Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole
Thesis (MNur)--Stellenbosch University, 2025.
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Published: |
Stellenbosch : Stellenbosch University
2026
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614133633941504 |
|---|---|
| access_status_str | Open Access |
| author | Van Greunen, Anriette |
| author2 | Kitshoff, Danine |
| author_browse | Kitshoff, Danine Van Greunen, Anriette |
| author_facet | Kitshoff, Danine Van Greunen, Anriette |
| author_sort | Van Greunen, Anriette |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MNur)--Stellenbosch University, 2025. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/134848 |
| institution | Stellenbosch University (South Africa) |
| last_indexed | 2026-06-10T12:47:10.728Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/134848 Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole Van Greunen, Anriette Kitshoff, Danine Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery. Nurses -- Job satisfaction -- South Africa Nurses -- Workload -- South Africa Health services -- Reorganization -- South Africa Health facilities -- Resources -- South Africa Health planning -- South Africa UCTD Thesis (MNur)--Stellenbosch University, 2025. Van Greunen, A. 2025. Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/f70f824b-5ab3-4998-b124-9095ec189eca ENGLISH SUMMARY: Background: Task shifting, the reallocation of responsibilities from physicians to nurses, is widely accepted as a solution to healthcare workforce shortages and the growing burden of disease. Successful implementation, such as with Nurse Initiated Management of Antiretroviral Therapy (NIMART), has evidently increased healthcare access, promising progress toward the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC). However, implementation, particularly in resource-limited settings like South Africa, is challenging. PHC nurses are the bedrock of the workforce, making their role pivotal. Since Registered Nurses are often the most qualified providers in PHC, shifting tasks to them is essential for improving patient access, especially given the anticipated task reallocation associated with the SDGs and South Africa's move toward national health insurance. Identifying potential barriers and motivators for nurses' engagement is crucial. This study aimed to explore the experiences of primary care nurses on task shifting working in the Cape Metropole. Method: A qualitative research design explored the experiences of primary care nurses on task shifting while working in the Cape Metropole. Sampling: Purposeful sampling selected ten registered nurses from PHC facilities in the Northern and Western substructure. Data Collection: Data was collected via recorded semi-structured interviews. Data Analysis: Data was transcribed verbatim and analysed using Braun and Clarke's thematic analysis. Lincoln and Guba’s criteria for trustworthiness were applied, and all ethical principles adhered to. Ethical clearance was obtained from Stellenbosch University and the City of Cape Town. Findings: Five primary themes and 22 sub-themes characterized the nurses' experiences. Firstly, task shifting significantly alters the nurse's role. Secondly, participants reported negative impacts: decreased access and timeliness of care, increased complexity, blurred professional boundaries, and exacerbated workloads. Thirdly, effective training programs, positive interprofessional relationships, and nurses' intrinsic motivation were identified as crucial enablers. Fourthly, despite general acceptance in principle, resistance was driven by increased risk or responsibility, existing heavy workloads, training deficiencies and delays, and insufficient post-training support and mentorship. Resource limitations, feelings of organizational misalignment, and underappreciation further compounded resistance. Lastly, the PHC environment was described as severely under-resourced with illusory and ineffective quality assurance measures. Conclusion: PHC nurses' experiences reveal that task shifting is significantly influenced by inherent contextual factors, contributing to the evolution of the nurse's role. Successful implementation requires critically evaluating resource accessibility, workload distribution, and the adequacy of support structures. Addressing nurses' expressed concerns is crucial, as their willingness is pivotal to task shifting's effective implementation and acceptance. AFRIKAANSE OPSOMMING: Agtergrond: Taakverskuiwing, die hertoewysing van verantwoordelikhede van dokters na verpleegkundiges, word algemeen as 'n oplossing vir tekorte aan gesondheidsorgwerkers en die groeiende siektelas aanvaar. Suksesvolle