Nursing Profession in Nigeria: The Long Road to Recognition

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The struggle to give nursing and nurses the professional recognition they deserve in the country has been a protracted one. At the beginning of the struggle, efforts were made to look inwards and identify the inherent professional factors in nursing, which could be put forward to the government for proper professional recognition and placement. Efforts were made to convince the government that nursing in Nigeria meets the established criteria for classifying a line of work as a profession. These include:

The profession has a special body of knowledge acquired through a long period of recognised educational programme, on which its skills and services are based; and continually expands this body of knowledge through continuing investigation, analysis and research.

NANNM President, comrade Abdrafiu Adeniji

The profession has a service orientation or concern which provides some needed unique services to the people which cannot be given by everybody (expertise).

The profession establishes and controls its own polices and activities. It is self-regulating with its practitioners in full control of their functions and services which are standardised by its code of ethics in the interest of the consumers; who experience and declare the quality of such services (Autonomy).

The profession has an association (to which all practitioners belong) to monitor, foster and ensure quality of education and practice as well as representing the members in negotiating condition of services and social wellbeing.

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Roy Bixler (1981) in agreement with these criteria, observed that a profession’s integrity is in its power to formulate provisional polices and control of professional activities.

Nursing education

On nursing education, it is not only of long duration but also at higher educational level. For schools of nursing, the period is 36 calendar months. For university-based nursing education, the duration is five years. Pratt (1968) relating education to standard, submitted thus: “It was realised that to raise the standard of nursing and to meet the increasing scientific knowledge and ever changing needs of the community, candidates with broad educational background, intellectual ability, technical dexterity and emotional stability are needed to meet the challenges not only of the present, but of the future”. This led to the review of basic nursing curriculum to include some general knowledge and social and natural science subjects.

In September 1964, the Department of Nursing at University of Ibadan was founded. Admission of the first set of students for the Bsc. programme was conducted in September, 1965. This was the first indigenous entry into university education in Nigeria. It is pertinent to mention here that educational advancement for professional development requires professional association in the frontiers of the struggle for professional emancipation. The birth of National Association of Nigeria Nurses and Midwives (NANNM) in 1981, led the struggle for recognition of the professional status of nursing.

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The above measures and more were put in place to improve the standard of nursing service delivery system and establish professionalism of nursing in Nigeria. This recognition of nursing as a profession was concretised and epitomised by the Industrial Arbitration Panel (IAP) award declaration of 1981, which states: “Nursing is a profession ‘sui’ generis, subject to no directions or control whatsoever by any profession, except in so far as it forms part of the organic whole”.

Threats to full recognition

With this award and recognition of nursing as a full-fledged profession, the implementation which would have redressed the lingering relegation of nursing and inappropriate remuneration of nurses, was expected to follow smoothly in Nigeria. Disappointingly, however, this never happened. Instead, various antics to make the award redundant started coming from government officials.

For instance, the recommended appointment of a director of nursing services (item 5 of the IAP ward) was made to be at the pleasure of the Minister of Health. NANNM was at a time informed that: “a nurse can be promoted to the post of director but the minister has the prerogative to organise the ministry to suit his Administration.”

In 1991, Professor Olikoye Ransome Kuti, the then Minister of Health restructured the ministry of health and scrapped nursing division on the grounds that he could not see the need to separate nursing from medicine.

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The same year, under Prof. Kuti, the Ministry of Health wrote a letter to the executive secretary, National University Commission, to stop designing or approving university degree programmes for health professionals (including nurses) other than medical doctors.

In addition, the needed professional scheme of service which would have adequately addressed items 3 and 4 of the award was always being checkmated by government officials. Thus, since the struggle seemed not to have been resolved by the IAP award, the legal tussle was taken to courts of competent jurisdiction. Thus in 1981, 1999, 2010 and 2012, respectively, there were nine judgments that consolidated the professional status of nursing in Nigeria.

Nurses therefore continued to express their frustration to the extent of being seen as perpetual complainants against professional injustice. The struggle for full implementation of the award took centre stage, with frequent trade disputes and strained industrial harmony in the health sector. This no doubt continued to have negative effect on nursing service delivery system, with nurses’ image at the receiving end. (Continues next edition)

By Comrade Nurse Abdrafiu Alani Adeniji

(National President, National Association of Nigeria Nurses and Midwives)

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