NANNM PRESIDENT Press Conference Text Address

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NANNM PRESIDENT Press Conference Text Address

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A TRIBUTE TO THE NURSE WHO MADE SUPREME SACRIFICE TO HER COUNTRY.
THE TEXT OF THE ADDRESS DELIEVERED AT A PRESS CONFERENCE AT NANNM LAGOS STATE SECRETARIAT, AGIDINGBI, ALAHUSA. IKEJA LAGOS ON SATURDAY 9TH DAY OF AUGUST, 2014 BY THE NATIONAL PRESIDENT OF NATIONAL ASSOCIATION OF NIGERIA NURSES AND MIDWIVES, NURSE ABDRAFIU ALANI ADENIJI.

Protocols,

It has become very important to address the press at this auspicious and trying time when our nation's health industry is in chaos. The state of the nation as regards national health care services is in pandemonium which has shown in the situation that has no peace due to happenings traceable to the fact that the health sector has been mismanaged.
The situation we have on ground has shown the whole nation who among the health care professionals group is sacrificing to sustain the health sector and those that are using the circumstances to enrich themselves and for personal aggrandizement at the expense of the nation. Who is the patriot? It is pertinent to make some analysis about the ongoing strike of our counterparts, the medical and dental practitioners.

THE INCESSANT STRIKES: The whole atmosphere is pervaded with uncertainty and lack of direction by the self-acclaimed leaders of the health sector. To put it simply and precisely, the strike embarked upon by members of Nigeria Medical Association is a reflection of injustice, inequity, mal- administration, reign of impunity, illegality, over-indulgence and misplaced privileges that has characterized health 'care service administration in this country. It became pronounced most especially from the time of late Prof. Olikoye Ransome Kuti and become highly entrenched with the current Minister for Health, Professor Oyebuchi Chukwu who has never denounced the fact that he is an extension of NMA leadership. He has always shown in very clear terms that he has only come not for all health care professionals but for the members of his profession as if he has forgotten that beside been a minister of the federal republic, the most important responsibility he was charged when appointed and sworn into office was to drive a process of returning harmony into health sector but situation has unfortunately been worsened. The Nigerians that are keen followers of events in health sector can lay credence to this. The whole of health sector have been plagued by the heavy presence of members of NMA dictating the pace and direction of affairs at the Federal Ministry of Health abdicating their primary responsibility to create artifiCial scarcity in their most needed areas, the 56 Teaching Hospitals; Federal medical Centres and Specialist Hospitals, all Government Agencies which have becomes gold mines has been turned into personal birth right. The scenario I pictured as incapable leadership that has truncated and stunted all the prospect and fortune of Nigeria health sector. They created and nurtured medical tourism for reason of incompetence the very menace they pretend to. be finding solution to. In summary, the current strike is an aberration, illegal and is a signal that health sector has been unfortunate to have this crop of self - centered class of professionals to handle the Nigeria health sector. It is a form of elite insurgency, 'Medico - Boko Haram'. Honestly I personally do not know how else to describe their 24 point 'command' I mean what supposed to be demand that are not capable of addressing needs of Nigeria health sector challenges but rather to meet a parochial interest at the detriment of the generality. They are most favoured, the highly pampered group not because they deserve it but due to a narrow-minded belief that the Nigeria public have also compounded. If I have to comment on each of their request one after the other you will agree with me that this strike is a well-planned conspiracy and unwarranted terrorism on the whole Nigeria public.

The whole process is illegal which the government at all levels is aiding and abetting. The point am stressing is that the body calling for the strike is known and recognized as professional entity. NMA is not a registered Trade Union, based on this; the government ought not to meet with them to negotiate anything, but in contravening the Laws of the Federal Republic of Nigeria which they put in place. How do we then blame common citizen for not obeying the government law? The Federal Ministry of Health who are the principal conspirators has implicated the Federal Government by playing roles as the employing authority and silently as member of NMA, what ironing. If the FMOH is sincerely desirous of preventing the current situation they know how to do it. Am sure if it were other health workers that are on strike before now the Hon. Minister of Health would have instructed the CMDs to terrorize, intimidate and dehumanize the leaders of other health workers Union, sometimes using law enforcement agents, invoke no work no pay and or head for the NIC to restrain the health workers not to go on strike at all or to have brought them back to work through court injunction. You can judge the indulgence on one hand and high handedness on the other, injustice that is playing back. This is the basis of my assertion that the strike is a form of conspiracy. The ideal thing all over the world is to organize a stakeholders meeting to discuss the issue of common interest, but what we have seen over the time is to just see circulars emanating from the government. The FMOH are of the habit of stage managing crises, the watch dog of the NMA in the garb of key government officials will appear to be on the side of government but work for their counterparts committing the government and allowed to be stampede into taking decision not only on issues concerning NMA members alone but transgressing their judicial bounds to take decisions on issues concerning the fate of other health professionals. The point here is that most of the people that are supposed to be sincerely committed to the FGN are seen to be working behind the scene to commit the FGN to the detriment of the government and people of Nigeria. The level of the war these collaborators are waging against government and people of Nigeria is so colossal that if known the public must change their view on the make belief that they are working for the general good of the nation. They work within the government to fight the government they sworn to defend. Each time they want to go on strike they put forward some issues on lack of adequate infrastructure, deficiencies in the system etc., but under the open issue there are underline agenda.

If you critically scrutinize the numerous demands of the NMA, there are embedded in it many of their command or dictate that has to do with rights and privileges of other health workers. Like the claim that all other health workers are not to be appointed as consultant in the teaching hospitals. What a deluded view. This claim does not follow any regulation but wishful thinking that if it could be achieved then it will be easy to further subjugate other professionals that have their own autonomy, body of knowledge, scope of practice and even academic attainment to be qualified for the appointment. The international best practices are that all professionals have consultants in their respective fields. We have consultant nurses, pharmacist, physiotherapist and Laboratory Scientist in their area of specialization and expertise.
For Nurses we have consultant in critical care, medico-surgical, mental health, ear- nose and throat, anesthesia, pediatrics, informatics, Ophthalmic nursing just to mention but a few fields of specialization. This is fact that can be confirmed from other countries, this is a world information technology. What the government and people of Nigeria should know is that the claims of the NMA today have the route traceable to those era in Nigeria when there were no indigenous practitioners, the available professionals then' were foreigners and they were then been remunerated with expatriates salary, now that we are having our indigenous practitioners that we use government resources to train, must we continue to subjected to the agony of producing our own product? It is only medical and dental practitioners that are been treated in a context of the foreign condition of service.

How can medical doctors insist on superintends over another professionals like nurse, pharmacist and others. This is professional oligarchy, which cannot be seen elsewhere except in Nigeria, absolute power and authority is said to corrupt absolutely. You can imagine professional neo-colonialism and imperialism in our own fathers land in the computer age. The appointment of a consultant is an issue that cannot be suppressed any longer, if other develop countries do it and they are better for it why must Nigeria be an exception. You should be able to detect that the fear of any other person challenging their authority or competition as 'its happening elsewhere. Health is a multidisciplinary sector not like the Ministry of justice where Law is the required field of study to be eligible to practice. The reference to university setting within ASU and NASU, where the NMA are comparing other health professionals to non-academic staff on the right to become Vice Chancellor is misleading not comparable.

Why should a competent professional be afraid of working with another colleague? -A professor in medicine, nursing, pharmacy, Laboratory sciences or physiotherapy are authorities in their own chosen field and I do not see how their claim that even if you are a professor in another field such person should subjugate their skill and academic prowess to a student in medicine, where is that done all over the world.

The pettiness that profession are now upgrading the training of their professionals requiring them to acquire Doctor of sciences in their field should not answer their title because a less trained person has abandoned their rightful name of physician to arrogate the name doctor must monopolize the name/ title. You can see how petty the supposed leader of sensitive health sector is!

The universal practice is that health care delivery is a team work and whoever among the eligible should be counted as fit for the job of leading the team. We have tried the leadership under a single profession which has led to sacrificing merit at the foot of mediocrity. The highest job becomes the birth right whether you have the pre-requisite qualification, emotional intelligence, leadership capability or not. This is what has always led to administrative lapses in our health system. There must be change to turn around the health sector.

On the issue of appointment of Surgeon General, must this cause strike action? The two ministers in the health sector are medical doctors yet they are not satisfied. There are a lot of make belief and rationalization in this issue. They are fighting to resist change for better performance in the health care services of Nigeria and to remain as drainage pipe for Nigeria health sector.

If the government adopts equity and justice the deception of always fighting for personal aggrandizement and making the public to belief they are fighting the course of improved health care that has hitherto shrouded in misery would have been unveiled. Reliable studies revealed that government of Federal Republic of Nigeria are expending billions of Naira annually on training of medical doctors for residency programme both home and abroad without any condition attached, yet they still turn back to fight the very authority that are fending for them, While other students of health discipline other than medicine at master degree level spends millions of naira to pursue their personal professional career development, this amount to injustice, inequity and indulgence.

The statistics of death that occurs as a result of the strike cannot be ascertained and definitely they would have assisted some to die a little earlier than their times. But I must reassure you that the mortality is not as high as expected. Could you have imagined that the Nigeria doctors could be on strike for almost four weeks and the heaven does not fall? Gradually, the government should take the issue squarely and see that there is no single profession that can swallow others. Even that health attendant in the hospital is very important to the running of the hospital.

The other health workers are at alert; though the government does not seem to be keenly interested to reduce the effect of the strike, they should have done more' to ensure accessibility of health care services to the public. Even it may interest you that those that can afford it have a way out by patronizing private hospitals. Nigerian medical doctors are only on strike at the public hospitals, they have their way at the private hospitals that belong to them. In essence they are only striking at the public hospitals but are fully having free days at their various private clinics.

You can see why their leaders may not want the strike to end soon. Nigeria public should be aware of this deception; they gain maximally while they attempt to paralyze the work at the public hospitals. They do this to punish the poor people. If not for the regulation in this country where even the publics are made to suffer by not allowing other professionals to do what they are trained and certified to do, the situation would have been more ameliorated. Even without the strike, nurses and even health workers at the primary health care levels are seeing patient, diagnosing them and treating them. It is pertinent to intimate the public that nurses and other health workers are at the hospitals, and nurses are trained to diagnose and treat minor prevalent ailments in an area. Also, the members of the medical and dental consultants are not expected to be on strike, because the NIC injunction which they sought for has ruled against their going on strike. The public are therefore encouraged to go to the hospitals where ever they are, services are awaiting them. The services of the Nurses and other health workers are keeping the health sector to run essential services if there are no conspiracy that I called medico-boko haram insurgence on health sector. The public that are on NHIS scheme are not expected to be punished unnecessarily because of the inordinate ambition of some people. They have the right to sue FGN and respective health providers for breach of contract agreement.
In any hospital that services are completely disrupted has to be investigated and fish out saboteurs. The ante natal care should not be disrupted at all as the midwives toe ones legally empowered to conduct ante care, take delivery and conduct post natal care and refer complicated cases not to general practicing doctor but consultant gynecologist. They are fully ready to do the job they are trained to do and I want to reassure Nigerians of safe, quality and accessible care without let or hindrances.
Together We Light Up The Profession one candle at a time.
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Re: NANNM PRESIDENT Press Conference Text Address

Unread post by Kunle Emmanuel »

THE ROLE OF NURSES DURING THE STRIKE.
Nigeria nurses are coping without doctors in the hospitals. It is necessary to use this medium to appreciate hardworking and dedicated nurses that has sustained the system along with other health care professionals. To be factual it has posed extra challenges because as nurses we are trained to respect jurisdiction in legalized practice. But we need to know that the profession of nursing has multiple roles to play in the hospital settings.

