Japa: Nigerian nurses, NMCN bicker over new verification policy
Nigerian nurses are currently agitated over the new circular by the Nursing and Midwifery Council of Nigeria, NMCN, which revised the guidelines for requesting verification of certificates for nurses and midwives to foreign nursing boards or councils.
They are demanding a review of the circular’s contents to avoid a situation where nurses’ progress and development are subjected to other professionals’ determination.
The development is coming amid poor healthcare infrastructure, funding, welfare, and working conditions in the health sector.
the revised guidelines for requesting verification of certificates for nurses and midwives come amid the mass exodus of healthcare professionals, especially doctors, pharmacists, and nurses, which has been a burning issue in the country.
Recently, brain drain has become a serious challenge in Nigeria’s health sector, with the nation losing healthcare workers in droves to other countries.
This imminent crisis has overwhelmed government authorities, with no plan to tackle it wholesomely.
The NMCN on Tuesday disclosed that over 42,000 nurses have left the country in the last three years to seek greener pastures in foreign countries. According to the council, over 15,000 nurses left Nigeria in 2023 alone.
Recall that earlier last year, the MDCAN disclosed that more than 100 members left the country within 24 months.
In addition, health officials say at least 5,600 Nigerian medical doctors have migrated to the United Kingdom (UK) in the last eight years.
Though complex and multifaceted, some factors, including low salaries, poor working conditions, lack of career opportunities, inadequate resources and infrastructure, political instability, and insecurity, have been attributed as the underlying causes.
Many have also blamed poor health sector funding as one of the reasons professionals are leaving the country, noting that the Nigerian government allocated less than five per cent of its annual budget to the health sector.
Seemingly worried by the imminent threat of brain drain in the nation’s health sector, the NMCN introduced revised guidelines for verifying nursing certificates to address the crisis.
The NMCN had, in a recent memo dated February 7, 2024, outlined the revised guidelines and requirements to be met by all applicants seeking the verification of certificate(s) to foreign nursing boards/councils.
It said that applicants seeking verification of certificates to foreign nursing boards and councils must have two years of qualification experience and pay a non-refundable application fee.
The memo signed by the Registrar/Secretary General of NMCN, Dr. Faruk Umar Abubakar, was sent to the Commissioners/Secretary of Health Services; Chief Medical Directors/ Medical Directors; National President; Directors of Nursing Services; Heads of Department; Provosts & Principals; Coordinators; Zonal Officers; All States Ministry of Health & Federal Capital Territory, Abuja; University Teaching Hospitals/Specialist & Federal Medical Centre and National Association of Nigerian Nurses and Midwives, National Headquarters, Abuja.
The circular was also sent to the Ministries of Health, Hospitals Management Boards, All States & Federal Capital Territory; All Universities Offering Nursing Programmes; Colleges of Nursing Sciences, Schools of Nursing & Midwifery, All Post-Basic Nursing Programmes; All Nursing and Midwifery Council of Nigeria Zonal Offices.
It provided that, “Eligible applicants must have a minimum of two (2) years post qualification experience from the date of issuance of the permanent practising licence. Any application with a provisional licence shall be rejected outrightly.
“The Council shall request a letter of Good Standing from the Chief Executive Officer of the applicant’s place(s) of work and the last nursing training institution attended, and responses on these shall be addressed directly to the Registrar/CEO, Nursing and Midwifery Council of Nigeria. Please note that the Council shall not accept such letter(s) through the applicant.
“Applicants must have an active practising licence with a minimum of six months to the expiration date. Applicants must upload Certificate(s) of Registration only. Notification of Registration is not acceptable.
“The applicant shall receive prompt notice via his/her email and dashboard on the status of the verification application.
“Please note: Processing of verification application takes a minimum of six (6) months. All applicants shall ensure that complete requirements are met before initiating verification application as incomplete documentation shall not be processed.”
NMCN is the only legal, administrative, corporate and statutory body charged with performing specific functions on behalf of the Federal Government to ensure the delivery of safe and effective Nursing and Midwifery care to the public through quality education and best practices.
The council was mandated by law to regulate the standards of Nursing and Midwifery education and practice in Nigeria and to review such standards from time to time to meet the changing health needs of the society.
However, there are indications that nurses and other health workers have kicked against the new development, insisting the guidelines and requirements are typical of a denial of human rights.
The health workers stressed that there had never been any occasion where regulatory bodies asked for work experience or mandated years of service as a condition for verification.
As a protest against the policy, the nurses, under the aegis of the National Association of Nigeria Nurses and Midwives, NANNM, Abuja and Lagos chapters, recently took to the street to express their disapproval of the new circular on certificate verification NMCN.
The nurses converged on the NMCN’s offices in Abuja and Lagos to express their dissatisfaction. They threatened a nationwide strike, describing the new guidelines as an effort to hamper their freedom.
