Posted on: Wed 22-06-2022

PRESS RELEASE ON REFUSAL OF DOCTORS TO SEGREGATE AND APPROPRIATELY DISPOSE HEALTHCARE WASTE 

PROTOCOL 

The National Executive Council of NANNM, 

The State Executive Council of NANNM, 

The Local Executive Council of NANNM, 

NANNM Leaders locally and abroad, 

Healthcare Policy Makers and Legislators, 

Comrades of Healthcare Organizations Worldwide, 

Leaders of Human Rights Organizations locally and Worldwide,

 Esteemed Members of the Press, 

Fellow Nigerians and Patients, 

Ladies and Gentlemen. 

It is a universal principle that "To every action, there is equal and opposite reaction". The account given by Association of Resident Doctors (ARD) in OAUTHC in their World Press Conference on Recurrent Harassment of Doctors in Ile-Ife, published on social media and some Newspapers on 20th June, 2022 refers. First and foremost, the account narrated by the ARD is full of falsehood and malicious manipulations of reality. Why should ARD deviate from the primary issue of their refusal to segregate waste generated during Doctor’s procedure and still ignore the precautionary request by the only nurse on duty that such must be done as a matter of their professional duty?

Despite prompt mediation and intervention of the Hospital Management, some senior Consultants and Directors in Nursing, the Association of Resident Doctors in OAUTHC in their usual garrulous and restive manner decided to ignore sensible operational policies, principles and guidelines of healthcare waste management as repeatedly emphasized by NANNM. The best they could come up with is a laughable accusation of recurrent harassment, without making reference to the substantial evidence of the case at hand. 

Is it not laughable how our doctors in training at OAUTHC always rush to publish their mess on social media all because they want to appeal to public sympathy? Is it not ridiculous, if you claim you have appropriately segregated and disposed your waste, yet the only nurse on duty still insisted that you should do so?

Is it not retrogressive for a registrar and a house officer not to know that if you generate waste, you follow the principles and policies of healthcare waste management that it should be segregated and disposed accordingly by the generator of waste? Is it not discouraging if the so-called medical professionals with all their level of education will expose their ignorance and childish ego by refusal to do the needful as a matter of duty, despite being cautioned by the nurse on duty? Is it not funny that worse event had happened in OAUTHC, where a Consultant physically assaulted a nurse and in the interest of peace, it was resolved amicably in-house? 

In response to the issue being publicly circulated, NANNM in OAUTHC strongly decided to focus on principles, policies and global best practices rather than engaging in personality attack and rumour without evidence as demonstrated by immature doctors-in-training. 

As a brief, the Nurse on duty prepared a trolley for the CardioThoracic Surgical Unit (CTSU) Team for an invasive procedure called "Insertion of Central Line". This procedure involves cutting into the deep vein of a patient using sharp surgical blades and insertion of central cannula and suturing of the deep vein and open wound accordingly. It is a bloody procedure that must be done under strict infection control and the equipment used must be properly segregated and discarded into sharps and colour-coded waste containers based on the World Health Organization standards and National Healthcare Waste Management Policy by the Federal Ministry of Environment and Federal Ministry of Health as far back as year 2013. Before completing the Doctor's procedure, the nurse had already informed the team of Doctors where the sharp box container and the central waste bin is located for appropriate segregation and disposal of the waste generated after the bedside, surgical procedure. The Senior Registrar that conducted the procedure consented and promised to ensure that the waste will be properly disposed accordingly. 

As usual the Senior Registrar and other Doctors left the House Officer on the ward to document and possibly segregate and discard the waste generated during the procedure. However, to the dismay of the nurse on duty, who went to attend to another patient on the ward, the House Officer left the scattered waste and the open needles and sharp objects at the patients' bedside and was tactically sneaking out of the ward. 

Proving the suspicion of the nurse on duty, the house officer refused to segregate and discard the hazardous and injurious waste generated and negligently abandoned by the doctors at the patient's bedside. In her professional wisdom, the only way to avoid physical confrontation is to lock-down the exit door of the ward, so that the House Officer can honourably complete the procedure that her senior doctors have left her to do.

