'Gates of hell will open'

"Make your decision tonight. If you want to continue with this mind-set of laziness, poor patient care, patients continuously complaining - understand this very carefully - the gates of hell are going to open against you and there is no turning back."

These are the words of Charles Meltzer, a doctor at the trauma unit of Linksfield Hospital, in eastern Johannesburg.

Last week Meltzer sent a long SMS to night-shift nurses .

He warned them that if "they stand in the corridor chatting to each other, instead of being in the cubicle with the patient, they would be going down a horrible road".

In the message, he said: "If nurses think they can organise to be transferred to another hospital, move to another ward, apply for another job, trust me, that would be far too predictable and easy on my part and you obviously don't have a clue whom you are dealing with."

Nurses were outraged at the SMS and complained to the hospital's management.

Netcare's spokesman, Mande Toubkin, said the doctor had apologised and reconciliatory meetings had been held.

She said most nurses were excellent but admitted that doctors did have occasional problems involving them.

"But this is the exception, not the rule.

"We also share our doctors' frustrations [about nursing staff] but there is a right and wrong way to deal with this kind of issue."

Sibongiseni Delihlazo, spokes-man for the Democratic Nursing Organisation of SA, said nurses faced many problems: from working in under-staffed hospitals to seeing too many patients in insufficient time .

One doctor, who would not be named, told The Times that the SMS was "entirely inappropriate" but said she understood Meltzer's frustrations.

"There are no good hospitals left in South Africa because nursing is so poor."

She said young nurses did not have the passion of older staff and were not willing to learn .

Nephrologist Trevor Gerntholtz said he thought nurses in South Africa "do a great job".

"That's why they are snapped up everywhere overseas."

"I have had lots of experience in private hospitals [with good nursing] and this month had two great experiences at Chris Hani-Baragwanath Hospital," he said.

Meltzer said he could not comment until after tomorrow.