Compulsory Community Service for New Nurse Graduates in South Africa: A Narrative Literature Review

Background

In South Africa, nurses and midwives who have undergone a comprehensive 4-year diploma or degree in nursing (General, Psychiatric, Community, and Midwifery) from a public nursing college or university are expected to perform compulsory community service (CCS) at public health facilities. Compulsory community service is a requirement for nurses and midwives to be registered with the South African Nursing Council—the South African regulatory body—as professional nurses in terms of Section 40 (3) of the Nursing Act.

Purpose

This narrative review seeks to understand the effectiveness, strengths, and areas of improvement of the CCS regulation for nurses in South Africa.

Methods

A narrative review of the literature was conducted to consolidate reported experiences and perceptions regarding the formal South African CCS program for new graduate nurses. Using purposive sampling, three online databases—African Journals Online, Google Scholar, and Science Direct—were searched for relevant literature. The review search items included “community service for nurses,” “compulsory community service,” “community service nurses,” “community service practitioners,” and “newly qualified nurses.” The review included theses, dissertations, and peer-reviewed publications written and published in English from 2008 to 2022. Included literature focused explicitly on the experiences of community service nurses (ie, nurses completing the CCS) or the perceptions of experienced nurses, including professional nurses and nurse mangers, with respect to CCS for nurses in South Africa. Media reports and reports from other databases were excluded.

Results

The findings identified from this review were categorized into three main themes: (1) positive and negative experiences of CCS, (2) perspectives regarding CCS, and (3) administrative and operational challenges encountered during CCS.

Conclusion

CCS enhanced the preparedness of new graduate nurses to practice, with several studies indicating a high level of confidence to practice among new graduates. However, the challenges encountered during the 12 months of the program—including issues with placement, remuneration versus the workload, and responsibilities, as well as the lack of scope of practice rules, clear policies, or standardized guidelines—cannot be ignored. There is an urgent need to address the administrative and operational challenges to achieve the objective goals of CCS for nurses in South Africa.