Reform in Nursing Education in Nigeria, Matters Arising By Abdulhaleem Ishaq Ringim

There are two educational pathways to nursing profession in Nigeria; the hospital-based pathway and the University-based pathway. The University based pathway is followed through a degree programme offered only in the university which runs for 5 years and leads to the award of BNSc(Bachelor of Nursing Science) , Registered Nurse(RN) certificate, Registered Midwife (RM) certificate and Registered Public Health Nurse (RPHN). The university-based nursing programme is jointly regulated by the NUC and the Nursing and Midwifery Council of Nigeria(NMCN)   The hospital-based pathway however is is followed through a 3-year certificate programme offered in schools and colleges of nursing in Nigeria. Completion of this programme leads to the award of the Registered Nurse (RN) certificate otherwise called the Basic Nursing Certificate(BNC) only. Unlike the university-based nursing education, schools and colleges of nursing are singly regulated by the NMCN.    Now, it is worthy to note that Schools and Colleges of Nursing in Nigeria do not qualify as tertiary institutions going by the National Policy on Education definition of tertiary education which so defines it as “the education given after Post Basic education in institutions such as Universities and Inter-Universities Centres such as the Nigeria French Language Village, Nigeria Arabic Language Village, National Institute of Nigerian Languages, institutions such as Innovation Enterprise Institutions(IEIs), and Colleges of Education, Monotechnics, Polytechnics, and other specialized institutions such as Colleges of Agriculture, Schools of Health Technology and the National Teachers’ Institutes(NTI).”   Also, these schools and colleges are not regulated by any of the 3 regulating bodies we have in Nigeria saddled with the responsibility of regulating institutions that award certificates with academic value which are; • The National Universities Commission(NUC) • National Board for Technical Education(NBTE) • National Commission for Colleges of Education(NCCE).   By implication, the 3-year hospital based nursing programme is not recognized as tertiary education in the Nigerian context and the Registered Nurse certificate awarded on completion has no academic value. In fact, one could view it as a mere professional programme for the only difference is the fact that graduates of the programme earn a license to practice as Registered Nurses in any health care institution and for employment purposes are placed in the same salary grade level as Higher National Diploma holders (Grade level 8, step 1).  

For one to earn a BNSc (Degree) certificate after the hospital based programme, he/she have to spend another 4 years in the university as the RN-BNSC programme usually spans for 4 years. That means, a registered nurse upon admission into the university through Direct Entry (DE) starts from 200 level just like a graduate of a Basic 1-1½ advanced level programme. Hence, this path allows for an individual to become a degree holding nurse after almost 8 years.    Isn’t this too much?  The Nursing and Midwifery council on its quest towards reforming the system and finding a solution to this problem proposed two options during the NMCN leadership conference held in Kaduna in 2017;  1. Schools of nursing and midwifery be absorbed or assimilated by universities that have departments of nursing inline with the requirement of NUC 2. Those unable to get absorbed should move to National Board for Technical Education (NBTE) as Colleges of Nursing Science so as to get the academic recognition of ND/HND for their graduates.    In consolidation, the NMCN on 16th February 2016 released a circular mandating all schools of nursing to adhere to any of the above mentioned options before the year 2023.   But why the ND/HND option when the system is gradually railing towards extinction?  The Nigerian government in June 2016 scrapped the award of HND ,a decision that was reached by the Federal Executive Council as part of the comprehensive reform of Nigeria’s tertiary education. The same policy also established the scrapping of all non-technical courses out of polytechnics.    Where is NMCN heading with its proposal for the ND/HND nursing programme?   Is nursing a technical course?    Why go for an ND/HND choice when sister professions in the medical space like Physiotherapy and Pharmacy are pressing for Doctor of Physiotherapy(DPT) and Doctor of Pharmacy(Pharm.D)?   We see the ND/HND model not as an option but as a pathway towards consolidating the nursing profession in a more darker abyss.    We have two major problems;  1. The academically non-valued certificate awarded on completion of schools/colleges of nursing,  2. The inconsiderate long duration of the RN-BNSc transition programme.    I therefore suggest that the NMCN in collaboration with the ministry of health, the NUC and ministry of education move every school/college of nursing to universities with departments of nursing or effect a holistic reform on school of nursing curriculums which will lead to its upgrade and the inclusion of core pre-clinical courses with adequate training in courses like Anatomy, Physiology, Biochemistry, Pathology, microbiology etc just as it is being done for university nursing students in their early pre-clinical years. With this, there would be a substantial reduction in the RN-BNSc transition period to at least 2 years (I. E School of Nursing graduates will be admitted into 400L).    This will not only reduce the inconsequential duration of nursing education but also proffer solutions to the contemporary problems nursing as a profession is facing like professional disharmony (in having many labour unions representing the profession eggs NANNM and UGONSA); political apathy – as the university programme or reformed schools of nursing curriculum would offer courses in politics, law and humanities which will rekindle the sense of direction in professionalism of nurses; gender issues etc.    I hereby call on JOHESU, NANNM, UGONSA, NANS, NUNSA and other relevant pressure forces to help in agitating for these reforms.    #WeSayNoToHNDNursing #MoveUsToUniversity or reduce the #RN_BNScTopUp to 2 years!    About The Author Abdulhaleem Ishaq Ringim is a student nurse, political and public affairs analyst, activist and an advocate for youth development. He is the serving president of ABU Teaching Hospital Student Nurses Association(ABUTHSNA).    He is based in Zaria and can be reached through haleemabdul1999@gmail.com

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