I am sure most people don't even know that nurses also take oath. Take a closer look at it and make out your own conclusions.

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.
Source: American Nurses Association

The 2 most important points in the pledge are:
1. I will not take or knowingly ADMINISTER any harmful drug ( they were careful enough not to use the work "PRESCRIBE"
2. With loyalty will I endeavor to aid the physician in his work.

they have modified the line "i will aid the physician with loyalty" to suit their selfish needs and rub their ego BUT want our hippocratic oath to reamain unchanged..... bunchaclowns!!

phantom: they have modified the line "i will aid the physician with loyalty" to suit their selfish needs and rub their ego BUT want our hippocratic oath to reamain unchanged..... bunchaclowns!!

They are trying to modify it, the universally accepted oath is the one posted above. It's still intact in the website of the American Nurses Association.
If they modify to suit their own ego like you said, what stop doctors from modifying theirs. But truth is, from the above, nurses were trained to be loyal to doctors and work with them.

Original "Florence Nightingale Pledge"
I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practise my profession faithfully.
I shall abstain from whatever is deleterious and mischievous, and shall not take or knowingly administer any harmful drug.
I shall do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
I shall be loyal to my work and devoted towards the welfare of those committed to my care.[1][4][5]

1935 revised version (changes from original italicized)
I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practise my profession faithfully.
I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug.
I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
With loyalty will I aid the physician in his work, and as a missioner of health, I will dedicate myself to devoted service for human welfare.[1]

"Practical Nurse Pledge", a modern version based on the "Nightingale Pledge"
Before God and those assembled here, I solemnly pledge;
To adhere to the code of ethics of the nursing profession;
To co-operate faithfully with the other members of the nursing team and to carryout [sic] faithfully and to the best of my ability the instructions of the physician or the nurse who may be assigned to supervise my work;
I will not do anything evil or malicious and I will not knowingly give any harmful drug or assist in malpractice.
I will not reveal any confidential information that may come to my knowledge in the course of my work.
And I pledge myself to do all in my power to raise the standards and prestige of the practical nursing;
May my life be devoted to service and to the high ideals of the nursing profession.[5]
http://en.wikipedia.org/wiki/Nightingale_Pledge

The pnly constant thing is change. And change will still continue. Surgeons used to be butchers, now they are surgeons. Nursing has evolved and will continue to evolve. So Nigerian Drs should deal with that.

prettyprettywow: Original "Florence Nightingale Pledge"
I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practise my profession faithfully.
I shall abstain from whatever is deleterious and mischievous, and shall not take or knowingly administer any harmful drug.
I shall do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
I shall be loyal to my work and devoted towards the welfare of those committed to my care.[1][4][5]

1935 revised version (changes from original italicized)
I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practise my profession faithfully.
I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug.
I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
With loyalty will I aid the physician in his work, and as a missioner of health, I will dedicate myself to devoted service for human welfare.[1]

"Practical Nurse Pledge", a modern version based on the "Nightingale Pledge"
Before God and those assembled here, I solemnly pledge;
To adhere to the code of ethics of the nursing profession;
To co-operate faithfully with the other members of the nursing team and to carryout [sic] faithfully and to the best of my ability the instructions of the physician or the nurse who may be assigned to supervise my work;
I will not do anything evil or malicious and I will not knowingly give any harmful drug or assist in malpractice.
I will not reveal any confidential information that may come to my knowledge in the course of my work.
And I pledge myself to do all in my power to raise the standards and prestige of the practical nursing;
May my life be devoted to service and to the high ideals of the nursing profession.[5]
http://en.wikipedia.org/wiki/Nightingale_Pledge

Please take a closer look at this part

To co-operate faithfully with the other members of the nursing team and to carryout [sic] faithfully and to the best of my ability the instructions of the physician or the nurse who may be assigned to supervise my work;

And this part

I will not do anything evil or malicious and I will not knowingly give any harmful drug or assist in malpractice.

prettyprettywow: Original "Florence Nightingale Pledge"


The pnly constant thing is change. And change will still continue. Surgeons used to be butchers, now they are surgeons. Nursing has evolved and will continue to evolve. So Nigerian Drs should deal with that.

Nothing has changed my dear. From what I pointed out above, nurses are meant to take instructions from doctors and their superiors (just like every other profession), they appreciate the fact that they work under doctors and must carry out their instructions.
Again from the revised edition you posted above, they were careful not to make the mistake of using the word "prescribe", instead they used the word "give" as against the "administer" used in previous editions.

Which version are you talking about? Nursing has evolved and is still evolving, so deal with it. When you talk, talk of the latest version.

Below is the original version of the hippocratic oath

I swear by Apollo the physician, by Aesculapius, Hygeia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and judgment the following oath:

To consider dear to me as my parents him who taught me this art; to live in common with him and if necessary to share my goods with him; to look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and to the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone, the precepts and the instruction. I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my art. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.
http://www.aapsonline.org/ethics/oaths.htm

I wonder why they Drs have changed the gods and goddesses to God

DebateNigeria:


Please take a closer look at this part

And this part

what has Give, prescribe, administer got to do with this whole thing? what's the difference between give and administer? or is the problem now English? Nurses already know that the don't work in isolation. so what's the headche?

DebateNigeria:

Nothing has changed my dear. From what I pointed out above, nurses are meant to take instructions from doctors and their superiors (just like every other profession), they appreciate the fact that they work under doctors and must carry out their instructions.
Again from the revised edition you posted above, they were careful not to make the mistake of using the word "prescribe", instead they used the word "give" as against the "administer" used in previous editions.

prettyprettywow: what has Give, prescribe, administer got to do with this whole thing? what's the difference between give and administer? or is the problem now English? Nurses already know that the don't work in isolation. so what's the headche?

Haba, we are not fighting.
Let me inform you sir/am, I am not a medical doctor.
As far as hierarchy is concerned, I am of the opinion that doctors should take the lead always. But in terms of managing the hospitals, I think it should be the job of health managers and not doctors or nurses or any other health professional.
Yesterday in my other thread, I asked one of the contributors to list just one hospital in the USA where a nurse if head over a medical doctor. I am yet to get a reply.

I only asked what give, administer and prescribe got to do with the debate as you pointed out. Nothing about leadership yet. below is the anser to your question about hospital CEO being a nurse

Below is the list of some Hospital CEOs that are nurses
http://www.beckershospitalreview.com/hospital-management-administration/from-nurse-to-ceo-qaa-with-marina-del-rey-ceo-fred-hunter.html
Other instances include
http://www.beckershospitalreview.com/hospital-management-administration/from-nurse-to-ceo-qaa-with-marina-del-rey-ceo-fred-hunter.html
http://www.arkansasonline.com/news/2012/oct/14/jodi-love-hospital-ceo-once-nurse-always-nurse/
http://mdjonline.com/view/full_story/24598425/article-Former-nurse-to-be-new-WellStar-CEO
http://www.bizjournals.com/dallas/blog/2013/10/charles-gressle-from-nurse-tech-to.html
http://news.nurse.com/apps/pbcs.dll/article?AID=2003308010318#.U8FEqPldVCg
Hope you are satisfied?

As Los Angeles braces itself for the coming changes in health care delivery, nursing roles are expected to change in light of an aging population that may outnumber nurses beyond the current mandated nurse-patient ratio. Among the aging population are nurses over the age of 50 who make up almost half of the nursing workforce according to the American Nurses Association.


