1.
Lack of
Interest in Research: The nursing professional is at providing quality
nursing care by providing a scientific base for the practice of nursing. Thus the
input of research has become necessary. Unfortunately, only very few nurses are
interested in research, even though it is the responsibility of all nurses to
do research to improve nursing care. The introduction of research methodology
as a course in schools of nursing has done little for now, to make students
attach must importance to research projects, as most students believe that
research ends after school.
2.
Work Environments: Some work
environments are un-conducive and non- supportive for nursing practice, as they lack sufficient facilities and equipment
to work on and they also lack sufficient
motivational input, such as housing transportation, incompetent supervision,
poor working relationship, general moral laxity in the society, undue
familiarity with subordinates, with a weakness in disciplinering staff, among
others nurse are no longer in control of the immediate environment in which
patients are nursed. If quality health care must be provided then we have to
look conically unto some of the problems of the physical, social and mental
environment.
3.
Nurse
Herself or Himself: The greatest
challenge to nursing practice in Nigeria is the nurse herself or himself. Nurse
in contemporary Nigeria are less caring, committed and dedicated to meeting the
needs of clients. Most nurse are resistant to change, professional development
and advancement. In nursing practice and education, some nurse tends to hold
onto previous, knowledge and skills without making efforts to improve and
maintain new skills. Many nurses are not willing to accept challenges of
staying abreast with education and development of new skills in their areas and
levels of nursing practice, similarly, the natural qualities expected to be
found in nurses (punctuality, self less service, among others) is virtually
absent these days. This has serious implication for nursing practice.
4.
Advancement
in Science And Technology: The
advancement in science and technology will continue to affect the nursing
profession. In the past nursing relied on their experiences, observation and
intuition but today, nursing has a defined body of knowledge specific to the
profession and continues to develop this knowledge through research and
practice as they relate to new drugs, methods of delivery, disease control and
prevention through sterilization and disinfections of equipments, and models in
nursing, among others, for instance, the knowledge and implementation of the
nursing process as a scientific and systematic approach to nursing care has been seen by many nurses as problematic. Some nurse
has found it difficult to implement because some professionals in the health
system do not understand what it is all about.
5.
Non
Implementation of Nursing Process: In
addition, some nurse have attached a lot of constraints such as shortage of
staff and lack of stationary as reasons hindering the implementation of the
nursing process which is a tools for improve nursing care. The changing role of
the nurse require continued competence. Many nurse are unable to maintain a
high level of individual competence in nursing practice, skill and knowledge, recognizing
and accepting responsibilities for individual action and judgment.
6.
Non
Participation in Making Policy:
Policy making on health issues is a major challenge to nursing practice. Most
nurses are women and therefore the position of nurse in Nigeria and the value
given to nurse work are a hinged with their position in the society. The nurses
of the past were grossly handicapped because of the type of training they received. They were maids and
took their feminine submissive roles without questioning, after all, their
husband is the head of the home. Nurses have traditionally been subordinate to
physicians and these have affected their leadership roles in policy making on
health issues. Nursing today is practiced in the midst of other health needs
competing for the scare resources allotted to health. These poor representation and participation of
nurses in decision making on health matters will not move nursing forward. This
situation must change if our wonderful dreams about the future of nursing must
be fulfilled.
7.
Infections: Increasing number of infections, many Nigerians
still very much patronize traditional headless and traditional birth attendants
especially now that they have to pay for the health service they receive. Even
if they come to the hospital acutely ill, they leave much sooner than they did
in the past, thereby increasing the demand on nurse to ensure high quality
comprehensive care before discharge. Some nurse are affected by nosocomal
infection eg Lassa Fever etc.
8.
Quackery:
The incursion of quackery in nursing has been a big threat to nursing practice
in Nigeria. Everybody in white answer a nurse. This cancer worm has eaten up
the integrity and image of nursing. The masses cannot differentiate between a
the quacks and scientific nurse.
9.
Poor Media
Projection of Nursing: The mass media
eg newspapers, radio station etc do not project us very well to the general
public.
a.
The doctors,
pharmacists even environmental health workers are being projected better to the
taste of the people.
b.
Notwithstanding,
every everybody need the services of the nurses at all times. They project us
as inferior or second-class citizens thereby demoralizing the regard, respect
and trust the public have on us.
10.
Academic
Regulation: Most of our universities
and schools of nursing do not have concrete curriculum for nursing education.
The national university commission and nursing council suppose to sit and make
the curriculum for nursing education common in Nigeria.
11.
Politics: This has eroded the general system including nursing
practice eg sitting of schools, hospital, health centers, and nurse’s wages!
Remuneration for nurses has been politicized even today.
12.
Lack of
Equipment: Unavailability, lack of
proper planning and budgeting due to non-involvement of nurses and many nurse
leaders in management’s budgetary meetings. Poor knowledge of nurse leaders,
knowledge about politics and the influence of nursing administration on general
hospital administration/ management
13.
Lack of
Continuous Training and Re-orientation:
Nurses continues to practice in most hospitals without re-orientation to the
needs of patients in the 21st century. Non attendance of clinical care
workshops by nurses and non organization of seminar /workshop on clinical
nursing issues are all inherent problems in many Nigerian hospitals.
14.
