Etapa de calma, arrepentimiento o luna de miel

The advent of strike action in the public-health sector is a reminder to nurse managers that human behaviour in organisations is unpredictable because it stems from deep-seated needs and different value systems.

Nurse managers should not use their own discretion or intuition, experience or tradition as a basis for making personnel management decisions. Use of administration or management theories enables prediction, gives clues to possible outcomes of decisions made and implemented, and minimises chances of unexpected or undesirable responses or behaviours. This is important because nursing work and management is performed in situations that are influenced by changes both in the external and internal environment (Griffith 2007:11-12; Stefl 2008:361).

i. Role of the government and the unions

The public expressed a view that the government, being the employer of nurses and regarding them as part of the essential services, should compensate them accordingly given the amount of work they do in public clinics and hospitals. A majority of the participants mentioned that to avoid strikes in future, the employer should be in touch with the needs of the nurses or workers in general. These participants are of the view that the government should think about the health of the people when engaging in negotiations instead of power struggles between the

164 employer and the unions.

“Also the way they treated the nurses in the strike, if you watched the incidents on TV – how they tear-gassed old, old nurses who worked hard for this government. So they didn’t have respect.”

“The government should inform itself of the needs of the workers to avoid people going on strike.”

“Disagreements between the government and the unions during negotiations indicated that the government did not worry about the well-being of the public.”

“The government did not handle the strike action well because strikes took longer and patients suffered while others were fighting for their salaries.”

“We should avoid strikes and the government should put the life of people first. They should not have taken this long at the cost of people suffering.”

“Government took too long for negotiations and did not want to compromise.”

The occurrence of strike actions in the public-health sector should compel the government and nursing managers to use the opportunity for constructive feedback when revisiting and considering why strike actions occurred, as outlined in this study and other site-specific studies conducted to date (Beinin 2009:450; Briskin 2011:1; Burns & Goodnow 1996:26; Cruess & Cruess 2008:550; Gyamfi 2011:1; Ketter 1997:324; Robinson, McCann, Freeman & Beasley 2008:272-275). Furthermore, the occurrence of strike action in the public-health sector provides the government an opportunity and platform to review existing policies and promote the implementation of intervention strategies to prevent similar disputes from taking

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ii. Role of the nurses

Strike action by nurses within the public-health sector raises ethical and moral concerns (Kowalchuk 2011:162-163; Ogunbanjo & Knapp van Bogaert 2009:58). Contrary to this concern, some authors consider strike action in some instances to be necessary and ethically imperative (Kravitz, Shapiro, Linn & Sivarajan 1989:1229-1230; Ogunbanjo & Knapp van Bogaert 2009:58).

Although the findings earlier indicated that healthcare consumers were empathetic towards reasons that led to nurses‘ involvement in strike action, most were against the use of strikes by nurses to raise their grievances. Some healthcare consumers also raised a need for nurses to put in place contingency measures when they go on strike such that the well-being of healthcare consumers is not negatively affected.

“Nurses should discuss their problems with management, with the intention of avoiding unnecessary disagreements that often make them to go on strike, leaving us stranded.”

“It was bad to see nurses involved in strike action and not being able to take care of patients’ health. They need to fight for their rights through negotiations and discussions but not go out there to strike.”

“I think at times, the nurses don’t care as they just neglected their patients at the cost of participating in strike action. Yes, they have rights and they need to be paid better but if they are not there to help us, where must we go? We don’t have money to go to private hospitals, they must think for the poor people that don’t have money to go to private hospitals, and stay at their jobs while their problems are being discussed.”

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“They should make sure that there is skeleton staff to look after the patients while other nurses are on strike, this will prevent people from dying during strike actions by nurses.”

According to Schoeman (2012:17), strike actions within the public-healthcare sector – regardless of the reasons, ethical and moral concerns – should not be taken likely as the nature of work is labour-intensive and there is little room for error. Therefore, management of strike actions within the public-health sector becomes a necessity to ensure adherence by nurses to their ethical code of conduct and to improve the health of all healthcare consumers.

4.3. CONCLUSION

This chapter and other relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Pay can be assumed to be involved in many of the collective bargaining disputes which are prominent causes of industrial action as is evident within the South African context. It is important to note that salary per se is not the most important factor. However, it is a tangible measure of the value that the employer places on people and, in the absence of the other dimensions discussed in this chapter, becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector.

Working conditions is also one of the common mentioned causes of strike action, especially amongst nurses internationally (European Foundation for the Improvement of Living and Working Conditions 2008:17; 20).

Unlike a ―normal‖ strike at a production plant which involves only employers or their unions on the one side and trade unions on the other side, the findings in this chapter indicate that a strike in the public sector does not only concern the

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economic and political interests of the public-sector employers. When strike action take place in the public-health sector, third parties such as the general public have to bear the consequences of such strikes.

Although freedom of association is guaranteed in South African law or is accepted as a constitutional right including the right to strike – when it comes to nurses, a constitutional right to strike is limited by the protection of essential services. However, it has been common that during the strike action by nurses in 2007 and 2010 other public-healthcare facilities did not provide for a minimum provision of service agreement prior to engaging in strike action, putting the health of consumers at risk.

The chapter further highlighted the importance of commitment in nurses‘ own work. It was observed that nurses would tend to be more committed to their work if they feel that they have a secure job, earn a good salary and have good benefits. Thus, the level of commitment of nurses who feel that the three issues mentioned are addressed increase, with a potential of minimising their likelihood to get involved in strikes.

The findings reflect a need for senior members of the government and the management to get closer to their workers by means of improved communication, opportunities for feedback and a better appreciation of the conditions that workers face in their work environment.

Overall, a considerable number of nurses and managers belong to a union, which makes it difficult at times for nurses to choose between their ethical code of conduct and following the demands of their unions. Unions with a strong hold amongst nurses are DENOSA and NEHAWU. A majority of unionised nurses tend to take part in strike action.

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Feedback from the general public supports the frustration by nurses in the workforce, with the public indicating that public-sector salaries are perceived to be unfair and that important civil servants like nurses are underpaid. No doubt, this is due partly to the fact that the publicised issues were almost all around the percentage salary increase.

169 CHAPTER 5

OVERVIEW, THEORETICAL IMPLICATION, RECOMMENDATIONS,