Our Patients Deserve Better: Addressing the Gap in Training and Support in South African Emergency Medical Care

In the heart of South Africa’s healthcare system lies a fundamental contradiction: we expect our medical teams to deliver exceptional care in environments for which they are often inadequately trained, or experienced.

This expectation arises from systemic challenges—shortages of healthcare staff, limited access to postgraduate training, and a health system strained to its limits. While these issues are not new, their consequences are deeply personal for the individuals who step into these roles, often at great emotional and mental cost, and the consequences are dire for the patient, who arrives to a provider/unit where they are expecting safety.

The Emotional and Mental Strain

Imagine being asked to perform a procedure, manage a patient, or make critical decisions in an area you’ve had minimal exposure to. For many healthcare providers, this is not a hypothetical scenario—it’s their daily reality. The weight of responsibility is crushing. The fear of making a mistake or missing a subtle clinical sign haunts them long after their shift ends. And when the inevitable occurs—when outcomes fall short of their aspirations—the self-recrimination can be brutal.

This emotional burden is compounded by the relentless pace of work, volume of sick patients and limited resources. In settings where staff shortages mean there is no time to pause, reflect, or even breathe, burnout becomes a foregone conclusion. The toll is more than professional; it is personal, with ripple effects that impact their families, relationships, and, ultimately, their ability to stay in the profession they once loved.

The Risk of Burnout and Mental Health Damage

Burnout is insidious. It starts with exhaustion but evolves into detachment, cynicism, and a loss of confidence in one’s abilities. For some, it leads to anxiety and depression. For others, it manifests as a loss of empathy—something no healthcare provider wants to experience. In extreme cases, providers may leave the profession entirely, creating a vicious cycle of increased workloads for those who remain.

But it’s not just the individual provider who suffers. The quality of patient care diminishes in environments where teams are overstretched and unsupported. Mistakes become more likely, and patients—the very people we aim to help—pay the price.

Creating Opportunities for Support

While we may not be able to solve the systemic issues overnight, we can take meaningful steps to support our medical teams and, by extension, improve patient outcomes. It starts with understanding the power of a an empathetic and dynamic leadership approach. Oppening the system to assistance, and review, and creating safe spaces for shared experiences.

1. Training in Units: On-the-job training can bridge knowledge gaps. By creating opportunities for skill-building and clinical learning within the environments where providers work, we empower teams to deliver safer and more confident care. In-situ simulation, bedside clinical teaching and mentored practice can all go a long way to improving outcomes for patients.

2. Just Culture: A just culture fosters an environment where mistakes are not met with punishment but with learning and growth. Shared experiences—through debriefing, mentorship, and reflection—can transform errors into lessons that benefit entire teams.

3. Collaboration Across Stretched Teams: When resources are scarce, teamwork becomes the most valuable asset. Encouraging open communication, mutual support, and shared decision-making can strengthen bonds and improve care, even in the most challenging environments.

4. Acknowledge vulnerability: We cannot fix what we refuse to admit, when we think our system is perfect, we place a lot of pressure on those who know it is not, and when we refuse to see the ways we need to work to correct the problems, the problems just get bigger.

A Commitment to Better Care

Despite these challenges, South Africa’s medical providers show an extraordinary commitment to their patients. They do their best under circumstances that would break many. They are, in a word, resilient. But resilience without support has its limits.

With appropriate training, a culture of safety and learning, and basic education that empowers rather than overwhelms, we can create safer spaces—not just for our medical teams to work in but for our patients to survive in. Every step we take toward supporting our healthcare workers is a step toward ensuring better outcomes for everyone.

Our patients deserve better. Our teams deserve better. And it is our shared responsibility—as healthcare leaders, educators, and policymakers—to bridge this gap. When we invest in our teams, we invest in our patients. And when we create safer spaces for those who deliver care, we create a foundation for a healthier, more equitable healthcare system. Together, we can make this vision a reality.

Share your approach to safer patient spaces in the comments, we would love to know how you are approaching the development of safe spaces for your teams and patients.