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OPINION: Quackery In Nursing, The Need To Be Strategic In The Fight By Erikan Benson RN
Date Posted: 06/Jan/2021
For long, quackery has been a nagging problem for many professional bodies all over the world. Products and services are imitated, counterfeited or faked by individuals or group of people who claim to be what they are not. This, in one way or the other, impacts, negatively, on quality of service delivered to the unsuspecting public, who are the end users of the service s so rendered. In the course of time, trust and customer’s confidence on the genuine producers or service providers are eroded.
 
Over the years, nursing profession have had a fair share of this problem, quackery, through a scheme called auxiliary nursing. The scheme successfully found its way into the healthcare system through private hospitals and clinics. These private health facilities train and roll out, unabated and unhindered, this group of impostors who then act or pretend to be nurses, and even midwives. The public sees them as such, so, their attitude and unprofessional conducts in their service areas, represent the nurse and nursing profession. When the film industry wants to act a nurse, they, unfortunately, copy them rather than the professional nurse; when the public wants to complain about poor quality of service received from nurses, they hinged their assertions on the experiences they had with this group of people. Suffice it to say, therefore, that the dominance of this group in the private health sector has created an image problem for the nursing profession. Besides, their penchant for stretching their arms to responsibilities way beyond their level of competence puts the lives of the end users of healthcare services at risk.
 
A recent survey of private health facilities in Akwa Ibom State projected that about 75% of private hospitals and clinics in the state, engaged the services of auxiliary nurses. They, effortlessly, train and recruit these people for cheap labour. It is obvious that the whole scheme is a lucrative venture for these institutions, who indulge in it. Those who train make money from the training fees charged; and those who recruit, couldn’t have found a better market for cheap labour. This makes economic sense! But it should be noted that in deciding to engage the services of quacks instead of qualified nurses, considerations such as quality of service, compliance to set standard and patient safety are thrown to the dustbin.
 
Late last year, Nursing Ambassadors (NAON), Akwa Ibom State branch in conjunction with a media organization, The Cable, undertook an investigation to uncover the rate of proliferation of quack nurses in Akwa Ibom State health facilities run by private organizations and individuals. The report of the investigation presents a chilling revelation of how quackery has permeated and dents our noble nursing profession. Believe it or not, this is just a tip of the iceberg. Nevertheless, NAON Akwa Ibom State branch, the media outfit and every person involved in the investigation should be commended, for their effort in fighting quackery in nursing. I want to see more of this fight from our professional body, NANNM; I want to see it from our regulatory body, NMCN. Their involvement and serious commitment in this fight would go a long way in eradicating this menace in our cherished profession. But their seeming inactivity would amount to a covert approval for quackery to thrive.
 
More than ever before, individual nurses have redoubled their effort in fighting quackery in nursing. Articles, like this, have been written, severally, and posted on nursing online media, social media groups and other outlets. Discussions have been held in nursing fora, as in seminars and conferences. I also observed some millennial nurses using the social media to name, shame and mock at quacks and those institutions who train them. But on a close observation, all of these approaches cut no ice.
 
There was a case where a young woman, who had just finished her auxiliary nursing training, displayed her certificate on Facebook, thanking God for the achievement she has made. An angry nurse commenting, mocked at this helpless youngster, describing her as a quack who has succeeded in wasting her years for nothing. The public responding, swooped on this nurse, describing her as wicked for venting such an uncomplimentary comment on a disadvantaged person’s achievement. Comments such as “so everybody would come and eat in your house since you are the only qualified nurse in town” filled the space. The public was angry with the angry nurse even as the angry nurse thought she was fighting for the safety of the angry public. 
 
Though I don’t see social media as a platform for dealing with serious issues like quackery, and as such, didn’t support the approach of that my esteemed colleague, I  came to realise one thing: That the public may not understand us if we are not careful with the approach we employ in dealing with this problem. Therefore, in fighting we don’t need to fight dirty; we still need to maintain our sense of nobility and the ethos guiding our noble profession. 
 
Do not confront an auxiliary nurse at her “legitimised” duty post; do not mock at them on the street or on social media. Let me state here, emphatically, that this fight should be taken off the social media. You don’t kill a tree by cutting the leaves, you cut the stem and the leaves would go. That is why I would call on NMCN and NANNM to step up their game through regular inspection and monitoring of private health facilities. There is a need for boardroom discussion;  policies and regulations need to be reviewed and updated. Other relevant government agencies need to be engaged in an effort at ensuring full compliance for extant regulations guiding the opening and operation of private hospitals and clinics.
 
I will also suggest a move to regulate the training and practice of auxiliary nursing (or nursing assistant) in this country, as it is done in the UK. This is because what you don’t regulate, you don’t have control over. There was a time in this country that the patent medicine dealers were operating without the direct control of the Pharmacists Council of Nigeria (PCN). The PCN not comfortable with their practices, moved and take-over the control of patent medicine dealers’ activities. They register them, organise seminar for them, control their practice, and also generate funds thereof. 
 
Though we have our own peculiar situation, nothing is wrong with the NMCN opening a register for auxiliary nurses (or nursing assistants), setting bounding for their practices, and giving them a distinct uniform that differentiate them from qualified nurses. With this, the NMCN would have control over their practices and also generate revenue therefrom. Regulate first, then gradually phase them out in due course, if necessary. 
 
Truth be told, outright stoppage of private health facilities from engaging the services of auxiliary in Nigeria is a Herculean task. Many powerful forces, with pecuniary interest, would work, aggressively, against such arrangement. When other healthcare professionals decides to run their private health facilities with auxiliary nurses, without recourse to guidelines, we know that we have a systemic problem to deal with; but when a nurse / midwife, who should know, engaged this same auxiliary hands in a thriving maternity home, without a single qualified nurse, we then know that this problem is not only multifaceted but also self inflicted. 
 
So, we should stop complaining and face the facts. Regulating the number of auxiliary hands to half the number of qualified nurses engaged in a private facility may be a realistic bargain for managers of facilities and other stakeholders. 
 
The NMCN needs to make this strategic move and the time is now.
 
About the Author:
Eikan Benson, a nurse in Akwa Ibom State public service, writes from Uyo. Comments and suggestions should be directed to: erikan.sbg@gmail.com or WhatsApp number - 08080539687
 
Disclaimer
The opinions expressed in this publication are those of the authors alone. 

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