With the increasing reports of nurses, especially those in private hospitals, being sexually harassed by patients and other healthcare workers, the Acting Chairman, National Association of Nigerian Nurses and Midwives (NANNM) Lagos State Council, Com. Mary Modupeola Lateef-Yusuf, has urged nurses to speak up on their experiences and report any type of harassment to the appropriate quarters. Speaking with Pharmanews recently, Lateef-Yusuf assured that the Lagos State Government has put policies in place to address such issues. The nurse leader also hinted on several issues hampering the provision of best nursing care in the state, while calling on government to intervene urgently. Excerpts:
The current COVID-19 pandemic has revealed that the essential roles of nurses are also fraught with many challenges. How can these issues be addressed?
There are many challenges affecting nursing practice in Nigeria, they range from inadequate staffing to violence at work place, lack of self-care facilities, and so on. I will examine them one after the other.
The first is inadequate staffing. Being short-staffed for brief periods of time is common in most professions, and in many of those situations, it is a minor inconvenience. But in nursing, inadequate staffing can be a matter of life and death. Inappropriate staffing levels not only threaten patients’ health and safety, and lead to greater complexity of care, but also impact on the nurses’ health and safety by increasing nurses’ pressure, fatigue, injury rate, and ability to provide safe care.
You will agree with me that staffing levels in a value-based healthcare system should not be fixed, as day-to-day hospital requirements are constantly changing. What I mean is that in Lagos State, what is practised is “exit replacement” when some nurses retire; and this is either done quarterly or bi-annually. This means that other nurses will continue to take on the roles till when others are employed.
Working long hours due to inadequate staffing, job turnover and other factors can result in chronic overtime, placing another burden on nurses. Nurses across the state are reporting a drastic increase in their roles and frequent by-shifts and this practice – caused, in part, by nursing shortage – is having a negative impact on patient care and could foster medical errors and burnout. This overwork, without commensurate appeasement or compensation is driving nurses away from our healthcare facilities to other sane climes, where nurses are appreciated.
Safety on the job is also important and now the state government needs to improve workplace safety in Lagos State which should include safe patient handling resulting in back injuries for nurses. This can be reduced through greater education and training for nurses, use of assistive equipment and efforts to reshape government ergonomics politics to protect Nurses.
Still on safety, needle stick injuries and blood-borne infections are also major concerns of our nurses in all tiers. While the majority of sharps injuries involve nursing staff, laboratory staff, physicians, attendants and other healthcare workers can also be at risk and need protection. Thus, there is need to reduce those risks through education and legislation: arming healthcare professionals with the guidelines and resources to prevent injuries; while our employers should create safe workplace environments where we can work.
Some nurses were kidnapped in Kaduna State. As sad as that was, the state government must be proactive by ensuring that it doesn’t occur here.
Another common challenge is workplace violence. Nurses face an increased risk of work-related assaults, resulting primarily from the violent behaviour of their patients, clients, and/or other professional colleagues.
While no specific diagnosis or type of patient predicts future violence, epidemiological studies consistently demonstrate that inpatient and acute psychiatric services, geriatric long-term care settings, high-volume urban emergency departments present the highest risks.
OSHA, the ANA, and many other organisations are focused on preventing violent incidences through regulations, guidelines, and education. “No staff nurse should have to deal with violence in the workplace, whether from staff, patients, or visitors,” the ANA says.
On the way forward, the first and most important step is improving self-care. This didn’t make the ANA’s tightly focused list, but it’s an issue inextricably linked with the nursing profession. As caregivers, nurses have been socialised to care for others and thus often prioritise their needs as second. Be that as it may, the employer of labour should emphasise that self-care remains vital for nurses to ease the detrimental effects of stress in the constantly and rapidly changing healthcare environment and to prevent progression of those effects to burnout, which can have devastating consequences for nurses and those under their care.
Healthcare workers, including nurses, continue to experience work-related stress that could be alleviated by the appropriate staffing, equipment and supplies, training programmes, and staff welfare programmes.
Concerning COVID-19, in particular, we all can remember how this novel disease crept on us unawares and unprepared for the magnitude proportions it elicited. Experience has made us better prepared to cope with the challenges of covid-19 pandemic.
I was made the Chairman of NANNM Lagos COVID-19 Committee and we were able to carry advocacies to companies, corporate bodies and non-governmental organisations that supported us by donating alkaline water (Lasena water), soaps, detergents, sanitizers, antiseptics and disinfectants, which we donated to COVID-19-specific facilities, where several of our members work, including other health facilities throughout the state.
We made use of the media to create awareness about COVID-19 prevention and the need to seek care promptly when infected. We also supported our members in cash and kind to reduce the disease burden.
Several of our members who became infected were treated freely by the Lagos State Government, though regrettably, we lost a few. The issue of health insurance is germane now which has been effected on paper but yet to be fully functional and operational.
It may interest you to know that we are paying for healthcare services rendered like any other patient in our hospitals, with minor exception here and there; particularly if your illness necessitates care at tertiary health institutions. The Lagos State Government is trying in this respect but needs to do more for us to be impressed. Nurses should enjoy free health services in facilities where they work, till the proposed health insurance begins to function.
We are grateful for the commencement of the vaccination exercise which many benefited from, and this exercise considerably reduced the rate of infection. I must also state here that our people must obey the dictates from the state’s Ministry of Health, which include: hand washing practices, use of facemasks, cough etiquettes and maintenance of social distancing, as COVID-19 is real.
Some nurses have raised concerns over being sexually harassed in the line of duty. Is there any panel in place to look into the harassment of nurses in the state?
Sexual harassment in academia, as well as the scientific, technical, and medical workforce, has been a reoccurring decimal. Students of Nursing Science in our various tertiary institutions are not exempted. They, like other students, suffer from sexual harassment and this impacts our students’ lives negatively.
The degree of occurrence within government employment is somewhat reduced, though it affects the recruitment, retention, and advancement of young nurses, who are mostly women. Once your employment is confirmed, sexual activities in any form, if they occur at all, are consensual, though some men could be severely manipulative, particularly when they promise marriage that they are not free to give.
I must emphasise here that the government of Lagos State has policies and strategies in place to address sexual harassments in government settings. The main problem is non-disclosure and, once the victims refuse to report, it didn’t take place.
At NANNM level, we have taken advocacy to our various institutions to empower our students on how to protect