc. collaborated on a global
representative survey of 2,203 nurses in eleven countries, including Brazil, Canada, Colombia, Japan, Kenya,
Portugal, South Africa, Taiwan, Uganda, the UK, and the U.S. The survey was conducted by APCO Insight.
Collated global results and methodology can be viewed at www.icn.ch.
“Nurses represent the largest group of healthcare providers in the world,” said ICN Chief Executive Officer,
David Benton. “We are keen to better understand nurses’ views of their work and the environments in which
they practice across the world. These results will inform the ‘Positive Practice Environment’ campaign ICN
and partners are implementing to improve the practice environment and with it the quality of care.”
“Nurses are key patient advocates and have always been patient-focused. The research shows that for nurses,
the most favourable aspect of their profession is indeed patient contact,” said Paula DeCola, R.N., M.Sc.,
from the office of the chief medical officer of Pfizer. “This survey supports the research of Dr. Linda Aiken
at the University of Pennsylvania – nurses perceive that inadequate staffing and high workloads are having a
negative impact on the quality of care patients receive.”
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Key findings from the research provide a glimpse into the challenges South Africa’s nurses face, and
opportunities for improvements:
• More than half of nurses (53 percent) in South Africa say their workload is worse today compared to five
years ago, potentially impacting the quality of patient care and their commitment to remain in the
• The survey finds that in South Africa, as in other countries surveyed, most nurses (85 percent) say that
they face time constraints that prevent them spending as much time with individual patients as they think
necessary. A large majority of the nurses surveyed in South Africa (87 percent) say that spending more
time with individual patients would have a significant impact on patient health.
• Nurses in South Africa view overwhelming workloads (32 percent), insufficient pay and benefits (22
percent), lack of recognition (11 percent), budget cuts and inadequate healthcare systems (11 percent) as
the least favorable aspects of their profession. Nurses are most likely to say that patient contact (39
percent) is the most favorable aspect of their work experience.
• Nurses in South Africa see their professional associations as effective in advancing their interests (86
percent) and supportive of their needs (87 percent). In fact, nurses in South Africa are much more likely
than nurses in the other countries surveyed to say their professional associations are “very” effective – 42
percent in South Africa say their associations are very effective vs. the global average of 17 percent.
• South Africa’s nurses also favor expanding their healthcare responsibilities, including the authority to
prescribe medicines to patients. Fifty percent of the nurses surveyed in South Africa say they currently
have the authority to prescribe medicines to patients. Additionally, eight in ten (83 percent) say they
favour nurses having this authority.
• The country’s nurses indicated there are now better opportunities for professional training and career
advancement (59 percent) and increased recognition for their contributions as nurses (53 percent) than
there were five years ago. Additionally, 63percent of nurses in South Africa perceive the nation’s
healthcare system as better than it was five years ago.
“Nurses in South Africa, like nurses worldwide, play a critical role in the delivery of care and the quality of
healthcare. We trust that this research will assist in providing necessary guidance for South African policy
makers in the designing of intervention strategies as part of the government’s ongoing efforts to improve our
healthcare system,” said Pfizer South Africa Country Manager, Brian Daniel.
“Nurses globally are thinking about leaving the profession, which will further impact already burdened
healthcare systems, including those in countries such as Kenya, Uganda, and South Africa. It is urgent to
respond to their needs with adequate staffing, greater independence and greater involvement in decision-
making. Nurses must be involved in crucial policy conversations as healthcare systems are growing,
developing and changing,” added ICN’s CEO, Mr. Benton.
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About the Survey
More information about the survey and the methodology can be found at www.icn.ch.
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DENOSA is a vigorous, dynamic, responsive member driven organisation that understands the unique
dynamics of nurses, midwives/accoucheurs and provides specialised expertise to address individual and
collective professional and union issues. Our professional and union solidarity impacts beyond the borders of
South Africa into Africa and the rest of the world. In representing the majority of health professionals,
DENOSA has a powerful impact on health care and health policy development and monitoring in South
About the International Council of Nurses
The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations
representing the millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN
works to ensure quality nursing care for all and sound health policies globally.
Pfizer Inc: Working together for a healthier world™
Founded in 1849, Pfizer is the world's premier biopharmaceutical company taking new approaches to better
health. We discover, develop, manufacture and deliver quality, safe and effective prescription medicines to
treat and help prevent disease for both people and animals. We also partner with healthcare providers,
governments and local communities around the world to expand access to our medicines and to provide
better quality health care and health system support. At Pfizer, more than 80,000 colleagues in more than 90
countries work every day to help people stay happier and healthier longer and to reduce the human and
economic burden of disease worldwide.