Aspects of the Working Life of Women in the Nursing Profession in South Africa: Survey Results

1 his article reports on a survey done among nurses registered with the South African Nursing Council. The survey was carried out in the last quarter of 2003. The purpose of the survey was to investigate aspects of the working life of women in the nursing profession in South Africa and to make recommendations on how their working environment could be improved. The important findings were that pay-related issues dominate as the main problem at work. Improving pay scales and being paid according to extra experience, responsibilities and qualifications could improve the nurses' working environm ent. Furtherm ore, training opportunities, medical insurance and equal opportunities should be addressed as a matter of urgency. In general, respondents had a positive attitude towards their job, which leaves the impression that nurses still regard their jobs as something they do for the sake o f a service to the comm unity and not only for the m oney they earn.


Introduction
The position of women in the workplace has ch anged sig n ific a n tly sin ce the implementation of a new dispensation in S o u th A fric a in 1994.T h e new constitution paved the way for women to ta k e th e ir rig h tfu l p la c e in the workplace as equal partners of men and their participation in the labour market has increased significantly during the past few years.In 1970 the workforce consisted of 77% men and 23% women active in the South African economy.By 1995 this figure had changed to 57% men and 43% women respectively and by 2001 the figure had become 53% men and 47% wom en (S tatistics South A frica 2001:7.1).The role of women in the South A fric a n e c o n o m y sh o u ld n o t be underestimated.The fact that women are joining organisations as managers and professionals has prom pted studies on various aspects of the importance of their contribution in general.Not only do they make a significant contribution to the 51 Curationis May 2005 alleviation of the skills shortage in South Africa, but the m anner in which they make this contribution is also noteworthy.The trend towards com bining a career with marriage and parenthood has run parallel with the opening up o f jobs as a result o f the dem ographic change in o rg a n is a tio n s , w h ic h has a ffe c te d women, men and families.Dual income fa m ilie s have beco m e in c re a sin g ly prevalent as a result o f the financial pressures brought about by higher first w o rld sta n d a rd s.T he sh ift from p r o d u c tio n -o rie n te d to se rv ic e s-, technology-and inform ation-oriented industries has opened the door for women to enter the labour economy on a large scale (Malan 2004:19).
In the nursing profession, women are predom inant in num ber, w ith m ales representing a small percentage o f the total workforce.According to M alan (2004:19), there were 109 194 nurses registered with the South African Nursing Council (SANC) in 1980.In 1990, the figure grew to 148 558 and in 2001, a total of 173 332 nurses were registered with the SANC.In spite of the growth in the num ber o f nurses registered with the SANC, South Africa is experiencing a huge shortage o f nurses, with 30 974 vacant posts in 2001 in the country.Most of these vacancies are in rural areas.The main reasons for this shortage are that fewer nurses com plete their studies than the number actually needed in the health care sector and more and more nurses leave the country for better salaries and benefits (Malan 2004:19).Unless drastic steps are taken to improve the working life of women in the nursing profession, this shortage will have a negative impact on the general health care services of the country.
B ec a u se w o m en in the n u rsin g profession are important role-players in the p re s e n t la b o u r m a rk e t and particularly in the healthcare services of South Africa, this investigation could c o n trib u te s ig n if ic a n tly to o u r understanding o f how their working life and their perceptions of that life could im pact upon the provision o f quality health care in this very important industry.

The objective of the study
The o b je c tiv e o f th is stu d y w as to investigate aspects o f the working life of women in the nursing profession in S o u th A fric a an d to m ake recomm endations on how their working environment could be improved.

Changes in the health care environment
The nursing profession has played an important role throughout history as an essential instrument in the preservation o f life.The purp o se o f the nursing profession is to meet p eople's health needs.Hence, as health needs change, so too must health care.

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New trends have em erged in society, including new dem ographic patterns, with people living longer and h e a lth ie r liv e s an d th e in c re a sin g population o f very old people requiring nursing care.One o f the negative results o f the HIV/ A ID S pandem ic is that thousands of orphans are being left without parents or homes.

