The President of the National Association of Nigeria Nurses and Midwives, Michael Nnachi, tells THE PRESS NIGERIA why the association does not recognise auxiliary nurses, in view of the arrest of a suspect who was said to have administered an injection on a musical artiste, Ilerioluwa Aloba, popularly known as Mohbad, before he died.
Some Nigerians find it hard to distinguish between a registered nurse and an auxiliary nurse when seeking medical care. How are these connected or unconnected to the nursing profession?
A registered nurse refers to a person who has undergone professional training to become a nurse. Even before entering into an institution, the person must be qualified, and the qualification has to do with having an O’level certificate that must include English Language, Mathematics, Physics, and Biology in not more than two sittings.
We have the basic nursing training which is run in a school of nursing, and through the Joint Admissions and Matriculation Board examination, you can study it in the university.
Whichever way, you must have the O’level qualification. That one is compulsory because, without it, you are going nowhere, and if you take the JAMB examination, you must pass it if you want to be offered admission. You need to get it right that if you are talking about auxiliary nurses, all these things I am telling you do not apply at all. So, it is not even necessary to compare the two.
An auxiliary (nurse) has nothing to do with professional nurses; they are incomparable. They are two things that do not match at all. It is an erroneous assumption that everybody in a white uniform is a nurse; it can be assumed by any individual.
It is like going to the hospital and saying that everybody in a white (uniform) is a nurse when you may not know that some of them are dieticians. You should not conclude that anybody who wears a white (uniform) is a nurse; that is a misnomer. The basic truth is that a professional nurse and an auxiliary cannot be compared.
Who certifies a person as a professional nurse?
Once a nurse has passed through the tutelage of education in a nursing institution and has professional qualifications, a regulatory body such as the Nursing and Midwifery Council of Nigeria needs to certify such an individual through professional examination where competency will be proved, and the person has to be qualified before they are registered and licensed. And then before they get to that level, they must have spent three years doing basic nursing. In a university, it takes five years before a person can get a certificate as a degree holder in Nursing Science, and when you see such a person in the hospital, you will know that they are professional nurses because of the areas of operation, disposition, and care. You cannot compare an auxiliary and a professional nurse.
Why then are auxiliary nurses prevalent in the country?
Anybody looking for cheap service will always go for unskilled service. If you are looking for something cheap, you will go to where you can get it cheap so that that person (offering cheap service) will not tell you what to pay or give you any condition; the person will be ready to take anything you give.
If you need such a service, you will go and pick it up and make use of it. You know Nigeria’s situation, especially in the health sector. You may notice that when we talk about the workforce, especially at the primary healthcare level, what is desirable is not there. So, as a result of that, there is a tendency to get what is cheap to get what is right done, and you will never get it right until it is right.
Why is it difficult to weed auxiliary nurses out if they are not important to the health sector?
They are human beings looking for what to eat. If they can give you what you want, you go for them. Some people establish clinics or hospitals and employ them without looking for professionals who were trained in school.
The Lagos state chapter of the NANNM issued a statement dissociating itself from the nurse who allegedly administered injection on a popular singer, Ilerioluwa Aloba, popularly known as Mohbad, before he died. What is your view on that?
The truth is anything that happens in a clinic or hospital, people ascribe it to a nurse or a doctor. It is when you get there that you will find out whether it is true or not. It is important to know that nursing is a medical profession. You cannot compare an auxiliary with a professional nurse because the scope of practice is different and you have to undergo transformative training to qualify as a registered nurse. Even when a person graduates from a university, they do not qualify professionally. They will still not be allowed to practice because they will be seen as quacks.
Once an issue comes up, and you know that the person involved is not a member (of the NANNM), the first thing is to write a disclaimer, do a press statement and exonerate yourself. Of course, when such a thing happens, you carry an investigation to actually establish the truth of what happens so that if there is any way to forestall a recurrence and if there is any way your member was involved, you have to ensure that such a person is punished to avoid a repeat of such. Human life is precious, nobody can joke about it because when you lose it, you have lost it.