Our roles are in three folds. We have the 3 roles though over lapping but with distinct features. Nurse according to ICN and WHO are recognized as follow: "A nurse is person having received authorized education and training arid has acquired knowledge, skills and attitude in promotion of health, prevention of illness, and care of the sick within the limit of his/her competence of the health problems which arises in the community" (WHO). Nurses are trained and acquire skills in identification of diseases entity and the required treatment to corroborate the work of the team members. This plays a role of checks and balances to correct any wrong diagnoses as there is no health system that is error free.

Even United State of America identified the presence of medical error that claims lives. In 2009 it was reported that the committee set up by the USA Institute of Medicine (10M) discovered that up to 98,000 Americans dies out of no other cause but for medical error. The nurses therefore as patients' advocates are trained like others to be able to effect correction of medical errors. The nurse has 3 roles like I said vis - a -vis Independent; interdependent and dependent roles. Some good and mannered medical doctors do not react negatively to the issue of detecting error and pointing it out, but many do react negatively.

THE PROFESSIONAL ROLES OF THE NURSES Independent roles of a nurse are those ones that do not require any chaperon or assistance before carrying them out. The nurses' independent role entails many professional responsibilities that depict the professional autonomy, but of specific reference is for the nurse to carry out assessments that may require the even analysis and interpretation of laboratory investigations and final diagnosis done called nursing diagnosis.

All other nurse's duties that are clinically placed are expected to be done independently. The interdependent roles are those that are to be done together with one or more team members, while the dependent roles are those works of the other team members are needed, the collection of patient's card from medical record officers, the expected lab test, or the medical diagnosis and drug prescription by medical doctors. This should not make a nurse look as apprentice since a doctor will also need a nurse's information about an inpatient before knowing what to do.

The public need to know this. Nurses' attention span has been found out to be the best and longest among other health workers. With good and longer/durable attention span for the entire patient's health need and demand can be satisfactorily met. It even pertinent to respond to a conflagration in the statement credited to the leadership of NMA that the duty of a nurse is to collect his hand gloves and discard just to mischievously drag home one their claim that others are only supportive staff to medical and dental practitioners. It is a derogatory statement that has no basis, and that is the behavior of many Nigerian medical doctors to look down on others whereas every profession has their place and relevance. In any surgical procedure you cannot be said to have completed your procedure until when you have complied with aseptic technique. Is he saying that he can leave his role in the aseptic technique to another person to be a doctor infection disseminator? Rather than his license withdrawn if other do not collect the gloves from him, the ethics of practice made him liable for not following aseptic technique, this could amount to professional misconduct.

THE NURSE AND THE RIGHT TO PRACTICE INDEPENDENTLY
What is hampering to Nigeria nurses as to prescribe therapies is uncalled for, the laws and professional regulations did not rule out nurses evaluating the patient condition and drawing an analysis to arrive at diagnosis and deciding what therapy to be given. It must be said here that medical practice here in Nigeria is not nearing the ideal.
The obstacles to identifying the nurse specialist competences like the Advanced . Nurse Practitioners course that empowers the nurses to diagnosis ailment and treat accordingly is the whims and caprices of medical doctors who felt threatened that their image might be reduced or the referencing might be shared with them, whereas the whole lot of Primary Health Care are largely in the hands of nurses and other health workers at the PHC level with good outcomes. The government will do much good for the citizenry by not restraining nurses in this issue of diagnose and treating patients as it is been done and regulated in USA.

Our attention has been drawn to the absurdity by some chief medical directors that are working against the wish of our nurses to continue to run outpatient treatment, antenatal care, taking deliveries and child welfare clinics along with the nurses in their area of specialization who are certified to diagnosis and treat patient not only in the absence of the medical doctors, but also as professionals who are taught to do nursing diagnosis treat and refer as •appropriate. We therefore call on the public to go to the hospitals they will be attended to appropriately.
The recommendation to the government to forestall incessant strike in health sector is that, the government should not use double standard in solving health care issues. There must be much attention and funding to presidential special committee on harmonious relationship on health matters and the issuance and release of enabling circular. The government should not engage in illegality and so must not negotiate any form of staff welfare with an unregistered trade union. It is equally beneficial if the professional organization would be pooled together to attend to the general problems that cut across the challenges of health sectors.

The issue of policy formulation should involve all the stake holders. The government should also call the NMA to a dialogue and make them recognize the need to be exposed to joint meetings to enthrone harmony in health sector. The government should be prepared to meet there genuine demand of not only NMA members but also every trade group. There must be an end to health sector industrial disharmony but establishing code of conduct to resolve conflict. The nurse specialist / advance practitioners should be empowered to carry out their duties as contained in their training curriculum.

The NMA should 'not be allowed to negotiate other health, professionals' condition of services. The NMA should be made to be registered appropriately as a trade union to be entitled for negotiation according to the laws of Federal Republic of Nigeria. The fundamental professional roles of the nurses should be allow without any further delay to make the public to enjoy the full professional duties and responsibilities of a professional nurse.

TRIBUTE TO THE DEAD COLLEAGUE ON EBOLA OUTBREAK.
Ebola hernorrhagic fever is no doubt a deadly epidemic. Since its first detection in Zaire in 1976, it has killed over 700 people with incubation period of 2-21 days, it can be said to be the most deadly viral infection. The mode of spread as personal contact, indirect contact, and contact with exudates, blood products, vomitus, and discharges from ear, nose and throats made nurses the most exposed group of health workers.

The death of these nurses and some others of his colleagues that are currently suffering because of their dedication to duty is an indication of who is more exposed, who is the closest person to the patient. Who are the patients' advocates, yet the nurses remains an unsung hero in the health sector.
"Nursing is a calling, a way of life. Nursing is a service profession that cannot be lived in isolation. Nurses rely on each other for the synergistic effect of teamwork in our efforts of care giving. It is appropriate that we honor our colleagues not only during their career, but also at the end of life's journey."

The National Association of Nigerian Nurses and Midwives {NANNM} will like to use this medium to commiserate with the family, friends and colleagues of Nurse, the first known Nigerian to die of the Ebola Virus Disease. Nurse {Name} until her death was a nurse at the {First Mainland Hospital, Obalende} where she sacrificed her life in the line of duty. We identify with her and pray that almighty God grant her soul repose as well e- as grant the families, friends and other colleagues the fortitude to bear the loss.

We also want to use this medium to put on record that Nurse will not be the first nurse in Nigeria to sacrifice her life for the health system of the nation. We also remember another colleague, Nurse Jemilah Yusuf who was killed in the course of service to humanity and to our nation. It will be recalled that Nurse Jemilah Yusuf was participating in a National Immunization Programme when she was gunned down by agents of terror. There are many nurses at Bornu, Yobe and Adamawa that have been killed, abducted or maimed by boko haram. There is no any other group of health care professionals that suffered that much.

They and many more unrecorded cases of nurses whose lives have been lost in the course of ensuring that health care and nursing services are being delivered to the citizenry represent the plethora of challenges nurses in this country face in the course of service to our nation and humanity. They are the unsung heroes and heroines of the nursing profession and the country Nigeria. We hope the government of the federation and governments at all other levels recognize the fact that nurses do not only spend the most time with clients {either sick or well} but also are the most exposed to hazards in the course of performing our duties which is a call to serve humanity.
As it has been in the days of Florence Nightingale when she defied all odds risking her life to be at the battle front to care for injured soldiers, so it is now that nurses in this country notwithstanding the hazards involved in the nursing profession in a country like ours where the healthcare system has been bastardized by retrogressive elements and enemies of progress who take pleasure in seeing the lots of innocent Nigerians suffer just to attain egocentric, self-serving and oppressive agenda.

