Seanda - Application Forms 67735

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. 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 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 ing 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 professionally with blue bottoms and white tops – and a closed pair of navy blue non skid shoes 2. Your hair is pinned up for infection control purposes and a wedding band is the only jewellery you are allowed to wear 3. You have a name badge bearing your name, designation and Seanda Healthcare Logo 4. You ensure that your cell phone is switched off or on silent and never used whilst on duty – may be used during tea and lunch times away from the ward 5. You are timeously on duty by 06h45 for full takeover in the morning and leave only once evening handover is complete depending on the shift you are working 6. You fill in the Seanda Healthcare time book at the end of every single shift 7. the Seanda Healthcare Clinical coordinator (084 8844776) should you have any doubt about your clinical competency or require a refresher on your skills /knowledge 8. Report any delays in pharmacy delivery of medication to the unit manager within 1 hour of sending the script to pharmacy Page | 1 Compiled by N Mohamed – March 2009 Version 1

9. Once you have taken over the unit – determine from the unit manager or sister in charge what the risks are in that particular unit and ensure that you implement all preventative measures 10. You ensure that you legibly and accurately document all patient 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 able for all your acts and omissions.

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SEANDA

H E A LT H C A R E

(PTY)

LT D

H E A 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. PERSONAL 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. EDUCATIONAL QUALIFICATIONS 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? PLACEMENT

Yes

COMMENTS IF ANY

No

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Please list below the wards that you can work in, in order of preference: • _______________________________ • _______________________________ • _______________________________ • _______________________________ 3. EMPLOYMENT HISTORY NAME OF EMPLOYER

PERIOD

UNITS WORKED IN

4. BANKING DETAILS BANK NAME NO. TYPE OF BRANCH NAME BRANCH CODE 5. REFERENCES INSTITUTION 1. 2.

PERSON AND POSITION

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

H E A LT H C A R E

(PTY)

LT D

H E A 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 Compiled by N Mohamed – March 2009 Version 1

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_________________________________________________________________________ no. _________________________ 3. CONTRACTUAL OF AGREEMENT 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 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 Compiled by N Mohamed – March 2009 Version 1

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 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 of professional indemnity 4. Bank details 5. Certificate of Qualifications 6. FAX Completed Form to : 0865562236

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