The Hidden Shame That Will Kill The Nigeria Nursing Profession

“For we who nurse, our nursing is something which, unless we are making progress every year, every month, every week, we are going back. No system shall endure which does not march.” - Florence Nightingale

My great grandmother occasionally reminded us that, it is only your good enemy that will tell you that your mouth smells and the clothes you put are torn, and it is only a naturally cursed and useless friend that will continue to fight that enemy without wanting to transform or accept transformations to defeat the enemy. Sometime ago, I went to the hospital with a friend who was ill and while in the ward with him, a beautiful young lady walked in and asked one of the nurses sitting and said “Ma, please let me have the folder of that patient over there”, which was given to him. I just saw her access a patient one after the other, wrote something on various files and walked away. As I looked at the nurse, she was fuming with anger and made an uncomplimentary remark, “all this small doctors wey say them be physiotherapists will just come here, touch some parts of the body and government will pay them big salary, while we earn nothing”

That word till date rings in my ear, and each time I remember it; I feel pity for nurses. That I love Nurses have never been in doubt and the love has never waned, despite the ills bedeviling the profession. How come Physiotherapy which is arguably a new profession ranked next to Med/Surg in the scheme of service that Nurses have become their enemies? How come that Physiotherapy which began with nurses has overtaken them from being just a technical course to a professional course that Nurses have to answer to them? I do not want to be reminded that Medicine started as a technical course as well, for I know; but one thing has distinguished them – training, research and pride of what they practice. These three things are what have made Nursing the butt of jokes in Nollywood today, where they are portrayed as slaves to physicians. I'm pained; really pained, knowing that it is not the true picture of things. This lengthy piece which was borne out of research with great assistance from a top medical colleague will answer that.

In this part of the world, when the word “Nursing or a Nurse is mentioned, it's simple interpretation is “that is woman” and this is attributed to the fact that, of course no tribe in the Africa continent that has a word for a nurse or nursing. Let us attempt to enroll more females (say 70% of female and 30% males into the medical schools for just two years, or allow more physician, pharmacists and physiotherapists (3 Ps) in the hospitals or allow female member of such professions to head their council for just two years and observed the impressions and expressions of members of the Nigeria communities, if the field would not be communized and lose it respect. The licensure exams nursing students write in every May and In November of every year can be written and passed confidently by a very good biology and health science secondary student, but that same student cannot even understand Medicine, Pharmacy, Physiotherapy, Dentistry nor Med.Lab exams let alone to attempt them; but because it known that, females brains don't want stress in the acquiring of knowledge, the nursing council exams, in both structures and patterns are watered down that, even a pregnant woman at second stage of labor will write and pass; in other words, the SSCE and JAMB exams are more difficult than the RN exams, and you think, these other medical practitioners are not seeing these?

For the nursing field to grow and be recognized by the societies, it required constant researches that will have direct impact on the improvement of the lives of the people; but while the other profession and their professionals are engaging into researches and announcing the outcome to the societies with the logo of their respective field on the results; nurses are busy attending weddings, buying exotic cars, fattening up, accumulating and sharing the several millions and billions of monies collected for council exams registration, indexing, license, renewal of license, from frustrated nursing students, as well as the ones collected from fake organized workshop, obsolete post-basic programs attendants. Instead of investing these monies into significant researches, they travel to Dubai and other countries; and you think these physicians are not seeing these?

Nursing in Nigeria was introduced into the university in 1965, and since then, the only change the NMCN has made, is to introduce objective like questions in the so-called council exam. Because they have decided to be enslaved in their mode of thinking and reasoning by the physicians and other clinical staff; they did not found any relevance in introducing a program that would improve on their professional image and practice, thus they become deaf and dumb and provided themselves with very hardened and repulsive skin to transformations, not even the President Goodluck's fake transformation agendas could penetrate the nursing nor nurses line of backwardness. I mean, the simple introduction of“internship” it did not occur to them, and when these generation of students want to improve on field of nursing practice and as well as to command and earn respect from other core medical practitioners and the members of the communities; the nurses in Abuja NMCN affairs, DNS and a host of other envious nurses in NANNM are ill bent to see that, their children don't grow. It is a shame to all nurses that have been practicing for over forty years and to RNs for refusal to allow for the internship.