Cathy Fickes, president and CEO of St. Vincent Medical Center, worries that there aren’t enough nursing programs to prepare hospitals for the retirement of these nurses, especially in light of how long it takes for a single nurse to receive the advanced training needed for nurses to play an even more important role in health care than ever before. In fact, Fickes is the epitome of just how important a role nurses with advanced education play into quality health care in Los Angeles. After 25 years of schooling, Fickes has become part of a rising trend of nurses turned hospital CEOs.
Career path of nurse turned CEO
Fickes earned her initial nursing degree from City College of San Francisco and started working as an emergency department nurse. Over the years, she specialized in critical care nursing while earning a bachelor of arts in business from University of Phoenix and a masters of science in health care administration from University of Laverne. Her nursing role eventually transitioned from the bedside into nursing administration, which gave her the opportunity to become chief operating officer of Mission Community Hospital and ultimately chief executive officer for the first time in her nursing career.
Fickes feels she is a better CEO because of the 20 years she spent taking care of the patients she continues to service even in her current role. “My education has allowed me to serve patients and their families at times of crisis in their lives when they cannot take care of their health care needs,” says the Los Angeles nurse turned CEO. “It has also allowed me to become an effective communicator between what is needed at the bedside and the economic and business aspects of health care,” she says.
Tips for career advancement in nursing
After more than 20 years of working as a nurse, Fickes is grateful for the fulfilling and sustaining life her registered nurse credential has given her. She has followed many different paths in medicine as a result of her registered nurse degree which helped her find her place in emergency medicine and nursing administration.
In light of all of her experiences, Fickes recommends learning what your strengths are and finding a career that embraces those strengths and makes you feel good about doing what you should be doing. “Nursing has so many opportunities,” says Fickes. “For a new nurse just beginning, try various types of nursing to see what best fits your personality, gives you the greatest joy and resonates with your specific skills and talents.”
Niki Payne is a freelance writer covering all things Entertainment in Los Angeles. Her work can be found on Examiner.com.

http://losangeles.cbslocal.com/2013/05/20/from-nurse-to-hospital-ceo-a-budding-career-trend-in-los-angeles/

DebateNigeria:

Haba, we are not fighting.
Let me inform you sir/am, I am not a medical doctor.
As far as hierarchy is concerned, I am of the opinion that doctors should take the lead always. But in terms of managing the hospitals, I think it should be the job of health managers and not doctors or nurses or any other health professional.
Yesterday in my other thread, I asked one of the contributors to list just one hospital in the USA where a nurse if head over a medical doctor. I am yet to get a reply.

@DebateNigeria, another nurse CEO
From Nurse to CEO: Q&A With Marina Del Rey CEO Fred Hunter
Written by Sabrina Rodak (Twitter | Google+) | October 04, 2011

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Fred Hunter, RN, president and CEO of Marina Del Rey (Calif.) Hospital, has an interesting perspective as a hospital leader because he began his career as a nurse. Mr. Hunter's first nursing job was as a vocational nurse, after which he returned to school to earn his RN and bachelor's degree in nursing. He worked at the bedside and entered into middle management, where he worked in the emergency department and critical care. In 2003, he graduated with a master's in business administration. Below, he discusses how his experience as a nurse has helped shape his leadership style and decisions as CEO of a hospital.

Q: How has your experience as a nurse affected your leadership style?

Fred Hunter: I think the most important thing is that it actually helped me be more process-oriented and outcomes driven, as well as understand that nothing can be achieved without a team. [This perspective] works well for the vision for a hospital as a whole.

So, when I'm looking at patient satisfaction, I'm looking at all the processes involved to achieve those metrics as outlined by value-based purchasing and understanding that there are several steps, [such as] how you introduce yourself to patients.

Q: How does your nursing background influence the decisions you make as a hospital CEO?

FH: What drives me is the patient. It's [all] about patient care. I model initiatives around the fact that this is about a patient, and no matter what the strategy might be, it's really about the patient.

When I was working as a director, I would be the one to receive patient complaints. [I learned to understand] that when you listen to patients about their experience it may be right or wrong, but their perception is really what you're dealing with. You have to create an environment so their perception is a positive experience.

Q: How has your experience influenced how you interact with nurses and employees at the hospital?

FH: Even to this day, I'm able to put myself in the nurses' place or employees' position, understand what they [may be] experiencing at a point in time and explain my vision. I'm able to empathize with them [regarding] the challenges they're going to experience and put in safeguards to address those concerns that they may experience. They may not always tell you [their concerns]. I'm able to draw it out of them because I can say "I remember when…" I have been in situations in the past where an idea is a great idea, but the process implemented is not the best process. So, you want to drive it back to people who have their hands with the patient: "What do you think is the best process to achieve this goal?" They have to be involved, committed. If the hospital CEO doesn't involve them, I do believe chances of failure will increase markedly.

Q: How do you involve employees in the hospital's vision?

FH: It is important that the CEO is visible to employees and the medical staff. Unfortunately, it's not an easy task to achieve; it requires time by the CEO to make [him or herself] visible in spite of all the responsibilities the CEO might have. I do believe that the employees want to see me. I do believe that rounding in all the departments periodically is valuable; it gives that individual, whoever may be on duty at that time, an opportunity to talk to me about their successes, to talk to me about concerns. Employees almost always have great ideas. I believe that they care about the hospital and want to make it better. So that's one mechanism I do utilize.

Another method I incorporate is employee forums. I will try to set up several over a period of a week [on a] quarterly [basis]. Anybody can come as they are able to come, and that gives me and the employees an opportunity to, as a group, interact and dialogue on certain activities within the hospital. I share what I'm thinking, then they can share with me their thoughts on those ideas. They always have an opportunity to give me thoughts on what else we can do for their own agenda. You always need to handle that very delicately. Sometimes, I don't like what I hear, but it's the truth and I need to listen.

Another method that I use, also on a monthly basis, is I have a breakfast with night staff and lunch with day shift staff. All this is really attempting to improve communication. The more opportunity that I have to interact with everyone and for them to interact with me, the better communication is. The breakfasts and lunches are by invitation, and my director of human resources works with me to select random folks from different areas of the hospital. That's actually turned out quite beneficial because now everybody knows each other. People are more comfortable sharing personal aspects of who they are, which is extremely valuable in building trust in the relationships that they have with me.

Q: Is your strategy for engagement different for physicians compared to nurses and other employees?

FH: Medical staff is a bit more formal. I attempt to visit with physicians when I do my rounds. I also try to keep an open door policy at all times. If the medical staff wants to talk to me about anything, I always try to make my time available to them, because their schedules are so strict — there are several hospitals they visit in a day. While they're here at my hospital and want to stop in, it's very important that I allow that audience.

I attend medical staff committee meetings, where I try to update them on activities within the hospital. We [also] have a biannual medical staff meeting. If they have not been able to attend one of the department meetings, they can come to the medical staff meeting where I have an opportunity to speak with them, hear what's happening, share what we're doing and how they can assist and how it impacts them. [In addition,] hallway discussions are always spontaneous and always very useful.

Related Articles on Hospital Leadership:
Leading Change With Vigor: 6 Questions and Answers for Hospital CEOs
A Relationship Checklist for Hospital CEOs: 7 Behaviors to Ace
10 Traits of Top Healthcare Leaders

DebateNigeria:

Nothing has changed my dear. From what I pointed out above, nurses are meant to take instructions from doctors and their superiors (just like every other profession), they appreciate the fact that they work under doctors and must carry out their instructions.
Again from the revised edition you posted above, they were careful not to make the mistake of using the word "prescribe", instead they used the word "give" as against the "administer" used in previous editions.

