Auxiliary nurses have no place within Nigeria’s healthcare system and laws, legal experts, nursing and medical professionals have insisted.
They said that a nurse or midwife is either registered by the Nursing and Midwifery Council of Nigeria, or the person is a quack.
Warning that quackery is a crime in the country’s healthcare system and the constitution, they insisted that without a licence, nobody is permitted to provide any medical or healthcare services to a patient without the prerequisite training.
According to an India-based paramedical and healthcare practical training institute, MNG Healthcare, auxiliary nurses are nursing assistants, who help patients with activities of daily living and other healthcare needs under the direct supervision of a registered nurse or licensed practical nurse.
The Indian academy noted that auxiliary nurses are commonly referred to as nursing assistants, patient care assistants, or nurse’s aides; a person who has completed a brief healthcare training programme and provides support services for RNs and LPNs.
Following the death of Ilerioluwa Aloba, popularly known as Mohbad, the auxiliary nurse alleged to have administered an injection to him was disowned by the National Association of Nigeria Nurses and Midwives, Lagos State Council.
They said she was not a registered nurse in tandem with Nigeria’s healthcare system.
The Association in a press statement signed by its Secretary, Toba Odumosu, insisted that auxiliary nurses do not have a place within the country’s healthcare system, saying that such a person should not be allowed to administer any injection until he or she upgrades to a registered nurse status.
According to the NANNM, to be recognised as a Nurse, one must complete a rigorous five-year Bachelor of Nursing Science Programme at a university, followed by an additional year of internship.
“Alternatively, one can undergo training at an accredited School/College of Nursing and become registered and licensed by the Nursing and Midwifery Council of Nigeria.
“We wish to clarify that the term ‘Auxiliary Nurse’ has no place within Nigeria’s healthcare system or its laws. An individual is either a qualified nurse or an unqualified individual performing tasks beyond their competence,” the Association declared.
It is regrettable that Nigeria’s healthcare system is facing significant regulatory challenges, which has led to the presence of unqualified individuals performing medical roles that they are not trained for, NANNM added.
Speaking on this, a Professor of Medicine at the Department of Nursing Science, University of Calabar, Cross River State, Mary Mgbekem, said she does not know where to categorise auxiliary nurses as they do not belong to healthcare professionals.
According to her, “I’m a trained and registered nurse and I can tell you that they do not belong here. They are people created by doctors for their own selfish interest and not to for the interest of patients. Doctors train them so that they can avoid paying the right salaries to the registered nurses.
“This class of people should never get close to the patients if patients’ safety means anything to medical professionals. They are trained with the little knowledge acquired by their employers. They are not licensed and will be held liable for anything that goes wrong.
“They are not recognised anywhere and do not belong to healthcare professionals and only by the doctors that use them. Apart from that, they are not known among healthcare professionals.”
Corroborating Mgbekem’s position, a Chief Nursing Officer at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Mrs. Joy Mbonu, said auxiliary nurses are the creation of doctors, who try to run away from paying the right salary.
She lamented that the training of quack nurses by healthcare workers across all levels in Nigeria is gradually becoming the new normal, and a major malpractice worsening the country’s healthcare system.
“They are being trained by one doctor or the other who use them as nurses instead of nurse’s assistants. Some of them are errand girls for the doctors and at the end of the day; they are issued certificates to assume the position of nurses in their privately-owned hospitals. They are being deceived that acquiring practical, is better than going through school to acquire knowledge.
“Tell me, how would they administer treatment? If they learn how to give injections, do they know why they are giving the injections and the quantity to give? Our association tried to fight it but it’s difficult because doctors are the ones training and using them,” she said.
“Unfortunately, when these doctors want to open hospitals, they would go and borrow registered nurses’ certificates to get approval and after that, they return to quacks.”
According to a copy of the Nursing and Midwifery (Registration, ETC) ACT, obtained by PUNCH Healthwise, the Act in Section 21, titled, ‘Unauthorised Training,’ prohibits any person from training an individual as a nurse or midwife, or providing any course of training without the Minister’s permission.
The Act, which establishes the Nursing and Midwifery Council of Nigeria, provides in Section 21(a) (b): “It shall be an offence for any person without the approval of the Minister, given on the recommendation of the Council, to train or purport to train any person as a nurse or midwife or to provide any course of training or establish any school for such purpose or as one of its purposes; and any such person shall be liable-
“(a) on conviction otherwise than in a High Court, to a fine of N1, 000 or to imprisonment for a term of six months, or to both such fine and imprisonment; (b) on conviction in a High Court, to a fine of N2, 000 or to imprisonment for a term of two years or to both such fine and imprisonment.”
Speaking further, a private practitioner and a consultant Gynaecologist and Obstetrician, Dr. Abayomi Ajayi said auxiliary nurses are trained to help nurses and should not assume the work of a nurse.
“They are helping nurses and not supposed to perform certain tasks in the hospitals or healthcare system. They are not permitted to give injections or infusions. They are just not meant to do the work of a registered nurse,” he insisted.
He, however, said their work is based on training and many of them are trained as traditional birth attendants.
“They have the basic training but that is not enough. It’s their basic knowledge that we need to build on for them to get better skills and study further to become registered nurses or midwives. They can’t give injections,” he insisted.
Training of auxiliary nurses outlawed by Lagos – HEFAMAA
Meanwhile, the Executive Secretary, Lagos State Health Facility Monitoring and Accreditation Agency, Dr. Abimbola Idowu, said auxiliary nurses are a group of individuals who have no formal, recognised or approved training in nursing care and are not registered or licenced by relevant bodies that regulate nursing practice.
She said, “Majority of them have had their training in private healthcare institutions that are not accredited or recognised by the government to do so. Training of auxiliary nurses was outlawed by the Lagos State government many years ago.
“Be that as it may, in order not to completely render them redundant in society, those of them who have been trained before their training was outlawed are allowed to assist and work under the supervision of registered nurses to do assigned ancillary services such as dressing of beds, emptying containers containing body fluids and such affiliated services.
“They are, however, not allowed to carry out any form of intervention on patient care such as giving injections, medications, wound dressing, setting lines and the like.
“Auxiliary nurses are not recognised by the Lagos State government because they don’t have any form of licensure to carry out patient care or medical services. There is also no government body or institution that trains or licenses them.”
On regulation and monitoring compliance among hospitals in Lagos, she said that HEFAMAA plays its regulatory and oversight function by inspecting and monitoring all health institutions to make sure that they have the required complement of qualified medical staff.
“The Agency ensures that anyone working in a healthcare institution in the state does not go beyond his scope of training,” he added.
Meanwhile, a lawyer and the Principal Partner, Lawrence Ndukwe and Co., Mr. Emeka Ndukwe said it’s a punishable offence for anyone to pose as a nurse or midwife to get patients’ attention and confidence when he or she is not.
