The Influence of Nursing Organisations on the Development of the Nursing Profession in South Africa: 1914-2014
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THE INFLUENCE OF NURSING ORGANISATIONS ON THE DEVELOPMENT OF THE NURSING PROFESSION IN SOUTH AFRICA: 1914-2014 by JOHANNA MARIA ESTERHUIZEN submitted in accordance with the requirements for the degree of DOCTOR OF LITERATURE AND PHILOSOPHY in the subject HEALTH STUDIES at the UNIVERSITY OF SOUTH AFRICA SUPERVISOR: PROF GH VAN RENSBURG June 2019 Student number: 30095158 DECLARATION I declare that THE INFLUENCE OF NURSING ORGANISATIONS ON THE DEVELOPMENT OF THE NURSING PROFESSION IN SOUTH AFRICA: 1914-2014 is my own work and that all the sources that I have used or quoted have been indicated and acknowledged by means of complete references. I further declare that I submitted the dissertation to originality checking software and that it falls within the accepted requirements for originality. I further declare that I have not previously submitted this work, or part of it, for examination at Unisa for another qualification or at any other education institution. 15 June 2019 ............................................................. ....................................... SIGNATURE DATE Johanna Maria Esterhuizen THE INFLUENCE OF NURSING ORGANISATIONS ON THE DEVELOPMENT OF THE NURSING PROFESSION IN SOUTH AFRICA: 1914-2014 STUDENT NUMBER: 30095158 STUDENT: JOHANNA MARIA ESTERHUIZEN DEGREE: DOCTOR IN LITERATURE AND PHILOSOPHY DEPARTMENT: HEALTH STUDIES, UNIVERSITY OF SOUTH AFRICA SUPERVISOR: PROF GH VAN RENSBURG ABSTRACT The purpose of the study is to explore past and current professional nursing organisations by means of historical inquiry and to explain the factors that influenced the development of such organisations, as well as the contribution that these organisations made to the professional development of South African nursing in the period between 1914 and 2014. The researcher conducted a literature review and collected data from archival primary and secondary sources. A priori codes provided structure and historical context, yet allowed flexibility. Philosophically critical realism guided the research and enabled the researcher to explain and critique the social world in which South African nursing organisations historically functioned and exerted their professional influence. The findings revealed that in the past one hundred years political, economic and cultural factors present in the social world influenced the nature of South Africa’s professional nursing organisations. Determined to create a female professional image, status and educational exclusivity, South African nursing leaders of the 20th century opted to establish the South African Trained Nurses’ Association (SATNA), a professional nursing association. Influential associations such as SATNA and the South African Nursing Association (SANA) guided the profession to develop a nursing culture based on philosophical and ethical principles of practice. The result was a recognised, respected and trained nursing corps. Over time, however, a social class system, religion, political ideology and nurses’ economic needs reshaped South Africa’s nursing associations and consequently the profession. By the end of the 20th century, South African nursing leaders accepted that nurses needed their socio-economic welfare to be prioritised and therefore the Democratic Nursing Organisation of South Africa (DENOSA), a professional organisation with a trade unionist stance, was established. The result was a trained, politicised, fragmented nursing corps struggling to find its collective professional voice. The greatest legacy bestowed on South African nursing by its first influential organisations is the professional associations evident today. Over time, the South African Nursing Association’s discussion groups that had been established in the 1950s to discuss nursing-related topics evolved into the specialist groups and associations that were present in 2014. Key terms Associations; critical realism; historical inquiry; nursing; organisations; professional development; professional influence; professional nursing image; South Africa; trade unions. DIE INVLOED VAN VERPLEEGKUNDIGE ORGANISASIES OP DIE ONTWIKKELING VAN DIE VERPLEEGKUNDIGE BEROEP IN SUID AFRIKA: 1914-2014 STUDENTE NOMMER: 30095158 STUDENT: JOHANNA MARIA ESTERHUIZEN GRAAD: DOKTOR IN LITERATUUR EN FILOSOFIE DEPARTEMENT: GESONDHEIDSSTUDIES, UNIVERSITEIT VAN SUID AFRIKA STUDIELEIER: PROF GH VAN RENSBURG OPSOMMING Die doel van die studie is om die verlede en huidige professionele verpleegkundige organisasies deur middel van historiese navraag te verken en om die faktore te verduidelik wat die ontwikkeling van sulke organisasies beïnvloed het, sowel as die bydrae wat hierdie organisasies gemaak het tot die professionele ontwikkeling