21st Century nursing practice in Nigeria, still a work in progress
By ABIOLA ATEBOH(Businessday Nigeria):
Technology is dramatically altering the ways in which we diagnose, treat, care for and manage patients. Information technology breakthroughs have been a key factor in the development of evidence- based practice and has supported this growing trend, to promote it in nursing and other health care disciplines.
“Information processing and communication are centrally involved in virtually all health care activities, including obtaining and recording information about patients; communication among health care professionals; accessing medical literature; selecting diagnostic procedures; interpreting laboratory results; and collecting clinical research data”
Nursing is a unique profession in the health team, that recognizes the practice of the profession as a public trust. This puts a responsibility on the profession to protect the public. Standard setting is a crucial aspect of the functions of the Nursing and Midwifery Council of Nigeria, established by the Nursing and Midwifery Registration etc. Act, cap N143, Law of the federation of Nigeria , 2004 as the statutory body charged with the responsibility of regulating the standards of professional nursing and midwifery education and practice in Nigeria . It also ensures that these standards are complied with. These standards are the yardsticks of measuring and evaluating the quality of the education and performance of the practitioners in the health care delivery system. Nursing standards are derived from core values which include respect for the dignity of persons, integrity in service, compassion, tolerance, intellectual and psychomotor competencies and accountability.
Unfortunately, various studies have revealed that the standard of nursing practice is gradually falling from what it used to be in the past. This is even evident from our day to day experiences in the clinical areas and in some of our training institutions.
Major challenges facing the nursing practice in nigeria.
A university don, Adebayo Adejumo of the Department of Psychology, University of Ibadan , has advocated the need to change the practice of nursing in Nigeria from performing roles of assistants to a profession, driven by science and research through innovative leadership and modern technology.
Adejumo gave the charge in Abuja in his lecture entitled ‘leadership and technology: key concepts in the transformation of the nursing profession in Nigeria ’.
He attributed the stagnation experienced in the profession on slow responses to innovations in the global health industry, intrusion of quacks as practitioners and weak administrative support which affects health care delivery expected in the 21st century, noting that introduction of computer education into the training curriculum of various programmes by training institutions must be encouraged.
On the application of technology to change the face of the profession, Adejumo stressed that training facilities and approach to administration of nursing colleges, should be overhauled. This, he said should be ensured with focus on facilitating accessibility to qualitative technology that would provide opportunity for practicing nurses to acquire more knowledge concerning current trends in the profession.
Lack of gear: Lack of appropriate planning and budgeting due to non involvement of nurses and several nurse leaders in management’s budgetary meetings. Poor knowledge of nurses, about policies and the influence of nursing administration on general hospital administration/management.
Lack of commitment on the component of nurses:- Several nurses just practice for practicing sake, they do not see the intricacies of nursing as a care from nurse specialists, rather they are committed to other issues of life than nursing care practice. Quite a few practice only for financial benefit, not because nursing is a calling for them. Student nurses are also victims of this situation.
The advancement in science and technology will continue to affect the nursing profession. In the past, nurses relied on their experiences, observation and intuition but today, nursing has a defined body of knowledge, specific to the profession and continues to develop this knowledge through research and practice, as they relate to new drugs, methods of delivery, disease control and prevention, through sterilisation and disinfection of equipment, and models in nursing, among others. For instance, the knowledge and implementation of the nursing process, as a scientific and systematic approach to nursing care, has been seen by many nurses as problematic. Some nurses have found it difficult to implement it because some professionals in the health system do not quite understand what it is about. In addition, some nurses have attached a lot of constraints such as shortage of staff and lack of stationery, as reasons hindering the implementation of the nursing process, which is a tool for improved nursing care. The changing role of the nurse requires continued competence. Many nurses are unable to maintain a high level of individual competence in nursing practice, skill and knowledge, recognising and accepting responsibilities for individual action and judgment.
Furthermore, the nursing profession aims at providing quality nursing care by providing a scientific base for the practice of nursing. Thus the imput of research has become necessary. Unfortunately, only very few nurses are interested in research, even though it is the responsibility of all nurses to do research to improve nursing care. The introduction of Research Methodology as a course in Schools of Nursing, has done little for now, to make students attach much importance to research projects, as most students believe that research ends after school.
Another major problem is that some work environments are un-conducive and non –supportive for nursing practice, as they lack sufficient facilities and equipment to work with. They also lack sufficient motivational input, such as housing, transportation, incompetent supervision, poor working relationship, general moral laxity in the society, undue familiarity with subordinates, with a weakness in disciplining erring staff, among others.
Most government policies do not focus on meeting the needs of the profession because nurses do not fully participate in policy making. Nevertheless, nurses occupy a central position in the health care delivery system. The shortage of nurses in Nigeria and lack of sufficient facilities and equipment to work with, are not just a “problem of nursing” but a health system problem, which undermines health system effectiveness.