What exactly are you insinuating ? That aid is not help but serve....... right.!!! Then there is problem. Physicians and nurses works together before other professionals came in and they have to be included in the oath too. Change is constant. The American Nurses Association that pasted that on their walls have members that prescribe instead of administer drug and members who no longer work with physicians but diagnose and treat independently. They know where they started from and are pushing for more.
From most articles flying around since the onset of these health sector crisis, nurses have been loyal to physician until they find out that to each its own.
So the status quo had to changed, no more loyalty, younger nurses are no longer taught Florence Nightingale crap......and then they pitched their tent and loyalty with JOHESU. A hell lot of crises it is giving us. Had it been it was the other way round without the emergent of the egoistical doctors at the helm of NMA affairs, when these two strikes( Doctors and nurses )the FG will come running with their tails between their legs.
So let it massage your ego as you see on the internet but in reality that part of the oath is no longer obtainable.

prettyprettywow: @DebateNigeria, another nurse CEO
From Nurse to CEO: Q&A With Marina Del Rey CEO Fred Hunter
Written by Sabrina Rodak (Twitter | Google+) | October 04, 2011

4
inShare
Share on Facebook
Fred Hunter, RN, president and CEO of Marina Del Rey (Calif.) Hospital, has an interesting perspective as a hospital leader because he began his career as a nurse. Mr. Hunter's first nursing job was as a vocational nurse, after which he returned to school to earn his RN and bachelor's degree in nursing. He worked at the bedside and entered into middle management, where he worked in the emergency department and critical care. In 2003, he graduated with a master's in business administration. Below, he discusses how his experience as a nurse has helped shape his leadership style and decisions as CEO of a hospital.

Q: How has your experience as a nurse affected your leadership style?

Fred Hunter: I think the most important thing is that it actually helped me be more process-oriented and outcomes driven, as well as understand that nothing can be achieved without a team. [This perspective] works well for the vision for a hospital as a whole.

So, when I'm looking at patient satisfaction, I'm looking at all the processes involved to achieve those metrics as outlined by value-based purchasing and understanding that there are several steps, [such as] how you introduce yourself to patients.

Q: How does your nursing background influence the decisions you make as a hospital CEO?

FH: What drives me is the patient. It's [all] about patient care. I model initiatives around the fact that this is about a patient, and no matter what the strategy might be, it's really about the patient.

When I was working as a director, I would be the one to receive patient complaints. [I learned to understand] that when you listen to patients about their experience it may be right or wrong, but their perception is really what you're dealing with. You have to create an environment so their perception is a positive experience.

Q: How has your experience influenced how you interact with nurses and employees at the hospital?

FH: Even to this day, I'm able to put myself in the nurses' place or employees' position, understand what they [may be] experiencing at a point in time and explain my vision. I'm able to empathize with them [regarding] the challenges they're going to experience and put in safeguards to address those concerns that they may experience. They may not always tell you [their concerns]. I'm able to draw it out of them because I can say "I remember when…" I have been in situations in the past where an idea is a great idea, but the process implemented is not the best process. So, you want to drive it back to people who have their hands with the patient: "What do you think is the best process to achieve this goal?" They have to be involved, committed. If the hospital CEO doesn't involve them, I do believe chances of failure will increase markedly.

Q: How do you involve employees in the hospital's vision?

FH: It is important that the CEO is visible to employees and the medical staff. Unfortunately, it's not an easy task to achieve; it requires time by the CEO to make [him or herself] visible in spite of all the responsibilities the CEO might have. I do believe that the employees want to see me. I do believe that rounding in all the departments periodically is valuable; it gives that individual, whoever may be on duty at that time, an opportunity to talk to me about their successes, to talk to me about concerns. Employees almost always have great ideas. I believe that they care about the hospital and want to make it better. So that's one mechanism I do utilize.

Another method I incorporate is employee forums. I will try to set up several over a period of a week [on a] quarterly [basis]. Anybody can come as they are able to come, and that gives me and the employees an opportunity to, as a group, interact and dialogue on certain activities within the hospital. I share what I'm thinking, then they can share with me their thoughts on those ideas. They always have an opportunity to give me thoughts on what else we can do for their own agenda. You always need to handle that very delicately. Sometimes, I don't like what I hear, but it's the truth and I need to listen.

Another method that I use, also on a monthly basis, is I have a breakfast with night staff and lunch with day shift staff. All this is really attempting to improve communication. The more opportunity that I have to interact with everyone and for them to interact with me, the better communication is. The breakfasts and lunches are by invitation, and my director of human resources works with me to select random folks from different areas of the hospital. That's actually turned out quite beneficial because now everybody knows each other. People are more comfortable sharing personal aspects of who they are, which is extremely valuable in building trust in the relationships that they have with me.

Q: Is your strategy for engagement different for physicians compared to nurses and other employees?

FH: Medical staff is a bit more formal. I attempt to visit with physicians when I do my rounds. I also try to keep an open door policy at all times. If the medical staff wants to talk to me about anything, I always try to make my time available to them, because their schedules are so strict — there are several hospitals they visit in a day. While they're here at my hospital and want to stop in, it's very important that I allow that audience.

I attend medical staff committee meetings, where I try to update them on activities within the hospital. We [also] have a biannual medical staff meeting. If they have not been able to attend one of the department meetings, they can come to the medical staff meeting where I have an opportunity to speak with them, hear what's happening, share what we're doing and how they can assist and how it impacts them. [In addition,] hallway discussions are always spontaneous and always very useful.

Related Articles on Hospital Leadership:
Leading Change With Vigor: 6 Questions and Answers for Hospital CEOs
A Relationship Checklist for Hospital CEOs: 7 Behaviors to Ace
10 Traits of Top Healthcare Leaders

Nice.
The website of the fist name you posted is still under construction, so no comment on that.
On this second name (Fred Hunter), I have nothing against this particular point as this is what I have been advocating. Fred hunter is a health manager, his knowledge in nursing is an added advantage. I took time out to go through their website, unfortunately Fred Hunter is not even there on the website as CEO (I am not disputing the facts here), instead it is still a team of medical doctors they call editors that was posted there. Hunter manages the hospital while the doctors are head of the clinicals not the nurses.
If you go through my previous posts, I have said it again and again, health managers (whether you are a nurse, doctor, lawyer, economist or whatever) should be made to manage our hospitals while the doctor heads the clinicals, all other health professionals follow

My dear, the problem is not about clinical services but about hospital management. Your arguement is another thing altogether. I thought your point is if a nurse can head a hospital? Doctors can head clinical services and that has never been the issue (e.g surgery dept, O&G dept, Family medicine dept etc same way wards are being managed by ward managers who are nurses), so that has been their area. Same way pharmacists manage their own dept and med lab manage the lab. The issue is that they said that the post of CMD (CEO) is their birthright which has been the problem on ground,and that is why I have shared the links to show that there are hospitals where nurses are the CEO. Even hospitals where Drs are the CEO, they still have the extra qualifications like management unlike what is obtainable here

I am sure you have also heard about independent nurse practitioners )specialists) that run their own clinics. Patient care still remain a team work, so nobody should claim ownership, unless it is their private hospital.

DebateNigeria:


Nice.
The website of the fist name you posted is still under construction, so no comment on that.
On this second name (Fred Hunter), I have nothing against this particular point as this is what I have been advocating. Fred hunter is a health manager, his knowledge in nursing is an added advantage. I took time out to go through their website, unfortunately Fred Hunter is not even there on the website as CEO (I am not disputing the facts here), instead it is still a team of medical doctors they call editors that was posted there. Hunter manages the hospital while the doctors are head of the clinicals not the nurses.
If you go through my previous posts, I have said it again and again, health managers (whether you are a nurse, doctor, lawyer, economist or whatever) should be made to manage our hospitals while the doctor heads the clinicals, all other health professionals follow

prettyprettywow: I only asked what give, administer and prescribe got to do with the debate as you pointed out. Nothing about leadership yet. below is the anser to your question about hospital CEO being a nurse

Below is the list of some Hospital CEOs that are nurses
http://www.beckershospitalreview.com/hospital-management-administration/from-nurse-to-ceo-qaa-with-marina-del-rey-ceo-fred-hunter.html
Other instances include
http://www.beckershospitalreview.com/hospital-management-administration/from-nurse-to-ceo-qaa-with-marina-del-rey-ceo-fred-hunter.html
http://www.arkansasonline.com/news/2012/oct/14/jodi-love-hospital-ceo-once-nurse-always-nurse/
http://mdjonline.com/view/full_story/24598425/article-Former-nurse-to-be-new-WellStar-CEO
http://www.bizjournals.com/dallas/blog/2013/10/charles-gressle-from-nurse-tech-to.html
http://news.nurse.com/apps/pbcs.dll/article?AID=2003308010318#.U8FEqPldVCg
Hope you are satisfied?