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The public is becoming more knowledgeable about health matters, and governments are therefore increasingly demanding that patients' views be sought and that equal partnerships be developed b e tw e e n p a tie n ts an d h e a lth care professionals.
• A f a c to r th a t c o n tin u e s to c o n stra in the h e a lth care system is finance, and its impact on the resources available and the mobility of the labour force.Patient/client periods of stay in h o s p ita ls are g re a tly red u c ed w ith m an ag ed care p rin c ip le s, and early discharge patterns are evident.Shifts in the location of care, for instance from a hospital setting to a primary health care c lin ic , and the tra n s fe r o f p a tie n ts between acute and chronic settings and then back to their homes, have resulted in fa r m ore w ork and g re a te r responsibility for general practitioners and primary health care practitioners.Nurse practitioners are placed mainly in the acute or community settings.

•
The ethical codes and oaths of health care professionals, with their rules of conduct, may have to be extended and augmented in future to include ethical th e o rie s d e v e lo p e d to suit d iffic u lt contemporary health care situations.The objectives of the nursing profession -to save life, to cure disease, and to alleviate suffering -now appear to conflict with ethical codes in some cases.We have the means to prolong life, but the result may be increased suffering, and the problem o f the morality of euthanasia is becom ing more pronounced.• W hite papers have been drawn up that aim to transform health care service delivery.These focus on aspects su ch as th e d e c e n tra lis a tio n o f responsibility, accountability, power and authority to the lower levels of health care delivery, the greater involvement of th e c o m m u n ity , th e re d u c tio n o f bureacratic practices that are far removed from the community, and the effective use of resources.Putting these measures into practice is the issue facing nursing leaders in the South African health care sector.
These changes play a fundamental role in th e w o rk in g e n v iro n m e n t and ultimately in the workplace of nurses.The follow ing section deals w ith studies w h ic h fo c u se d s p e c ific a lly on the workplace o f nurses.

Nurses and their workplace
Various studies have focused on different aspects o f the w orkplace o f nurses in South Africa.Manona (2000:5)  Jooste (1997:7) identified six factors that c o u ld s ig n ific a n tly im p ro v e the empowerment of nurses.These factors are the co n trib u tio n o f m anagem ent structures, pow er-sharing, participative decision-m aking, m an agem ent skills developm ent, m otivation and rew ard s tra te g ie s , and a ttr ib u te s w hich characterise an em pow ered nurse.The a n a ly s is o f the d a ta re v e a le d the fo llo w in g im p o rta n t e le m e n ts: decentralisation o f pow er to the lowest possible level; the acknowledgm ent and if possible the im plem entation o f the suggestions of nurses; the delegation of authority to enhance decision-m aking; and the design o f tasks in a way that promotes independent performance in the workplace.
In a study of occupational burnout among nurses, Erasm us (1995:13) identified e x c e ssiv e ly heavy w o rk lo a d s, sta ff shortages and uncertainty regarding role description in the working environment as factors leading to negative feelings, rigidity, anger, apathy and fatigue, all of which impact negatively on performance.
In a study undertaken am ong registered nurses in the service of local authorities to obtain a perspective on the quality of th e ir w o rk in g life, Ja c o b s (1 9 9 3 :4 ) id e n tifie d n eg a tiv e fa c to rs, such as limited participation in decision-making and limited career opportunities.
Phillips ( 1993:8) focused on stress in the nursing profession and stress-related factors referring to access to adequate support and coping m echanism s.This study revealed that m ost nurses were coping with the stress and stressors that go with the job, but the most important aspects o f stress w ere related alm ost exclusively to personnel m anagement.R e c o m m e n d a tio n s in c lu d e d g re a te r em phasis on interp erso n al skills and training for nurse managers.
T he im p o rta n c e o f a p a rtic ip a tiv e m anagerial style in order to prom ote re te n tio n an d jo b s a tis f a c tio n o f professional nurses is em phasised by S ta n d e r (1 9 9 3 :3 ).In th is stu d y o f participative managem ent in the nursing service, he concludes that no guidelines exist on what participative management is or how it could be im plem ented in a nu rsin g se rv ic e .D am an e (1 9 9 2 :3 4 ) id e n tifie d s a la r ie s , p ro m o tio n a l opportunities and working conditions as major sources o f dissatisfaction among nurses.This study was supported by a study by Ngcobo (1998:52), in which she used the Nursing Stress Scale, Index of S o cial S u p p o rt an d S o c ia l S u p p o rt Appraisal Scales.She found that nurses experience medium to low levels of stress.T here are no sig n ific a n t d ifferen ces between registration categories in stress levels and perceived sources o f stress reported by n ursing staff.In general nu rsin g s ta ff re p o rt a h ig h level o f s a tis f a c tio n w ith th e su p p o rt th ey receive.
From these studies, one can conclude that the future w orkplace o f nurses in South Africa will be influenced by the following:

Statistical analysis
The data obtained from the questionnaire w e re a n a ly se d w ith th e aid o f the Statistical Package for Social Science (SPSS).Frequencies, arithmetic means and standard deviations were used in the initial stages to analyse the data.Further statistical analyses were conducted to determine whether significant differences (at 0,05%) existed between the different categories of nurses regarding various work-related issues.When one compares categories (nominal or ordinal data) with regard to their mean scores on interval or ratio data, the appropriate technique is the analysis of variance (ANOVA).This test calculates the F-value and a p-value, w here the p-value is a guideline for determ ining which differences can be co n sid ered "re a l" and w hich due to chance (Salkind 2000:170). In

Biographical information
In this section, a brief overview of the b io g ra p h ic a l in fo rm a tio n o f the respondents is provided.
• E m ploym ent: O f the 102 respondents, 18,1% w e re e m p lo y e d in large organisations (5 000 em ployees and m o re), 3 9 ,4 % in m e d iu m sized organisations (more than 100 but fewer than 5 000), 13,8% in small organisations (fewer than 100 employees), 4,3% were self-employed, 21,3% em ployed by the g o v e rn m e n t, 2,2% by ac a d e m ic in s titu tio n s and 5% by o th e r organisations.
The majority (80,4%) o f the respondents indicated that they were employed in a full-time capacity, 13,4% were employed on a part-tim e basis, 2,1% w ere selfem ployed, 1% were unem ployed but seeking em ploym ent and 3,1% have retired.
• Fam ily size: The majority (53,6%) of the respondents had children under the age of 18 years living at home, and of this number 53,1% indicated that they were satisfied with their current childcare arrangements.

Results
In this section, the results of the survey will be discussed by focusing on the following important aspects:

Problems encountered at work
In th is s e c tio n o f the questionnaire, respondents were given a list o f v ario u s issues (potential problems) and asked to indicate the seriousness o f these issues in their w orkplace.The rating scale ranged from 1 "not at all serious" to 5 "one o f the most serio u s" .The respo n ses are reproduced in Table 1 in order of priority.The arithmetic mean is given for each statement.
It seem s th a t th is g ro u p o f respondents feels that the most se rio u s p ro b le m s th a t they experience on the jo b are related to pay benefits and stress and it does not differ from a similar study done in 1998 which showed the same problem s.It appears that these aspects were not adequately addressed the past six years by employers and that this should be considered a priority by employers and government.
The issues that respondents indicated as not very serious or not applicable are represented in Table 2 (arithmetic means are again given for each statement).
T h ese issues also co rrespond to the issues identified by the 1998 survey.
W hen comparing the different categories o f n u r s e s ' p ro b le m s at w o rk , no s ig n ific a n t d iffe re n c e s w ere fo u n d between the respondents in terms o f the types of organisations they were working for, employment (full-time or part-time), incom e group, age group and having children at home.There were, however, significant differences between the race groups.1As a high score indicates that a problem is experienced to a greater extent, the black respondents experienced each of the problem s listed in Table 3 to a significantly greater extent than the white respondents.
Significant differences were also found betw een resp o n d en ts from d ifferen t educational levels with respect to feeling overqualified and acting in positions without receiving the salary attached to those positions.The better qualified a respondent is, the more o f a problem this becomes.Graduates and postgraduates are more subject to this problem than resp o n d en ts w ith m a tric o r a low er qualification (see Table 4).Salary and benefit adjustm ents sh o u ld therefore start with nurses on these educational levels.
Married respondents were more likely to feel that they were acting in a position w ith o u t re c e iv in g th e p ro p e r remuneration for that position than the single respondents (F = 6,38 and p = 0,013).My workplace is male dominated 1,37 1 For the purposes of the analysis, black and coloured respondents were grouped together.