One of the biggest problems militating against the progress of nursing been noticed and used against nurses is the different types of certificates existing in the nursing field. First it is the non-academic and without-educational based RN license. I imagine for goodness sake, how can a RN holder be allowed to gain direct entry admission into two hundred to study nursing with RN and O'level subjects; why? Does RN have any NUC accredited background like diploma and IJMB? It is just a license for practicing and nothing more. This is just like asking a road side machinist to use the certificate given to him in the mechanic shop after freedom party to go and write SSCE O'level and the engineering department should admit him for two hundred level; or patent medicine dealer to use his certificate of serving in a chemist shop to add SSCE O'level and ask the Pharmacy department to admit should a person into two hundred to study Pharmacy. To give standard to field; please for respect reasons, this should stop, and every students aspiring to study the program should write JAMB or acquire IJMB or A'level subjects as it is done in other respected health disciplines and as approved by the NUC. Secondly, it is only in nursing in Nigeria, somebody will have RN from school of nursing (SON), then go and get first degree in any of the following: health science, or sociology, psychology, education curriculum, law, education and will be telling the world he/she is a nursing graduate and professional. I mean, how one can have a RN license, which does not have any educational supervisory body interpretation, but only meant for practicing, and he/she will be parading S/he as a professional nurse with BNS degree.

This cannot be seen in a well respected and masculine dominated health professional program like Medical Rehab, Medicine, Pharmacy, Med.Lab.Sci , etc. Some with the RN and first degree in nursing, but go further to do their masters in any of : sociology, psychology, health science, food and nutrition, education and curriculum, Law, guidance and counseling, etc. for goodness sake, are those courses “Masters in nursing?” and they will even preferred to be called nurse practitioners (NP); and in a similar vein, those who had it at Ph.D level want to be considered nurse consultants (NC). With this Nursing will never grow or assumed full autonomy. Now in Nigeria, how many nurses have their Masters and Ph.D in nursing? How many have DNP or DNS? Rather they will prefer to seek for women accepted and easy courses outside nursing to do their Masters and Ph.D, so as to continue with confusion and further bring do down the once respected field.

How can you have Masters and Ph.D in absolutely disassociated courses with RN and in some cases with BSc(n)/BN.Sc and be demanded to be placed as lecturer one and/or be called nurse consultant? And you expect nursing to grow and be accepted by the other health teams to train students at Masters and Ph.D level with which knowledge? Is it knowledge of sociology or Psychology? If such a lecturer is allowed in nursing department, then all lecturers in sociology, psychology, education and even guidance and counseling will be drafted to all nursing departments as lecturers and as lecturer one. This can never be obtainable in a well organized healthcare training college, like Med/Surg , Medical Rehab, Pharmacy, Med.Lab.Sc etc. How do you place, compare or equivalent, a Ph.D/MA/MSc in sociology/Psychology/Health Sc./Nutrition/Edu. Curriculum, with nursing background in RN and/or with either BSc(n)/BN.Sc , with a Ph.D/MSc in Pharmacy or Medicine with Pharmaceutical or Medical background in B.Pharm (Pharm D) , BMR or MBBS? A consultant or a just nursing officer! Another problem is the HND status accorded to RN holders in the civil service scheme (CSS) meant to tell us that, a nurse with RN, RM, RPHN, RICUN and other so-called post-basic SON courses have HNDs. Somebody with RN/RM/RPHN, has three HNDs- this is laughable. Nursing is a dynamic, scientific and universally researchable science field and not for weak and shallow thinking brains like what is seen in Nigeria, especially among the hairdressers who called themselves nurses, without any senses of engaging in significant researches to improved on the lives of their patients and the lives of physicians so as to earn and command respect from the public and from other health teams. Nurses in Nigeria please accept to change so that transformation can change the profession of nursing for all. Please refuse jealous, envy and bad belle so that nursing can see light; please allow your trainees and young professional children to grow, which is the prayer of every parents.

When in the 21st century developed health care societies are improving and advancing in health care curriculum so as to further meet or supersede the universal health best practices by converting all schools of nursing into 3-5 credit courses colleges/university; in Nigeria the reverse has been the case. Imagine a program that is called health professional course is been ran in a national open university (NOUN); is medicine, Pharmacy, Med.Lab, Physiotherapy, even community health ran in NOUN? What is nursing among all the health disciplines doing in NOUN for goodness sake? Instead of thinking of converting all schools of nursing into masters, DNP, PhD running and degree awarding institutions/colleges, so as to develop efficient and competent and skill man powers that would favorable compete with their counterpart and meet up with the internationally accepted health best practices and standards all over the world; NMCN is busy thinking of setting up nursing polytechnics with 2-credit unit NABTE accredited courses. Instead of NMCN to set a pace for the developed world to follow by converting all post-basic nursing courses into Masters, Ph.D, DNP and DNS to be taught in the colleges where different researches would be done, it is busy thinking of 2-credit unit courses in polytechnics, so that weak and non-oriented research brains will attend and further worsen the backwardness of the nursing in Nigeria. And these physicians, Physiotherapists and Nigerians are watching.

