WHY NURSING IS A CHARITY WORK IN NIGERIA
By Ikechukwu Ogbu
A story is told by Moses Iorapu of Hilary Clinton’s visit to the Asian country of Parkistan. Hardly had her convoy passed through the ghetto part of the country than she saw shiny beautiful sheets hanging infront of the houses on clotheslines apparently to cover the shame of poverty in those slums. Then, suddenly, a strong wind blew away the sheets and Clinton saw the fowl’s rump: horrifying scenes of poor children with swine on a refuse dump, and emaciated dogs scrambling around piles of garbage. There was a man picking “edible” on top of the refuse dump. A nurse poet had said, “The man was many years pregnant of worms.”
Nigerian nurses have remained hidden behind the clotheslines with beautiful smiles amidst excruciating pains of toothache and an impending tooth decay. The public see just this beautiful clothesline and this accounts for the increased number of innocent minds scrambling to gain admission into nursing schools or universities to study nursing. Some men masquerading as husband materials would also express affection to a nurse in order to lure her into the marital home and take the advantage of her caring services as well as her very meagre financial reward. My point here is obvious: the salaries of a nurse is an insult over the kind of services she renders, even as a professional that he or she is. When some courageous nurses decide to go the way of pen and others, the way of strike, the result is always a dismal picture, so fragile under some agile feet that have suppressed us to almost suffocation. And again, when we are set to tighten a noble screw, some colleagues are already loosening from the other end. This has been the outcome: a smart exercise of fetching water with a basket.
Nursing came to the world as Charity, but later, the modern man would think of advancement and so, in 1981, the Industrial Arbitration Panel awarded nursing the legal status of a Profession. Since the creation of the world that nursing began up to the times of Florence Nightingale in the 1880s that the modern nursing took a noble dimension, it was just in 1981 that nursing was recognized and awarded a profession. From the tender hands that would first open the eyes of a baby at birth to the very hands that would last close the eyes of a man at death, we should know how noble nursing is and how this nobility was not just recognized lately, but also, still groveling on the earth, struggling to eke out a bare existence in the arid soil of the Nigerian culture.
In the Nigerian healthcare industry, there is a system that calls for reflection. Whether it is a revolution, evolution or a conspiracy of silence, the trend is a caricature of healthcare management and its attendant politics. No matter how educated a nurse is, s/he is not allowed by the health policies of the Nigerian government to head a government hospital let alone heading the health ministry, even these days that professors of nursing are erupting and glowing like academic seraphs. However, among nurses too and in nursing, there’s a great discrepancy in the incorporation of some extra nursing educational programmes. For instance, law, political science etc have no significant place in the nursing profession that would have hitherto needed them to make a paradigm shift.
In the health sector, doctors are always incharge. Whether the stethoscope is behind their neck or resting on their chests, they are always the boss of all bosses. This is not just the ca#se as they will bravely argue that long duration in the university alone is a prodigious step for them to ascend the throne of any healthcare facility no matter whose horse is gored. The condition of a nurse is quite pitiful in Nigeria and the regulating body is even multiplying the problem especially in their recent gross increment in the requirement of a nurse who wants to fly abroad and practice, instead of finding solutions to bridge the heaving gap, discrimination, degradation and intimidation meted out on nurses. A young man struggles his way into Nursing school to gain a certificate, “Registered Nurse (RN)” that can neither be at least equalled to HND nor OND. He spends three giant years (3 years, if his school has no problem of accreditation, unlike some of us who spent 4 years while other colleagues, 5 years) to get this. As promising and ambitious as he is, he either goes for a post basic course where he would spend at least one year before enrolling for his degree program that would cost him not less than 4 years and at least, 2 years in other countries including Ghana. That is, to bag a common degree in nursing from passing through nursing school, the nurse must spend a minimum of 7 years before talking about any other programme. If he decides to go directly into the university to study nursing for 5 years and spend one year as a NYSC member, he would eventually face the discriminating problems of salary and job placement whereby some hospitals would like to employ specialist nurses or nurses who have gone through nursing school because they’re thought to be elegant in clinical practice. This stack reality is in the labour market and not experienced or taught in the classroom. At the end of the day, he spends a good number of his lifespan in school only to be bargained for peanut pay by the doctors who spend 6 years in school. As appalling as this could be, the pay of an Assistant Director of Nursing Services in Nigeria is not up to what a young boy who is newly employed as a doctor earns monthly.
Some nurses will go shouting at this, but no doubt, nursing made nurses and nurses are marring nursing by way of our negative image projection, relationship with junior colleagues and students and our non participation in politics etc. For instance, the champions of quackery in the nursing profession in Nigeria are well educated nurses who have clinics and doctors who have hospitals. There is no strict task force unit (if there is at all) in the Nursing and Midwifery Council of Nigeria to set out and fish these so-called auxiliary nurses masquerading on white uniform. No! The regulatory body will not do it because most of the members are victims of what they preach against. When the public eventually see these species of quack nurses practising and going against some standard ethics, they will therefore, resort to a fallacy of hasty overgeneralization whereby all the nurses are thought to be the same.
Some wise doctors have discovered that the hospital can run smoothly even in their absence, but can’t run in the absence of a nurse. This is the reason why they would employ male nurses for consultation jobs but will not pay them as consultants. Some nurses who have learnt earlier of how charitable their work is go off the lane of dependent practice to build a health empire whereby doctors would be working for them. These set of nurses realised earlier that to make it unto the upper class of the socioeconomic stratum without butchering the ethics of the profession and moral standards with vicious knives, one needs to have a deep business acumen, otherwise, nursing profession continues to be “oke aha n’egbu nwa nkita”- a big name that kills a puppy.
To move on to the fore with scintillating swags and make a massive and drastic change, we must subscribe to the voice of our founding lady, Florence Nightingale:
“The world of progress is divided necessarily into two classes: those who take the best of what there is and enjoy it; and those who wish for something better and try to create it.”