The equal and opposite reaction of our most admired and highly assertive nurse to the negligent and highly injurious action of the resident doctors triggered the World press conference of the ARD which further showcased their characteristic disregard for patients' lives and professional ethics by threatening to go on strike because the Hospital Management refused to be swayed and be dragged into their obvious abuse of professional privilege. 

In their usual dictatorial pride, the ARD in OAUTHC further threatened to go on strike for 48 hours so as to coerce the Hospital Management into initiating disciplinary measure against the Nurse who was enforcing principles of global best practices in waste management. It is our sincere belief that "No life must be further put at risk or lost to the senseless ego and refusal of resident doctors to comply with global best practices in Nigeria". For how long will the resident doctors put the lives of innocent Nigerians at risk and hold everyone to ransome, only because they were privileged to be educated and paid with Nigerians' money? 

Considering the above, the following facts of the case have been established which shall guide the next line of action by Nurses and NANNM in OAUTHC unit and Nigeria at large. 

• According to the International Code of Nursing (ICN) Code of Ethics, a Nurse is universally empowered to protect the rights of the patient to a safe healthcare environment that is free from harm or injury, irrespective of the patient's race, gender or social status.
• All Nurses in OAUTHC are fully in support of the action of the Nurse on duty and will not hesitate to do everything ethically, legally and professionally appropriate to defend her personal and professional rights to protect the patient, patients' relatives, and other healthcare workers in the hospital. 
• In compliance with rule of law, NANNM is in possession of the 'video evidence' referenced to be the ARD in OAUTHC and additional introvertible pictorial evidence to substantiate our truthful and trusted report of the scenario. 
• The Nurse is acting as a legitimate advocate of the patient, relatives and other healthcare professionals whose lives are put at hazardous risk due to the erroneous ego of some over-pampared resident doctors. 
• If the resident doctors are confident enough that their member is harassed illegally, why not honourably seek legal redress and unbiased judgment from the Court of Law, instead of threatening to further put innocent lives at risk. Will the loss of lives of Nigerians be a legitimate remedy for enforcing global best practices of waste management? 
• As legally compliant association, the Lawyer of NANNM has written to the OAUTHC Management to protect the personal and professional rights of the Nurse and all Nurses at large in OAUTHC and world at large.
• • In the video evidence referenced, one of the doctors was asking the nurse to order another healthcare worker to discard the waste generated by the doctors, which she refused. The principle of duty of care dictates that "whoever generates waste must segregate and dispose it". The refusal of the nurse to put the life of other healthcare workers and environmental staff at risk that the waste generated by the resident doctors must be appropriately segregated and discarded cannot be refuted, hence the need to call for action by the nurse. 
• • Nurses who they claim to be very important in the training of Resident Doctors during their Facility Accreditation by both the National Postgraduate Medical College of Nigeria and West African College of Surgeons; cannot be listened to or reasonably engaged on her precautionary request that doctors should discard the waste they generated. 

In summary, all Nurses in OAUTHC have unanimously agreed to continuously uphold the "duty of care" to ensure that the ward environment is safe for the patients, relatives and the entire staff within the hospital. No more intimidation or professional harassment from the Association of Resident Doctors in OAUTHC.

Due to the disturbing look of the abandoned medical waste left at the patient's bedside, we decided not to bother the public with such a scene but if the issue continues, we shall show the workstation and patient's bedside as the house officer left it. 

We hereby solicit for the unbiased support of all human rights organizations, multi-lateral healthcare organizations (especially WHO in Nigeria, etc.) and well meaning Nigerians to join our efforts to ensure that all Nigerians have the right to safe and quality healthcare that is free of deliberate risk and injury from misguided doctors. The time to make healthcare services in Nigeria safe for all is now! 

Signed:

Com. Ajayi O.O. 

Com. Oyeniyi O.L

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