van Suid Afrika se verpleegkunde in die periode tussen 1914 en 2014. Die navorser het ‘n literatuur oorsig gedoen en data versamel vanuit primêre argief bronne en sekondêre bronne. A priori kodes het struktuur en historiese konteks voorsien, maar het ook ‘n mate van buigsaamheid toegelaat. Filosofies, het kritiese realisme die navorsing gelei en die navorser toegelaat om die sosiale wêreld waarin Suid Afrikaanse verpleegkundige organisasies histories gefunksioneer het en hulle professionele invloed beoefen het, te verduidelik. Die bevindings het onthul dat politiese, ekonomiese en kulturele faktore teenwoordig in die sosiale wereld, die aard van die Suid Afikaanse professionele verpleegkundige organisasies beinvloed het in die laaste een honderd jaar. Vasbeslote om ‘n vroulike professionele status en onderwys eksklusiewe beeld te skep, het Suid Afrikaanse verpleegkundige leiers van die 20ste eeu gekies om die South African Trained Nurses’ Association (SATNA) ‘n professionele verpleegkundige assosiasie, te stig. Invloedryke assosiasies soos SATNA en die South African Nursing Association (SANA) het bygedra tot ‘n verpleegkundige kultuur wat gebou was op filosofiese en etiese praktyk beginsels. Die resultaat was ‘n erkende, gerespekteerde en opgeleide verpleegkundige korps. Oor die jare het ‘n sosiale klasse sisteem, geloof, politieke ideologie en verpleegsters se ekonomiese behoeftes die Suid Afrikaanse verpleegkundige assosiasies en gevolglik die beroep hervorm. Teen die einde van die 20ste eeu, het Suid Afrikaanse verpleegkundige leiers aanvaar dat verpleegsters hulle sosio-ekonomiese welsyn gepriotiseer wil hè, en daarom is die Democratic Nursing Organisation of South Africa (DENOSA), ‘n professionele organisasie simpatiek tot vakbondwese gestig. Die gevolg was ‘n opgeleide, verpolitiseerde, gefragmenteerde verpleegkundige korps wat sukkel om ‘n kollektiewe professionele stem te vind. Die eerste invloedryke verpleegkundige organisasies se grootste nalatenskap aan Suid Afrikaanse verpleegkunde is die professionele organisasies wat vandag aktief is. Oor tyd het die South African Nursing Association gespreksgroepe wat in die 1950s gestig was om verpleegkundige onderwerpe te bespreek ontwikkel in die spesialis groepe en assosiasies wat nog in 2014 aktief was. Sleutelwoorde Assosiasies; kritiese realisme; historiese navraag; verpleegkunde; organisasies; professionele ontwikkeling; professionele invloed; professionele verpleegkundige beeld; Suid Afrika; vakbonde. UMTHELELA WEZINHLANGANO ZOBUNESI EKUTHUTHUKISENI UMKHAKHA WOHLENGIKAZI ENINGIZIMU AFRIKA NGO: 1914 KUYA KU-2014 INOMBOLO YOMFUNDI: 30095158 UMFUNDI: JOHANNA MARIA ESTERHUIZEN IZIQU: DOCTOR IN LITERATURE AND PHILOSOPHY UMNYANGO: HEALTH STUDIES, UNIVERSITY OF SOUTH AFRICA OPHETHE: PROF GH VAN RENSBURG NGAMAFUPHI Inhloso yalolucwaningo kwakungukuhlola izinhlangano zobuhlengikazi ezikhona nezakudala ngomlando, ukuchaza izinto ezibenomthelela othize ekuthuthukisweni kwalezi zinhlangano nomnikelo lezi zinhlangano eziwufakile ngokungenamkhawulo ukuze kubenentuthuko esezingeni emkhakheni wobuhlengikazi eNIingizimu Afrika esikhatini esisuka ku-1914 kuya ku-2014. Umcwaningi wenze ukubuyekezwa kwezincwadi futhi waqoqa imininingwane evela emithonjeni eyinhloko neyokugcina. Amakhodi angaphambilini ahlinzeka ngesakhiwo nomlando oqoshiwe; kodwa futhi bavumela inkululeko. Ochwepheshe bezocwaningo bahola lolucwaningo bavumela umcwaningi achaze ngemibono yabantu, Inhlangano yezobuhlengikazi eNingizimu Afrika isabenzise umlando ukuqhamuka nezinhlelo ezintsha okusebenza okusezingeni. Lokhu okutholakele kuveza ukuthi eminyakeni eyikhulu edlule yezombusazwe, ezomnotho nezamasiko ezikhona emhlabeni wezenhlalo zithonye isimo sezinhlangano ezihle zabahlengikazi zaseNingizimu Afrika. Ukuzimisela ukwakha isithombe sowesifazane sangasese, isimo nokuzibandakanya kwezemfundo, abaholi babahlengikazi baseNingizimu Afrika bekhulu lama-20 bakhetha ukusungula Inhlangano Yabahlengikazi BaseNingizimu Afrika (SATNA) inhlangano yabahlengikazi abaqeqeshiwe. Izinhlangano ezinamandla ezinjenge-SATNA kanye ne-South African Nursing Association (SANA) ziqondise lo msebenzi wokuthuthukisa isiko lobuhlengikazi elisuselwa ezimisweni zefilosofi nezokuziphatha. Imiphumela kwabayisidumbu somhlengikazi ezaziwayo, ezihlonishwayo futhi eziqeqeshiwe Ngokuhamba kwesikhathi, kodwa-ke, uhlelo lwesigaba sezenhlalo, inkolo, imibono yezepolitiki kanye nezidingo zomnotho zabahlengikazi zakha kabusha izinhlangano zabahlengikazi zaseNingizimu Afrika futhi ngenxa yalokho umsebenzi. Ekupheleni kwalelikhulu lama-20, abaholi babahlengikazi baseNingizimu Afrika bamukela ukuthi abahlengikazi badinga inhlala-kahle yezenhlalo nezomnotho yabo ukuze kubekwe eqhulwini ngakho-ke kwasungulwa iDemocratic Nursing Organisation of South Africa (DENOSA), inhlangano yobungcweti enesimo sezinyunyana zabasebenzi. Imiphumela