implementering, soos met Verpleegkundige-Geinisieerde Bestuur van Antiretrovirale Terapie (NIMART), het duidelik toegang tot gesondheidsorg verhoog, wat vordering met die Volhoubare Ontwikkelingsdoelwitte (VOD'e) en Universele Gesondheidsdekking (UGD) beloof. Die implementering, veral in hulpbronbeperkte omgewings soos Suid-Afrika, is egter uitdagend. Primere Gesondheidsorg (PGS) verpleegkundiges vorm die kern van die werkmag, wat hul rol sleutel maak. Aangesien Geregistreerde Verpleegkundiges dikwels die mees gekwalifiseerde verskaffers in PHG is, is die verskuiwing van take na hulle noodsaaklik vir die verbetering van pasienttoegang, veral gegewe die verwagte hertoewysing van take wat verband hou met die VOD'e en Suid-Afrika se skuif na nasionale gesondheidsversekering. Die identifisering van potensiele struikelblokke en motiveerders vir verpleegkundiges se betrokkenheid is noodsaaklik. Hierdie studie het ten doel gehad om die ervarings van primeresorgverpleegkundiges oor taakverskuiwing in die Kaapse Metropool te ondersoek. Metode: 'n Kwalitatiewe navorsingsontwerp is gevolg om die ervarings van primere sorgverpleegkundiges oor taakverskuiwing, terwyl hulle in die Kaapse Metro werk, te verken en te beskryf. Steekproefneming: Doelgerigte steekproefneming het tien geregistreerde verpleegkundiges van PGS-fasiliteite in die Noordelike en Westelike substruktuur gekies. Data versameling: Data is ingesamel deur opgeneemde semi-gestruktureerde onderhoude op te neem. Analise van data: Die data is verbatim getranskribeer, en geanaliseer deur Braun en Clarke se tematiese analise te gebruik. Lincoln en Guba se kriteria vir betroubaarheid is toegepas, en alle etiese beginsels is nagekom. Etiese klaring is van die Universiteit Stellenbosch en die Stad Kaapstad verkry. Bevindinge: Vyf primere temas en 22 sub-temas het die verpleegkundiges se ervarings gekenmerk. Eerstens verander taakverskuiwing die verpleegkundige se rol beduidend. Tweedens het deelnemers negatiewe impakte gerapporteer: verminderde toegang en tydigheid van sorg, verhoogde kompleksiteit, vae professionele grense, en verswaarde werkladings. Derdens is effektiewe opleidingsprogramme, positiewe interprofessionele verhoudings, en verpleegkundiges se intrinsieke motivering as deurslaggewende fasiliteerders geidentifiseer. Vierdens, ten spyte van algemene aanvaarding in beginsel, is weerstand aangedryf deur verhoogde risiko of verantwoordelikheid, bestaande swaar werkladings, opleidingsgebreke en vertragings, en onvoldoende na-opleiding ondersteuning en mentorskap. Hulpbronbeperkings, gevoelens van organisatoriese wanaanpassing, en onderwaardering het weerstand verder vererger. Laastens is die PGS-omgewing as ernstig onderbeman beskryf met illusoriese en ondoeltreffende gehalteversekeringsmaatreels. Gevolgtrekking: PGS-verpleegkundiges se ervarings onthul dat taakverskuiwing beduidend beinvloed word deur inherente kontekstuele faktore, wat bydra tot die evolusie van die verpleegkundige se rol. Suksesvolle implementering vereis die kritiese evaluering van hulpbrontoeganklikheid, werkladingsverdeling, en die toereikendheid van ondersteuningstrukture. Die aanspreek van verpleegkundiges se uitgesproke bekommernisse is noodsaaklik, aangesien hul gewilligheid sentraal staan tot taakverskuiwing se effektiewe implementering en aanvaarding. Masters 2026-01-12T12:49:29Z 2026-01-12T12:49:29Z 2025-12 Thesis https://scholar.sun.ac.za/handle/10019.1/134848 Stellenbosch University xiii, 140 pages ; includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Nurses -- Job satisfaction -- South Africa Nurses -- Workload -- South Africa Health services -- Reorganization -- South Africa Health facilities -- Resources -- South Africa Health planning -- South Africa UCTD Van Greunen, Anriette Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title | Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title_full | Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title_fullStr | Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title_full_unstemmed | Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title_short | Exploring the experiences of primary care nurses on task shifting while working in the Cape Metropole |
| title_sort | exploring the experiences of primary care nurses on task shifting while working in the cape metropole |
| topic | Nurses -- Job satisfaction -- South Africa Nurses -- Workload -- South Africa Health services -- Reorganization -- South Africa Health facilities -- Resources -- South Africa Health planning -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/134848 |
| work_keys_str_mv | AT vangreunenanriette exploringtheexperiencesofprimarycarenursesontaskshiftingwhileworkinginthecapemetropole |