‘All auxiliary nurses are quacks’
Alhaji Faruk Umar is the Registrar, Nursing and Midwifery Council of Nigeria. In this interview, he speaks on the need to establish more schools of nursing and midwifery in the North, the regulatory activities of the council, and the use of auxiliary nurs
Can you tell us the number of nursing and midwifery schools in the country?
There are about 209 of them regulated by the Nursing and Midwifery Council of Nigeria. There are 126 schools in the south and 83 in the north.
The total approved slots in the 209 schools is about 8,485. Out of this number, 4,995 is from the South while 3,490 is from the northern part of the country. Twenty-five schools are embargoed in the south and two in the north.
It is no gain saying that the southern part of the country is more advanced in terms of Western education and has more schools of nursing and midwifery. The council is ready to accredit more schools of nursing and midwifery. The admission quota has been increased to 100, and is based on how an institution meets the requirements including having a hospital, manpower and infrastructure and other guidelines.
There is need for northern states to establish more schools of nursing and midwifery. This would help provide the needed manpower for healthcare in the states, complement government efforts as well as bridge the gap between the number of nursing and midwifery institutions in the southern part of the country compared to the north.
If any state is interested in establishing a new school of nursing and midwifery, we give it the guidelines, and if it meets up, there is nothing that will stop the council from giving the institution accreditation. Also any state that makes request for 50 admission slots for instance, in an institution, we will assess it based on the availability of man power and infrastructure and if it meets the requirements, we give the allocation.
There is need for more nurses and midwives to work in the communities, and this can only be achieved when more indigenes are trained through the institutions in their areas.
There is also need for well to do individuals and faith organizations in the north to establish hospitals which would in turn help in the establishment of Nursing and Midwifery institutions.
Only Kaduna, Benue and Kogi have faith based Nursing and Midwifery institutions while those in the remaining 16 northern states are all owned by the government. This is unlike the southern part of the country where some are owned by faith based organizations.
What is the number of registered nurses and midwives in the country?
As at the middle of June this year, we had 173,574 registered nurses and 114, 468 midwives in our register. So if you add them together, that will give you 288, 042 registered nurses and midwives in our register. The numbers continues to grow on daily basis as more people register.
In terms of the training, an average of about 5,699 nursing ( general nursing and post basic nursing) are produced annually while about 2, 696 midwives (this includes basic, post basic and community midwifery) are produced averagely annually. So if you add them together, you will have an average of about 8,395 nurses and midwives produced annually in the country.
It also depends on the numbers of nurses and midwives that registered for exams because we usually have exams four times in a year, two for general nursing and two for midwifery.
What is the criteria for denying a school of nursing and midwifery accreditation?
We have a check list for accrediting institution, such as man power, infrastructure, library, transport utility services, hostel accommodation to mention a few.
Any institution that cannot score 50% from the checklist, loses accreditation. Some institutions lost accreditation because they lack a hospital; you need both theoretical and practical training. The hospital should also be worthy to provide training. The hospital should have nothing less than 250 beds.
Many private hospitals in the country particularly small ones utilize the services of auxiliary nurses. Does your organization regulate them?
There is nothing like auxiliary nursing. When you say auxiliary nurse, it refers to a quack. We don’t recognize them and they are a threat to the health of Nigerians, and the nursing profession in the country.
As far as we are concerned, any hospital operating with auxiliary nurses, is operating with quack nurses, because they are quacks. They are not competent, to deliver nursing care and members of the public that access services from such hospitals are doing so at their own risk.
Hospitals are supposed to ensure that nurses are qualified, registered and licensed to practice as nurses. If you want to set up a hospital, you send the list of nurses to our organization, we then send our officers to verify, because we have verification offices which verify whether a person is qualified to practice or not.
Also trained nurses are issued practicing licenses. A practicing licensed lasts for a period of three years, and before the expiration ,the nurse is expected to undergo a mandatory development program which is attached with a two credit unit. You must attend it before your license is renewed after three years, at least then your knowledge is updated and you will have the current skills to improve your capacity and productivity at the hospital level.
Do you have any penalty for some of these hospitals employing them because even some big hospitals employ them as their salaries are usually a lot smaller than those of qualified nurses?
Of course there are penalties because the law clearly states that if you employ somebody who is unqualified, you are liable to be charged to the court of law. Even if you employ or practice as a quack , you are also liable to be punished under the Act of the Nursing and Midwifery Council of Nigeria.
Some hospitals claim they train the auxiliary nurses on the rudiments of nursing. Some doctors who also work in public hospitals and own private clinics, leave the care of Nigerians to these auxiliary nurses after ‘training’ them?
It is an illegal training because they don’t have the power to train them as nurses. A doctor in a hospital has no power to train a nurse. Nursing is an independent profession that cannot be trained by another profession, and we have our own ethics.
If a doctor establishes a hospital and begins to train people on nursing, he has bridged the law of nursing in this country.
One of the council’s major challenges is the lack of man power. With enough manpower, we will go round to check all the clinics and hospitals.
We have been trying to strengthen our six zonal offices basically to check these domains and report to us. We will then liaise with relevant security agencies to crush the quack nurses.
Also, the council’s act has provided that at the state level, the directors of nursing services are the state directors of nursing and midwifery committee which is empowered by the Nursing and Midwifery Council to control nursing activities within the state level.
So it is within their domain to check the excesses of these hospitals, and if they see that something has gone wrong, they should report to us.
We are working towards partnering with relevant security agencies to flush out these quacks. We will soon embark on ‘Operation show your license at both the private and the public sectors’ and will charge those found wanting.
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What are you reposition the council?
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The Nursing and Midwifery Council of Nigeria is under the Federal Ministry of Health, and responsible for regulating nursing education and practices in the country.
I am trying to ensure that the statutory responsibilities of the council are up to date. I am also working towards strengthening services to ensure it is effective and productive, in terms of the accreditation of institutions.
I also ensure that practicing licenses are issued on time, and ensure mandatory continuous vocation development program so that nurses and midwives have current and update knowledge in line with global norms.
We are trying to strengthen our activities so that more schools of nursing have manpower development, and infrastructural development so that they can increase their slots.
Do you find problems with Nigerians who study nursing and midwifery abroad or even in other West African countries, when they come to practice in the country?
We don’t have issues as far as foreign training is concerned but we regulate to ensure that the person is competent, and capable of delivering nursing care in conformity to the norms and ethics of the Federal Republic of Nigeria. Then we register and licensed you to practice.
If you are trained outside this country, it is not within our requirement to regulate the institution but first and foremost, we find out if the university you are trained in is accredited by the Federal Ministry of Education .
If the institution is not accredited by the Federal Ministry of Education, we don’t have any legal right to accept such a person into our own process.
Secondly, we expect the institution where you are trained to send your transcript to us, we will now request the ministry of education to interpret if it’s a French country, the Ministry of Education will interpret and tell us the status of that particular training.
There are two categories. For the first category, there are countries that have regulatory bodies like ours, if you undergo training in a country that has a regulatory body, and have been registered and licensed in that particular county, then we will set an exam and interview for you. We then send you to any of the hospitals of your choice for three months’ orientation so that you acquaint yourself with the norms and rules of the Nigerian system.
For the second category, all countries with regulatory bodies on nursing are all members of the International Council of Nurses, ICN. So if you train in a country where there is no regulatory body, then the training is not within the global acceptable norms.
We send such persons to any school of nursing of their choice in the country so that they have orientation in the hospitals affiliated to the schools. They are supervised for 18 months and thereafter seat for examinations. If they pass, we then register them as nurses to work in Nigeria.