As Los Angeles braces itself for the coming changes in health care delivery, nursing roles are expected to change in light of an aging population that may outnumber nurses beyond the current mandated nurse-patient ratio. Among the aging population are nurses over the age of 50 who make up almost half of the nursing workforce according to the American Nurses Association.


Cathy Fickes, president and CEO of St. Vincent Medical Center, worries that there aren’t enough nursing programs to prepare hospitals for the retirement of these nurses, especially in light of how long it takes for a single nurse to receive the advanced training needed for nurses to play an even more important role in health care than ever before. In fact, Fickes is the epitome of just how important a role nurses with advanced education play into quality health care in Los Angeles. After 25 years of schooling, Fickes has become part of a rising trend of nurses turned hospital CEOs.
Career path of nurse turned CEO
Fickes earned her initial nursing degree from City College of San Francisco and started working as an emergency department nurse. Over the years, she specialized in critical care nursing while earning a bachelor of arts in business from University of Phoenix and a masters of science in health care administration from University of Laverne. Her nursing role eventually transitioned from the bedside into nursing administration, which gave her the opportunity to become chief operating officer of Mission Community Hospital and ultimately chief executive officer for the first time in her nursing career.
Fickes feels she is a better CEO because of the 20 years she spent taking care of the patients she continues to service even in her current role. “My education has allowed me to serve patients and their families at times of crisis in their lives when they cannot take care of their health care needs,” says the Los Angeles nurse turned CEO. “It has also allowed me to become an effective communicator between what is needed at the bedside and the economic and business aspects of health care,” she says.
Tips for career advancement in nursing
After more than 20 years of working as a nurse, Fickes is grateful for the fulfilling and sustaining life her registered nurse credential has given her. She has followed many different paths in medicine as a result of her registered nurse degree which helped her find her place in emergency medicine and nursing administration.
In light of all of her experiences, Fickes recommends learning what your strengths are and finding a career that embraces those strengths and makes you feel good about doing what you should be doing. “Nursing has so many opportunities,” says Fickes. “For a new nurse just beginning, try various types of nursing to see what best fits your personality, gives you the greatest joy and resonates with your specific skills and talents.”
Niki Payne is a freelance writer covering all things Entertainment in Los Angeles. Her work can be found on Examiner.com.

http://losangeles.cbslocal.com/2013/05/20/from-nurse-to-hospital-ceo-a-budding-career-trend-in-los-angeles/

Well, what I got for st. Vincent medical center is different.
The CEO/President is a medical doctor.
Here is the link http://www.stvincents.org/about-us/executive-team/stuart-marcus
http://www.stvincents.org/about-us/executive-team

What I noticed about st Vincent is that they have a board of trustees who are not necessarily health care professional and an executive team who are mainly Mds

CMD and CEO are they really the same thing

prettyprettywow: My dear, the problem is not about clinical services but about hospital management. Your arguement is another thing altogether. I thought your point is if a nurse can head a hospital? Doctors can head clinical services and that has never been the issue. The issue is that they said that the post of CMD (CEO) is their birthright and that is why I have shared the links to show that there are hospitals where nurses are the CEO. Even hospitals where Drs are the CEO, they still have the extra qualifications like management unlike what is obtainable here

I am sure you have also heard about independent nurse practitioners )specialists) that run their own clinics. Patient care still remain a team work, so nobody should claim ownership, unless it is their private hospital.

Now we are saying the same thing. No more argument. In a clinical setting (not management) doctors are the head. But if a nurse, laboratory scientist, pharmacists, chose a career path in management and he's qualified, he should be allowed to lead. Such a person is not leading because he's a nurse or pharmacist, it's simply because of his managerial skills.
My position is that mangers should head our hospitals while doctors head the clinicals. I hope we are now with one voice.

prettyprettywow: My dear, the problem is not about clinical services but about hospital management. Your arguement is another thing altogether. I thought your point is if a nurse can head a hospital? Doctors can head clinical services and that has never been the issue (e.g surgery dept, O&G dept, Family medicine dept etc same way wards are being managed by ward managers who are nurses), so that has been their area. Same way pharmacists manage their own dept and med lab manage the lab. The issue is that they said that the post of CMD (CEO) is their birthright which has been the problem on ground,and that is why I have shared the links to show that there are hospitals where nurses are the CEO. Even hospitals where Drs are the CEO, they still have the extra qualifications like management unlike what is obtainable here

I am sure you have also heard about independent nurse practitioners )specialists) that run their own clinics. Patient care still remain a team work, so nobody should claim ownership, unless it is their private hospital.

On a second thought, I think their argument is right looking at the terminology "CMD". Why don't we fight for "CEOs" that will, lead our hospitals while medical doctors are made CMDs. I must tell you, most of these CMDs don't even have any managerial skills.

It depends on the year. we may be talking about different years

DebateNigeria:

Well, what I got for st. Vincent medical center is different.
The CEO/President is a medical doctor.
Here is the link http://www.stvincents.org/about-us/executive-team/stuart-marcus
http://www.stvincents.org/about-us/executive-team

What I noticed about st Vincent is that they have a board of trustees who are not necessarily health care professional and an executive team who are mainly Mds

The fight is to change the name from CMD to CEO. we are talking about the same thing

DebateNigeria:

On a second thought, I think their argument is right looking at the terminology "CMD". Why don't we fight for "CEOs" that will, lead our hospitals while medical doctors are made CMDs. I must tell you, most of these CMDs don't even have any managerial skills.

prettyprettywow: The fight is to change the name from CMD to CEO. we are talking about the same thing

Can you please post a comprehensive details of NMA and JOHESU requests respectively.... Would like to do an analysis.
Thanks

JOHESU does not have any request for now. It is the NMA that has 24 commandments. JOHESU's case has been handled by the industrial court but NMA is asking the FG to disobey court ruling

DebateNigeria:
Can you please post a comprehensive details of NMA and JOHESU requests respectively.... Would like to do an analysis.
Thanks

BELOW IS NMA's 24 commandments
RESOLUTIONS OF THE NIGERIAN MEDICAL ASSOCIATION (NMA) NATIONAL OFFICERS’ COMMITTEE (NOC) MEETING HELD ON THE 10TH OF JUNE, 2014 AT THE NATIONAL SECRETARIAT AND SUBMITTED TO THE OFFICE OF THE SECRETARY OF THE GOVERNMENT OF THE FEDERATION WEDNESDAY 11TH JUNE 2014.

1. The post of Deputy Chairman Medical Advisory Committee (DCMAC) has been circularized and operational. Rather than abolish it, the NMA hereby demands that four (4) DCMACs for teaching hospitals and three (3) for the Federal Medical Centres be appointed forthwith to assist the CMACs whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several Deputy Directors, why not the CMAC who is also a Director? Such a DCMAC must have same qualifications as the CMAC. www.medicalworldnigeria.com

2. The NMA is opposed to the appointment of Directors in the Hospitals. This Position distorts the chain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.

3. The NMA demands that grade level 12 (CONMESS 2) in the health sector MUST be SKIPPED for medical doctors. Consequently no medical/dental practitioners should be on that grade level anymore.

4. The title “CONSULTANT” in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own patient. NMA therefore declares with unmitigated emphasis that if “non-doctor consultants” are appointed, it will lead to chaos and anarchy in the health sector. This should not happen.

