Saturday, 30 November 2019

13 Ways to Prevent Type 2 Diabetes



Type 2 diabetes is a chronic disease that affects millions of people worldwide. Uncontrolled cases can cause blindness, kidney failure, heart disease and other serious conditions.

Before diabetes is diagnosed, there is a period where blood sugar levels are high but not high enough to be diagnosed as diabetes. This is known as prediabetes.

It's estimated that up to 70% of people with prediabetes go on to develop type 2 diabetes. Fortunately, progressing from prediabetes to diabetes isn't inevitable (1).

Although there are certain factors you can't change — such as your genes, age or past behaviors — there are many actions you can take to reduce the risk of diabetes.

Here are 13 ways to avoid getting diabetes.
1. Cut Sugar and Refined Carbs From Your Diet

Eating sugary foods and refined carbs can put at-risk individuals on the fast track to developing diabetes.

Your body rapidly breaks these foods down into small sugar molecules, which are absorbed into your bloodstream.

The resulting rise in blood sugar stimulates your pancreas to produce insulin, a hormone that helps sugar get out of the bloodstream and into your body's cells.

In people with prediabetes, the body's cells are resistant to insulin's action, so sugar remains high in the blood. To compensate, the pancreas produces more insulin, attempting to bring blood sugar down to a healthy level.

Over time, this can lead to progressively higher blood sugar and insulin levels, until the condition eventually turns into type 2 diabetes.

Many studies have shown a link between the frequent consumption of sugar or refined carbs and the risk of diabetes. What's more, replacing them with foods that have less of an effect on blood sugar may help reduce your risk (2Trusted Source, 3Trusted Source, 4Trusted Source, 5Trusted Source, 6Trusted Source).

A detailed analysis of 37 studies found that people with the highest intakes of fast-digesting carbs were 40% more likely to develop diabetes than those with the lowest intakes (7Trusted Source).

    Summary:
    Eating foods high in refined carbs and sugar increases blood sugar and insulin levels, which may lead to diabetes over time. Avoiding these foods may help reduce your risk.
2. Work Out Regularly

Performing physical activity on a regular basis may help prevent diabetes.

Exercise increases the insulin sensitivity of your cells. So when you exercise, less insulin is required to keep your blood sugar levels under control.

One study in people with prediabetes found that moderate-intensity exercise increased insulin sensitivity by 51% and high-intensity exercise increased it by 85%. However, this effect only occurred on workout days (8Trusted Source).

Many types of physical activity have been shown to reduce insulin resistance and blood sugar in overweight, obese and prediabetic adults. These include aerobic exercise, high-intensity interval training and strength training (9Trusted Source, 10Trusted Source, 11Trusted Source, 12Trusted Source, 13Trusted Source, 14Trusted Source).

Working out more frequently seems to lead to improvements in insulin response and function. One study in people at risk of diabetes found that burning more than 2,000 calories weekly via exercise was required to achieve these benefits (14Trusted Source).

Therefore, it's best to choose physical activity that you enjoy, can engage in regularly and feel you can stick with long-term.

    Summary:
    Performing physical activity on a regular basis can increase insulin secretion and sensitivity, which may help prevent the progression from prediabetes to diabetes.

3. Drink Water as Your Primary Beverage

Water is by far the most natural beverage you can drink.

What's more, sticking with water most of the time helps you avoid beverages that are high in sugar, preservatives and other questionable ingredients.

Sugary beverages like soda and punch have been linked to an increased risk of both type 2 diabetes and latent autoimmune diabetes of adults (LADA).

LADA is a form of type 1 diabetes that occurs in people over 18 years of age. Unlike the acute symptoms seen with type 1 diabetes in childhood, LADA develops slowly, requiring more treatment as the disease progresses (15Trusted Source).

One large observational study looked at the diabetes risk of 2,800 people.

Those who consumed more than two servings of sugar-sweetened beverages per day had a 99% increased risk of developing LADA and a 20% increased risk of developing type 2 diabetes (16Trusted Source).

Researchers of one study on the effects of sweet drinks on diabetes stated that neither artificially sweetened beverages nor fruit juice were good beverages for diabetes prevention (17Trusted Source).

By contrast, consuming water may provide benefits. Some studies have found that increased water consumption may lead to better blood sugar control and insulin response (18Trusted Source, 19Trusted Source).

One 24-week study showed that overweight adults who replaced diet sodas with water while following a weight loss program experienced a decrease in insulin resistance and lower fasting blood sugar and insulin levels (19Trusted Source).

    Summary:
    Drinking water instead of other beverages may help control blood sugar and insulin levels, thereby reducing the risk of diabetes.

4. Lose Weight If You're Overweight or Obese

Although not everyone who develops type 2 diabetes is overweight or obese, the majority are.

What's more, those with prediabetes tend to carry excess weight in their midsection and around abdominal organs like the liver. This is known as visceral fat.

Excess visceral fat promotes inflammation and insulin resistance, which significantly increase the risk of diabetes (20Trusted Source, 21Trusted Source, 22Trusted Source, 23Trusted Source).

Although losing even a small amount of weight can help reduce this risk, studies show that the more you lose, the more benefits you'll experience (24Trusted Source, 25Trusted Source).

One study of more than 1,000 people with prediabetes found that for every kilogram (2.2 lbs) of weight participants lost, their risk of diabetes reduced by 16%, up to a maximum reduction of 96% (25Trusted Source).

There are many healthy options for losing weight, including low-carb, Mediterranean, paleo and vegetarian diets. However, choosing a way of eating you can stick with long-term is key to helping you maintain the weight loss.

One study found that obese people whose blood sugar and insulin levels decreased after losing weight experienced elevations in these values after gaining back all or a portion of the weight they lost (26Trusted Source).

    Summary:
    Carrying excess weight, particularly in the abdominal area, increases the likelihood of developing diabetes. Losing weight may significantly reduce the risk of diabetes.

5. Quit Smoking

Smoking has been shown to cause or contribute to many serious health conditions, including heart disease, emphysema and cancers of the lung, breast, prostate and digestive tract (27Trusted Source).

There's also research linking smoking and second-hand smoke exposure to type 2 diabetes (28Trusted Source, 29Trusted Source, 30Trusted Source, 31Trusted Source).

In an analysis of several studies totaling over one million people, smoking was found to increase the risk of diabetes by 44% in average smokers and 61% in people who smoked more than 20 cigarettes daily (30Trusted Source).

One study followed the risk of diabetes in middle-aged male smokers after they quit. After five years their risk had reduced by 13%, and after 20 years they had the same risk as people who had never smoked (31Trusted Source).

Researchers stated that even though many of the men gained weight after quitting, after several smoke-free years, their risk of diabetes was lower than if they'd continued smoking.

    Summary:
    Smoking is strongly linked to the risk of diabetes, especially in heavy smokers. Quitting has been shown to reduce this risk over time.

