Seanda - Application Forms

INFORMATION LEAFLET TO CONTRACT EMPLOYEES

VISION

Our vision is to be a leading Nursing Agency nationally, through the provision of nursing staff who are highly professional and dedicated to the delivery of Quality patient care and exceeding our clients expectations. expectations. MISSION

We strive to fulfill our vision by attracting and retaining skilled and dedicated nursing staff. We will have an open door policy to staff wanting to update their skills/competencies skills/competencies and seeking any assistance that will promote the Quality of care they deliver. We will always conform to the rules and regulations as stipulated by the South African Nursing Council. Welcome and thank you for joining Seanda Healthcare. We pride ourselves on the delivery of high quality cost effective patient care. You represent the company when you are allocated to a particular hospital and it is imperative that you ensure that you uphold the vision and mission of the company by adhering to the following:

1. You are dressed dressed profess professional ionally ly with with blue bottom bottomss and white white tops tops – and a closed closed pair pair of navy navy  blue non skid shoes 2. Your hair hair is pinned up for infect infection ion control control purposes purposes and a wedding band band is the only jeweller jewellery y you are allowed to wear  3. You have have a name badge badge bearing bearing your your name, name, designation designation and and Seanda Seanda Healthcare Healthcare Logo Logo 4. You ensure ensure that your your cell phone phone is switch switched ed off or on silent silent and and never used used whilst whilst on duty –  may be used during tea and lunch times away from the ward 5. You are timeous timeously ly on duty by by 06h45 for for full takeover takeover in in the morning morning and leave leave only once evening handover is complete depending on the shift you are working 6. You fill fill in the Seanda Seanda Healthcare Healthcare time time book at the the end of every every single single shift 7. Contact Contact the Seanda Healthca Healthcare re Clinical Clinical coordinato coordinatorr (084 8844776) should should you have have any doubt about your clinical competency or require a refresher on your skills skills /knowledge 8. Report any delays delays in pharmacy pharmacy delivery delivery of medication medication to to the unit unit manager manager within within 1 hour of  sending the script to pharmacy Page | 1

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9. Once you have have taken taken over the unit unit – determine determine from from the unit unit manager or or sister sister in charge charge what the risks are in that particular unit and ensure that you implement all preventative measures 10. You ensure that you legibly legibly and accurately document all patient related related issues Ps. You are a health care professional in your own right and need to ensure that how you are  practicing is legally correct and be accountable for all your acts and omissions.

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SEANDA

HEALTHCARE

(PTY )

LT D

H E A LT LT H P R O F E S S I O N A L S P L A C E M E N T A G E N C Y   APPLICATION FORM  ALL INFORMATION IS REGARDED AS  CONFIDENTIAL KINDLY COMPLETE IN BLACK INK 

AGENCY NO.ALLOTTED : CT_______ 

1. PERSONA ONAL

SURNAME ________________________ FIRST NAME __________________________  ID NO. _______________________________ MARITAL STATUS _____________________  RESIDENTIAL ADDRESS/CODE  ___________________________________________________________________________   ___________________________________________________________________________  POSTAL ADDRESS/ CODE  ___________________________________________________________________________   ___________________________________________________________________________  HOME TEL. _______________________ CELL NO. ___________________________  SANC NO. _______________________  Please ring appropriate answer  I have current registration with SANC I have current professional indemnity cover

Yes Yes

No No

I utilize OWN / PUBLIC transport. 2. EDUCA EDUCATIO TIONAL NAL QUALIF QUALIFICA ICATIO TIONS NS

RN / EN / ENA / WA / OTHER (Specify) _________________________________________  QUALIFICATION (Degree/Diploma/Certificate) DETAILS

YEAR OBTAINED

Have you worked in a private healthcare organization? If you have, was it Part Time / Full Time?

Yes

COMMENTS IF ANY

No

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Please list below the wards that you can work in, in order of preference:  _______________________________  • •

 _______________________________ 

•

 _______________________________ 

•

 _______________________________ 

3. EM EMPL PLOYM OYMEN ENT T HIS HISTO TORY RY

NAME OF EMPLOYER

PERIOD

UNITS WORKED IN

4. BANK BANKIN ING G DETA DETAIL ILS S

BANK NAME ACCOUNT NO. TYPE OF ACCOUNT BRANCH NAME BRANCH CODE 5. REFER EFEREN ENC CES

INSTITUTION 1. 2.

CONTACT PERSON AND POSITION

CONTACT NUMBER

DECLARATION

I hereby declare that all particulars and responses in this application are TRUE and no required material has been withheld. I agree that the withholding of any information or failure to answer any questions honestly will constitute a breach of a condition of my employment for which I could face disciplinary action and possible dismissal. Signed on this _________ day of ___________________ 20_____. SIGNATURE ____________________________ 

WITNESS _______________________________ 

SEANDA

HEALTHCARE

(PTY)

LT D

H E A LT LT H P R O F E S S I O N A L S P L A C E M E N T A G E N C Y   EMPLOYMENT CONTRACT Page | 4

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Between SEANDA HEALTHCARE CK 2008/028377/07 And

Employee’s Full name_______________________________________________  ID No. _____________________________  SANC No. __________________________  PARTICULARS OF BOTH PARTIES

1. EMPLOYER As per Seanda Healthcare details heading current page (3) 2. EMPLOYEE Full name ___________________________________  Street Address  ________________________________________________________________________________   ________________________________________________________________________________ 

Postal address  ________________________________________________________________________________   ________________________________________________________________________________  Telephone no __________________________  Next of kin

Name _______________________________  Address_________________________________________________________________________  Contact no. _________________________ 

CONTRACTUAL TERMS OF AGREEMENT 3. CONTRACTUAL

3.1 Remuneration - The employee shall work as per the rates negotiated by Seanda Healthcare Services and the organization where the employee is placed / working 3.2 Disciplinary Procedure  – If the employee is guilty of poor work performance or misconduct, disciplinary action may be instituted against the employee in terms of the code of disciplinary conduct, a copy of which is annexed hereto. The employee shall avail herself within 5 working days of any offence /complaint/ adverse incident brought to his/her attention either telephonically/via e mail/ SMS/or face to face in order for a thorough investigation to be conducted into any alleged incident during her practice Page | 5

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3.3 Retirement  – Unless otherwise agreed to in writing, the employee shall retire at the age of sixty- five (65) years of age. 3.4 Application of the Basic Conditions of Employment Act and Labour Relations Act  – With regards to all matters not stipulated in this contractual agreement, the provisions of the Basic Conditions of Employment Act and Labour Relations Act in force and as amended from time to time, shall apply.

SIGNED BY SEANDA HEALTHCARE in CAPE TOWN ON THIS________ DAY OF__________________ 20____ 

WITNESSES 

1.  ________________________ 

2.  ________________________  SIGNED BY THE EMPLOYEE at CAPE TOWN ON THIS _______ DAY OF ________________ 20____  WITNESSES 

1.  _______________________ 

2.  _______________________  Please ensure that a Copy of your SANC Receipt, Certificate, Green bar coded ID and bank details

Thank you for choosing to register with Seanda Healthcare. We look forward to a mutually beneficial and long  lasting working relationship based on professional etiquette, honesty, integrity and the delivery of world class quality patient care..

Please ensure the following are attached: 1. Copy of ID Document 2. Current SANC registration receipt 3. Proof Proof of prof profess ession ional al inde indemni mnity ty 4. Bank details 5. Certif Certifica icate te of of Qual Qualifi ificat cation ions s 6. FAX Completed Form to : 0865562236

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