General feelings about the job
In this section respondents were given a list o f various options and had to indicate their general feelings about their job.A large percentage (48,5) indicated that they love their jobs, 28,9% said they like it, while 14,4% described their jobs as "OK" .A very small percentage (1,0%) said they dislike it, w hile 3,1% indicated th at th e y fo u n d th e ir jo b s to ta lly miserable and 4,1 % said that they would rather do something else.The majority o f the resp o n d en ts (7 7 ,4 % ) are very positive about th e ir jo b s.T he 1998 survey indicated that a majority of 76,8% of the respondents w ere very positive about their jobs.
No significant differences were found between any of the biographical variables and nurses' general feelings about their job.

Possible changes for a better workplace
In this section respondents were given a list of changes (statements) that might provide them with a better workplace.On a ten-point scale, ranging from 1 (not important) to 10 (very important), they had to rate the im p o rta n c e o f each statement.The responses are given in Table 5 in order of priority.The arithmetic mean is supplied for each statement.
The tw o issues w hich featured m ost prominently in this study as well as in th e 1998 stu d y w e re pay re la te d (im proving pay scales and being paid a c c o rd in g to e x tra e x p e rie n c e , responsibilities and qualifications).Onth e -jo b tra in in g o p p o r tu n itie s and medical insurance for all employees also proved to be fairly im portant for the respondents in this study as well as the 1998 study.To keep nurses in the country and to encourage people to select the n u rsin g p ro fe s s io n as a c a re e r, rem uneration, and m ore sp ecifically p e rfo rm a n c e-related rem u n e ra tio n , should receive immediate attention.
W hen comparing the changes that would improve the workplace with the different c ateg o ries o f n u rses, no sig n ific a n t differences between respondents from different types o f organisations were found.When comparing full-time and p a rt-tim e em p lo y e es, h o w ev er, tw o significant differences were found.Equal opportunity in the workplace (F = 5,37, p = 0,023) and paid leave to care for newborns or seriously ill relatives (F = 5,01, p = 0,028) become more important to full-time nurses.
W hile there is no significant difference between age groups in term s of what changes w ould m ake their workplace better, the two race groups did differ on a few aspects.These are indicated in Table 6.
From Table 6, it is clear that black nurses need more support to care for children, dependants and seriously ill relatives than white nurses.They also need equal opportunities in the workplace, on-thejo b tra in in g an d jo b sh a rin g opportunities m ore than white nurses, probably because o f som e rem aining imbalances from the past.

Career path barriers
In this section, respondents were firstly asked to indicate whether they perceive barriers in their career paths as women working in the nursing profession that prevent them from achieving their full career potential.The majority (61,4%) of the respondents indicated that they do not perceive any barriers, while 38,6% indicated that they do.On this Yes/No answ er, there is only one significant difference with regard to the biographic variables, namely race.Only 23,8% of the white respondents felt that there are barriers in their career path, while 53,8% of the black respondents felt this way (F = 7,723, p = 0,005).Secondly, respondents were asked to indicate the importance of possible barriers w hich they believed impeded their career prospects by using a scale of 1 (not important) to 10 (very important).Table 7 gives these barriers in order of priority (arithmetic means are also indicated).
M a jo r b a rrie rs in d ic a te d by the respondents in this study as well as the 1998 study are a lack o f recognition and respect for w ork com pleted and low salaries which cannot support child-care paym ents.
In com paring the different categories of nurses with regard to barriers in their career paths, the race groups showed two significant differences, namely in lack of re c o g n itio n and re s p e c t fo r w ork completed (F = 7,08, p = 0,009) and in p rev en tio n from bein g creativ e and innovative (F = 4,37, p = 0,040).In each case the black respondents were finding the specific item more o f a barrier than th e w h ite re s p o n d e n ts .
M arried respondents found the lack o f flexibility in working hours (F = 4,86, p = 0,030) and the inadequate allowance made for family commitments (F = 5,29, p = 0,024) more of a problem than those respondents who are not married.As can be expected, those respondents with children at home also found the inadequate allowances made for family commitments to be more of a problem than those without children (F = 5,57, p = 0,021).