6. Follow a Very-Low-Carb Diet

Following a ketogenic or very-low-carb diet can help you avoid diabetes.

Although there are a number of ways of eating that promote weight loss, very-low-carb diets have strong evidence behind them.

They have consistently been shown to lower blood sugar and insulin levels, increase insulin sensitivity and reduce other diabetes risk factors (32Trusted Source, 33Trusted Source, 34Trusted Source, 35Trusted Source, 36Trusted Source).

In a 12-week study, prediabetic individuals consumed either a low-fat or low-carb diet. Blood sugar dropped by 12% and insulin dropped by 50% in the low-carb group.

In the low-fat group, meanwhile, blood sugar dropped by only 1% and insulin dropped by 19%. Thus, the low-carb diet had better results on both counts (35Trusted Source).

If you minimize your carb intake, your blood sugar levels won't rise very much after you eat. Therefore, your body needs less insulin to maintain your blood sugar within healthy levels.

What's more, very-low-carb or ketogenic diets may also reduce fasting blood sugar.

In a study of obese men with prediabetes who followed a ketogenic diet, average fasting blood sugar decreased from 118 to 92 mg/dl, which is within the normal range. Participants also lost weight and improved several other health markers (36Trusted Source).

For more info, check out this Guide to Healthy Low-Carb Eating With Diabetes.

    Summary:
    Following a ketogenic or very-low-carb diet can help keep blood sugar and insulin levels under control, which may protect against diabetes.

7. Watch Portion Sizes

Whether or not you decide to follow a low-carb diet, it's important to avoid large portions of food to reduce the risk of diabetes, especially if you are overweight.

Eating too much food at one time has been shown to cause higher blood sugar and insulin levels in people at risk of diabetes (37Trusted Source).

On the other hand, decreasing portion sizes may help prevent this type of response.

A two-year study in prediabetic men found that those who reduced food portion sizes and practiced other healthful nutrition behaviors had a 46% lower risk of developing diabetes than the men who made no lifestyle changes (38Trusted Source).

Another study looking at weight loss methods in people with prediabetes reported that the group practicing portion control lowered their blood sugar and insulin levels significantly after 12 weeks (39Trusted Source).

    Summary:
    Avoiding large portion sizes can help reduce insulin and blood sugar levels and decrease the risk of diabetes.

8. Avoid Sedentary Behaviors

It's important to avoid being sedentary if you want to prevent diabetes.

If you get no or very little physical activity, and you sit during most of your day, then you lead a sedentary lifestyle.

Observational studies have shown a consistent link between sedentary behavior and the risk of diabetes (40Trusted Source, 41).

A large analysis of 47 studies found that people who spent the highest amount of time per day engaged in sedentary behavior had a 91% increased risk of developing diabetes (41).

Changing sedentary behavior can be as simple as standing up from your desk and walking around for a few minutes every hour.

Unfortunately, it can be hard to reverse firmly entrenched habits.

One study gave young adults at risk of diabetes a 12-month program designed to change sedentary behavior. Sadly, after the program ended, the researchers found that participants hadn't reduced how much time they sat (42Trusted Source).

Set realistic and achievable goals, such as standing while talking on the phone or taking the stairs instead of the elevator. Committing to these easy, concrete actions may be the best way to reverse sedentary tendencies.

    Summary:
    Avoiding sedentary behaviors like excessive sitting has been shown to reduce your risk of getting diabetes.

9. Eat a High-Fiber Diet

Getting plenty of fiber is beneficial for gut health and weight management.

Studies in obese, elderly and prediabetic individuals have shown that it helps keep blood sugar and insulin levels low (43Trusted Source, 44Trusted Source, 45Trusted Source, 46Trusted Source).

Fiber can be divided into two broad categories: soluble and insoluble. Soluble fiber absorbs water, whereas insoluble fiber does not.

In the digestive tract, soluble fiber and water form a gel that slows down the rate at which food is absorbed. This leads to a more gradual rise in blood sugar levels (47Trusted Source).

However, insoluble fiber has also been linked to reductions in blood sugar levels and a decreased risk of diabetes, although exactly how it works is not clear (4Trusted Source, 47Trusted Source, 48Trusted Source).

Most unprocessed plant foods contain fiber, although some have more than others. Check out this list of 22 high-fiber foods for many excellent sources of fiber.

    Summary:
    Consuming a good fiber source at each meal can help prevent spikes in blood sugar and insulin levels, which may help reduce your risk of developing diabetes.

10. Optimize Vitamin D Levels

Vitamin D is important for blood sugar control.

Indeed, studies have found that people who don't get enough vitamin D, or whose blood levels are too low, have a greater risk of all types of diabetes (49Trusted Source, 50Trusted Source, 51Trusted Source, 52Trusted Source).

Most health organizations recommend maintaining a vitamin D blood level of at least 30 ng/ml (75 nmol/l).

One study found that people with the highest blood levels of vitamin D were 43% less likely to develop type 2 diabetes than those with the lowest blood levels (49Trusted Source).

Another observational study looked at Finnish children who received supplements containing adequate levels of vitamin D.

Children who took the vitamin D supplements had a 78% lower risk of developing type 1 diabetes than children who received less than the recommended amount of vitamin D (50Trusted Source).

Controlled studies have shown that when people who are deficient take vitamin D supplements, the function of their insulin-producing cells improves, their blood sugar levels normalize and their risk of diabetes reduces significantly (51Trusted Source, 52Trusted Source).

Good food sources of vitamin D include fatty fish and cod liver oil. In addition, sun exposure can increase vitamin D levels in the blood.

However, for many people, supplementing with 2,000–4,000 IU of vitamin D daily may be necessary to achieve and maintain optimal levels.

    Summary:
    Consuming foods high in vitamin D or taking supplements can help optimize vitamin D blood levels, which can reduce your risk of diabetes.

11. Minimize Your Intake of Processed Foods

One clear step you can take to improve your health is to minimize your consumption of processed foods.

They're linked to all sorts of health problems, including heart disease, obesity and diabetes.

Studies suggest that cutting back on packaged foods that are high in vegetable oils, refined grains and additives may help reduce the risk of diabetes (53Trusted Source, 54Trusted Source, 55Trusted Source).

This may be partly due to the protective effects of whole foods like nuts, vegetables, fruits and other plant foods.

One study found that poor-quality diets that were high in processed foods increased the risk of diabetes by 30%. However, including nutritious whole foods helped reduce this risk (55Trusted Source).

    Summary:
    Minimizing processed foods and focusing on whole foods with protective effects on health may help decrease the risk of diabetes.

12. Drink Coffee or Tea

Although water should be your primary beverage, research suggests that including coffee or tea in your diet may help you avoid diabetes.