The obsolete white-and-white uniform has really bastardized Nursing image. In the societies; community health extension workers (CHEW) who also wears the white and white portray themselves as nurses in community primary health centers and whenever blunders are committed as its normal with all profession, the first name sang all over the media without knowing it was caused by a CHEW. The white and white uniform should be immediately discarded and be seen as out dated, and in place of it, the fast growing using of different colors of scrub uniforms should be adopted or a more unique color, with their tags displayed, as well as the nursing symbol. These white uniforms are seen worn by nurses in the market squares, entering public toilets, hairdressing salons, public transport vehicles and other odd places and in each of these places, they attract dirty, germs, infectious agents, that they take to their love one at home and health facilities.

Do we talk about the negative and annoying administrative and exorbitant high fees collection attitudes of NMCN which was exposed to me by a source within the council? The Nursing administrations and managements in that NMCN office in Abuja is very poor, and all of those staff in the office are advice to go for further proper administrative skill training and to as well seek for better intellectual skills to enable them develop efficient thinking and reasoning abilities, so as to make them have constructive critical thinking and logical and rational decisions making and proper Law making. It is only in Nigeria NMCN that, after students use three days to write the council exams; it will take seven to eight months before the results will be released and after the results are released, it will take another five to six months for license to be given to students. It takes over a year for the results of the exams and the license for NMCN to issue it to students. For the fees and what are they used for, EFCC or the ICPC should be invited to begin probe of such monies collected. Imagine, N6,000,00k for indexing, N1,800,00k for green book, N30,000,00k for the council exams (i.e. for two papers), N12,000,00k for logistic of the examiners, N20,000,00k for collecting the license, all for an exams that lasted for just three days, these are not part of the N3,000,00k that each student will give to the department HOD for the conduction of what NMCN called “hospital final” All the charged amount put together for an exam; summed up to over N80,000,00k per student, yet there is no improvement in the profession. The NMCN does not give money to each department to equip their nursing and midwifery demonstration Labs; NMCN does not organized watery workshops without collecting money from the participants, NMCN does not have research built institutes; it does not pay staff; what about the money NMCN collected for renewal of licenses? How many research works has it sponsored? Please, for estimated benefits, that total sum should multiply the numbers of Schools of nursing in the country, and the numbers of nursing departments in the universities in the country, and a clearer picture of NMCN richness would be understood. Do they think these other medical practitioners are not seeing these atrocities of thievery and exploitations of students and their parents?

One thing I have always heard from Osahon Enabulele (NMA National President) in the course of our discussion is that the nursing field should change it attitudes of backwardness and professional conservatism. He was simply telling NMCN that, NMCN and NANNM as well as all those obsolete nurses should wake from the old paths of nursing training and practices and embrace the scientific and technological trends of training and practices. He's telling NMCN and NANNM to accept internship scheme, so as to improve their public image. He's telling NMCN to convert all S.O.N to colleges awarding Masters and Ph.D and DNP nursing programs. He's telling NMCN to be wise and select only nursing professionals and professors in nursing as members of its board, so that their secret will jealously protected. And while he must have made some uncomplimentary remarks at time, which I have always taken him up, I totally agree with all the above he stated

Let auxiliary nurses be jettisoned, while the council begins a proper monitoring of all hospitals training such and deal ruthlessly with them through the law. Just as the Med Lab Scientists, Physicians, Physiotherapists and Pharmacists do not allow unnecessary practice of their technical colleagues without supervision, so should Nurses not allow any Nurse practice without a degree holder supervising such. Physical therapists assistants, Lab technician, dental technicians all have their specified duties which can be copied by the Nursing council and even create their own board for them. Until the Bachelor of Nursing graduates take over the helm of affairs, Nurses can keep gnashing their teeth in pity while they take orders from men whom ought not to order them

These little things matter…
Fejiro Oliver, a Journalist can be reached on [email protected] and +2348026797588 (sms only please). Follow on twitter @fejirooliver86 and Facebook fejirooliver86. Like our Facebook page - secretsreporters

NOTE: This work is a compilation, hence it's mainly raw and unedited

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Articles by Fejiro Oliver