Career expectations and goals
In this section o f the questio n n aire, respondents were required to indicate their expectations and goals for their career.They could indicate more than one possibility from the list provided.The main expectations in order of priority are given in Table 8 ( W hen com paring cate gories o f nurses' career expectations and goals, it was found that full-time an d p a rt-tim e n u rse s differ significantly with reg ard to th eir ex p ec ta tio n s fo r p ro m o tio n and recognition.Promo tion (F = 13,6, p = 0,000) and recognition (F = 4,56, p = 0,048) are more important to full-tim e employees th an to p a rt-tim e e m p lo y e e s.The re s p o n d e n ts a g e d 39 and y o u n g e r sh o w ed a h ig h e r e x p e c ta tio n fo r promotion opportunities, while 81% of the young group indicated promotion as one of their main expectations, compared with the 64% o f the 40 to 49 year old group and 45% o f those older than 50 years (F = 7,5; p = 0,023).The race groups showed the biggest difference in terms o f career expectations.Black respondents were more likely to have mentioned promotion (F = 18,57, p = 0,000); power and status (F = 24,61 , p = 0,000); professional su p p o rt (F = 15,5, p = 0,000 ) and recognition (F = 11,1, p = 0,001).White respondents were more likely to have m en tio n e d a b a lan ced p ro fe ssio n a l/ private life (F =5,09, p = 0.024).Education and marital status had no influence on n u rs e s ' c a re e r e x p e cta tio n s.T hose resp o n d en ts w ith the low est incom e (R500 -R4 999) were the least concerned with job satisfaction (F = 6,68, p = 0,035) and prom otion (F = 6,68, p = 0,035).Those respondents with children at home indicated greater expectations with regard to promotion (F = 16,99, p = 0,000), power and status (F = 11,54, p = 0,001), and professional support (F = 9,18, p = 0,002).
Respondents were also asked to indicate whether their goals and objectives were different from those o f men in their organisation.They were also asked to state w hether they had m odified their career expectations since graduation.The majority (79,1 %) o f the respondents did not b elie v e th a t th e ir g o als and objectives were different from those of men in their organisation, while 70,7% of the respondents had modified their career expectations since graduation.Factors indicated by respondents w hich have c h a n g e d th e ir p re v io u s c a re e r e x p e c ta tio n s ra n g e fro m a lack o f re c o g n itio n and sa la ry , c h a n g e s in nursing as a job, working for a medical fu n d e r, re m u n e ra tio n , fam ily com m itm ents, stress, lack o f support from the organisation, studies, theatre e x p e rie n c e , a ffirm a tiv e a c tio n , s p e c ia lis a tio n , p ro m o tio n , ra c ism , children, lack of time for family, working hours, low standard o f nursing care, R e sp o n d e n ts w ere a lso re q u ire d to present their long-term career goals.The responses varied from being able to lecture, to becoming involved in child psychology, to being prom oted to the position of trustee on the medical board, to doing clinical research, to furthering th eir stu d ies, to being p ro m o ted , to opening their own clinic, to becoming computer literate, and to feeling secure in their jobs.

Nursing Council
The majority (89,1 %) o f the respondents believe that the South African Nursing Council has a role to play in providing more assistance to women members with th e ir c a re e rs .T h e fo u r m ost p ro m in e n t issu es that em erged from the responses were

Conclusions
From the above results it is evident that pay-related issues still dom inate as the main problem at work.This is in line with international sentim ents regarding the issue o f rem uneration.Significant differences were found when race groups were compared with regard to problems at work.Black respondents experience each o f the fo llo w in g problem s to a greater extent than white respondents: "I don't have the flexibility to meet family responsibilities" ; "It's hard to find quality child or elderly care that I can afford" ; "I travel and sleep aw ay from home too m u ch " , and "I am o v e r q u a lifie d " .
Significant differences w ere also found when educational levels were compared w ith p ro b lem s at w o rk .T he b etter qualified a respondent is, the more of a problem this becomes.
In general the respondents had a positive attitude towards their job, which leaves the general impression that nurses still regard their jobs as something they do for the sake of a service to the community and not only for the m oney they earn.Pessim ism was expressed about good n u rse s leav in g th e co u n try and the profession, the lowering of standards, the fact that fewer nurses are available and the increasing workload on existing staff.Significant differences were reported between black and white nurses.Black respondents were more likely to have mentioned prom otion, power and status, professional support and recognition.White respondents were more likely to have mentioned a balanced professional/ private life.
By a d re ss in g th e se a s p e c ts o f the working life of woman in the nursing profession in South Africa, a contribution will be made not only to the retention of nurses in the country, but also to the improvement of the general standard of health care of the country.

