Nurses' perceptions of the implementation of occupational specific dispensation at two district hospitals in the Gauteng Province of South Africa

Abstract

This paper explores nurses' perceptions of the implementation of occupational specific dispensation (OSD) at two selected district hospitals in the Gauteng province of South Africa. At each hospital, in-depth interviews were conducted with key informants that included the chief executive officer, nursing service manager, human resource manager, and trade union shop steward (n=8). Day duty nurses (n=27), who were permanently employed, completed questionnaires after informed consent had been obtained. Both the interview schedule and questionnaire focused on the OSD policy and its implementation. Key informants and nurses were of the opinion that the OSD resulted in nurses' salary improvements and facilitated the hospitals' ability to attract nurses with specialised skills. However, 72.0% of day duty nurses indicated that the OSD had been implemented unfairly, 54.1% that OSD demoralised them and 58.3% that OSD adversely affected the relationships between management and nurses. Only 24.0% of the nurses agreed that communication around OSD was good, and 22.7% agreed that OSD improved service delivery. The participating nurses had both positive and negative perceptions about the OSD implementation. Recommendations include: clear communication to ensure the same understanding of the policy; involvement of front-line nurses; training to ensure uniform interpretation and implementation; and improved monitoring and evaluation of the OSD implementation.