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• TOP providers need to be taught coping skills, assertiveness training etc. In-service
education through seminars or workshops should be given regularly to help the
registered nurses with acceptance, confidence, better management of mental health
problems and development of a positive attitude towards TOP, TOP services and
personnel.
• Value-clarification workshops need to be organised to gain knowledge of the
concerns of registered nurses regarding TOP and to assist them to relate their
values and beliefs systems to the needs of the clients (Marais 1997:7).
Furthermore, the services of a psychologist are recommended. The psychologist could
offer the TOP provider advice/guidance on very limited and well-thought-out situations,
in order to smooth out overly stressful moments and reduce tension, and to help them
transcend uncooperativeness of colleagues (Rawlins, Williams, Beck 1993:105).
For health care workers other than the TOP providers, there is a need to design
different training modules that address the above TOP-related issues.
5.5.3 Clinical practice
To ensure proper implementation of the Termination of Pregnancy Act and the provision
of effective and efficient TOP services, the following are recommended:
• A support group of the nurses involved in TOP should be formed. McDonald
(1994:40) states that the program should have the full support of management. The
support group would create an environment where the nurses could share their
feelings, concerns, hopes and values, and where stereotypes could be broken down.
Trust and empathy would need to be fostered (Gmeiner et al 2000:76). The group
members would have an opportunity to explore their own personal world and reflect
back on that (Jooste 2003:158-159).
• Skills and guidelines for handling clients, especially young ones, should be taught.
This should include the rights and responsibilities of the clients.
• In Barometer (May 2002:17), it is suggested that through the involvement of a social
worker and psychologist, structures and interventions for health care providers can
be built into their curriculum to serve as a peer support structures. A model that will
facilitate the following can be adopted: