I have read quite a handful of stories about unfortunate and preventable deaths in our hospitals, both private and public. Some have touched me personally, especially when it involves a pregnant woman, or a young promising life like the uniport student. For anyone who has been a victim, no amount consolation would be enough to pacify the pain of losing a loved one. As a nurse, i have seen this scenario play out time and again, to the point that i have grown thick skin, but i still feel deeply for anyone who has lost a loved one in death. Death is usually more painful when it could have been avoid. But in Nigerian hospitals, avoidable deaths tend to be more common. Believe me, only a few actually come to public knowledge. And when it does, one set of healthcare professionals are often at the receiving end of the vituperation and opprobrium it generates ; The NURSES!. They are the easiest to vilify, and push around. Often times, we only hear one side of these stories, that is the deseased's side, or in rare cases we hear the side of the hospital management. This article is not meant to exonerate nurses from all blame, (sometimes they are directly responsible) it is meant to tell one of such stories from the nurse's angle.

If we look at these stories carefully with an open mind you would discover one major problem in our hospitals, and that is lack of equipments. Like in the case of the upth student, the problem was lack of bed space. We only heard the story from one side, and we vilified the nurses and doctors, and berated them for not finding an alternative. Well i wasn't at upth, so i have no idea what really happened. But i have lost a patient in similar fashion before, and i was almost beaten up by the patient's relatives, so i can relate. In my own case, we were only two nurses on duty, myself and another nurse who was pregnant at the time. We were covering the emergency and labour ward together.

The patient in question arrived with his family members, he was in obvious distress, but his condition did not seem life threatening at the time. Myself and my colleague were both in the labour room, trying to deliver a baby with breech presentation, an extremely risky procedure. When i heard their shout for attention, i left my colleague alone to handle the delivery (which was risky) in order to attend to the new patient. There was no bed space, so i simply spread a blanket on the ground for him to lie on. The family members protested, but i had neither the time nor the patience to explain and negotiate with them. I explained our admission procedure to them, told them to pay for a card, and purchase the A&E kit. Once again, they protested that they had no money. I explained to them that given the fact that he had been vomiting and stooling, he would need i.v infusion immediately. I put a call across to the doctor on call, who was equally busy, and headed back to the labour room.

After about 30 minutes, the doctor arrived. The family had not purchased the A&E kit, neither had they paid for a card. So he referred them to a teaching hospital and left for the theater. They called me out a few minutes later, this time one of them had an i.v infusion with him, which he had gone to buy from a local chemist that night. They begged me to give him the infusion. I explained to them that the hospital policy does not permit me to insert a canula into a patient's vein, hence they have to wait for the doctor. I left them again, and called the doctor to inform him. The doctor came back, and insisted that they should go to the teaching hospital.

About thirty minutes later, i heard a loud shout, and rushed out to see what was happening. Behold, our patient was unconscious, and almost not breathing. I advised the family to quickly take him to the teaching hospital, because we do not have equipments to resuscitate him. They requested for an ambulance and someone to accompany them. There was a problem, we only had one ambulance driver, and he doesn't work night shifts, and more so we had no personnel to spare for the trip. All hell broke loose, the family members began to shout and make threats. I had to hide my head. I left them and went back to the labour room. I did not hear from them again that night, until the morning after when hoodlums invaded the hospital, bearing matchets and sticks. I scaled the hospital fence and got away. The doctor and the morning nurses weren't so fortunate, they vandalised cars and beat them up.

The boy died, but the story that was circulated was that " because they had no money, the wicked nurse refused to attend to them, and left them to go and sleep elsewhere. When they even bought drip from a chemist, the wicked nurse refused to give their son the drip, insisting that they must buy from the hospital." No one considered the fact that the overworked nurse was busy handling another delicate situation, and could not focus attention on a patient who has not been admitted. Now you must be wondering, since it was an emergency, why did we not just attend to the patient and worry about the money later? My answer; HOSPITAL POLICY. If i admit the patient, and use the hospital's consumables without the patient paying for it, the bill would be subtracted from my salary, after i am issued a query. If the bills of 3 or 4 patients are subtracted from my salary, how much would be left?. The best i could do was to refer them to the teaching hospital, where they ll receiving free emergency treatment for 24 hours before payment.

Now, let us examine the most recent case. When the man arrived with his wife, the nurses told him straight away to go to igando general hospital, because there was no doctor. But he refused, insisting that the hospital was too big not to have a doctor on call. But it is very possible that the hospital may have only one doctor, who cannot work for 24 hours. I have seen such scenarios alot. There are unreasonable restrictions placed on nurses in nigeria today, our scope of practice is unjustly limited. Hence, when a nurse refuses to touch a patient, she is probably afraid of crossing a line and indicting herself. So when there is no doctor, and the hospital policy prevents the nurse from doing what he/she knows, what do you expect the nurse to do?. That was probably why the nurses insisted that he take his wife to igando. But the man stubbornly carried his wife into the hospital himself. When he insisted, the nurses probably out of pity cautiously did the little they could do without crossing a line, which was obviously inadequate.

When he agreed to go, the nurses did not have the key to the ambulance, maybe the ambulance driver was not on duty! Again, the nurses did not want to accompany him, probably because they were already understaffed and overbooked, and had no one to spare. Do we know how many nurses where on duty? What about the doctor who arrived late? It is also possible that he is the only doctor in the hospital, and works 8 to 4pm like everyone else. If he leaves his house at all that night, he is only doing you a favour, he is not paid to work at that time. It sounds cruel, but that is the truth.

When he got to igando, there was no bed space! Are the health workers to blame for that? Peharps, while he waited for what seemed like an eternity, the nurses were frantically making efforts to secure a bed space for the patient. And then the money issue came, which i have already dealt with.

I can assure you of one small truth. The issue will be swept under the carpet, because if it is investigated constructively, the blame will fall largely on the government. Our health sector is in shambles, it needs massive investment, in terms of man power and infrastructure. Until this happen, we cannot continue to heap all the blame on our hardworking doctors and nurses. They are just like the soldiers sent to confront boko haram without weapons. They deserve our sympathy, not insults. When next a nurse in a public hospital seem not to perform to your expectation, it may be because her hands are tied!




Lalasticlala, dominique, give us a chance to defend ourselves

Just 2 nurses on duty,covering both Labor and emergency wards? For real?

Lalasticala ishilove dominique.... Time to put foward anoda perspective, lets b balanced

Then they should close those akara hospitals. No equipment, no doctor on call, no nurses on duty, No ambulance, No driver on seat, no gen, No keys to pharmacy, No pharmacist on seat, no nothing all they have is the buildings and a staff to give the list of things they dont have when a patient comes in.
Those Akara hospitals should not be allowed to addmit patients or run maternity/Emergency wards and they should be told to close at 5 or 6 pm everyday so every one knows they are not available for work. They should just be clinics to treat cough and cartarh and n9thing more.
If a so called hospital cannot respond to patients and give some form of care while they arrange for the transfer of the patient to a bigger hospital then they should not be allowed to run as a full blown hospital.
Shame on Nigerian government through the years. They cannot support health care in any way. All the billions looted daily will go a long way in staffing and equiping our state run hospitals and also ensure that the average Nigerian can get decent medical treatment. They should also put laws in place that will regulate all hospitals
They should be categorized and given licence and operational time based on equipments, number of staff and qualification or experience on doctors and nurses on duty. Enough of the bloodshed. I dey vex o. My blood dey boil.
BTW when will govt step up on health insurance for Nigerians?

Jackeeh:
Just 2 nurses on duty,covering both Labor and emergency wards? For real?

Hmmmm, you've not seen anything.

I have been on night duty with two ward maids who doubles as my assistants, with three patients in active phase of labour.
I have delivered babies with Nokia torchlight strapped on my hairnet, sutured perineal tears with kerosene lanterns.

No wonder my professional colleagues are writing NCLEX-RN, GFNS, TOEFL and other exams with acronyms I can't remember just to get at of this hellhole.

@topic, nurses are always at the receiving end because they are at the forefront of health service delivery.

LadyFiona:
Hmmmm, you've not seen anything.

I have been on night duty with two ward maids who doubles as my assistants, with three patients in active phase of labour.
I have delivered babies with Nokia torchlight strapped on my hairnet, sutured perineal tears with kerosene lanterns.

No wonder my professional colleagues are writing NCLEX-RN, GFNS, TOEFL and other exams with acronyms I can't remember just to get at of this hellhole.

@topic, nurses are always at the receiving end because they are at the forefront of health service delivery.

God will bless and reward you. Have worked with nurses and can't imagine their selfless services. Imagine a nurse working as a 'nurse', attendant and as a cleaner. Please if u can write the above mentioned exams, u should better write and go to a place where u are appreciated. Don't know when we will reach the 4 patient per Nurse ratio.

Imagine 1 doctor covering a general hospital, 2 nurses on duty in LW with more than 5 women in active Labour. God bless Nigerian Nurses( some are mean sha) God bless Nigerian Doctors and other health workers.

Some nurses can be so calm and cool despite all d harsh conditons they work under, my fiancee and nurse friend comes to mind.

It is a general decadence that makes mockery of our glorified health institutions. Everybody in the health sector have negative tales to tell that affects our discharge of our professional duty.

ehnnnn

This is interesting!

V

Nigerian Nurses & Doctors can be cruel & heartless, when a case is life threatening, you do everything to save that life cos that's shud be ur No.1 priority instead of giving excuses. LIFE NO GET DUPLICATE

,

Hm

Happy weekend- Power Must Change Hand

Dis is just a view of one nurse out of how many.. In vs much as u av sounded some salient points; most of us can attest 2 d ill manner of most medical practitioners!!
There is really very little d government can do in d present difficult times. Dats y "whitch hunt" or whatever u call it is needed 2 recoup stolen money back 2 help us fix dis problem.

Sad

While I agree there are not enough equipment and even manpower in our hospitals, the lacadestical attitude of out nurses might be doing much more harm to the patients. We have cases of women giving birth on the roads but because other women with experience would rally round her and offer basic support and assistance, the lives of both mother and baby would be spared.

When you are in pains, there are physical and psychological pains involved. The psychological pains if not managed, can kill faster than the physical pains. What nurses do with their callous and nonchalant attitude is to drain you emotionally, increase the physchological pains you are feeling, thereby making you lose the will and desire to fight for life. And death is only too happy to offer respite to such a person

Nurses, as a first step need to really ask themselves why they are in that line of work at all. If it's for the money, they should just exit the profession cuz that profession ain't about money making. It's a vocation of sacrifice and only those who have in them can do it. It's a calling and it's not for everyone.

However, government also need to provide the enabling atmosphere for nurses to work as there is little that can be done without the right equipment and incentives. Thereafter, anyone found wanting or culpable in his or her line of duty should be not be spared and when live(s) is involved, whoever is found deficient should be treated as what he or she really is - murderer! No sugar coating of what it is and the full weight of the law should apply. #nigerianlivesmatter

Mr dicefrost,

Our health sector is in shambles, it needs massive investment, in terms of man power and infrastructure.

This is the only truth in your write-up

God help us

I understood the nurse perspective but it is not an excuse for negligence. If an hospital is understaffed that hospital has no business operating under a liscence. That hospital is better known as quack. As for victims and patients who are affected i blame them. For God sake this is present day Nigeria, There is no regulatory framework governing our hospitals in respect to facilities and adequate equipment. Not all buildings labelled hospitals here in Nigeria had the full functions and capabilities of an hospital. You can't compare the hospital's here with that of UK. It is better for one to have prior knowledge of the quality of hospitals in their neighbourhood especially when it comes to maternity than to get disappointed during emergency and then start blaming the hospital. And some patients and their relatives can kill. When they know they can't and won't pay hospital bills for a dying patient why bringing the patient to a private hospital for complete treatment in the first place. Many of them will ignore the instructions of the doctor and if anything happen, na doctor kill am we go hear. Though it is understood

We need a change, complete overhaul of our health sector



Meanwhile, check my signature

@op how do you explain the insensitive manner and bashful manner nurses talk and treat their patients? especially does at state own hospitals. they treat you like you are not human and obviously don't care. a patient is in pains and these nurses look/treat you like "shey na we send you message, if you wan die, you better die"

COMMUNIQUÉ ISSUED AT THE END OF 17TH NATIONAL PROFESSIONAL CONFERENCE OF THE UNIVERSITY GRADUATES OF NURSING SCIENCE ASSOCIATION (UGONSA) HELD AT LAW AUDITORIUM, EBONYI STATE UNIVERSITY, ABAKALIKI, BETWEEN 8TH AND 11TH OCTOBER, 2015.

Theme: PROFESSIONAL ISSUES IN NURSING
Internship and proper placement of graduates of B.N.Sc degree: The Final Stroke.
Nursing and Midwifery Council of Nigeria Establishment Act: The need for urgent reformation.
Upgrade of Schools of Nursing and Midwifery to degree awarding institutions: A must for sustainable relevance of Nursing and Midwifery in our health system

Preamble
UGONSA highly appreciates the Federal Government of Nigeria for its Progressive CHANGE Agenda for the common good of all Nigerians; Comrade Ogah Chinedu,OON,AOJ, the Chief Executive Officer Chiboy Group of companies and the Chief guest of honour to the event; Prof. Francis I. Idike, the Vice Chancellor Ebonyi State University Abakaliki; Dr. Onwe Ogah Emeka, AOV, the Chief Medical Director Federal Teaching Hospital Abakaliki; the Government and good People of Ebonyi State for providing peaceful and hospitable atmosphere for our National Professional Conference, and the Ebonyi State Chapter of UGONSA for a well-organized hosting.

The opening ceremony
The flag-off of the ceremony was done by Comrade Ogah Chinedu, OON, AOJ, who was decorated with the prestigious UGONSA National award of ‘Ambassador of Justice (AOJ)’ in recognition of his altruistic fight for the rights of the common man. The event chaired by Chief (Hon).Solomon E. Egwuenu, UGONSA National President, ably represented by Nurse Goodluck.I. Nshi, UGONSA National secretary, witnessed the attendance of the following dignitaries; Dr. Onwe Emeka Ogah, AOV, the Chief Medical Director Federal Teaching Hosptal Abakaliki represented by Dr. Ewa L. Richard, the deputy CMAC of the hospital; Ass. Prof Elkanah C. Ndieh, the head of department of Nursing Science, Ebonyi State University Abakaliki; Mr Igboji Jonathan, Director Nursing services, Ebonyi State; Mrs. Chukwu Winifred, the Head of Nursing services Federal Teaching Hospital Abakaliki; Mr Akuna E. Ernest, the South-South zonal coordinator Nursing and Midwifery Council of Nigeria among others.
There were goodwill messages from the dignitaries and the professional sessions were anchored by Nurse Onwusonye Chioma, Nurse Nshi Goodluck I. and Nurse Nwodoh Chijioke Oliver who introduced UGONSA positions for deliberations by the congress.
RESOLUTIONS
FEDERAL GOVERNMENT WAR AGAINST CORRUPTION AND INSURGENCY
UGONSA passed a vote of confidence on President Muhammadu Buhari, GCFR, and his anti-corruption crusade and maintained that those that looted Nigeria into its present economical woes must be made to face the consequences of their unconscionable actions. UGONSA also superlatively commended the Government of President Buhari on the rejuvenated , focused ,coordinated and methodical attack on insecurity and insurgency and implored Nigerians to be security conscious and always avail timely information about strange or suspicious persons or activities within their environment ,as the duty of security does not lie on Government only but also on the citizens.
INTERNSHIP AND PROPER PLACEMENT OF GRADUATES OF BACHELOR OF NURSING SCIENCE (B.N.Sc) DEGREE
It was affirmed that internship training for fresh graduates of B.N.Sc degree, as approved by the National Universities Commission, is paramount to qualitative client care as it blends the more theoretical science-based university nursing education with comprehensive clinical expertise for optimum performance.
The association strongly frowned at the continued exclusion of graduates of Bachelor of Nursing Science(B.N.Sc) degree from internship training scheme of the ministry of health that accommodates the baccalaureate graduates of other healthcare professions and argued that it defied logic for nurses to be the only professionals left out of the scheme whereas mounting evidence underscores that they need the internship training more than any other member of the health team since they stay longer and closer with patients, care for them and as well monitor them round-the-clock. UGONSA also strongly condemned and described as reprehensible the aberrant under placement of graduates of B.N.Sc degree on CONHESS 07 post-NYSC (National Youth Service Corps) whereas their counterparts in other healthcare professions who they share similar entry qualification and course duration in the university with, are placed on at least CONHESS 09 post-NYSC.
The association passionately appealed to President Muhammadu Buhari, GCFR, to prevail on the Head of Civil Service of the Federation, the National Council on Establishments and other concerned authorities to expedite the release of the long awaited circular for internship and proper placement of graduates of Bachelor of Nursing Science (B.N.Sc) degree.
NURSING AND MIDWIFERY COUNCIL OF NIGERIA (NMCN) ESTABLISHMENT ACT
UGONSA noted with serious concern that the current established legal framework for Nursing education and practice in Nigeria is now obsolete as it is riddled with myriad of flawed sections that fall short of current trends and international best practices.
It therefore strongly called on the National assembly and other relevant stakeholders to urgently review the NMCN Act to reflect a less rigid dichotomy between the autonomy of nurses and other healthcare providers for enhanced collaborative teamwork.
UPGRADE OF SCHOOLS OF NURSING AND MIDWIFERY TO DEGREE AWARDING INSTITUTIONS.
The congress in session also noted with worrisome concern the continued accreditation of more schools of Nursing by the Nursing and Midwifery Council of Nigeria (NMCN) against the proposed road map to make all Nursing /Midwifery institutions degree awarding by the year 2015 and called on the NMCN to be committed to phasing out the Hospital-based Nursing programmes in favour of University-based Nursing Education as this will naturally remove the internecine conflicts and bickering in the profession and as well foster qualitative client-care, higher dignity and better image for the profession.
