The Nurse and her Auxiliary: A Doctor’s and Private Practitioner’s Perspective

The health sector in Nigeria is besieged by multifaceted crises of different dimensions. Some of these are needless and should be tackled promptly so that healthcare providers can walk in unison. It is when we “work and walk together” that these gargantuan issues facing us can be overcome with relative ease.

One of these needless crises is the issue of the registered nurse locking horn with her auxiliary. History truly shows that before Nightingale, care-giving was already in existence. The fact that her advent ushered in standardization of nursing practice should reasonably not take out the existence of others in a situation where more hands are required on deck daily.

Regulation and refining of the nursing practice should not end at the nursing schools and colleges.

However, what is ultimately visible to onlookers is that the registered nurse – using her connections with the authorities in civil service, with a misinformed government – have blackmailed and tagged the auxiliary as “quack” to make her extermination out of existence easier. Being mindful that the nonchalance of the major end users of these auxiliaries, further worsened the situation. And today, the end users – doctors, mostly in private practice – are paying a heavy price for that nonchalance.

As doctors, if we still want to lay claim to being head or lead of the medical team, it is our paramount responsibility to wade into these matters with leadership ingenuity and resolve them amicably.

The undeniable and obvious truth is that Nigeria’s population is massive and the number of trained nurses available cannot go round the state capitals of the nation, talk less of serving the remote areas across the massive country. The need for care-givers of all categories outnumber the available supply. To make matters worse, the trained hand would rather go out to London than to accept to practice in Ondo state.

One then wonders, why in the midst of insufficiency, there should still be wastage? Truly, this is what happens when two elephants fight. Shockingly and surprisingly, the same trained nurses that chose to fight their auxiliaries into extinction, are also involved in training traditional birth attendants and herbalists or native doctors using the apparatus of government. But refuse to see this also as promotion of quackery. This shows that there must be a lot more to this issue, than what society is being told.

To label the “auxiliary nurse” a quack, is not enough accusation to hack them down. Because quackery, by definition, ramifies all sectors and is practiced by all professionals.

However, overtime, a key factor known to aggravate this is the strict reservation and sole dominance of the title “nurse” among the formally trained and registered nurses. Hence, if this is principally accrued to nomenclature and misidentify, the matter can be resolved completely by giving appropriate titles, in the interest of peace and unity across the health sector and to encourage progress in our frail health sector. As any little effort to stabilize the failing system will go a long way and should not be underestimated.

Personally, from experience and in my opinion, a viable solution to this particular causative factor is simply to allow the “nurse” hold onto her title, while the other party – the auxiliary – be given a befitting and distinct title, which is reflective of their important role in healthcare delivery and does not strip them of their value. I believe, the term “auxiliary nurse” be dropped by the auxiliary, and the reality of who and what they really are – which is clearly undeniable and cannot be taken away – be accepted i.e., that she or he is an “assistant” and an important partner in the healthcare industry. And therefore, embracing the title “Healthcare Assistant” – as used in more developed healthcare system.

This clear use of terms and appropriate titles, helps to delineate roles and motivate synchrony within the healthcare system, where everyone knows exactly who/what they are, and will function as such.

Also, the nurse, other healthcare professionals, government agencies and the society at large, must recognise and accept them for who/what they are, thereby regulating them the same way the tradomedicals, the nurses, the doctors and others healthcare providers are being regulated.

About Author:
Dr. Ogungbayi, Olajuwon Ezekiel (MB;BS Ibadan) is the Medical Director of Cornerstone Foundation Family Hospital located in Isheri Oshun, Alimosho Lagos. An active member of Nigerian Medical Association (NMA Lagos), he is also the Zonal Secretary of ANPMP – Association of Nigerian Private Medical Practitioners – Agege Alimosho and Administrator of Medical Job Market (MJM).