Studies have reported that drinking coffee on a daily basis reduced the risk of type 2 diabetes by 8–54%, with the greatest effect generally seen in people with the highest consumption (56Trusted Source, 57Trusted Source, 58Trusted Source, 59Trusted Source, 60Trusted Source, 61).

Another review of several studies that included caffeinated tea and coffee found similar results, with the largest risk reduction in women and overweight men (62Trusted Source).

Coffee and tea have antioxidants known as polyphenols that may help protect against diabetes (63Trusted Source).

In addition, green tea contains a unique antioxidant compound called epigallocatechin gallate (EGCG) that has been shown to reduce blood sugar release from the liver and increase insulin sensitivity (64Trusted Source, 65Trusted Source).

    Summary:
    Drinking coffee or tea may help reduce blood sugar levels, increase insulin sensitivity and reduce the risk of diabetes.

13. Consider Taking These Natural Herbs

There are a few herbs that may help increase insulin sensitivity and reduce the likelihood of diabetes progression.
Curcumin

Curcumin is a component of the bright gold spice turmeric, which is one of the main ingredients in curries.

It has strong anti-inflammatory properties and has been used in India for centuries as part of Ayurvedic medicine.

Research has shown it can be very effective against arthritis and may help reduce inflammatory markers in people with prediabetes (66Trusted Source, 67Trusted Source).

There's also impressive evidence that it may decrease insulin resistance and reduce the risk of diabetes progression (68Trusted Source, 69Trusted Source).

In a controlled nine-month study of 240 prediabetic adults, among the group who took 750 mg of curcumin daily, no one developed diabetes. However, 16.4% of the control group did (69Trusted Source).

In addition, the curcumin group experienced an increase in insulin sensitivity and improved functioning of insulin-producing cells in the pancreas.
Berberine

Berberine is found in several herbs and has been used in traditional Chinese medicine for thousands of years.

Studies have shown that it fights inflammation and lowers cholesterol and other heart disease markers (70Trusted Source).

In addition, several studies in people with type 2 diabetes have found that berberine has strong blood-sugar-lowering properties (71Trusted Source, 72Trusted Source, 73Trusted Source, 74Trusted Source).

In fact, a large analysis of 14 studies found that berberine is as effective at lowering blood sugar levels as metformin, one of the oldest and most widely used diabetes medications (74Trusted Source).

Because berberine works by increasing insulin sensitivity and reducing the release of sugar by the liver, it might theoretically help people with prediabetes avoid diabetes.

However, at this point there are no studies that have looked at this.

In addition, since its effects on blood sugar are so strong, it should not be used in conjunction with other diabetes medications unless authorized by a doctor.

    Summary:
    The herbs curcumin and berberine increase insulin sensitivity, reduce blood sugar levels and may help prevent diabetes.

The Bottom Line

You have control over many of the factors that influence diabetes.

Rather than viewing prediabetes as a stepping stone to diabetes, it may be helpful to see it as a motivator for making changes that can help reduce your risk.

Eating the right foods and adopting other lifestyle behaviors that promote healthy blood sugar and insulin levels will give you the best chance at avoiding diabetes.


 Written by Franziska Spritzler, RD, CDE on January 29, 2017

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Friday, 15 November 2019

UGONSA SENDS LETTER TO SEVEN STATES OVER NON-IMPLEMENTATION OF NURSING INTERNSHIP

Following the call by UGONSA for its members to indicate States where the nascent nursing internship training for the graduates of BNSc degree is yet to be implemented, the association has sent letters to seven States identified by its members. Letters were sent to both the Governors of the concerned States and their Commissioners of Health. The States include Imo, Delta, Enugu, Ogun, Kaduna, Abia, and Plateau State. Below is a sample of the letter sent to the States:




His Excellency,
Rt. Hon. Simon Bako Lalong,
The Executive Governor of Plateau State,
Government House, Jos,
Plateau State, Nigeria.

Sir,

A PASSIONATE APPEAL TO CREATE INTERNSHIP POSITIONS FOR FRESH BNSc GRADUATES OF PLATEAU STATE ORIGIN IN THE STATE-OWNED HOSPITALS

We laud the ongoing effort of the Plateau State government to reposition the health system of the State for efficiency in service delivery. We also laud the great effort of the State Government at manpower build-up and development in the health system of the State.

2. However, we passionately appeal for the kind intervention of your good office to bridge the missing link in the nursing education of the graduates of Bachelor of Nursing Science (BNSc) degree of Plateau State origin, which is non-availability of internship position for them in Plateau State-owned hospitals; an unfortunate scenario that has hampered the completion of nursing education of the majority of the baccalaureate-prepared nursing students.

3. The release of the internship circular, Ref No. HCSF/EPO/EIR/CND/S.100/ST/97, on 8th September 2016 by the office of the head of the civil service of the federation (HCSF) made it mandatory that every graduate of BNSc degree must undergo a one-year internship training to be eligible for issuance of a full license by the Nursing and Midwifery Council of Nigeria (NMCN). What this portends is that internship training is a sine qua non of their graduation and change of licensure status from “provisional to full” by the NMCN and thus anyone who was unable to find internship placement remains trapped in the transition gulf between graduation and licensure.

4. Since 2016, when internship training commenced in Nursing, no hospital owned by the Plateau State Government has ever included the post of nurse interns in their internship adverts whenever they advertized for internship placement. Thus, as the fresh university graduates of Plateau State origin from other core healthcare disciplines such as Medicine, Pharmacy, Dentistry, Med Lab, Optometry, Physiotherapy, etc, are given the opportunity for internship training in the State-owned hospitals, those of nursing are ostracized and left to wallow at the mercy of hospitals in other States when their own State has capable hospitals that can take care of their needs.

5. We, therefore, most passionately implore that you intervene to see that nurses, who can be described as the mother of the hospital (if the hospital is likened to a family) is given the opportunity to blend their theoretical know-how with comprehensive clinical skills by affording the fresh graduates of BNSc degree internship opportunity in Plateau State-owned hospitals to enable them get adequate training and skills to provide exceptional nursing care to the populace.

6. The lives of people have been entrusted onto the care of nurses; it is thus imperative that nurses are well educated and trained to carry out this task effectively and efficiently.

PRAYER

We most humbly and passionately request that you kindly use your good office to

1. see that the post of nurse intern is included in subsequent internship adverts of Plateau State-owned hospitals that offer internship training for fresh graduates of core healthcare disciplines.

2. give fresh graduates of BNSc degree of Plateau State origin, the opportunity to do internship in Plateau State-owned hospitals as done for the fresh graduates of other core healthcare disciplines.

3. make the Plateau State Specialist Hospital, Jos, and the Plateau State Hospital Management Board to extend the internship opportunity they have been availing the fresh graduates other core healthcare professions to the fresh graduate nurses.

Please find the attached circulars and implementation guide for the nursing internship from the NMCN for guidance on placement and postings during the nursing internship.