5. Relativity in health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3rd, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years during which her members were short changed.

Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctors’ salary to maintain the relativity as agreed and documented once CONHESS is adjusted.

6. That Government should expedite the passage of the National Health Bill (NHB), and extend Universal Health Coverage to cover 100% of Nigerians and not 30% as currently prescribed by National Health Insurance Scheme (NHIS).

7. Surgeon General of the Federation MUST be appointed with immediate effect.

8. The entry point of the House Officer should be corrected to CONMESS 1 step 4 as originally contained in MSS/MSSS while the Registrar/Medical Officer is moved to CONMESS 3 step 3.

9. Clinical duty allowance for Honorary Consultants should be increased by 90% of CONMESS

10. Adjust the specialist allowance as contained in the 2009 collective bargaining agreement. Additionally, ALL doctors on CONMESS 3 and above MUST be paid specialist allowance or its equivalent that is not less than 50% higher than what is paid to other health workers.

11. Hazard allowance MUST be at least N100, 000 per month for Medical Doctors.

12. Immediate release of the circular on rural posting, teaching and other allowances which MUST include house officers.

13. Immediate withdrawal of the CBN circular authorizing the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licenses for the importation of In-Vitro Diagnostics (IVDs). www.medicalworldnigeria.com

14. Immediate Release of Circular on retirement age for Medical Doctors as agreed with the Federal Government (FG)
15. The Federal Government through the Federal Ministry of Health should formalise and implement the report of the interagency committee on residency training as well as release the uniform template on appointment of Resident Doctors in line with earlier agreements. Moreover, a concrete Funding framework for residency training must be established. The Overseas clinical attachment must be fully restored and properly funded in the interest of the nation.
16. That in the interest of harmony in Federal Medical Centre, Owerri the government should pay the salaries of our members in the centre as agreed on 21st October, 2013.
17. Immediate concrete steps must be put in place for the reintegration of our members back into the IPPIS platform.
18. All attempts to coerce house officers not to join NARD must stop.
19. The orchestrated intimidation, harassment and physical assault of our members in departments of Pathology (Laboratory Medicine) by Laboratory Scientists which is being tolerated by the Federal Ministry of Health (FMOH) must stop.
20. The Endless circle of incomplete salary payment to our members in many hospitals in the name of shortfalls in personnel cost must stop.
21. Universal applicability of all establishment circulars on the remuneration and conditions of service for doctors at all levels of Government must be guaranteed.
22. Government should as a matter of urgency set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria.
23. The position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary Hospitals. This position remains sacrosanct and untouchable.
WHY DID THEY NOT ASK THAT THE POST OF VICE CHANCELLOR BE OPEN TO EVERYONE IN THE UNIVERSITY SINCE ASUU AND SANU ARE MADE UP OF GRADUATES

CAN YOU BE A JUDGE OF THE HIGH COURT OR COURT OF APPEAL IF YOU ARE NOT A LAWYER?

WHY DO THEY THINK THE HOSPITALS WHERE LIVES ARE SAVED EVERYDAY SHOULD SACRIFICE THE ESTABLISHED LEADERSHIP I.E. CHIEF MEDICAL DIRECTOR?

24. The NMA henceforth shall not accept the continued violation of any of the terms of the 2009 Collective Bargaining Agreement. This is exemplified by the payment of Medical Physicists and Optometrists with OD (who are on CONHESS) call duty allowance using the CONMESS Circular. Similarly, the phrase “Ministries, Departments and Agencies” (MDA) in the said agreement should replace “Federal Ministry of Health and other Federal Health Institutions” as contained in the 2009 CONMESS Circular. www.medicalworldnigeria.com
In the light of the fore-going therefore, the NMA hereby gives government 14 days to meet all her demands as stated above or have her members called out for a resumption of the TOTAL and INDEFINITE withdrawal of service suspended on 5th January 2014.
The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted.
We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.

We hereby appeal to all Nigerians for their understanding and to press on Government to meet with our demands to avoid the STRIKE which is scheduled to start on the 1st of July 2014 from 00.10 hours GMT.

BELOW IS THE ANALYSIS OF THEIR DEMAND

NMA and Her Egocentric Demands: The Height of Gross Lawlessness, Impunity and Blackmail

In an open letter written to the secretary to the Federal Government of Nigeria, Senator Anyim Pius Anyim, on the 10th of June and sent to him on the 11th of June 2014, the Nigerian Medical Association (NMA) under the leadership of Dr. Kayode Obembe as President and Dr. Adewumi Alayaki as secretary had written 24 demands that must be urgently met. They have given the Government a 14-day ultimatum, failure of which NMA would call her members out on an indefinite strike nationwide. NMA is made up of ASSOPON- Association of Pathologist of Nigeria, MDCAN - Medical and Dental Consultants of Nigeria, ARD-Association of Resident Doctors and smaller sister Associations, who are doctors in public and private practice.

For many years, Allopathic Medical Doctors in Nigeria have always hoodwinked the Government and the general public, through falsehood and blackmail. They have coerced the Government to take unfavorable decisions which have always been detrimental to the health sector and the Nigerian populace. They have continually done this as a result of the structural injustice that has been perpetuated by many members of NMA in high places in Government. They undermine the laws setting up the hospital system, the Public Service Rules and above all the constitution of the Federal Republic of Nigeria.

At this juncture let us have a critical look at those demands.

(1) APPOINTMENT OF THE POST OF THE DEPUTY CMAC IN HOSPITALS. In line with the University Hospitals (reconstruction of boards) cap U15, LFN 2004 commonly called decree 10 of 1985 which governs Hospital practice in Nigerian, there is the office of the CMAC but it never provided for the office of the DCMAC. In section 4, it provides thus; “there shall be for each Hospital, a Chairman of the Medical Advisory Committee who shall be appointed by the Board and responsible to the Chief Medical Director for all the Clinical and Training activities of the Hospital”. Section 2i provides that; the CMAC is a member of the board. There is no place in the organic law setting up the hospital that created the office of the DCMAC and there is no place it says that only Allopathic Medical Doctors should be appointed as such. Yet NMA is insisting that the Government must appoint four DCMAC in every Teaching Hospital and three in every Federal Medical Centre. All along, Boards of Hospitals as a result of threats from NMA have been allowing this illegal office to be used to undermine statutory approved Scheme of Service of other professional groups. The Public Service Rule in section 1-general in 160101 provides; ‘A Parastatal is a government-owned organization, established by statutes to render specified service(s) to the public. It is structured and operates according to the instrument establishing it and also comes under the policy directives of government. In line with 160201 (a) statutory boards/council shall set operational and administrative policies in accordance with government policy directives and supervise the implementation of such policies. A situation where Allopathic Medical Doctors in Nigeria wants the Government to continue to create post and responsibilities not backed by statutes undermines the principles of good governance. It is gross violation of the law setting the Government owned institution. Moreover, it is trite law that you cannot add to a statute. That will be ultra verse.

