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• Nurses should receive ongoing training and information to make them aware of
women’s plight under the previous Act and to inform them about the Termination of
Pregnancy Act.
• All health care workers should be provided with in-service training so that they gain
knowledge of and insight into TOP issues. This should unfreeze the status quo and
counteract the negative attitudes of the staff. In this way TOP providers’ support
systems will increase as peers become more knowledgeable and the stressful
factors will decrease.
• Information pertaining to TOP should be given to the community to encourage
proper decision-making by clients.
• There should be ongoing monitoring of service provision through quarterly reviews to
check adherence to set standards, availability of TOP equipment and availability of
psychological support.
• Quality-control protocols, such as quarterly TOP reviews and psychological
assessment tools, should be in place and form an integral part of the monitoring and
evaluation system to ensure that a holistic service is rendered (Cronje & Grobler
2003:75;Jooste 2003:217, 270, 338, 340).
5.5.2 Health science education
The following recommendations, of which some were mentioned in Chapter 4, pertain to
training the registered nurses involved in TOP to help themselves. They are based on
the assumption that, through self-management, the registered nurse can grow towards
professional maturity and become assertive, confident, independent and emotionally
stable and a good TOP provider in the unit where she is practicing.
The following refer to subjects to be covered in the training of nurses involved in TOP,
whether before or in-service:
• Nurses must be informed about their right not to participate in termination of
pregnancy if it violates their morality (Pera & Van Tonder 2005:84).
• Ethical decision-making skills should be incorporated in the curriculum.
• A module to develop reflective skills could be incorporated in the course content.
The TOP providers would be assisted to identify and be aware of the defence
mechanisms they use to cope with emotional responses. This insight could help
them to develop more effective ways of managing stress.