A job analysis of selected health workers in a district health system in KwaZulu-Natal. Part One: Job analysis of nurses in hospital settings.

The aim of this descriptive survey was to do a job analysis of different categories of nurses in a District Health System in order to clarify job expectations, describe current practice of nurses in hospitals and clinics and to make recommendations about skills mix in district services. A mail questionnaire requested the sampled nurses to rate the frequency and importance of the tasks they perform. Only 19% of the nurses (41 nurses of all categories) returned the questionnaire, and an index taking into account frequency and importance, was calculated. The self-report data was compared with data from non-participant observation done over 19 days in 14 units in all three hospitals. A total of 39 tasks were done more than six times per week, of which most (16) were in the category of clinical assessment and recording. Counselling and teaching (8 tasks), were the second most frequent type of task. Only two tasks were rated as very important (giving injections and assessing respiratory status). When frequency and importance were combined into a Task Index, a large number of tasks scored in the middle range, with very few very high or low. Respondents identified 33 tasks that did not appear on the questionnaire. The observations showed that all categories of nurses shared many tasks in hospital settings. However, Registered Nurses were involved in specialized treatment and care, as well as administration of the unit. The specialists type tasks of Registered Nurses were also clear in Operating Theatre settings. The implications of the study are discussed and recommendations are made.

A job analysis of selected health workers in a district health system in KwaZulu-Natal. Part Two: Job analysis of nurses in primary health care settings.

The aim of this descriptive survey was to do a job analysis of different categories of nurses in a District Health System in order to clarify job expectations, describe current practice of nurses in hospitals and clinics and to make recommendations about skills mix in district services. This article deals with the clinics only. A mail questionnaire requested the sampled nurses to rate the frequency and importance of the tasks they perform. A total of 71% of the nurses (60 nurses of all categories) returned the questionnaire, and an index taking into account frequency and importance, was calculated. The self-report data was compared with data from non-participant observation done over 11 days in five clinics. The respondents rated 11 tasks as being performed more than six times per week, and no task as being important in that more than 70% of respondents felt it could never be omitted. However, on the task index, which combines frequency and importance, 57 tasks received the highest possible score of ten, and few (25%) were rated below five. The work context of nurses in PHC settings and hospitals was compared using Exhaustion-Disengagement Model and it was proposed that hospital nurses had higher job demands and lower job resources, and therefore ran a higher risk of both exhaustion and disengagement. A clear difference in the roles of different categories of nurses was found, although they have many tasks in common.

A job analysis of selected health workers in a district health system in KwaZulu-Natal. Part three: Other categories of health workers.

This article described the third part of a study aimed at doing a job analysis of nurses and non-professional health workers in a district health system. This article describes the tasks of five categories of workers, their training and their work-load over an ordinary week. Interviews were done with 52 workers from three hospitals and five clinics, of whom 14 were men and 38 women. The three PHC guards had a much more varied job than the hospital security staff (also three). All of them have had specific task related training. The six General Assistants in Primary Health Care settings were almost exclusively involved in cleaning, while the 23 in hospitals added food and drink management and running errands to their work. Only one had training pertaining to the specific tasks. All three clerks were found in the PHC setting, and their tasks were mainly that of receptionist. None had specific task related training. The three Ground's Men worked at gardening and cleaning at PHC clinics, but a range of other tasks were added from time to time. Porters, of whom ten were interviewed, did mainly transporting of patients and running errands. GA's and security staff were also used to control violent patients and visitors, something for which none of them have had training. Recommendations were made about training and work redesign in the district.