References
Different factors affect current health care se rv ic e s in S o u th A fric a , such as e c o n o m ic an d p o litic a l c h a n g e s, p o p u la tio n g ro w th , th e ra te o f technological ad v ances and ongoing global problem s such as hunger and poverty.The health care environment is changing rapidly, causing fundamental changes in health care organisations and ultimately changing the working life of nurses.Som e o f these ch anges are outlined below (Jooste 2003:7).
in a study of causative factors am ong public sector r e g is te re d n u rse s fo u n d th at determ inants whose decrease resulted in increased turnover w ere prom otional o p p o r tu n itie s , d is tr ib u tiv e ju s tic e , opportunity for self-developm ent, age and tenure.Better control o f turnover could improve the quality o f patient care, re d u c e lab o u r c o s ts and im p ro v e employee morale.
was designed, developed and applied in the U nited S tates o f America.A questionnaire was, based on this study, developed for South African p u rp o ses.It fo cu sed on the unique challenges of woman in the South African nursing profession.The questionnaire consists of two parts.Part A o f the questionnaire focuses on questions on problems that nurses experience in the w orkplace, how nurses generally feel about their job, possible changes that m ig h t p ro v id e th e m w ith a b e tte r workplace, barriers in their career path as w o m en w o rk in g in the n u rsin g profession, main career expectations and goals, the role o f the SANC and the role of woman in the nursing profession.Part B o f th e q u e s tio n n a ire fo c u se s on b io g ra p h ic a l in fo rm a tio n re g a rd in g em ploym ent, age, fam ily size, m arital s ta tu s , ra c e , in c o m e , p ro v in c e , e d u c a tio n a l le v e l and re g is tra tio n categories.
tern al c o n siste n c y ex am in es how u n ifie d the ite m s a re in a te s t or a ssessm en t.O ne o f the m ost used sta tistic al to o ls to m easu re in tern a l consistency is the C ro n b ac h 's A lpha which is a correlation coefficient (Salkind 2 0 0 0 :1 1 2 ).T he C ro n b a c h A lp h ac o e ffic ie n t p ro v id e d an a c c e p ta b le reliability score o f 0,89 for the whole questionnaire.Normally, an Alpha score o f 0,7 or higher is regarded as reliable.
the p e rc e n ta g e o f the re sp o n d e n ts c h o o sin g an option are also given).Jo b s a tis f a c tio n and r e c o g n itio n w e re the m ost im p o rtan t career ex p ectatio n s indicated by respondents, which c o rre s p o n d s to the fin d in g s o f the 1998 survey.
R e sp o n d e n ts w ere requested to indicate which services the Council could provide for those members who had temporarily left the profession.Respondents could indicate more than