The nurses and midwives were at the NMCN office protesting, singing, and carrying placards peacefully around the premises.
Some of the placards read, ‘Address unemployment among nurses, address quackery, address nurses welfare’.
Others are: ‘#No to verification rules,’ ‘Stop frustrating the Nigerian nurses,’ ‘We are going through a lot already, Protect nurses, protect healthcare,’ ‘NMCN, we say no to the verification rules,’ NMCN don’t reduce nurses.’
Meanwhile, some others took to social networks to protest against the policy.
For instance, a public health nurse, identified as @DTechNurse on X, said, “It is absolutely wrong to attach Nigerian nurses’ verification conditions to Chief Executive Officers who are always Medical Doctors.
“Nurses now await the approval of a medical doctor before they can make progress in their career. This decision has to be reversed.”
Also, @AlongeElijah wrote, “Nonsense!!! This is a denial of human rights, and it shall be informed to @ICNurses @WHO @UNHumanRights. Haven been verified by different nursing bodies around the world. There has never been an occasion where regulating bodies asked for work experience or mandated years of service”.
While reacting, the body of Heads of the Nursing Services Department and Principals of Schools in Federal Health Institutions (BOHNAPFHI) urged the Council to review the guidelines and delete any item likely to frustrate early verification of the licence issued to professional nurses by NMCN.
In a letter signed by its Chairman, Dr. (Mrs) Awoseemo Aderonke, addressed to the Registrar/Secretary General of NMCN, the association urged the council to review some contents of the circular to avoid a situation where the progress and development of nurses were subjected to the determination of medical doctors or other professionals.
According to the group, “verification of license issued by NMCN is to ascertain whether the one presented by the applicant is issued by it and not fake, stressing that it should have nothing to do with either character or working experience of the applicant.
“I am directed by the body of the Head of Nursing Department and Principals of Schools in Federal Health Institutions (Basic and Post) in Nigeria to request and urge you to review some contents of the circular to avoid a situation where the progress and development of Nurses are subjected to the determination of medical doctors or other professionals.
“Thus, affirmation of the character of graduands has to be attended by the head of the training institution, who is a professional nurse. While the license to practice should be verified by the issuer, that is, the Nursing and Midwifery Council of Nigeria. (NMCN).
“We would appreciate it if you could further review the guidelines and delete any item likely to frustrate early verification of the licence issued to professional nurses by NMCN. It is our opinion that verification of the license issued by NMCN is to ascertain whether the one presented by the applicant is issued by the NMCN and not fake. It should have nothing to do with either the character or working experience of the applicant.
“In addition, we humbly suggest that the NMCN should endeavour to carry nurse leaders along when taking such salient decisions in order to prevent regression.”
Over 42,00 nurses left Nigeria in three years – FG
Meanwhile, the Nursing and Midwifery Council of Nigeria has said that over 15,000 nurses and midwives left in 2023 to seek greener pastures in foreign countries.
The registrar of NMCN, Faruk Abubakar, made this known on Tuesday on Channels Television’s Morning Brief while fielding questions about the controversial new guidelines.
Justifying the revised guideline for nurse’s verification, Abubakar said the number of nurses leaving the country increases yearly.
“42,000 nurses left the country in the last three years. Last year alone, it was over 15,000; the number is increasing yearly”, he said.
When asked what the Council was doing to protect and improve the welfare of the nurses, he said the Federal Ministry of Health was working towards improving the nurses’ working conditions, allowances, and salaries.
“The FMoH and the honourable Minister of State (for health) are working hard to ensure a conducive working environment, providing state-of-art equipment and instruments to help them provide quality care for Nigerians.
“And I want to assure (you) that within a couple of months, a lot has been integrated and provided in 2024 that will improve the welfare of the nurses we are talking about. When talking about the salary they are talking about, I think it’s a general phenomenon, and I believe it’s a general thing.
“There is a lot of progress going on to review the salary, and nurses are also included in that policy. I think it’s a general phenomenon; all other sectors are also complaining, and the government is doing a lot,” he stated.
Dr. (Mrs) Awoseemo Aderonke, the Chairman of Nursing Services Department and Principals of Schools in Federal Health Institutions, BOHNAPFHI, said her association was more worried by about the issue of professional autonomy.
Aderonke said the issue of asking for the certificate of character from the medical doctors hasn’t gone down well with BOHNAPFHI, adding that the development could take the nursing profession back to the stone age.
She suggested that even if there’s a need for such a recommendation it should be from a training institution.
According to her, there were steps that could be taken to ensure that the nation retained its young ones in the profession in order to serve their nation.
She said: “You know the group is the group of leaders in nursing, both in practice and education, for those of us that work in federal institutions in Nigeria. So it’s a group of my people, it’s a group of leaders that are ready to ensure that we uphold the standard of nursing profession and plan for better life for the younger ones and the future generations.
