Francistown — It is almost a week since nurses in local government clinics stopped going out of their way to perform tasks that are not in their line of duty.

In a position paper, signed by the president of the Botswana Land Boards and Local Authorities Workers Union (BLLAWU), Pelotshweu Baeng and secretary general, Moshe Noga, the organisation said: "...though regrettable, but after having exhausted all means to resolve the issue amicably Local Authorities Nurses shall cease to perform non-nursing duties and operate as per approved O and M (Organisation and Methods) exercise job description with effect from 12/06/08 until the above matters have been positively resolved".

A Francistown-based trade unionist in the teaching profession had a taste of his own medicine last week when on visiting one of the clinics in Francistown, nurses refused to assist his son, who had dislocated his ankle in a street football game. He had to go to a private clinic after being refused service at the council clinic. However the sister in charge of the council clinic denied there had been any industrial action at the facility. It looks like the government is already feeling the pressure as Noga, who declined to give details disclosed that the employer has called them to a meeting. "We are still unsure as to what the meeting is about, but I can tell you that we have been called by the employer (Local Government) to a meeting, which we will attend tomorrow," Noga said on Monday afternoon.

In the paper entitled: 'BLLAWU Position Paper on Cessation of Non-Nursing Duties by Nurses in Local Authorities' the organisation says it has held several consultations with the Department of Local Government Service Management (DLGSM) that did not bear fruit.

The paper stipulated the contentious issues with the local authorities as:

• Local Authorities Nurses performing non-nursing duties of which they are not remunerated for like pharmacy duties, laboratory and medical officers' duties;
• Added workload and responsibility that comes as a result of extra qualifications like midwifery;
• Retention and attraction policy - despite Local Authorities Nurses performing tasks of those cadres like medical, laboratory and pharmacy services, which are deemed scarce, the government does not take into consideration to afford them a token of appreciation for the added workload they carry out in rendering Primary Health care services; and
• That multiple grading at C-band Scale has not been implemented to date in spite of the DPSM Directive Number 11 of May 2007.

"So, after further scrutiny of the relevant articles of the Nurses and Midwifery Act, Nursing Standards/policies, we have come to the conclusion that the manner in which we are operating is not in harmony with the ... articles which bind nurses' daily operations.

"It is out of dispute that nurses and midwives are regulated by Nurses and midwives Act Chapter 61:03 of the laws of the Republic of Botswana which came into effect on the 21st July 1967.

"This Act provides for the registered nurses disciplinary and ethical rules. For clearing the minds as far as our grievances are concerned, we paid particular attention to Part II Breach of Discipline or Professional Ethics.

"Section 3 of the Rules provides that a nurse shall be guilty of breach of discipline and professional ethics and may be dealt with in accordance with the provision of Part IV of these rules if she/he:

• l Willfully does or omits to do anything which act or omission is calculated to bring the Council or any of its members into contempt or disrepute or to hamper the work of the Council;
• Commits an act or conducts herself/himself in a manner unbecoming a nurse, whether such act or conduct constitutes or involves the commission of a criminal offence or not.

"This is meant to demonstrate with utmost clarity, that whatever steps we take to conduce the employer to address our grievances as a matter of urgency does not in anyway amount to breach of discipline or professional ethics," said the position paper at length.

BLLAWU argues that its position is buttressed by Section 5 of Part III which provides that "a nurse shall not attend a patient where the required attention falls outside the scope of such nurse's registration except in an emergency or when a correctly qualified person is not available from any source. In such an event, the nurse shall forthwith report the facts of the case to the council in writing."

BLLAWU contended that they were not happy with an excuse given by the employer that they were not entitled to the scarce skill allowance because its members are too many.

The organisation finds this a hypocritical position by the government, given the fact that they (government) continue recruiting expatriates and retired nurses.

"We continue to be used as tools to perform duties supposedly for laboratory technicians, pharmacy technicians and doctors. Where scarce skills beneficiaries are absent, it is nurses who perform such duties, which are non-nursing duties.

"This is a clear admission that nurses have critical skills and serve as a panacea in circumstances where a vacuum is created by the so-called Scarce Cadres. The gist of our argument is that we should be remunerated for this extra work we perform under the guise that a job description prescribes that we are expected to perform 'any other related duties'".

"We contend that these duties are not in any way related to nursing," BLLAWU charged in the highly emotive paper. The organisation said nurses at clinics are not going to bandage patients, neither are they going to issue them with tablets or perform any other duty not related to their job description.