T
h e ra n k in g fo r b a r r ie r s in th e workplace changed in 2003.Low salaries w h ic h c a n n o t s u p p o rt c h ild c a re paym ents and lack o f recognition and respect for work com pleted were ranked first and second respectively in the 1998 study, while the 2003 study ranked them as sec o n d and f ir s t re sp e c tiv e ly .Restriction on the type o f work given thus limiting experience (ranked third in 1998) w as re p la c e d by in a d e q u a te allow ance for fam ily com m itm ents in 2003.These barriers again stress the need for b e tter p e rfo rm a n c e-re la te d remuneration.Bigger allowances should also be made for fam ily commitments, which should lower nurses' stress levels.Job satisfaction and recognition remain th e tw o m o st im p o rta n t ca r e e r e x p ec ta tio n s and g o a ls fo r nurses.Annual refresher courses and forming d is c u s s io n a n d m e n to r g ro u p s are important suggestions m ade by nurses totheSA N C .
leave to care for newborns or seriously ill re la tiv e s , o n -th e -jo b tra in in g opportunities to learn new skills, student loans for courses to provide new jo b s k ills , g iv in g e m p lo y e e s m ore responsibility for how they do their jobs and job sharing opportunities.A lack of recognition and respect for work completed and low salaries were the major c a re e r p ath b a rrie rs id e n tifie d by respondents.In com paring the different categories of barriers in their career paths encountered by nurses, the race groups show ed tw o sig n ifica n t d iffe ren c es, namely a lack of recognition and respect for work completed and prevention from being creative and innovative.In each case the black respondents were finding the issue more of a barrier than the white re sp o n d e n ts.M a rrie d re sp o n d e n ts found the lack of flexibility in working hours and inadequate allowances made for family commitments more of a problem than those resp o n d en ts w ho are not m arried.As can be expected, those respondents with children at home also found inadequate allowances made for fam ily com m itm ents to be m ore o f a problem than those without children.L o n g -te rm g o a ls in th e n u rsin g pro fessio n covered a w ide range o f responses which supported the view that nurses do see the nursing profession as one in which they can realise their own dream s and ideals.H ow ever, nurses e x p re sse d c o n c e rn a b o u t the re m u n e ra tio n th e y re c e iv e , th e recognition they receive as a profession, their conditions o f service and the whole issue around the handling o f AIDS and th e ir e x p o s u re to the p a n d e m ic .
rs in flu e n c in g jo b s a tis fa c tio n or dissatisfaction am ong female registered nurses employed by the Department of H ealth, T ran sk ei.U n p u b lish ed M Sc D is s e rta tio n , U n iv e rs ity o f N a ta l, Dalbridge.E R A S M U S , B J 1 9 9 8 : N u rsin g professionals' views on the workplace.Curationis.21(4):50-57.ERA SM U S, L 1995: Occupational burn o u t a m o n g st n u rs e s in a p riv a te psychiatric hospital.U npublished MA Dissertation, Rand Afrikaans University, Auckland Park.JA C O B S , IP 1993: A perspective on the quality of w ork-life for registered nurses employed by local governments.Unpublished M(Cur), University of South Africa, Pretoria.J O O S T E , K 1 9 9 7 : A m odel fo r em pow ering n urses -a m anagem ent model.Unpublished D Litt et Phil thesis, University of South Africa, Pretoria.JO O S T E , K 2003: Leadership in health services management.Cape Town: Juta.M A L A N , M 200 4: SA v erloor so duisende verpleërs.Rapport.20 Junie: 19.M ANONA, W W 2000: Causative factors o f tu rn o v e r a m o n g p u b lic se c to r reg istered nurses.U n p ublished, MA Dissertation, University of Stellenbosch, Stellenbosch.N G C O B O , M B 1998: Social support, s tre s s and h e a lth in th e n u rsin g p ro fe s s io n .U n p u b lis h e d MA Dissertation, University of Port Elizabeth, Port Elizabeth.P H IL L IP S , N 1993: Stress and stress management in nursing managers.MSc d is s e r ta tio n , U n iv e rs ity o f N atal, Dalbridge.SALKIND, N J 2000: Exploring research.4th ed.Upper Saddle River, New Jersey: Prentice Hall.S T A N D E R , J 1 9 9 3 : P a rtic ip a tiv e management in a nursing service.MCom.Rand A frikaans University, Auckland Park.ST A T IST IC S SO U T H A FR IC A 2001: Labour Force Survey, February.

Table 1 Most serious problems encountered at work
• Province: The majority (22,7%) of the respondents lived in Gauteng; 19,6% in the Western Cape; 15,5% in KwaZulu/ Natal; 12,4% in the Eastern Cape; 10,3% in the N o rth e rn P ro v in c e ; 7,2% in Mpumalanga; 6,2% in the North West;

Feedback on what it is like to be a working woman in the nursing profession
In this section, respondents were asked what would they tell President Mbeki

Table 10 A comparison between research done in 1998 and 2003
to b lac k re s p o n d e n ts th an to w h ite respondents: information about support for child or dependent care, ensuring equal opportunity in the workplace, paid