Kindly accept the assurances of our esteemed regards!


Signed


CHIEF (HON.) S.E.O. EGWUENU                                   NURSE G.I. NSHI
         National President                                                         National Secretary

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Wednesday, 6 November 2019

UGONSA CLARIFIES NOHE ON ELIGIBILITY FOR SCREENING AND SELECTION OF CANDIDATES FOR NURSING INTERNSHIP

The Medical Director,
National Orthopaedic Hospital Enugu,
Enugu State, Nigeria.

Sir/Madam,
SOME SALIENT POINTS ON SCREENING AND SELECTION OF ELIGIBLE CANDIDATES FOR THE NASCENT NURSING INTERNSHIP TRAINING FOR B.N.Sc DEGREE GRADUATES

We highly commend the ongoing effort of your Hospital to recruit nurse interns and wish to intimate you on some salient points that bother screening and selection of eligible candidates for the programme.

2. The release of the internship circular, Ref No. HCSF/EPO/EIR/CND/S.100/ST/97, on 8th September 2016, prompted the Nursing and Midwifery Council of Nigeria (NMCN) to declare official commencement of the internship training nationwide on February 3, 2017, vide a memo Ref No.N&MCN/SG/RO/CIR/24/VOL.4/4 with the release of the implementation guide for the programme.

3. Section 2.2 No.2 (page 4) of the internship guide stated that screening shall be based on institutional criteria.   

4. This clause was necessary to allow for flexibility for hospitals to use their discretion to handle areas of seeming controversy in the screening and selection of eligible candidates. 

5. At the time of the release of the circular in 2016 and throughout 2017 that the internship commenced, the issuance of provisional licences to fresh B.N.Sc graduates was not streamlined until the first quarter of 2018. Thus, most candidates who graduated in the year 2016 and 2017 received a permanent licence from the NMCN despite being eligible for running internship.

6. Thus, it is up to hospitals to work around the internship guide and consider screening and selection of candidates based on when they graduated from school in a match with when the internship circular was released.  

7. In lieu of this, candidates who graduated in the year 2016 and 2017 that received permanent licences when the nursing council was yet to streamline the issuance of provisional licences are eligible for screening and selection for internship. 

8. Kindly find attached documents for further guidance on the subject matter.

Thank you.

                                                                             Signed:


CHIEF (HON.) S.E.O. EGWUENU                                                       NURSE G.I. NSHI
National President                                                                                     National Secretary

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Sunday, 29 September 2019

PROPER PLACEMENT: UGONSA WRITES THE NEW MINISTER OF INTERIOR







The Honourable Minister of Interior,
Federal Ministry of Interior (FMOI),
Block F, Old Federal Secretariat,
Area 1, P.M.B. 7007, Garki, Abuja.
Phone: 09-6713526.
E-mail: info@interior.gov.ng.

Sir,

NURSES CONGRATULATE YOU ON YOUR DESEVERD APPOINTMENT AS THE HONOURABLE MINISTER OF INTERIOR AND PASSIONATELY IMPLORE YOU TO URGENTLY INTERVENE TO END THE PERENNIAL INJUSTICES NURSES SUFFER IN THE MINISTRY

We are delighted to extend our warm Nightingalic congratulations to you over your recent appointment by President Muhammadu Buhari, GCFR, to serve the country in another great capacity as the Honourable Minister of Interior. It was the special vigour and hard work you elaborated in the past in other realms of service to the country that paved way for your elevation to this new post to help the country solve its internal challenges that are growing in complexity at this auspicious moment in our national life. We give all glory to God for this positive development and wish you every success in your new assignment. 

2. However, we wish to draw your esteemed attention to a perennial injustice nurses have suffered in the Ministry of Interior for your urgent intervention.

3. We make haste to call your esteemed attention to this injustice because of the inclination that neither you nor President Muhammadu Buhari (who appointed you to this post) condones or adulates injustice and marginalization. 

4. On this very issue in question, we had written the Ministry twice vide our letters Ref Nos UGONSA/018/FMOI/01 & UG/NAT/19/ FMOI/01 dated 18th May, 2018 and 4th March, 2019 respectively, yet the injustice persists unaddressed.

5. The issue is the inexplicable delay in implementation of Federal Government of Nigeria’s service circulars for nurses by the Federal Ministry of Interior despite the ministry being in the know of such circulars.

6. Extant circulars for placement of nurses in the Civil/Public Service of the Federation stipulate that the entry point of Registered Nurses (RN) with Bachelor of Nursing Science (B.N.Sc) degree post-NYSC (National Youth Service Corps) is CONHESS 08 (.i.e. Grade Level 09) as evidenced by the following circulars herewith attached for your on-the-spot attention and confirmation:

(a).  Circular, Ref No. HCSF/EIR/CND/S.100/ST/97 dated September 8, 2016 from the    
        office of the Head of Civil Service of the Federation (HCSF) (attached herewith as 
        Annexure A).

 (b). Circular, Ref No.C6093/T/13 dated 19th June, 2017, from Federal Ministry of Health 
       (FMOH) [attached herewith as Annexure B].

 (c). Circular Ref No. C.6093/T/16 dated February 20, 2018 from FMOH (attached
        herewith as Annexure C).

(d). Circular Ref No. C2920/5.3/C.2/1/155 dated 5th February, 2019 from the FMOH
       (attached herewith as Annexure D).

(e). Circular, Ref No. B63279/S.7/II/T/273 dated 24th April, 2002 from the office of the 
       HCSF (attached herewith as Annexure E).

(f). A letter by the FMOH to a Chief Medical Director (CMD) on entry point placement of 
      graduate nurses (RN with B.N.Sc/B.Sc.Nursing) on CONHESS 08 (attached herewith
      as Annexure F).

(g). The Implementation Guide for Internship Programme for graduates of B.N.Sc degree 
       from the Nursing and Midwifery Council of Nigeria (NMCN), the statutory regulatory 
       body for nursing in Nigeria (page 6 attached herewith as Annexure G).

(h). Industrial Arbitration Panel (IAP) award of the year 1981, which granted that the
       profession of Nursing is on parity with that of Pharmacy in Nigeria, as is the case in 
       Great Britain from the National Industrial Court of Nigeria (attached herewith as 
       Annexure H).

7. It is very painful, inexcusable and inexplicable that the current entry point placement of CONHESS 08 post-NYSC of Registered Nurses(RN) with B.N.Sc/B.Sc. Nursing, that came into effect since year 2016, is yet to be implemented in any of the services/agencies under the Ministry of Interior such as the Nigerian Correctional (Prisons) Service (NCS), Nigerian Security and Civil Defense Corps (NSCDC), Nigeria Immigration Service (NIS), and the Nigeria Fire Service (NFS).

