https://thestreetjournal.org/nigerian-hospitals-recruit-retired-nurses-as-last-resort-amidst-massive-brain-drain/

Many hospitals in the country have been forced to recruit retired nurses on contract to bolster their work-force due to the massive migration of medical workers to foreign countries.

A nurse, simply identified as Mrs. Turaki, who has been in the profession for over 15 years, said that decrease in number of health personnel has only gotten worse at the tertiary hospital where she works in Bauchi state.

Turaki complained about the many things wrong with the health sector in the country including shortage of staff, poor working conditions, inadequate equipment and a heavy workload.

She noted that seven amongst her friends at the hospital have left the shores of the country for greener pastures.

Turaki, while speaking, said that, “I’m not enjoying the job again. This was not what I longed to see before joining the profession.

“I thought it’s meant to get better but things are getting worse. There has been shortage of staff and equipments, also the remuneration is nothing to write home about.”

The nurse now runs longer shifts and attends to more patients, adding that she is meant to care for four patients, or at most 10.

Turaki said that whenever she arrives at work, she has to decide which of the 50 patients on the queue needs urgent care or minor surgeries, The Punch reports.

She said that, “In a day, I attend to at least 20 patients and if I’m on the triaging table, I must attend to about 50 patients daily.

“I will triage them one after the other to know the department to refer them to.

“I have to go through their folders and check if they are new cases or they are emergency cases,” she added.

For minor surgeries, between 10 and 15 patients, Turaki noted that she usually attend to them one after the other, working hand in hand with the doctors.

“In my clinic, we work from 8 am to 4 pm but if you’re on duty, once you close by 4 pm, you remain on duty from that 4 pm till 8 am the next day,” she said.

As a result of the gruelling workload and lack of working tools, Turaki thinks the world is on her shoulders.

Turaki said that, “There was a patient who required an emergency tracheotomy but the equipment was not available.

“We referred the patient to another hospital in Jos, which was the closest but before getting there, he died.”

The nurse noted that for all her troubles, she earns N210,000 on a monthly basis.

Turaki said that, “I’m on CONHESS 12, which is grade level 13 in the civil service, and I earn N210,000 monthly.

“Meanwhile, our colleagues who have travelled abroad earn up to N1 million per month,” she added.

Similarly, another nurse based in Ondo state, Mrs. Ameh, feels overwhelmed and undervalued doing what she loves to do the most.

Ameh said that, “I enjoy my nursing job but I am overwhelmed. We are only two nurses in the clinic.

“We get easily exhausted because we attend to more than 40 patients a day, sometimes 70 patients a day.

“This is what we face every day. The work that should have been done by four people is being done by two people.

“If I see the opportunity to leave Nigeria today, I won’t wait, I will leave the country immediately because the work is overwhelming.

“If I have the means to go, I will go. I think about it every day,” she added.

Thousands of nurses like Turaki and Ameh are frustrated on the job due to the increasingly difficult working conditions.

According to the president of the National Association of Nigeria Nurses and Midwives, Michael Nnachi, at least 57,000 nurses left the country between 2017 and 2022 in a bid to earn practise abroad and earn better pay.

Despite the World Health Organisation (WHO) code of practice, which states that member states should discourage active recruitment of health professionals from developing countries facing critical shortages of health workers, the latest data from the nursing and midwifery council shows that there is a big rise in the number of Nigerian-trained nurses who join the list.

The nursing and midwifery council noted that almost half of the foreigners last year were aged 30 or under, and a similar number were in their 40s.

Only five percent were 41 and above, compared to 14 percent of the people who joined from the United Kingdom.

The NMC, which is the regulator for nursing and midwifery professions in the UK, said that many are settling in and around London.

However, NMC data does show that medical professionals are moving to all corners of the UK and England.

According to the NMC data, 7,256 trained nurses in Nigeria relocated to the UK between March 2021 and March 2022.

Nnachi confirmed that the migration of nurses to other countries leaves the burden of care on the few available medical workers.

With an estimated population of over 200 million persons in Nigeria, there is one nurse per 1,660 people in the country, according to Nnachi.

Nnachi said that, “The concern is that care has to be qualitative but as nurses are leaving, there is such an increase in the workload that if I tell you that it is one nurse to 60 or 80 patients, it might be modest.

“But if you’re looking at the statistics and population of Nigeria, the nurse-patient ratio is one to 1,660 patients,” he added.

To save the situation, the managements of hospitals in Nigeria have decided to call back retired nurses.

Some of them believe that retired nurses still have much to offer despite their age.

Though some hospitals denied resorting to such a scheme, the recruited nurses are speaking out in anger.

