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South Africa

Stroke Champion | Zasskia Brings Her A Game

Making a seasoned trauma nurse with bossy-big-sister energy responsible for its stroke programme has turned out to be a tipping point for a provider of private healthcare services in South Africa.
Angels team 21 March 2024
Zasskia (right) with colleagues Sr Dineo Magasela (Trauma and Plastics Unit Manager) and Mr Katlego Tabana (Emergency Department Unit Manager).

WHEN she runs out on the left wing for the Alberton Madeliefies, the name on her black-and-yellow player uniform reads “NURSIE”. But away from the rugby field, that’s about the last thing anyone should have the nerve to call Sr Zasskia Wiese.

There is nothing meek about the trauma nurse steeped in blood, guts and adrenaline or the national stroke coordinator for one of South Africa’s foremost private healthcare groups who has steered the group from 0 to 32 WSO Angels Awards in just over a year.

It’s a role she accepted in November 2022 – just months before a gold award for Netcare Alberton Hospital broke the drought for the Netcare group. Since then, the newest hospital in the group has claimed its third diamond and Netcare hospitals have collectively reeled in 12 – three more than the rest of South African hospitals put together.

Zasskia is clear that more awards mean a more positive impact on vulnerable lives and that every chance to win an award is a chance to do better for patients. It is with this in mind that she monitors every hospital every week to keep track of their door-to-needle times and stroke pathway adherence. It’s why stroke teams are encouraged to do case- by-case reviews in multidisciplinary meetings, why data collection isn’t optional, and why, at least for now, she is capturing prehospital data herself. (Data collection for the group’s ambulance service, Netcare 911, began relatively recently, but late last year, the KwaZulu-Natal region broke the ice with two consecutive EMS Angels Awards. She’s keeping a close eye on her “new baby”.)

Zasskia doesn’t hesitate to say she likes to win: “I am very competitive; I like to be first. I am very determined; if I want something, I go out and get it, and I don’t settle for second best.”

The record shows that even when she’s had no choice but to go with option two, she has turned a compromise into victory.

Never say never

Nursing wasn’t Zasskia’s first choice after she finished school. At 17, as her best friend lay dying in her lap following a freak accident on a farm road, she’d made up her mind to become a doctor. But admission to medical schools in South Africa is famously competitive, and when Zasskia failed to secure a place on her first attempt, she opted for a few years of nursing before trying again.

But nursing wasn’t doctoring, and Zasskia lasted just one year in nursing school before dropping out and purchasing a plane ticket to the UK. While working as an assistant restaurant manager, she enrolled with an agency that placed people in casual jobs on their days off. She disliked routine, and the suspense of getting on a bus without knowing what she might be asked to do at the other end fed her craving for the unexpected. Some of the assignments involved providing palliative care to elderly patients – the kind of work that schools you in patience. When she returned to South Africa after two years abroad, her perceptions about nursing had changed. Recognising that it was “caring, compassionate work”, she resumed her studies at Arwyp Medical Centre in Kempton Park.

Still, the all-out war of trauma nursing wasn’t for her – or so she decided on day one of a third-year rotation through the emergency department where a patient had been admitted after taking an overdose. He’d been given a rapid-acting emetic, and Zasskia was giving him warm water from a jug when projectile vomiting hit her face and soaked her hair. Never again, she decided. But in the end, the mix of adrenaline and the unexpected would prove irresistible.

For her training in trauma and emergency, Zasskia was assigned to Netcare Milpark Hospital in Auckland Park, Johannesburg, where, eight months after becoming a trauma sister, she was invited to apply for the position of trauma unit deputy manager. After just eight months in that position, she successfully applied for the manager’s role.

Asked to account for her rapid rise, she says simply: “I make things happen, and I am good at my job.”

Mission accomplished

Stroke care wasn’t her first choice either. When the management of Netcare Milpark Hospital gave her three months to turn the hospital into an accredited stroke centre, she didn’t know where to begin, and she wasn’t that keen.

“I’m a trauma nurse,” she explains. “I deal with blood and guts. When you work in a trauma unit, you want excitement. Medical priority patients are boring, I thought stroke was boring. But the first time I saw a stroke patient treated with thrombolysis – he was a healthy, active 31-year-old presenting with left hemiplegia – I saw the difference it made. I watched as movement returned to his left arm and leg. Afterwards, I stood next to his bed, and we both cried.”

With the help of the Angels Initiative’s Renathe van der Merwe, Zasskia assembled a team and trained over 500 doctors and nurses, and three months later, stood in the same boardroom explaining how capturing data in the stroke care improvement registry RES-Q would help stroke teams identify stroke pathway gaps and fix them.

When we caught up with her on a Monday morning three years later at Netcare Alberton Hospital, where she’s been trauma programme manager since November 2022, she was busy loading hospitals onto the recently launched new and improved RES-Q platform. Netcare has 38 hospitals with emergency departments that can treat stroke patients, she explained. By the end of the day, every one of them would be registered on RES-Q, ready for continuous quality monitoring to support their stroke care improvement journey.

Zasskia is also a single mom raising a superhero.

Raising heroes

As well as managing a trauma programme and coordinating stroke care at up to 38 hospitals, Zasskia is a single mom raising a superhero. The little girl with her mother’s thousand- watt smile dreams of becoming a teacher or a helicopter paramedic nurse and wears her FAST Heroes T-shirt everywhere. Zasskia introduced the FAST Heroes stroke awareness campaign at home, and the eight- year-old quickly mastered the signs of stroke.

Zasskia recalls how, when she was fumbling her words during a ride home f rom school, her daughter instructed her to look her way.

Mom had to keep looking ahead as she was driving, she explained. But her passenger insisted: “Look at me! Now smile!”

That was Zasskia’s cue to reassure her little FAST Hero that Mom was not having a stroke; she just needed a break.

Time off typically means going to the gym, cooking supper and supervising grade-three homework, but switching off is more easily said than done. Zasskia’s phone is rarely out of reach, not even when she is in the shower. During a two-week camping trip this past summer, she agreed to leave her phone in the caravan and check it only twice a day. “It was very difficult,” she says.

On the upside, this level of dedication communicates itself to others, and as excitement about stroke care improvement spreads throughout the group, her job becomes easier.

Zasskia (far left) with some of Alberton’s rugby-playing Madeliefies.

It’s a draw for the daisies

As for the rugby, it started as a joke.

Zasskia’s partner Anton plays in the over 35s team of the local club and wives and girlfriends generally support them from the sidelines. But during
an impromptu game of touch rugby last winter, a surprise display of grit and talent led to the establishment of the Alberton Madeliefies women’s rugby team.

They soon had a coach, and by September 2023, they were participating in their first national competition.

It was a baptism of fire. For while the Madeliefies (their name means “daisies”) were no shrinking violets, their opponents had the physical advantage. Two dislocations and three concussions in, they were considering their options, Zasskia says. “We were getting hurt.”

But the Madeliefies stood their ground, and the game ended in a draw. Their left winger has yet to get onto the scoreboard, but it can only be a matter of time: “Nursie” won’t settle for second best.


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