She started working at Murchison Hospital in the paediatric unit for one year. She moved to Ngwelezane Hospital in Empangeni where she was exposed to all types of patients presenting with physical and cognitive challenges. This is where she gained extensive experience in clinical case management, coordination of rehabilitation programmes, staff management, report writing and functional goal settings.

Nomakhaya developed the love and passion of changing peoples lives and gaining insight into health behaviours, a contextual understanding between providing therapy, educating clients, counselling, managing, mentoring, coachimg and how to use interventions steered into her practice management. Nomakhaya opened a Private Practice in  Empangeni in 2004. She was servicing almost all North Coast and Midlands areas that includes Melmoth, Ulundi, Nongoma, Mtubatuba, Hluhluwe, Hlabisa, Jozini and as far as Manguzi.

Nomakhaya attended various courses and workshops including AMA guidelines certificates to equip her in mastering various clinical skills and become an expert in enabling occupation.