Nursing Services in Nigeria: Prevalence of Auxiliary Nurses and The Role of Hospital Management


Recently, I became really bothered about the state of Nursing practice in Nigeria. I mean, we already have existing problems we are struggling with as a nation, why do we have to deal with this as well?

Almost every citizen of Nigeria knows about a group of people called “auxiliary nurses”, they are usually found in private hospitals as one of the nurses on duty. You may not know or be able to tell the difference between an “auxiliary nurse” and a “registered nurse” at the nurses’ station until it’s time to perform some procedures. You still may not be able to tell except you’re familiar with how things are usually done in the healthcare setting or you are a healthcare professional as well.

Before I continue, I’ll like to tell us the difference between a Registered Nurse and the other group of people who pose themselves as one – an Auxiliary Nurse.

A “registered nurse” is simply an individual who has gone through the formal recommended process and gained a license at the end of training to perform as a nurse. This license is only issued by the Nursing and Midwifery Council of Nigeria upon successful completion of the council’s examinations. Whereas, an “auxiliary nurse” is one that wasn’t trained in an accredited higher institution but went through an informal training in a medical, community or traditional clinic or setting.

Yes, some of these people end up been highly skilled but in my opinion, it’s best to still undergo the formal training – for the in-depth of knowledge and proper application – when it comes to such an  important sector as health, because we deal with human lives. Many of these auxiliary nurses are trained in private hospitals, so the same facilities employ them as nurses, and the cycle continues.

Putting this into perspective with the current economic situation in Nigeria, an average hospital/hospital manager will rather employ 3 auxiliary nurses and 3 Registered Nurse than have 6 registered nurses in total. Do you know why? IT IS SIMPLY MORE COST EFFECTIVE for these hospitals, and if you ask me, I will say, they are just inconsiderate.

Working with the current inflation rates, hospitals especially in Lagos state have increased their tariffs. In fact, they actively adjust rates at any slight inflation, yet, these things DO NOT reflect in the salaries of their employees and it is very unfair. Every single time the thought crosses my mind, I cringe because these staff are meant to be the ones at the forefront of patient-care. Oh well, this is definitely a topic for another day and I mentioned it because I’m trying to explain how these hospitals don’t care much about their  employees as much as patient satisfaction is important to them.

The emergence of this set of people is really alarming in Nigeria with the highest rates in some private hospitals. Nowadays, some hospitals have made it better by only employing auxiliary nurses as health care assistants. In their defense, they call them something else forgetting that there is meant to be an actual school where people are taught to be professional health care assistants. Also forgetting that for these people, their highest level of education is SSCE. Personally, I really think that it is not okay to have such individuals care for people in any capacity of the hospital.

The hospital managers play a great role here because they can greatly influence this employment processes, and make them sign up in an institution for proper training prior to employment.

I understand hospitals are probably doing this to balance up staffing and salary payments, especially now that we have nurses migrating daily. However, I also believe that for hospitals that bill patients massively, they should also be ready to employ certified and qualified professionals because patients pay huge bills and they deserve the best. I truly feel like if the conditions are great or close-to-great in Nigeria, we won’t have as many nurses emigrating on a daily basis. This migration has posed a lot of challenges on the Nigerian hospital and healthcare system, especially in 2021,  as there’s a huge gap when it comes to staffing/nurse to patient ratio.

In addition, I must mention that we now have a number of hospitals who truly place their nurses in high esteem and this makes me smile every time I think of them. Other hospital managers should learn from these, if they truly want their staff to spend longer period working at their facilities or organizations. It starts from the simple things like the nurses room. If the nurses room in your facility is sub-standard then you have a long way to go when it comes to the welfare of your nursing staff. It’s as bad as some hospitals having their nurses change under the stairways. These ridiculous and unbelievable acts towards nurses in hospitals are so unfair and should not be heard of in the healthcare syatem.

It is truly the “little things” that matter before the “big things” like remuneration. When the change(s) nurses love to see begin to show in the Nigerian healthcare system, some nurses who won’t mind, will gladly stay back.

About Author:

Temitayo Olatunji is a Registered Nurse/Midwife and Entrepreneur who is passionate about improving the quality of care available to people in Nigeria and contributing towards improving the status of the nursing profession in Nigeria.

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