8. For example the advert for recruitment of officers into the Nigerian Prison Service (now known as Nigeria Correctional Service) made by the Civil Defence, Fire, Immigration, and Prisons Services Board (CDFIBP) on Daily Trust Newspaper of Monday 30 April, 2018 aberrantly placed all Registered Nurses (including those with B.N.Sc/B.Sc.Nursing degree) on CONHESS 06 in a bizarre disobedience to the extant law that prescribes CONHESS 08 for Registered Nurses(RN) with B.N.Sc/B.Sc.Nursing degree post-NYSC (please kindly refer Annexure I for the Nigerian Prisons Service advert).

9. This year, 2019, CDFIBP, in its current advert for recruitment into the NSCDC (made online via https://cdfipb.careers/jobs/civil-defence), trampled again upon the law and listed the entry point of all Registered nurses and midwives, including the graduates of B.N.Sc/B.Sc.Nursing degree, as CONHESS 07 without specifying CONHESS 08 as the entry point for the Registered Nurses (RN) with B.N.Sc/B.Sc.Nursing post-NYSC, as stipulated by the extant circulars (please kindly refer Annexure J for the NSCDC advert).

10. Compounding the woes of nurses in the Ministry of Interior is the suppressive placement by CDFIBP of all nurses, including those with university degree in nursing, in the inspectorate cadre whereas the university graduates of other core healthcare disciplines such as Pharmacy, Medicine, Dentistry, Optometry, etc, are all placed in the superintendent cadre (please refer to the attached adverts. i.e. Annexure I & J). This anomalous and provocative behaviour by CDFIBP and other board of agencies/services/parastatals under the Ministry of Interior is totally in defiance of the verdict of the gazzeted Industrial Arbitration Panel (IAP) Award of year 1981that granted that the profession of nursing is on parity with that of Pharmacy in Nigeria as is the case in Great Britain (please refer Annexure H). It is also reeks of either a deliberate feigning of ignorance of existence of baccalaureate and post-baccalaureate nursing degrees registrable by the Nursing & Midwifery Council of Nigeria (NMCN) or a mischievous sinister plot to cast the nursing degree (.i.e. B.N.Sc/B.Sc.Nursing) as inferior to other bachelor degrees.  

11. This issue is of grave concern as par uncertainty enveloping the applicability of rule of law and engagement of due process in the Ministry of Interior that is otherwise supposed to be a bastion of rule of law, equity and fairness.  

12. We in the nursing community are very appalled by this ugly development in the Ministry of interior and passionately implore your urgent intervention to put things in the right perspective.

13. Our people are already agitated and find it difficult to endure a day longer without having what is duly their right granted by the Ministry of Interior and it will not be in a good light that the implementation of the circulars came in subject of protest, picketing and “placard carrying”.

PRAYER
We most respectfully implore your urgent intervention to end the perennial injustice nurses suffer in the Federal Ministry of Interior by using your good office to compel CDFIBP and other boards of agencies/parastatals/services under the Ministry to
  
1. implement CONHESS 08 (.i.e. Grade Level 09) as the entry point for Registered Nurses (RN) possessing B.N.Sc/B.Sc.Nursing degree in line with the provision of the  extant circulars of the Nigerian Government. 

2. upgrade to CONHESS 08 the existing Nurse Officers possessing B.N.Sc/B.Sc.Nursing degree who were employed before 8th September, 2016  but are still below the new base of CONHESS 08 effective from 8th September, 2016 (being the date of release of the circular REF No. HCSF/EIR/CND/S.100/ST/97 by the office of the Head of Civil Service of the Federation .i.e. Annexure A) as prescribed by the civil service circular, Ref No. B63279/S.7/II/T/273 dated 24th April, 2002 (.i.e. Annexure E).

3. upgrade all graduate nurses (i.e. RN with B.N.Sc/B.Sc.Nursing degree) who were wrongly employed below the new base of CONHESS 08 after 8th September, 2016 to CONHESS 08 effective from the date of their employment as prescribed by the civil service circular, Ref No. B63279/S.7/II/T/273 dated 24th April, 2002 (i.e. Annexure E).

4. employ the university graduates of nursing (.i.e. RN possessing B.N.Sc/B.Sc.Nursing degree) on the superintendent cadre as done for the university graduates of other core healthcare disciplines.

Accept please the assurances of our highest regards as we heartily wish you a successful and rewarding tenure!
Signed:

      CHIEF (HON.) S.E.O. EGWUENU                                    NURSE G.I. NSHI
            National President                                                           National Secretary

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Thursday, 26 September 2019

UGONSA NORTHERN ZONE SPEAKS ON NMCN-ABU ACCREDITATION SQUABBLE

RESTORATION OF ACCREDITATION TO THE DEPARTMENT OF NURSING, ABU ZARIA: FACTS, FALLACIES AND KUDOS BY UGONSA NORTHERN ZONE

The University Graduates of Nursing Science Association (UGONSA), Northern zone, appreciates the efforts by various stakeholders that culminated to restoration of accreditation to the department of Nursing Science, Ahmadu Bello University (ABU) Zaria especially the efforts of the management of ABU Zaria, members of the House of Representatives, the Nursing & Midwifery Council of Nigeria (N&MCN), Students and Staff of the department of Nursing Science, the ABU alumni and the former staff of the department of Nursing Science ABU, who throughout the period of the unfortunate fray, showed maturity and decorum in the face of unwarranted mudslinging, despite unquantifiable contributions and commitment to building up the department.

2. Notwithstanding that the accreditation of the Department of Nursing has been restored, it is imperative to address the misconceptions elaborated in a press statement that was made while the issue was raging, as published on the online media, medicalworldnigeria.com, and widely circulated on social media, with the title “Academic Situation in the Department of Nursing Science Ahmadu Bello University” dated 10th September, 2019 purportedly made by the management of ABU Zaria and signed by the Registrar of the school. Reading through the statement, the fallacious innuendoes it was riddled with at first made us doubt that it actually emanated from the ABU management because we found it hard to believe that the management of the revered ABU Zaria could throw caution to the
wind and stoop so low to spew such verbiage. But as the ABU management has not come up to disown the statement till date, the possibility that they actually authored such a misleading statement
cannot be totally ruled out.

3. Our association which is the umbrella body of University Graduates of Nursing Sciences is concerned because the statement falsely painted the nursing profession and its graduates especially in Northern Nigeria in bad light, and therefore is obligated to speak up.

4. Having taken time to investigate and unravel the truth from current and past students and staff of the department of Nursing Science, ABU, we feel it proper at this time to set the records straight.

5. It is our honest view that the authors misinformed the public and university community by changing the narrative probably to suit their personal ulterior agenda and further destabilize the department of Nursing Sciences.