After a fulfilling nursing career that spanned 35 years, Abimbola Johnson (not real name) took a bow from a federal hospital in Lagos state in 2019.

Johnson retired as an assistant director of nursing services in one of the general hospitals in Lagos.

The civil service rule in Nigeria mandates civil servants to retire either after serving for 35 years or attaining the age of 60.

The former was the basis for Johnson’s retirement as she was 58 years old at that time, however, her retirement phase was short-lived and she found herself back at work two years later.

Johnson, who is now 61 years old, said that she was recruited again as staff shortage hit the critical workforce and the pressure on hospitals escalated.

Johnson, who is currently working in the health service as a contract worker, noted that her grade level was stepped down by a rank.

She said that many of her colleagues are also back to work, all in a bid to salvage the health sector from collapse.

Johnson stated that, “I have seen colleagues who have renewed their contract up to four times, some of them have even passed age 65.

“We see them and we know ourselves. Even in the Lagos University Teaching Hospital (LASUTH), Idi-araba, we have some of our good old hands who are back there as contract nurses because of the mass exodus of nurses.”

The veteran nurse noted that she would have felt uncomfortable staying at home when she still had something to offer.

Johnson said that, “The ability is still there to work. Why would I stay indoors when I still have something to offer?

“My two-year contract ends this December but if I wish to continue, all I have to do is re-apply and renew my contract for another two years.”

Another retired nurse, who wished to remain anonymous, said that even though she is contributing her quota to healthcare delivery in the country, she is saddened by the overstretched health system.

She said that she retired from service in 2022 at age 59 as a GL 16 officer but she was recruited almost immediately as a contract nurse on GL 15.

She noted that,“Even as a retired nurse, when I begin to look at my gratuity, I am not happy.

“I look at my counterparts that work with Shell and NNPC, and I know what their gratuities are.”

The xhairman of NANNM, Lagos state council, Olurotimi Awojide, while speaking on the development, said that, “The government needs to review the salary of nurses and that is one of the reasons young nurses are leaving the country.

“We should declare an emergency in the healthcare sector. The workload is enormous and we are overstretched in taking care of patients.

“It is meant to be one nurse to four patients but because of our peculiarity in Nigeria, we still accepted one nurse to eight patients but now, you will see one nurse taking care of more than 15 patients.

“This is not allowing us to provide the expected professional care to patients.

“Nurses are graduating and leaving immediately after their final year exams because the working conditions are not encouraging.

“More nurses will still leave as it is a very serious situation. Almost everybody is planning to go abroad,” he lamented.

A nursing advocate, Bunmi Lawal, said yhT though nurses constitute the largest healthcare workforce, little attention is paid to addressing the push factors.

Lawal stated that, “We know that in the Federal Capital Territory (FCT), more than five nurses leave for the US, UK and Saudi Arabia weekly.

“Our hazard allowance is nothing to write home about despite battling COVID-19, Lassa fever and other deadly diseases.

“You have a situation where one nurse will run the night shift in some of our general hospitals.

“In hospitals like the National Hospital, Abuja, two nurses run the night shift, no matter the workload. We are left with fewer hands, and the quality of care is poor.

“The government needs to address the issue of remuneration and specialty in the profession, and improve the equipment in the hospitals. Some hospitals still take delivery on the floor,’’ she noted.

Recall that a leaked memo from the Federal Medical Centre, Abeokuta showed that over seven staff collapsed during surgeries in one month due to exhaustion in September 2022.

The memo written and signed by the theatre manager, A.G Fagoyinbo, and dated August 29, 2022, was titled ‘Request to reduce the number of elective surgeries: Two patients per specialty per day.’

The memo reads, “The situation is such that only one peri-operative nurse works in the suite instead of three peri-operative nurses, same with other surgical staff (members).

“The excess workload has resulted in serious burn-out and extreme tiredness.”

The medical advisory committee chairman at LASUTH, Prof. Adetokunbo Fabamwo, said that medical directors are also in pain as the brain drain digs deeper into the nursing profession.

“We are already down to about 30 per cent since about one year now that it got worse,” Fabamwo said.

“At the state government level, stakeholders have examined the issues and decided to expand the capacity of the school of nursing in Igando to produce more nurses.

“Some of them are still young and not up to 60 years and some who are 60 are still capable of working.

“In the last month or two, we have six applications from retired nurses who want to join us,’’ he added.

He noted that the hospital had sought the consent of its governing board in recruiting single qualified nurses for specific areas.

Such nurses will be required to acquire their second qualification within two years of recruitment, according to Fabamwo.