The congress passed a vote of “no confidence” on the current acting Registrar of NMCN, Mrs. Eunice Azuike, and lamented that her tenure has been an unquantifiable disaster and represents the darkest era in the contemporary affairs of nursing in Nigeria when we have witnessed more retrogression the progression. The congress recommended strict appointment of nurses with integrity, competence and towering qualifications, especially Professors or Ph.D. holders, in nursing, as registrars and chairmen/Chairpersons of the board of NMCN. The congress believes that this will facilitate the upgrade of schools of nursing and midwifery to degree awarding institutions because such persons would have the capacity to supervise and regulate all nursing programmes up to Ph.D. levels unlike the current crop of council leadership that is bereft of advanced degrees in nursing and therefore incapacitated in supervising and regulating nursing and midwifery programmes higher than the basic and post-basic levels, hence the inertia to upgrade schools of nursing and midwifery to degree awarding institutions.
OTHER RESOLUTIONS INCLUDED
UGONSA strongly emphasized that the frustrating conservatism that advancement to the top has to strictly follow seniority by length of service to the exclusion of higher education and efficiency of performance, has to give way to recognition of educational and professional excellence for progressive hope of positioning the nursing and midwifery professions in the limelight.
The need to restore teaching allowance to Nurses and Midwives on CONHESS 07 and 08 was reiterated. The association re-emphasized that Nurses and Midwives irrespective of grade and cadre are involved in the teaching of students on clinical posting, advocacy and education of patients/ relatives and strongly condemned the non-reversal of the teaching allowance by most healthcare institutions despite the vacation of the circular that wrongly instigated its removal. In addition, the congress bemoaned the current poor rate of hazard allowance being paid to Nurses/Midwives and requests for its upward review that should be commensurate with their round-the-clock, daily exposure to clinical hazards.
The congress in session equally condemned in strong terms the increasing proliferation of Quackery in the health sector in general and nursing in particular and appealed to Government at all levels to step up measures to checkmate this ugly menace.
It was also re-emphasized that enlisting of fresh university graduate nurses into UGONSA at point of induction into the profession is paramount and mandatory. Departments /Faculties of nursing in the University were implored to uphold the involvement of UGONSA in their induction exercise/ceremony as sacrosanct.
Congress in session approved a mandatory levy of ten thousand naira only (N10000.00) for graduates and one thousand naira only (N1000.00) for undergraduates to be paid before the last day of December, 2015 into UGONSA national FirstBank account, 3089525712, or through the leadership of state chapters, for graduates, or the unit’s NUNSA leadership, for undergraduates. This aims to raise fund for sustainable national action on realization of internship and proper placement, reformation of NMCN establishment Act and upgrade of schools of nursing and midwifery into degree awarding institutions.
The mandate to host the next national professional conference by October, 2016 was unanimously granted jointly to Osun and Bornu State to be hosted in Osogbo, the Osun State capital.
Finally, the congress in session enjoined nurses and midwives to employ aggressive individualized campaign on social media against the increasing menace of quackery that is exponentially denting the image of the profession and as well use such platforms to advocate and galvanize support for expedite release of the long overdue circular on internship and proper placement of graduates of B.N.Sc degree.

Signed:

Nurse G.I. Nshi, National Secretary and Rep of Chief (Hon). S.E.O Egwuenu,the National President

Nurse Agbo Gabriel, Chairman Communiqué Committee

Nurse Hammawa Abdul-qadir, Secretary Communiqué committee.

I appreciate your write up but in some cases it's also negligence and carelessness from doctors.

Hmmm. It is well. This is as a result of bad governance from independent time till date. All sectors collapse which in turn endanger the lives of people. When will Nigeria change, when are we going to have government that will equip our health facilities to help the masses.

When they have common headache, they use our money to fly overseas for medical check up.

That is why I don't pity the wicked leaders who die shamelessly before their time.

Long life and prosperity shall be our portion IJN, Amen.

Just that our nurses need to be calm and provide the necessary support when attending to patients.

Choi, Nigeria.

I personally have learnt never to blame or fault nurses and Doctors especially those in privately owned hospitals.

They should be appreciated in my own opinion.....achieving what they achieve with the most of the odds usually against them.