6. The content of the said publication clearly showed that the authors were either grossly ignorant of the regulatory functions of the NMCN as powered by its establishment Act and its role in maintaining
standards in nursing education and practice in Nigeria or being deliberately mischievous as evidenced
by the declaration that council registration and regulation was meant for only nurses practicing in the
clinical area and does not apply to nurses practicing nursing education. It is settled that the NMCN registers and regulates all nurses and every shred of nursing practice, be it in the clinical area or in the
nursing classroom.

7. Globally, a foreign nurse or a foreign trained nurse cannot practice any form of nursing in another
country where such a nurse was not trained without first of all being registered as a nurse in the new country. The Act establishing N&MCN (Cap. N143, LFN 2004) followed the global trend as it succinctly stipulated that every foreign trained nurse must register with the N&MCN in order to practice in Nigeria, be it in the classroom or clinical area. Instead of being sober for breaking the law of the country by allowing a foreign trained nurse practice in its facility without being registered by the NMCN as stipulated by the law, the authors of the press statement purportedly from ABU management was audacious to signpost their ignorance or mischief, unfortunately ridiculing the revered institution.

8. The publication again in another display of either deep rooted mischief or crass ignorance labeled registered nurses with Bachelor of Nursing Science (BNSc) degree who possessed MSc and PhD in other areas relevant to nursing as “unqualified” to teach and supervise undergraduate and post-graduate nursing students in negation of the known global trend. The publication went on to even blame the lecturers it mischievously labeled as “unqualified” as the cause of the problem, thus tactically sweeping aside the real cause of the imbroglio which was allowing a foreign trained nurse to practice as a nursing lecturer in ABU without being registered as a nurse by the NMCN as stipulated by the law. To have turned around to blame the poor lecturers for its self inflicted woes was not only pathetic but also a languid display of mythomania and pseudolagia fantastica. The authors should have been bold enough to name the lecturers they were referring to if they were very sure the lecturers were indeed the culprits.

9. Across the World, highly rated universities within and outside the country have, in their employ, reputable lecturers, with the same qualifications which the ABU barefaced statement mischievously labeled as “unqualified”, impacting positively, and they will continue to have them because nursing education in the university is polyvalent and transcends clinical nursing. We hope that the memo of the National body of UGONSA on global trends in nursing finds the authors of the ABU statement to help them get educated on who is qualified or not qualified to teach nursing. In this case, the only person not qualified to teach nursing is the foreigner who was not registered by the NMCN as a nurse in Nigeria. Ironically, the lecturers that were mischievously labeled as “unqualified” were the very people that started the ABU department of Nursing Science and built it to its present commendable level as testified to by past and current students and staff of the department.

10. Can ABU management deny that the history and foundation of their department of Nursing Sciences cannot be complete without strong reference to the invaluable input and contributions of those academic staff they unfortunately debased in their publication as “unqualified”? It is on record that the pioneer head of department (HOD) of nursing ABU, Late Dr. Zhara Yusuf (RN, RM, RNT, M.Ed, PhD.) of blessed memory had MSc & PhD in education.

11. To have attributed the success of the department of nursing to the unregistered expatriate professor while demeaning the indigenous nurse lecturers who worked tirelessly to stand the department, is not only pathetic but amounts to standing logic on its head. Can a tree make a forest? and can one offer what one does not have?

12. The efforts of ABU management in bringing the expatriate professor to promote academic standard is highly appreciated and commendable by our association but not compelling her to register with the N&MCN as stipulated by the law stands condemnable just like the thinly veiled attempt to attribute achievement of full accreditation status by the department to her efforts solely. Can an individual not registered by the N&MCN achieve full N&MCN accreditation for her department?

13. The great roles played by the lecturers that are now unfortunately vilified should rather be acknowledged and commended as, truly, a tree does not make a forest. Those who seek to change the narratives are nothing but desperados seeking to pitch the hard working staff of the nursing department against each other in ABU Zaria.

14. Our investigation revealed that the expatriate has been in the country as an employee of ABU since year 2011 but only approached the N&MCN for registration and licensing between October and November, 2018 long after the university had received the N&MCN’s accreditation report of 2015 and after the second accreditation report of 2018 that strongly frowned at her non-registration with the Council. This is despite complaints from various team members of other accreditation visits to the department including the National Universities Commission (NUC) accreditation visits of 2012 and 2017.

15. In the course of our investigations we were also reliably informed that only her transcript was transmitted to the N&MCN sometimes in November 2018 which is her first official contact with the N&MCN. With this finding, it is clear that the innocent expatriate professor was not properly guided by the ABU management whom she works for. The embarrassment this has caused the expatriate professor is, to say the least, regrettable and could have been avoided if the ABU management had truly played their role.

16. Furthermore, the expatriate Professor of Nursing Sciences holds a clinical degree of Doctor of Nursing Sciences (DNSc), and the road map to nursing education and practice developed by N&MCN captures DNSc for clinical progression hence the university should give all necessary support to the expatriate professor to register with the Council. Her presence in the department should be utilized to develop terminal clinical degrees in the department as this will help maintain the University brand which is known for high quality of its products and sustain her much chanted slogan “an ABU graduate is ahead of you naturally”.

17. It is correct that there is currently a dearth of lecturers with MSc and PhD in Nursing Sciences, and that the NUC, N&MCN, NANMM (National Association of Nigerian Nurses and Midwives) and UGONSA encourage career lecturers to try to maintain their development in core MSc and PhD nursing to address the shortage, but that does not translate to saying that a lecturer with BNSc/BSc Nursing and MSc and PhD in another relevant field is not qualified to teach and supervise undergraduates and postgraduate studies in Nursing. By this assertion the authors of the said press statement clearly showed that they do not understand the polyvalent nature of the bachelor of nursing Sciences (B.NSc.) degree.

18. Again we also discovered further mischief in the statement where it claimed that the news that the department will be closed down and that the students therein have no future, may not be unconnected to those academic staff who have been found to lack the requisite academic qualifications to teach undergraduate and postgraduate programmes in nursing sciences. Our investigation revealed that the claim was a phantasm and flight of fancy of the author of the said press statement. The final year students of the department, who peacefully protested the delay in the resolution of the issue between the University and N&MCN, were addressed by the principal officers of the University’s College of Medical Sciences and not the nursing lecturers being made scapegoats. One of the Principal Officers was quoted to have made statements that infuriated and devastated the students and led to some suicidal attempts which were reported and managed in the University Medical Centre. Our association found some content of the said address misleading and not totally correct. However, in fairness to the said principal officers the recorded conversation, though capable of being variously perceived to mean different things, was contextual and articulated within reasonable perspectives.

19. UGONSA Northern zone hereby advices the ABU management to tender a solemn apology to the lecturers who were mischievously demeaned as “unqualified” and seek out strategies to negotiate a return of those that have left, back to the department of nursing. It was a mistake to have provoked some of them to the point that they decided to leave the department. As they left ABU, other universities that know and appreciate their value quickly embraced them and they have remained very relevant in helping these universities develop their departments of nursing science.