(2) NMA IS OPPOSED TO THE APPOINTMENT OF DIRECTORS IN HOSPITALS. It should be noted that this statement is laden with deceit as postulated by NMA, that having Directors in hospitals will affect patient care negatively. This is fallacy of the highest order. The truth of the matter is, NMA does not want professional departments as directorates in the various Scheme of Service, rendering professional duties like the department of Pharmaceutical Services headed by the Director of Pharmaceutical Services who is a Pharmacist. Department of Nursing Services under the Director Nursing Services, who is a Nurse. The Department of Medical Laboratory Services under the Director of Medical Laboratory Services, who is Medical Laboratory Scientist etc.And all are answerable to the Chief Medical Director. It should be noted that, NMA and her members were the ones who negotiated their present Scheme of Service that all their members can rise to level 17 without being called Directors. Other Healthcare Personnel have continued to follow their own Scheme of Service where only one person gets to level 17 and is designated the Director, which is the most popular path in the Public Service. Again in the criteria for employment as stated in the Public Service rule in 020205,-“to be eligible for appointment into the federal Public Service, every applicant must 020205(e) possess requisite qualification as provide in the Scheme of Service.” The Scheme of Service of all other Healthcare Personnel in the hospital provides for a Directorate system. Now NMA and her members want to go on strike for Government to jettison the Public Service Rule which is a Government Policy Document. The Scheme of Service for Allopathic Medical doctors provides for a non Directorate system. AND NO PROFESSIONAL GROUP IMPOSES HER OWN SCHEME OF SERVICE ON THE OTHER. SECONDLY NO EMPLOYEE DETERMINES THE CONDITION OF SERVICE OF ANOTHER EMPLOYEE. They are agitating for this in order to entrench professional imperialism, so that all other healthcare staff will not reach the zenith of their career. That is the singular reason, a doctor on level 15 is called a Head of Department heading someone already on level 17 and is designated a Director .This is gross absurdity against the Public Service Rule. There is no Government Institution in Nigerian where such is seen, only in our Hospitals. And that is what NMA wants to perpetuate. Rule 160103 of the Nigerian Public Service Rule provides –“Parastatals are to retain and improve existing rules, procedures and practices in their establishments and ensure that there are no deviations from the general principles contained in the Public Service Rules………………………………however in the absence of internal rules and regulations on any matter, the relevant provisions of the Public Services Rule shall apply”. This can also be seen in section 5(5) and 17 of the act governing hospital practice in Nigeria. NMA’s demands are anti- Public Service Rule.

(3) NMA DEMANDS THAT GRADE LEVEL 12 SHOULD BE SKIPPED BY DOCTORS.
This demand is not in line with Government approved Scheme of Service for Doctors.NMA in her usual falsehood has always accused JOHESU members of skipping when in actual sense there is nothing like that. The term is a misnomer this is because skipping is when a Civil Servant moves from a grade level to a higher grade level that is not provided for in the Scheme of Service e.g. when a worker moves from 8-10 and there is no approval for such a special promotion ,this is skipping. But when you move from 10- 12 this is not skipping because this is provided in the Scheme of Service and there is no level 11 in the Scheme of Service. A baby physician enters the Service on level 12, which is a principal grade. Now NMA is insisting that they must be appointed on level 13, which is an Assistant Chief Cadre. Haba! How can a beginner enter the Civil Service on an Assistant Chief Cadre? There is no Nigerian worker that enters the Service on such grade. There is no Nigerian Civil Servants that skips. This is not provided in any known Nigerian scheme of Service.

(4 ) APPOINTMENT OF OTHER MEDICAL PERSONNEL AS CONSULTANTS.
NMA is threatening to go on strike because the Government has chosen to obey Court judgment in favour of other Health Personnel that they can also be appointed as consultants in their chosen field. In a false sense of well being, NMA insists that they own the patients and as such only the medical doctor can be called a Consultant. Nobody owns the patient; rather the patient is the epi-centre of Healthcare Service. Medical doctors are just one of the professional skilled healthcare attendants in a hospital, attending to the healthcare needs of the patient. Each medical personnel are given a license to practice their chosen field. The various scheme of Service for Pharmacists, Physiotherapist, Nurses, Medical Laboratory Scientists etc provides that they can be appointed as consultants. All over the world, it is not only Allopathic Medical Doctors that are appointed as consultants. A simple google search will show that there are different consultants in the Health Field. The word consultant is not an exclusive term to designate Allopathic Medical Doctors who are specialists. William A .Cohen, PhD, in his bestselling book “How to Make It Big as a Consultant” has this to say on pages 2 and 3. “Consultants operate in many different fields. Import-export, management, human resources, engineering, and marketing are some of the more common ones. There are consultants in archeology and consultants in clothes selection. There are even consultants to help authors overcome writer’s block.” On page 3 he has this to say. “A consultant is simply anyone who gives advice or performs other services of a professional or a semiprofessional nature in return for compensation”. NMA wants to stop working because other Healthcare Personnel are appointed as consultants. Is NMA saying that they are the only Professionals in the Health Field?

(5) RELATIVITY IN HEALTH SECTOR
On what basis is NMA still agitating for relativity when at the point of entry this has been taken care of and resolved based on the number of years one spends in school. Those who spend four years have their entry point as level 8,those that spend five years on level 9 ,those that spend five years with one year of internship on level 10,while those that spend six years with one year internship on level twelve. The agitation for the so called relativity is discriminatory and violates the Nigerian Constitution as stipulated in section 34-(1). NMA insisting that this must be sacrosanct in the Health Sector is on what basis? It should be noted that members of NMA are just employees of the Government, just like every other Civil Servant, and as such no employee determines what another employee is to be paid. It is never done anywhere in the world. This is a sense of megalomania, and so this jack of all trade mentality must stop.

(6) NATIONAL HEALTH BILL.
NMA is calling for the implementation of the National Health Bill which has been shown to contain a lot of clauses that are anti-people. Many professional Associations, Civil Societies and well meaning Nigerians have called for the removal of these obnoxious sections of the Bill. But NMA in the bid to actualize her set selfish agenda has refused to give good reason a chance. Again some part of the Bill undermines the Nigerian Constitution in use in a Federal System of Government. No Nigerian Health Worker is against having a Health Bill but all we are saying is that in order to meet Government set objectives to enhance the total wellbeing of the citizenry the obnoxious sections has to be expunged.

(7) THE APPOINTMENT OF SURGEON GENERAL.
This office is not created by law. There is no Nigerian statute that says that we must have the office of the Surgeon General. Creation of this office will lead to more agitation and anarchy in the Health Sector which is already polarized. Every professional group will be agitating for the creation of X-general, e.g. Pharmacist general, Nurse general, Optometrist general, Radiographer general, Physiotherapy general, Dietician general; Medical laboratory scientist general etc. The creation of this post will lead to more problems in the health sector. Secondly of what role and benefit is the office of the Surgeon general when we already have two Ministers of Health and there are many Directors also having such functions?

( THE ENTRY POINT OF HOUSE OFFICER TO BE ON COMMESS 1 STEP 4
This level is equivalent to grade level 10 steps 4. On what is this agitation predicated on, when such entry point is not supported by any Scheme of Service, used as one of the criteria for appointment into the Public Service of the federation? It should be noted that house officers are intern or Pupil Medical Doctors. There is no intern in Nigerian that enters the service on step four. Moreover, steps are indicators of the level of experience or years the person /officer have spent on that grade level. On what criteria is a neophyte/green horn in his profession placed on step four? What you have is either step one or step two. Government should not accede to this demand that undermines ethical procedural practice in the Public Service.

(9) CLINICAL ALLOWANCES FOR HONORARY CONSULTANTS TO BE INCREASED BY 90% OF CONMESS.
Early this year, under the immediate past President of NMA, Dr Enabulele, NMA had had an upward salary increase for their members. Not up to 5 months, NMA is now calling for another bloated allowance. Note that consultants are meant to render quality service as Attending Physicians, but what do we see daily in our hospitals? Most of the times, the “consultants/honorary consultants” are never around. Yet they want to be paid such a jumbo allowance. Those that are around, work four times in a month, having one clinic day in a week.

(10) NMA, with the huge sum they are paid, still wants adjustment in their specialist allowance to be paid to all doctors on CONMESS 3 and above, and must be paid its equivalent that is not less than 50% higher than what is paid to other Health Workers. How can NMA be the one to decide what other Health Workers get? NMA should go and read the Parable of one Talent Payment.