We want to use this medium to call on our entire professional colleagues to be more careful and take safety precautions while attending to clients as the government of the day in view of recent ridiculous actions in the health sector is not dependable and as such cannot be relied upon to put in place preventive measures for us in the health sector. A government that does not know better than to jettison valid agreements obtained through due and judicial process to satisfy baseless and senseless demands of a few egomaniacs has only communicated that other professionals in the health sector and indeed all Nigerians are on their own. Albeit, though they want us to consider us as being on our own and them as not being responsible to and for us, let it be known to such governments and their evil agents that God is on our side and with God we form the majority. We encourage nurses to continue as we have always done and in the spirit of our commitment through the Nightingale's pledge "to do all in our powers to elevate the standards of our profession" and healthcare delivery to the citizenry.

To those in government and their agents; those ones that are clueless, confused and others with minds "unteachable", we want to advise that there is still time to retrace these wrong steps and harken to the voice of reason. They should stop making mockery of the rule of law which their propagandists are quick to shout at the top of their lungs and should take steps to bring the health sector out of the jungle that it has been plunged by years of mismanagement in the hands of a few who are highly literate but yet poorly educated. We can only hope that they learn before it is too late. Government should learn to kill snakes rather than setting up committee on snakes. They should take proactive measures directed towards curbing this pandemic and quickly transit from the process of making arrangements for universal precautions.

It is appalling that Nigeria is still at the stage of making arrangements when the virus has already been granted certificate of occupancy and has taken full residence in the country. Government should learn to copy from true international best practices which their agents are quick to shout when they are out on their mission of deceit. Serious governments have already put in place precautionary measures to prevent the pandemic on their soil and some even have treatments even though such are still in the clinical trial stage. Government needs to understand that the business of government should be doing more than we say and taking actions that surpass mere arrangements.
On behalf of the entire Nigerian nursing populace, we pray that God grant you eternal rest which is what you deserve for your service to humanity and we pay the Nightingale tribute in your honor as follows;
Nursing is a calling, a lifestyle, a way of living. Nigerian Nurses today honor our colleague, who is no longer with us and her life as a nurse is not remembered by her years as a nurse, but by the difference she made during those years by stepping into people's lives, by special moments.

We hereby call on nurses to remain committed to their callings and be cautious of the precautionary measures to forestall further incidences. The government at all levels should do their part to provide adequate equipment's, infrastructures, protective wears, policies to take care of the victims of the viruses and other deadly issues. Life is precious. The government should be able to provide adequate Infectious Disease Hospital without all forms of isolation, barrier nursing. This people should also be given an appropriate care possible.

The government should immediately set up intervention team to attend to the situation.
We call on all contact to please surrender them to proper care as early diagnosis portray fair diagnosis.

SHE WAS THERE
When a calming, quiet presence was all that was needed,
She was there.
In the excitement and miracle of birth or in the mystery and loss of life, She was there.
When a silent glance could uplift a patient, family member or friend, She was there.
At those times when the unexplainable needed to be explained, She was there.
When the situation demanded a swift foot and sharp mind, She was there.
When a gentle touch, a firm push, or an encouraging word was needed,
She was there.
In choosing the best one from a family's "Thank you" box of chocolates,
She was there.
To witness humanity, its beauty, in good times and bad, without judgment,
She was there.
To embrace the woes of the world, willingly, and offer hope,
She was there
And now, that it is time to be at the Greater One's side,
She is there.


NURSE ADENIJI A. ABDRAFIU, NATIONAL PRESIDENT, NANNM.
Together We Light Up The Profession one candle at a time.
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Re: NANNM PRESIDENT Press Conference Text Address

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