Lack of commitment
on the part of nurses: many nurses
just practice for practicing sake, they do not see the intricacies of nursing
as a care from nurse professionals,
rather they are committed to other
issues of life than nursing care practice. Many practice only for financial
benefit not because nursing is a calling for them. Student nurses are also
victims of this situation.
15.
Nurses
idea about improvisation: In order
to have the favour of management, most
nurses are committed to improvisation to a faulty level, instead
of asking for the right
equipment and materials for
nursing care services. Nurses seldom go on industrial action because of lack of equipment for
nursing clinical works rather they continue to improvise to the detriment of
their professional practice.
16.
Rural
urban migration of nurses: Nurses
idea about rural care and delegation of
this care to untrained person is a major problem that is causing declining nursing services in Nigeria. Many nurses don’t like
to live in rural settings.
17.
Leadership
Problem Leading To Poor Management:
most nurse leaders lack experience and they retire away quickly as soon as they
enter into nursing administrative arena because of age on entry and number of
years in services. The experienced nurses are not also available in the
clinical settings to render service rather they are kept in offices away from
their patients and fellow nurses that needs to learn from their past clinical
experiences. They seek office allocation, good chair
to seat on as soon as they have been promoted to higher ranks, this they claim is to show the level of their
status instead of good clinical practice to be
shown for the status. Also nurses
now migrate at alarming rate out of the country to seek greener pastures. Some
experienced nurses also hide under the canopy of poor health not to render
services yet they remain as leaders. All these are copied by the junior nurses and
nurses in training and subsequently as soon as nurses become registered they
form the association of nurses that seat round the table or in offices in
different wards with their bags full of items that are on sale and latest
materials in town (cloth and jewelries).
18.
Professional
Rivalry: (inter/intra professional rivalry) nurses not seeing
themselves as the strongest pillar in health field, rather they practice other
professions that are not nursing in
order to seek personal/societal recognition. Most times many nursing
independent activities are left undone the interdependent activities are done
with much commitment. Bed bath, bed pan round, monitoring of vital signs and patient care reporting are fast leaving hospital setting. The
relatives are made to carry bed pans,
doctors to see patient alone on wards/ clinics, and do patients vital
signs themselves while in clinics, nutritionist
also have to book meals for the
patients themselves without the nurses
participation. Nurses claiming to be too busy to perform these activities and
making them to do less important activities of nurses. With the nursing professional cadres in
Nigeria the educational reform has made it possible for nurses with first
degree to practice along with those with diploma trainings. This is supposed to
be a strength for nursing care in
Nigeria. If intra -professional rivalry are removed nurses would learn from
each other and subsequently nursing care would be improved in this century. Nurses at
leadership position should consult
their learned and experienced fellows
nationally and internationally to be able to acquire both theoretical
experience and practical skill needed
for improved services. Consultation now
made easy with computerization. E- mailing each other on ideas about care in
hospital settings that are more advanced than ours. Use of internet facilities to
improve nursing care in Nigeria. Entry
level into nursing permits aspiration to top level in the career structure,
not running from clinical setting to school of nursing or to
teaching. Clinical setting requires nurse clinicians for appropriate rivalry
inter professionally in the health care setting. Nurses are to teach themselves as well, as
the public, these days the public is well informed, they need to inform nurses
too. Omolade (2003) In all these our senior nurses or nurse leaders may be copied positively or
negatively by the junior ones or nurses is training. It is necessary for nurse
leaders to serve as good example by practicing appropriately having appropriate,
education and ensuring same by others. Adequate dressing promotes the image of
nursing so also is the professional
rivalry- (Omotoriogun 1996).
19.
The
Educational Goal of the Nurse: Nurses
satisfaction with basic qualification and practice for financial reward in
the 21st century is
another major cause of declining
care because it always amount to great competency in terms of
advancement in education vise-visa in clinical nursing practice. Professional
nursing educational now borders on continuous education and specialization.
Continuous training and development leads to good leadership and better skills
in nursing care services, it also promotes the image of nurse in the society.
The status of nursing is our society has not promoted good professional image,
for the nurses largely because of poor facilities in the training institutions
and lack of commitment to practical teaching in
the ward by all cadres of nurses. Nurses leaving professional care to
student nurses or pupil midwives. Nurses must
practice to show the learners how to do it, nursing professional
training is hospital based. All cadres of nurse must be committed to this apart
form clinical instructors.
20.
Image of
the nurse: The nursing professional
image in Nigeria is dwindling because of nurses inherent sub-servant behaviour
in clinical settings even though nurses have been granted professional status in Nigeria they are still sub-servant in practice (Omofuma 2007). The nurse leaders need to learn to regulate
their own services not leaving it for others to decide upon.
21.
Nursing
procedure/quality assurance: There is
need to review procedure manual nationally and steps in the procedures should
be implemented appropriately in all hospitals, this would always improve the
quality of care rendered by nurses. Quality assurance units must be established
to ensure auditing of nursing services. Nurses
need to be closely monitored to ensure quality care and accountability
22.
Financial problem/ poor information system: poor information system is another cause of declining
nursing services, proper planning and budgeting plus monitoring are essential information that have delayed the
progress of nursing services in Nigeria. There are no realizable and accurate
data in which care is planned. Information to patients is very poor.
Interpersonal relationship between various professional in the hospital setting
is poor and this also can cause a fall in care rendered and negative image of
the professionals. Nurses need to read newspapers, journals and internet
articles to be more informed about current issues in nursing services