Signed:

Nur. B.B Afoi                                          Nur. M.A. Garba
UGONS President Northern Zone              UGONSA Secretary Northern zone
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Monday, 16 September 2019

UGONSA SENDS MEMO TO UNIVERSITIES ON GLOBAL TRENDS IN NURSING

The university Graduates of Nursing Science Association (UGONSA) has sent a memo to Universities offering nursing, Schools of Nursing, Schools of Post-Basic Nursing, Hospitals, General Nursing Community and the General Public on global trends in nursing that must be followed in Nigeria. The memo Ref No.UG/NAT/19/GEN/MEMO/02 dated 16th September, 2019 reads as follow: 

To
Vice Chancellors of Nursing-Offering Nigerian Universities,
Provosts, Colleges of Medicine,
Deans, Faculties of Nursing/Heads of Departments of Nursing in Nigerian Universities,
Principals, Schools of Nursing/ Coordinators of Post-Basic Nursing Schools,
Heads of Institutions involved in Nursing Education/Clinical Nursing Practice,
Nigerian Nursing Community/General Public

Sirs/Madams,
GLOBAL TRENDS ON NURSING PRACTICE IN NURSING EDUCATION AND CLINICAL NURSING PRACTICE 

The University Graduates of Nursing Science Association (UGONSA), the Professional Association of Nurses with a minimum qualification of first degree in nursing, wishes to extrapolate the global trends on nursing practice in the areas of nursing education and clinical nursing practice that MUST be followed to enable the nursing profession in Nigeria stay afloat and surf the contemporary complexities and global advancements in the profession.

2. Nursing is regulated because it is one of the health professions that poses the risk of harm to the public if its education or clinical aspect is practiced by someone who is unqualified or incompetent.

3. Every country has an entity (nursing council or board of nursing) saddled with the responsibility of determining competency and eligibility for nursing practice, whether in nursing education or clinical nursing practice. 

4. The nursing council or board of nursing in countries across the world carryout their regulatory activities through issuances of licences to qualified individuals to practice as nurses, nurse educators or clinical nurse specialists. They are authorized to develop administrative rules and regulations that are used to clarify or make specific pronouncement on matters affecting public health, safety and welfare, especially issues that border areas of nursing practice such as engagement in nursing education or clinical nursing practice.

5. The Nursing and Midwifery Council of Nigeria (NMCN) is the authorized entity with the legal authority to regulate nursing education and clinical nursing practice in Nigeria. It regulates nursing Education via “Nurse Educators’ and Nurse Tutors’ Licences” and clinical nursing practice via “licences on general nursing and in different sub-specialties of nursing”.

6. Globally, for one to be eligible for licensure in any country to practice as a nurse educator or a clinical nurse specialist in any of the nursing sub-specialties, the person must have first of all been certified as having the minimum competency required to practice nursing in that particular country via licensure as a Registered Nurse (RN).   

7. If a nurse, whether a clinical nurse specialist or a professor of nursing, migrates from his/her country of original registration to another country such a person is considered incompetent in the new country for not being abreast with the nursing rudiments in the new country and must be re-licensed as an RN by the nursing council or board of nursing of the new country after exhibiting proof of having minimum competency to practice nursing in the new country to the council or board. 

8. Proof of minimum competency lies in passing the nursing council’s or board of nursing’s requisite nursing exams. Failure to pass any country’s general nursing exam portends lack of minimum competence to handle anything related to nursing in that country, be it nursing education or clinical nursing practice, as one cannot give what one does not have.

9. This explains why any Nigerian Nurse, including Professors of Nursing, migrating to another country, e.g.  United States, United Kingdom, Egypt, Canada, Ireland, United Arab Emirates, etc., MUST first of all show proof of minimum competency to the nursing council or board of nursing of the country the nurse is migrating to by passing the requisite nursing exams and being re-licenced as a Registered Nurse (RN) in the host country to be eligible to practice in any area of nursing be it in nursing education or clinical area.

10. Corollarily, any nurse from another country, be it a Professor of Nursing or not, migrating to Nigeria must show proof of minimum competency to the NMCN (the statutory regulatory entity for nursing education and clinical nursing practice in Nigeria) and be listed as a Nigerian RN for such a person to be eligible to practice in any area of nursing in Nigeria be it nursing education, clinical specialist area or general nursing. Not doing so is not only a brazen assault on the Nigerian laws but also an inimical antithesis of best global practices.

11. On eligibility for teaching postgraduate and undergraduate nursing students, the global trend accentuates a pool of nurse lecturers with experience in diverse fields and disciplines that form the modules of study of nursing science.

12. The integrals of Nursing science programmes at baccalaureate and post- baccalaureate levels are derivatives of other relevant fields such as Sociology, Law, Economics, Statistics, Nutrition, Pharmacology, Anatomy, Physiology, Psychology, Epidemiology,  Pathology, Measurement and Evaluation, Public Health, Community Health, Health education, Guidance and Counseling,  etc.

13. The contemporary global trends emphasize synergizing a pool of nurse lecturers possessing MSc and PhD in nursing with those that obtained MSc and PhD in the aforementioned relevant fields after their first degree in nursing, for tutorship in post-graduate and undergraduate nursing programmes.

14. After the first degree in nursing, differentiation and diversification, ipso facto, are norms that herald a pool of nurse lecturers that are knowledgeable and versatile in areas outside core nursing that are much relevant to nursing education and clinical nursing practice. 

15. While those that majored in MSc and PhD in nursing help maintain the core nursing modules, those that majored in the aforementioned relevant areas stabilize the pod by synergistically overseeing integration of relevancy of these areas to nursing education and clinical nursing practice having had sound baccalaureate foundation in nursing.  

16. Globally, it is preferable to have a nurse with first degree in nursing (BNSc/BSc.Nursing), who majored in MSc and PhD in another relevant field, say Sociology or Nutrition, handle the aspects of nursing education that border on Sociology or Nutrition, than have a sociologist or a nutritionist who has no prior nursing background handle such.

17. Therefore, “not putting our eggs in one basket” after the first degree in nursing, while ensuring and enhancing competence, professionalism, ethical standard, character and capacity, is the global trend that MUST be followed by and in the Nigerian Nursing community.

We hope that by this memo, adequate and concise expositions have been succinctly made for individuals and institutions that are involved in nursing education and clinical nursing practice in Nigeria for proper guidance on the global best trends in Nursing education and clinical nursing practice that MUST be observed to help the profession remain ever responsive and dynamic to its healthcare mandate to the Nigerian public. 

