Mrs.Henrietta Okedo, a nurse, is the Executive Secretary of the West African College of Nursing (WACN), a member of the West African Health Organisation (WAHO). A former Director of Nursing in Anambra State, Okedo sheds light on issues bordering on nurses’ attitude to patients and nursing-patient ratio. 

What is the role of the college in promoting the nursing profession?
The college is the highest organ of nursing profession in West Africa. It was established in 1981 in The Gambia. The main objectives of setting up the college is to train nurses at a higher level. The college awards fellowship, and before you become a fellow of the college, you must have gone through many stages in your chosen profession. When you become a fellow, it means you have gotten to the zenith of your profession.

Before 1981, other colleges were in existence. We had the West African Postgraduate Medical College, which accommodates physicians and surgeons only.

But you cannot talk of healthcare without nurses since we constitute more than 50 per cent of the work force in the health care sector. Therefore, you cannot do any meaningful thing without nurses. When they saw that there was lacuna in the West Africa Postgraduate Medical College, ministers of health at that time started thinking of what to do. That was how the West African College of Nursing was born, through the instrumentality of health ministers at that time.

We help in the sub-region to train nurses both at the basic and post-basic level. Sometimes, when there is a need for accreditation process in some of these colleges of nursing, the college comes in.

We collaborate with the Nursing and Midwifery Council of member states and National Association of Nurses in the West African sub-region. For instance, in Nigeria, we have the National Association of Nigerian Nurses and Midwives (NANNM) and in Ghana, we have the National Association of Ghanaian Nurses. We all come together to push the nursing profession forward, and to provide quality and accessible healthcare.

We should not only access quality care in Europe. We want to help cut down on medical tourism. If people know that we can give quality nursing and midwifery care in Africa, there would not be any need to take hard currency to Europe or America for healthcare.

Most nurses practicing in the US are Nigerians. If we can do that in Europe and America, what is wrong in giving the same kind of care in West Africa?

Patients still complain of wrong attitude of nurses. Is there anything that can be done to change such attitude?
The only thing that should be done is to speak to their hearts, advise and counsel them, because you know that nurses do the bulk of the work in hospitals. Others come and go, but nurses stay on. So, when they stay on, because they are human beings, they can get irritated.

You know, they are dealing with sick people and sick people are also edgy and very irritated, so that everything that is done for them can be misconstrued. But we have a few patients who understand that nurses are also human beings who have their own problems. Even when a nurse has a sick child, she is expected to leave the sick child and attend to a sick person in the hospital. Put yourself in their shoes.

I am not saying it is proper. But remember there are individual differences. Nursing is a profession where you bring people from East, West, South and North together. If you go to the post office and airport, you see arrogant and naughty people. These people we are talking about are people who are not dealing with sick people. Then, think of those who are dealing with sick people.
But we will continue to talk and counsel to nurses. There is no workshop we do that we do not talk about nurses’ attitude to work and patients. We expect nurses to be more polite because we deal with sick people.

Do we have enough nurses in the West African sub-region?
In 2010, a survey revealed that the ratio of nurse to patient is about 1: 35. It is practically impossible for one nurse to take care of 35 sick people. We are talking of nurses’ attitude, how will this person fare? But the nursing council ratio for Nigeria is 1:5. If we have a situation of a nurse attending to more than 20 patients, the quality will be watered down.

Have we met that ratio?
There is no way we can meet that ratio because there is a limited number of schools for nurses, and employment opportunities are also limited.
When we talk about ratio, are we also talking ratio in terms of nurses working in government hospitals or in terms of all nurses? It is not feasible, at least for now, in the West Africa sub-region.

A few weeks ago, I was in Ghana. Ghanaians also complained that government was not employing nurses, and those who are out of schools are not finding jobs. So, how do you calculate the ratio? Is it the ratio of an unemployed nurse to patients in the community, or to the ones in the hospital? It is difficult. But for what I know, we have not met the standard yet in Nigeria and in Africa.