UGONSA has written the Delta State government over the recent move by the State to start the controversial LCN programme. The letter, Ref No. UG/NAT/20/DSCOH/01 dated June 23, 2020, and titled, "BEFORE THE HEALTH SYSTEM OF DELTA STATE IS DESTROYED" was addressed to the Delta State Commissioner of Health and copied to the Governor and Director of Nursing, Delta State. Below is the full text of the letter:
Delta
State Ministry of Health,
Asaba,
Delta State.
Sir/Madam,
BEFORE THE HEALTH SYSTEM OF DELTA
STATE IS DESTROYED
We
warmly extend to your person and esteemed office the Nightingales' greetings
from the leadership and members of the University Graduates of Nursing Science
Association (UGONSA), the professional association of nurses with a minimum
qualification of first degree in nursing.
2. The news reaching us that the Delta
State Ministry of Health (DSMOH) under your able watch is planning to introduce
a Licensed Community Nursing (LCN) programme in the State prompted us to write you
to give you insight on the dark sides of the programme lest it further dilutes
the health system of the State.
3. We make haste to reach out to you
because we believe you must have been misled by the faulty circular on the LCN
programme, Ref No. N&MCN/SG/RO/CIR/24/VOL.4/152 dated March 3, 2020, which
emanated from the Nursing and Midwifery Council of Nigeria (NMCN) (marked and
attached as Annexure A). The circular falsely alleged that the reason the
council was introducing the LCN programme is that there is a “gross shortage of nurses” occasioned
by a mass migration of Nurses & Midwives to urban areas and other countries.
This incorrect statement is capable of deceiving any well-meaning person and
the unsuspecting public on the issue of availability of nurses for employment
in our health system.
4. One thing with nursing is that it is
very complex and forms the nucleus of healthcare delivery be it medical,
surgical, psychiatry, rehabilitation, palliative or, any other type of care. Such
a complex role can only be handled efficiently and effectively by sound brains
which the existing nursing programmes attract and parade in adequate numbers
and not daft school leavers which the purported LCN programme seeks to flood
nursing with.
5. The
existing nursing training in Nigeria meets the best international standard and
verily equips the Nigerian nurses with the necessary knowledge, skills and
latitude for critical thinking, clinical reasoning & judgment, and the
clinical competence to play and coordinate independent, dependent and
interdependent roles in the healthcare delivery system anywhere in the world.
Hence, when they migrate outside the country they are able to fit in and perform
excellently well in the health system of the developed world such the US,
Canada, UK, Ireland and so on, where our political class throng for treatment
for lack of confidence in our own health system. What this shows is that the
Nigerian nurses are not the reason our health system is backward but the faulty
system and faulty policies such as this misguided introduction of LCN programme.
6. The LCN programme primarily seeks to lower
the existing standard of nursing education via the introduction of a 2-years
programme for a lower cadre of Nurses with having a very poor O’level result
(.i.e. at least a credit in English and Biology) being the principal admission
requirement. Contrasted with the current situation for the existing nursing
programmes in the schools of nursing and the departments of nursing in the
university where entry requirements of five credits in English, Maths, Biology,
Chemistry and Physics is the basis for admission you will understand that the
LCN is nothing but a fig tree to hand over the complex roles of nursing to
individuals that have limited mental capability to carry out such roles when we
have enough qualified unemployed nurses and midwives currently roaming the
streets in search of nursing & midwifery jobs.
7. That the NMCN issued the LCN circular on
a false and faulty premise of “gross
shortage of nurses” has been attested to by series of empirical facts.
Mounting evidence shows that unemployed nurses and midwives are in excess and
want to be employed and deployed to rural community settings. For example, a
study conducted by this association (marked and attached as Annexure B) showed
that at least 41% of Nigerian Nurses & Midwives produced in a session
remain unemployed, and 95% of them are willing to work in the rural community
settings if given the opportunity. Again, the National Association of Nigerian
Nurses and Midwives (NANNM) Delta State Council in her enumeration of
unemployed nurses and midwives of Delta State origin found that about 1500
nurses and midwives of the State origin are unemployed (kindly refer to the
report marked and attached as Annexure C).
8. From the foregoing, you can see that the
problem is never a shortage of qualified nurses and midwives for employment but
a gross shortage of opportunity for them in our healthcare delivery system even
in rural community settings.
9. On this note, we respectfully admonish
that you should jettison the negative deception of the NMCN LCN circular and
move to positive a direction that will strengthen the root of the healthcare
system which is shaky everywhere in Nigeria (and not only in Delta State) by
creating employment opportunity in the rural communities for the teeming number
of unemployed nurses and midwives of Delta State origin with commensurate
motivation of rural posting allowance.
10.
Furthermore, in the spirit and letters
of the task-shifting & task-sharing policy and to ensure that highly
skilled and competent nurses that have diagnostic and prescriptive authority
are available all the time in the rural communities, we recommend and urge that
the Delta State Ministry of Health (DSMOH) partners with the NMCN and the
departments of nursing in the universities offering nursing in Delta State to
create an Advanced Practice Registered Nurse Programme (Nurse Practitioners’
programme) for the holders of Bachelor of Nursing Science (BNSc) degree who
majored in Public health nursing awardable and licensable via a masters’ degree
in Community Health Nursing (Please kindly
refer to page 14 of the Task-shifting & Task-sharing policy document on Recommendations
on the Service delivery at the Community Level hereby marked and attached as
Annexure D).
11.
Having Community Health Nurse
Practitioners working in association with Community Health Physicians in the
rural communities of Delta State for prompt diagnosis and treatment of diseases
& illnesses, as is obtainable in developed countries, will go a long way in
changing the narratives of inadequate healthcare coverage bedeviling the rural
communities.
PRAYER
The good people of
Delta State deserve to be cared for by educated, well-trained, competent, and
highly skilled nursing workforce and their health and well-being should be the
priority of the State government. Therefore, we respectfully demand that the
DSMOH
I. totally stops its voyage into the
training of the so-called LCNs which portends entrusting the lives of the good
people of Delta State unto the care of the weakest brains among the secondary
school leavers. Nursing is a complex profession that deals with human lives.
Those whom people’s lives are entrusted unto their care must have the requisite
mental capability and must be well educated, trained, skilled and competent to
carry out such tasks effectively and efficiently.
II. starts recruiting and deploying to the
rural community settings at least 100 (one hundred) Registered Nurses and
Midwives including those with BNSc degree every year to boost the availability
of skilled nursing workforce in the rural areas.
III. liaise with the NMCN and the
universities offering nursing in Delta State to start offering Masters’ degree
in Community Health Nursing leading to licensure as Advanced Practice
Registered Community Health Nurse (.i.e Community Health Nurse Practitioner) who
will work in association with Community Health Physicians to diagnose, and
prescribe treatments for common diseases and ailments in the rural community
settings in the spirit and letter of the task-shifting & task-sharing policy.
Submitted with deepest
sense of respect and responsibility.
CHIEF
(HON.) S.E.O. EGWUENU NURSE P.O. ETENG
National President Ag.National Secretary
CC:
Director, Nursing Services Delta State.
His Excellency,
The Governor of Delta State.
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