(11) NMA is calling for Government to pay her members 100,000 naira every month as just hazard allowance. How can NMA be demanding for such, despite all she is already receiving? She is being too selfish/greedy in her demands. Even other workers with worse occupational hazards are not receiving such.

(12) NMA insists on immediate release of circulars on rural posting, teaching and other allowance which must include House Officers. Since 2009 NMA and her members have been collecting teaching allowance even though that teaching allowances as approved by the Government was for very Senior Medical Doctors (Consultants and very Senior Registrars)that are involved in teaching of doctors in training, especially the junior and senior interns. House officers are the junior interns while Resident doctors are senior interns doing a student fellowship to become a specialist .Now NMA is agitating that the interns who are still doctors in training should be paid teaching allowance. House officers and resident doctors by government circulars are not entitled to this payment; it is because of them that Government is paying the teaching allowance. How can the doctor in training be asking for teaching allowance when he is a trainee, and who is he teaching? Since the approval in 2009 and full implementation in 2010, House Officers and Resident Doctors who are NMA members, have been fraudulently collecting huge monthly teaching allowances which they are not entitled. There is no government circular or template that approved such payment. It was in this year 2014, that the Government through the Call Budget Circular from the Ministry of Finance opposed and stopped the payment of teaching allowance to interns. For five years members of NMA who were not entitled to teaching allowance have been defrauding the Government. He who comes to equity must come with clean hands.

(13) NMA calls for immediate withdrawal of CBN circular authorizing the Medical Laboratory Science Council of Nigerian (MLSCN) to approve licenses for the importation of in vitro diagnostics (IVDS). It is so petty that NMA is going on strike because the Federal Government (which means well for Nigerians), has taken the bull by the horn to making sure that fake/ substandard diagnostic consumables are removed from the system, by effectively empowering MLSCN-the Agency who has the statutory function to do this job. Sections 4b, and 4e of MLSCN act 11 2003 provides- the function of the board are
(B) Regulate the Practice of Medical Laboratory Science in Nigerian.
(c) Regulate the production, importation, sales, and stocking of diagnostic reagents and chemicals.
Section 19 of the MLSCN act mandates MLSCN Board to also make rules. Section 19(d) goes thus-the board may make rules for the maintenance of good standard of Medical Laboratory practice and services with respect to the regulation and control of private practice including statutory inspection, approval, and monitoring of all Medical Laboratories including those adjoined to Clinics, Private and Public Health Institutions. Instead of NMA to partner with MLSCN to kick fake diagnostics out of Nigeria, she is out there encouraging quackery and fighting a lost battle by being anti-Establishment.

(14) NMA wants immediate release of circular on retirement age. Dear Nigerians by increasing retirement age from 60 to more years how will it bring better productivity in the health sector? When within the next ten years of a doctor starting work ,he can get to the zenith of his career which work will he be doing? And when most of our consultants are part time doctors because they work and have Clinics days only once a week.

(15) NMA , Residency and Oversee Training.NMA should look inwards and stop hiding under residency and oversee training to encourage medical tourism and waste of tax payers money. For self reliance and self determination the Alma Ata declaration has a lot to help a young economy like Nigeria. Health has a lot to do with socio-economic indices. Diseases in the tropics are not the same as in the temperate region. Alma Ata declaration of 1978, encourages young economies to look inwards locally in providing healthcare at low and affordable manner. All over the world it is not only one group in the health field that does residency. Veterinarians, Podiatrist, Medical Physicist, Optometrist, Pharmacist, Physical Therapist, Doctors of Ethnomedicine, Doctors of Holistic Medicine, Doctors of Natural Medicine etc all have residency program. Yet none of these group in Nigeria have gone on strike because of no oversee residency program. A privilege is not a right. There is no government law that says that Allopathic Doctors can only become good doctors only when they go oversee.NMA should stop encouraging this mentality that anything African is inferior.NMA should know that what they are asking is not part of the rules of engagement. This is the time for more humane and humble request. Indian doctors are becoming one of the best doctors in the world not because they are looking overseas but because they are looking inwards.

(16) NMA insist on payment of salaries of her member in Owerri. Her members should also meet part of their own responsibilities and agreement as workers. NMA must learn to obey constituent authority, and must make her members to be amenable to discipline.

(17) NMA members and IPPIS platform. NMA has always shown double standard on this issue. Before now, members of NMA went on strike because of the Government policy that all worker must be on IPPIS platform. How come it is now that NMA is just waking up from sleep, to say that if her members are not on IPPIS she will call her members for indefinite strike? The Government policy is that if you are not on a pensionable appointment you cannot be on IPPIS. So how can house officers and residents be on IPPIS when their appointment is not permanent? Moreover the 2014 Call Budget Circular from the Ministry of Finance provides that you cannot hold more than one appointment and be placed in two places under IPPIS platform. When IPPIS came many members of NMA opposed it because it did not allow them to be on Government pay role in two places.

(18) NMA wants to go on strike because House Officers are said not to be part of NARD-National Association of Resident Doctors. The big question here is, are house officers also paid the same as their senior residents? In as much that the House Officer is a junior resident while the doctor in training to become a specialist is a senior resident the duo cannot be part of any strike action even with their consultants, because they belong to an Association and not a trade Union.NMA is only calling for House Officers to be part of NARD for them to be part of their numerous illegal strike action.

(19) NMA accuses Medical Laboratory Scientists of harasment.NMA has shown herself that she is a Joker. The world knows that it is the other way round. That it is members of NMA that are harassing Medical Laboratory Scientists in Nigerian. The number of Medical laboratory Scientist that NMA members have instigated their sack/termination of appointment/suspension is worrisome. But thanks are to the Most High for the Judiciary who brings hope for the common man, by setting aside most of the sack/termination/suspension. Medical laboratory Scientists are people who do not act on impulse, or with impunity. Why is NMA resorting to self help when issues she has with members of Association of Medical Laboratory Scientists of Nigerian are in court? Why is she the judge in her own case? The spirit of Medical Laboratory Scientists can never be broken. We shall always move with great crescendo to protect patients’ interest and the public at large, despite the provocation and lawlessness that is being perpetuated by members of NMA in the Health Sector. The laws of the land shall be our strength, for he who holds the mace of truth and justice can never falter. We cannot be intimidated by her Goliath posturing.

(20) NMA says-‘the endless circles of incomplete salary payment to our members in many hospital in the name of short falls in personal cost must stop’. This is the only legitimate demand out of the 24 demands by NMA because the labourer is worthy of his wages. But NMA cannot call her members out for strike based on this, because she is not a registered Trade Union but a charity. This problem is not peculiar to only Allopathic Medical Doctors but to all personnel working in the Health Sector.

(21) NMA in her number 21 demand states ‘universal application of all establishment circulars on remuneration and condition of service for doctors at all levels of Government must be guaranteed’. NMA is not justified here, because this borders on Constitutional Matter. And the Central Government has some limits to want they can impose on the State, bearing in mind that we are practicing a Federal System of Government, where power is shared among the three tiers of Government, the Federal, State and the Local Government. NMA members should come to terms that they are the employee and not the employer. It is very interesting to note, that NMA who champions the lost battle, insists that the approved Scheme of Service/circulars of other healthcare workers will never be implemented is the one now agitating that even things not given by any Scheme Service/circular must be implemented.

(22) NMA demands that Government must urgently set up a health trust fund that will enhance the upgrading of hospitals.NMA is being sentimental here, the problems of our hospital is not funding but mismanagement and accountability. Even if the Government sets 100 trust funds with billions of naira much will not come out of it, because the hospitals are managed contrary to Government laws and principles. Hospital/health administrators should be the ones to head and manage the hospitals. Our hospitals have been poorly managed under the leadership of Allopathic Physicians. When there is good management and accountability Government set goals/objectives can be actualized.