Signed:


               CHIEF (HON.) S.E.O. EGWUENU                     NURSE G.I. NSHI
                  National President                                                     
National Secretary

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Friday, 30 August 2019

PROPER PLACEMENT: UGONSA WRITES NEW MINISTER OF HEALTH




In a letter, Ref No.UG/NAT/19/FMOH/06 dated 30th August, 2019, UGONSA had written the new Minister of health, congratulating him and presenting the lingered issue of underplacement  of graduate nurses for rectification. Below is the full text of the letter:




The Honourable Minister of Health,

Federal Ministry of Health (FMOH),
New Federal Secretariat Complex,
Phase III, Ahmadu Bello Way,
Central Business District,
P.M.B 083, Garki, Abuja, Nigeria.

Sir,
CONGRATULATIONS ON YOUR DESERVED APPOINTMENT AS THE HONOURABLE MINISTER OF HEALTH: PLEASE RECTIFY THE INJUSTICE OF UNDERPLACEMENT OF GRADUATE NURSES DURING YOUR TENURE

The University Graduates of Nursing Science Association (UGONSA) and nurses under its commune heartily congratulate you on your deserved appointment as the Honourable Minister of Health. Your re-appointment and elevation to a higher post in the Ministry of Health by President Muhammadu Buhari, GCFR, is a testament to the fact that you utilized the opportunity given you in the first term with great accountability. We pray God to grant you abundant grace, wisdom, good health and strength to enable you excel and do greater things for our health system in your new post.

2. We deem it appropriate to intimate you, at this budding period of your tenure, on the perennial injustice of underplacement of graduate nurses, which the ministry is yet to rectify, to enable you form a robust framework for righting the wrongs of yesterday to enthrone a repositioned ministry that is equitable and fair to all the healthcare team members, especially the nurses that have so long been marginalized. 

3. As at date, nurse interns are placed on CONHESS 07 whereas their counterparts from other core healthcare disciplines such as Pharmacy, Medical Laboratory Science, Physiotherapy, and so on, are placed on CONHESS 08. Post-NYSC (National Youth Service Corps), the graduate nurses are employed into the Civil Service on CONHESS 08 whereas their counterparts in other core healthcare disciplines are employed on CONHESS 09.   

4. What is more? This injustice of underplacement of graduate nurses to the tune of one grade level below par occurs despite that nursing and the aforementioned core healthcare disciplines have similar entry requirements and course durations for the first degree in the university. 

5. Moreso, the wrongful underplacement is at variance with the gazetted verdict of the Industrial Arbitration Panel (IAP) award of the year 1981, which granted that the profession of Nursing is on parity with that of Pharmacy in Nigeria, as is the case in Great Britain (Please refer Annexure A for the IAP award document).  By the unambiguous provision of the IAP award, the basis for appointment of graduates of Bachelor of Pharmacy (B.Pharm) degree unto CONHESS 09 post-NYSC also justifies why the graduates of the Bachelor of Nursing Science (B.N.Sc) degree, who are on parity with them, should be appointed on the same grade, especially as both professions of nursing and pharmacy have similar entry requirements and course durations for the first degree in the university plus a one year internship training pre-NYSC.

6. When we registered our displeasure over this wrongful shortchange of nurses, to the immediate past Minister, and demanded for upgrade of salary grade level (GL) of the graduate nurses, in the spirit and letter of the IAP award, to be at par with what is obtainable with their counterparts in other core healthcare disciplines, whose entry points in the civil service are CONHESS 08 for interns and CONHESS 09 post-NYSC, the ministry in her reply, vide a circular Ref No. Ref No. C.6093/T/13 dated 19th June 2017, averred that issues on proper placements or adjustments on cadre/rank/post/GL fall within the purview of the office of the Head of Civil Service of the Federation (HCSF)/National Council on Establishment (NCE) and not the Federal Ministry of Health (FMOH). 

7. Consequently, the ministry advised that if the association (.i.e. UGONSA) wanted a review and upgrade of the current entry point for the graduate nurses, it should send a memorandum to the Nursing and Midwifery Council of Nigeria (NMCN) on a new proposed entry point of CONHESS 09 against the CONHESS 08 that is currently in place. The ministry added that the NMCN, after deliberation on the new memorandum, can forward same to the FMOH for onward transmission and submission to the HCSF for presentation at next NCE meeting for consideration (kindly refer Annexure B for the FMOH response).

8. Based on the advice of the FMOH, we forwarded a memorandum to the NMCN proposing CONHESS 09 as the entry point of the graduate nurses and as well recognizing higher degrees in nursing such as MSc and PhD in the nurses’ schemes of service. With the tipping that the memo has been transmitted from the NMCN to the FMOH, it portends that the issues of righting this wrong now lies on your table as it is the responsibility of the FMOH to transmit the memo to the office of the HCSF and follow it up to till it is passed and approved by the NCE as was done for other core healthcare disciplines.

9. We feel dejected whenever we juxtapose the work load and contributions of nurses to clientcare with this unwarranted ill treatment of wrongful underplacement below par.  

10. In terms of work load, nurses are the frontline care givers with the highest bedside visibility, who stay with patients round-the-clock from birth till death serving as a tapestry of care similar to the roles played by mothers in families; a tapestry woven through nurses' daily contact with patients, through attending to patients' physical, psychological, emotional or otherwise holistic needs, administering treatments and medications, monitoring patients' responses to those treatments and medications, helping patients to live with their illness or helping educate them about how to live with their illness, dealing with patients’ family members, and  helping patients die with some measure of comfort and dignity when recovery is paled and death is inevitable.

11. It therefore defies logic, common sense and rationality that nurses who play to our healthcare delivery system similar roles as what mothers play in our homes are the ones singled out for unwarranted marginalization, for no tenable reason, in the same health system where they play central coordinating role.

12. Our unwavering hope now lies in your rising above whatever sentiment that might have informed the inexplicable perennial ill treatment of wrongful underplacement meted out to nurses by putting on a fatherly garb of equity, justice and fairness and see that the university graduates of nursing science get similar entry placement as their counterparts in other core healthcare disciplines during your tenure.

PRAYER 

We passionately appeal that you kindly 

1. confirm that the ministry has forwarded to the office of Head of Civil Service of the Federation (HCSF) the memorandum on proper placement of graduates of B.N.Sc degree seeking to make CONHESS 08 (.i.e. grade level 09) the entry point of nurse interns and CONHESS 09 (.i.e. grade level 10) the entry point of graduates post-NYSC and to recognize MSc and PhD in nursing in the nurses schemes of service. 

2. follow-up with the office of the HCSF to see that the memorandum is presented to the National Council on Establishment (NCE) for approval at their next meeting. 

3. classify the lingering issue of wrongful underplacement of graduate nurses among the priority items of your tenure and work to rectify it within your first year in office. 

Once more, we offer you our most sincere congratulations for your deserved elevation to the top most position in the FMOH and pledge our unalloyed support to your tenure as we look forward to productive cooperation with you.

Kindly accept the assurances of our highest regards!

Signed:


CHIEF (HON.) S.E.O. EGWUENU                                     NURSE G.I. NSHI
          National President                                                           National Secretary

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