Money cannot compensate for a life lost, and the economic consequences are enormous. So we do not encourage quackery and we make sure that quackery is not allowed to rear its ugly head.
Some people believe auxiliary nurses are trained to assist registered nurses…
It is not true. They are not trained to help any nurse. Private clinics can train them and use them because it is cheap labour.
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What is your association doing to check the use of auxiliaries in private hospitals and the impact it has on the profession?
Once the joint committee of the Nursing and Midwifery Council of Nigeria and the National Association of Nigeria Nurses and Midwives discovers that, they will make a formal report and engage the facility. The committee is in all the states in Nigeria, and we do not take it for granted. I also want you to know that every profession has an element of quack – Medicine, Law, even Journalism, because some people will claim to be what they are not. People can buy a lawyer’s gown and wig and claim they are lawyers and they will do what the professionals do and succeed, but one day, they will be caught. Some people even pose as military officers in military uniforms, but like they say, every day is for the thief but one day is for the owner.
We are doing a lot. Basically, in every state, we have a joint committee of the Nursing and Midwifery Council of Nigeria and the National Association of Nigeria Nurses and Midwives. What they do is to serve as vanguard to the issue of quackery and if anybody is reported, disciplinary action is taken against such a person once it is established that the person is a quack. We do not encourage quackery because people’s health is at risk. Somebody called recently about some nurses alleged to have false certificates in the United Kingdom, but I had to let the person know that in all honesty, we do not have any official report regarding that.
Recently, a victim of ‘one-chance’ robbers who was identified as Greatness Olorunfemi was reported to have been rejected by a hospital in Abuja before she died. Is your association also assisting in investigating the death of the lady?
What we are doing is, first of all, to get the necessary information surrounding such an incident. We have our members in all states, and in any particular state where we have any incident directly or indirectly, what we do is use a committee to establish what is playing out because sometimes, you may get information from any quarter, so you need to confirm that the information given to you is true or not.
We always require further investigation to establish the truth. So what we do is that at any time we receive a report of an incident, the first thing is to investigate the veracity of that situation, and whatever sanction or punishment that is due will take its shape. If it requires going to court, then it is taken to court.
We are not relaxing over such issues because of the sanctity of life and of course, to safeguard our name because when anything happens, you see people calling doctors and nurses without knowing whether the health worker involved is a doctor or a nurse until the truth has been established.
So, those who get such information should try as much as possible to get the facts because any information that is misrepresented causes more damage to the system and society. You have to be convinced that the information you want to give is verified. When you throw out information, it will go a long way and many people will pick it up. So, let us be sure of the facts before giving out any information. The media is also the vanguard of the nation, it is what you tell us that drives the direction of our action and thinking. So, I urge everyone to be sure of the facts to avoid causing more damage to the system.
How is the NANNM handling the depletion of Nigerian nurses who leave in search of greener pastures?
The japa syndrome is a thing of concern, and basically, it is because of brain drain, looking at the pull and push factors. The health sector is at a very challenging level. The condition of service is poor, the environment is poor, and so are the tools to work. Today, we are celebrating Nigeria at 63, but the question is: What is the situation in the health sector and other sectoral ministries like education, the judiciary, and agriculture? How far have we gone at 63? When the japa issue comes in, we are looking at welfare and socioeconomic conditions.
In commemoration of the nurses week in May, you said 75,000 nurses left the country within five years. What is the situation like now?
The truth is that almost every week, there are applications sent to the NMCN (by nurses) either to leave the country or be relieved of their duties. That is where to get reliable data. So, in essence, every week nurses submit applications requesting certification to travel or retire.
Some of your members complain about poor working conditions and blame it for the emigration of nurses. How is the association handling that?
Ours is to articulate a request and forward it to the government, and of course, the Federal Ministry of Health is our parent body. So, any information of such relevance that serves as a challenge from any facility to us will be sent to the ministry.
Have you been getting positive responses from the ministry?
Sometimes, there is what I will describe as a delayed response because one’s letter may be acknowledged, with a promise that something will be done, but if it is not done within weeks, it is as good as nothing.