“Actually, I will say we are a body and we have an association, we have the umbrella association which is supposed to be the National Association of Nigerian Nurses and Midwives.
“And we have a branch of it that covers the federal health institutions. So the president and the chairman of those groups have been informed. They were copied concerning our own view as nurse leaders in federal institutions both in nursing practice and education.
“We don’t want to exceed anything outside our paper because very soon we are going to hold our meeting, our conference.
“And when we hold our conference, we will come up as a body to look at issues, because the interest of everybody and interest of the Registrar of Nursing and Midwifery Council of Nigeria, NMCN, and the entire nurse leaders is to ensure that the people – the citizens, they get the best at every point in time.
“With that at the back of our mind, I believe there are steps that could be taken to ensure that we are able to retain our young ones in the profession in order to serve their nation.
“The only issue that is being stressed by my own association is the professional autonomy because when they talked about Chief Executive Officer, CEO, and looking at Nigeria, the CEO in federal institutions for now are medical doctors.
“We are convinced and we know that the operation of our amiable Registrar is to ensure reforms and professionalism of nursing to get better on a daily basis because he has come up with many reforms, which we believe, every member of my forum will always drop caps for this action of the man.
“So, the issue of asking for the nurse’s character or certificate of character from the medical doctors doesn’t go down well with us because we cannot take our profession back to the stone age.
“Moreover, the nurses prepare these people. It’s expected that the head of the training institution, either the head of nursing department or nursing science department in our universities or the head of program in each of our various colleges of nursing sciences and principals of schools – are the one that are expected to comment on their character.
“What we are actually talking about is the verification of certificates. For you to have that certificate, you are expected to have gone to a certified training school, well accredited.
“When we talk about accreditation, we talk about all the resources in terms of personnel and infrastructure and all things that are there. And since they are adequate and the person is presented for the professional exam, and the person passed – the professional exam we are talking about is being organized by the Nursing and Midwifery Council of Nigeria with the help of leaders in nursing education and practice, that means everything about it is about nursing.
“It’s expected that even if there’s a need for such a recommendation, it should be from a training institution. That’s what we are really emphasizing.”
Suggesting further on how the profession could retain its best, Aderonke said, “Another aspect of it I want us to talk about that we mentioned in our letter is that the Council has the responsibility to verify certificates; it’s the Council that issues the license and certificate. That means it is the issuer that has those responsibilities.
“The emphasis of our leaders, yes, we have the concern of our community.
“It is a personal decision, either for you to stay or want to go. I don’t believe you can coerce people but people can be encouraged in many ways. People can be motivated in many ways to stay. And part of the motivation is this professional autonomy that we are talking about.
“We can’t sell professional autonomy out. We can’t trade with it because that is what we have been doing and building in order to ensure that nursing as a profession also stands out as one of the best professional groups in the nation.
“I believe there will always be a way out. Yes, the interest of our people is very important, it’s dear to us. I know some people that are just encouraged that they want to stay. There are people that even traveled and they came back again, and they were able to bring the skills they acquired there for the benefit of the community.
“I think as we talk about the freedom of movement, if we put in some things to motivate them, to encourage some people, they could even say, ‘I want to go in the next two years’. When you’re being motivated, you can say ‘Okay, let me spend five years serving the land for me to go and explore’.
“This is what we are saying. Actually we are not attacking the Registrar. The Registrar is very amiable. He’s a man that listens to advice. But you know as leaders, sometimes you make decisions, you may look at things from different dimensions.
“That’s what we are battling with, even in education; people don’t want to come into academics again because there’s nothing really much motivating them. It’s not easy. If you go to many of our institutions now, many of our educators, for us to get lecturers, it’s not an easy matter.
“I believe if we have this motivation, when they go for workshops, you sponsor them. When they have to go for training – things that will develop them, you give them necessary support. Nobody will look out for other things.
“If you look at our country Nigeria, we are so much blessed. Look at our weather, climate and many other things. Look at our social setting – you rarely see people getting crazy, except some people that go into addiction or whatever. Because if I have something bothering me, I have somewhere to ventilate, you know, my colleagues will advise me.
“The federal government, state governments, private sector, and all the groups should motivate their personnel, not only the nurses but even the medical persons.
“When they are working with them, they need motivation. Everything is not about money; people need fulfillment. Yes, money is also very important to take care of your basic needs.
“Look at the situation of things in the country today but salaries still remain the same. The government should keep them motivated and accord them the honour.
“With this, one may not even feel the need to go out. The only thing that can take them outside the country is to acquire more skills to serve their community.”
Meanwhile, some members of the National Association of Nigerian Nurses are accusing the president of the association, Mr Michael Nnachi of compromise.