(23) APPOINTMENT INTO THE OFFICE OF THE CMD/MD.
NMA is always doctoring and adding to organic laws. In her 23rd demand, NMA stated “the position of the Chief Medical Director/Medical Director must continue to be occupied by a medical doctor as contained in the act establishing the tertiary hospitals. This position remains sacrosanct and untouchable.” I can beat my chest and say that the leadership of NMA have never seen nor read the content of University Teaching Hospitals (reconstruction of boards) cap U15, LFN 2004 commonly called decree 10 of 1985.There is no where it stated what NMA quoted above. In fact the term medical doctor was never used in that document or Act. Section 5 of the act provides;
(1) There shall be for each hospital a Chief Medical Director who shall be appointed by the president on such terms and conditions as may be specified in his letter of appointment or as may be determined from time to time by the Federal Government.
(2)The Chief Medical Director shall
(a)Be a person who is medically qualified and registered as such for a period of not less than 12 years, and has had considerable administrative experience in matters of health and holds a post graduate medical qualification obtained not less than 5 years prior to the appointment as chief medical director and
(b)Be charged with the responsibility for the execution of the polices and matters affecting the day to day management of the affairs of the hospital.
In the afore-mentioned Act, there is no place it said that the person must be a Medical Doctor. The International best practice is that, it is not only Medical Doctors that head Hospitals rather, in most places; it is a qualified hospital/health administrator that manages the Hospital. If you do a search on the internet on the criteria to become a truck driver in USA, note that you will see that it says that the person must be medically qualified. So does being medically qualified here mean that one must be a medical doctor to be a truck driver? The capital answer is “no”. It means being medically fit. The term medically qualified as used in the act has been misinterpreted to mean a holder of a certificate registrable by MEDICAL AND DENTAL COUNCIL OF NIGERIA.(MDCN). Currently there is a case instituted in the Federal High Court Awka by Comr. A. A Obi a distinguished Medical Laboratory Scientist and the suit number is FHC/AWK/CS/38/2013.The suit is to interpret the meaning of who is medically qualified as used in section 5 of the act. So why is NMA and her members jumping the gun to go on strike on an issue before the Court is that not subjudice? All along NMA has used acts of impunity to undermine the rule of law. The organic law did not say the person will be a Medical Doctor or be registrable with MDCN even though all adverts for the posts of CMD/MD have come to illegally say so.
It is lucid that from the foregoing, certain questions arise. Can NMA as an Association declare and call for strike, when it is not a Trade Union? Is NMA above the law, that it can undermine the provisions of the Constitution of the Federal Republic of Nigeria, by trampling on the code of conduct for Public Officers as stated in the constitution? Section 2 subsections 1,2 and 3 of the Trade Union Act, states “A trade union shall not perform any act in furtherance of the purpose for which it has been formed unless it has been registered under this act……………..”

section 2 subsection 2-where a trade union registered under this act ceases to be registered, it shall not there after perform any action in furtherance of this purpose…………….
section 2 subsection 3-if any act which is prohibited by section (1) or (2) of this section, is performed by a trade union, then
(a)The Union and every official thereof; and
(b) Any member thereof who, not being an official thereof, took any active part in the performance of that act, shall be guilty of an offence against this act.
NMA is not a registered Trade Union, so she cannot be doing this, entrenching sabotage and acts of impunity against the State. Above all, endangering the lives of the citizens, she swore on oath to protect. A situation where NMA is going on strike as a result of these frivolous demands is gross misconduct and acts of negligence. Section 3 of 030301( h) of the Public Service Rule terms negligence as a misconduct.030402 (e) terms absence from duty without leave as serious acts of misconduct. Sabotage in 030402(t) is also stated as serious misconduct. Section 33(1) of the Nigerian Constitution 2011 as amended provides every person has a right to life and no one shall be deprived intentionally of his life………section 172 of the same Constitution states “A person in the Public Service of the Federation shall observe and conform to the code of conduct of the Federation “.

The fifth schedule part 1 code of conduct for Public Officers says:
(1) A public officer shall not put himself in a position where his personal interest conflicts with his duties and responsibilities.
(9) A public officer shall not do or direct to be done, in abuse of his office, any contrary act prejudicial to the rights of any other person or contrary to.
It is so glaring that what NMA is asking is prejudicial and tramples on the rights of Nigerian Citizens.
(24) IN her 24 demand NMA forgot that she is an employee of the Government and it is not for her to dictate on how Optometrist or Medical Physicist should be paid. Nigeria is not Govern by the whims and caprices of NMA but by laws and polices made by the Government.

CONCLUSION.
NMA and her members are not justified on going on strike. The only reasonable demand is demand number 20 haba! A student who scored one out of twenty four is not doing well at all. NMA members should know that as workers they have duty of Fidelity, they as Civil Servants are bound to only obey rightful orders from NMA. They also have duty of care and skill to the patient. And above all their loyalty/allegiance is to the Nigerian state. A situation where NMA gives her members unlawful orders undermines the rule of law and as such, such orders cannot hold sway.

NMA has become a fifth columnists working against the state. It is sad that NMA and her members who have benefitted so much from the state are now turning themselves against the Nigerian state to become the killer of the Nigerian People, instead of being the Physician who is to be the healer of the patient and people. Nigerians must rise and say no to this medical imperialism by using the instrumentality of the law to stop NMA from inflicting untold hardship on her citizenry. The Federal Government through the Ministry of Health under Prof Onyebuchi CHukwu must act to maintain law and order, now that NMA has told the world that it is because of some of the things She granted to JOHESU on merit, is the reason NMA is going on strike. She should seek an injunction restraining NMA from going on strike just as he did to JOHESU, pending the determination of the motion on notice to know if NMA has the locus standi to go on strike when she is not a Trade Union. JOHESU should be firm to seek a legal redress to restrain NMA in this acts of lawlessness,if the Government does not act.There must be a total restructuring of the Health Sector. All Nigerians from all works of life must condemn these acts of sabotage against the State by doctors of Allopathic Medicine under the auspices of NMA. The Nigerian Government as a matter of urgency should support the Natural Medicine Development Agency Kofo Abayomi Victoria Island, to reposition our Traditional Medicine to be like what is seen in China, USA, U.K, India, Korea etc. And it should be integrated into the mainstream Healthcare System in Nigeria.

Allopathic Monopolistic Medicine should give way to Pluralistic Medicine. Government should create an enabling environment for the practice of the different Medical Systems like, Functional Medicine, Holistic Medicine, Ethnomedicine, Ayurvedic Medicine, Homeopathy, Osteopathy etc. All over the world, no country is currently solely dependent on one Medical System. Nigerians must say no to NMA that has become anti people. The Nigerian Government should not allow herself to be blackmailed by NMA. She should first and foremost challenge NMA for acts of impunity against the state. The federal Government should take a leaf from Governor Fashola of Lagos State, for enough is enough. The Government should also take a queue from the former governor of Anambra state, Mr Peter Obi

BY BENJAMIN CHUKWUNONSO AJUFO

Naija Nurses Forum

Igbojionu Ijeoma Joy >
Pls what is d best treatment to a 14wks primip who complains of having lower uterine contraction

Edafeadhe Onome:
Now that the doctors are on strike what will you do? Are you going to their houses and call them that a patient is having pre-term contractions. Say something reasonable.
This is the opportunity Nurses
have to prove their worth in the hospital.
Thanks for all your
contributions. What of Ergometrin or dexamethasone. These drugs helps to reduce spasms.

prettyprettywow: JOHESU does not have any request for now. It is the NMA that has 24 commandments. JOHESU's case has been handled by the industrial court but NMA is asking the FG to disobey court ruling

Thanks for the post. Will do my analysis also

phantom: CMD and CEO are they really the same thing

American pattern is different from ours. In our system,CEO is the director of administration which should be a health manager. Do u want us to have 2 health manager?