"I solemnly pledge myself before God and in the presence of this assembly,

To pass my life in purity and to practise my profession faithfully.

I will abstain from whatever is deleterious and mischievous,

And will not take or knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the standard of my profession,

And will hold in confidence all personal matters committed to my keeping,

And all family affairs coming to my knowledge in the practice of my calling.

*With loyalty will I endeavour to aid the physician in his work,*

And devote myself to the welfare of those committed to my care."

- The Nightingale Pledge, 1893. (Asterisks added.)

 

Those are the words of the original version of the Nightingale Pledge. Back then, the health team was one, had a Doctor as the captain and the nurse as his sidekick, and worked. Back then, daughters of Nightingale were not averse to swearing loyalty to Doctors, the men of honour were yet men of honour, and no one thought he had to displace the sons of Hippocrates to "reach the peak of their careers". Back then... before the envy and strife and hypocrisy that we see now.

 

For now we have a health team wherein everyone wants to do everything that is a Doctor's job even when they can barely master theirs, where everyone wants to take everything that is a Doctor's pay even when theirs is relatively more, where everyone wants to be the Doctor's public foe yet private friend so that they may keep those free, secret, consultations aboard. Now they want to be Doctors (and Consultants), do not want to go through Medical School to be such, and definitely do not want to endure the rigours of residency.

 

And what is worse? Rather unlike when they threatened strike actions, cut ICU power supply, and locked everything up, even bedpans, whenever they go on their political strikes; now they form a coalition against the disciples of Hippocrates so that they can challenge our rights to freedom of association and of decision, malign us, and sue us to court– and actually do.

 

So that now government hospitals are paralysed, people are dying, and privatization is looming. And all these because of insincerity, for JOHESU want to have their cake and eat it, yet he who comes to Equity must come with clean hands... They feed the common man with lies to turn him against his Doctor, Boko-Haram style, and hope, foolishly enough, that their propaganda will survive. Of course they won't; falsehood may endure for a night but truth comes in the morning...:

 

The peak of their careers: Consultancy.

 

JOHESU are quick to point out the particular dictionary meaning of a consultant being a specialist in his chosen field. Yet, as there is hardly a word worthy of placement in the dictionary and yet having a singular meaning, JOHESU are mischievously silent on such definitions (for example, as in Oxford Concise Medical Dictionary, Sixth Edition, page 155), that "A Consultant is a fully trained specialist in a branch of medicine who accepts total responsibility for patient care."

 

Alas, each field of human endeavour has its rules and regulations, and consultants– those that, as JOHESU conveniently put it, have reached "the peak of their careers". Yet, there are requirements for reaching this peak, and there are jurisdictions. For example, however brilliant, versed, confident a paralegal is, he will not represent the client in court, not as a lawyer; he will never be a Judge without first going to Law School and being a lawyer; he will never be the Chief Justice or the Attorney-General, arguably the peak of his career.

 

Coming back to Medicine… In the other climes that JOHESU readily cite, non-Doctor consultants are fellows of postgraduate colleges such that there are minimum requirements and qualifications, and so that the competence of each consultant can be vouched for having been assessed. The question therefore that the NMA asks is, Are JOHESU consultants-to-be going to be enrolled in residency programmes? Are they going to be Fellows of (inter-)national medical colleges? Or are they just going to be sharing consultancy titles among themselves?

 

Sounds fair, doesn't it? But the best answer JOHESU can proffer is that Doctors must not dictate the goings-on in other professions. Fair enough! In the spirit of the International Best Practices that JOHESU are purportedly agitating for, standards must be set, especially since human lives are irreplaceable; and to set standards, each discipline must know its duties and boundaries so it may (itself) be disciplined and be disciplined (of others). Yet JOHESU have refused to state what shall be the boundaries of their own consultants, one thing very much worth clamouring for since every arrangement must have a control. 

 

And what is worse? Since our government is only amenable to violence and strike actions, the latter a rather frequent tool of JOHESU in recent times and one they are now begging the courts to approve their copyright patent to, and to grant them a monopoly of; the government went ahead anyway and appointed non-Doctor consultants despite NMA insistence that the appointees only be those, if any, who have successfully passed through residency training and/or are fellows of reputable postgraduate colleges.

 

At the Nnamdi Azikwe University Teaching Hospital, a “Consultant Pharmacist” invaded the wards with his team, cancelling patients’ prescriptions and also demanded that a Consultant Cardiologist remove a key drug in an inpatient prescription, on grounds that the drug has some known adverse effects. 

 

In the Abuja University Teaching Hospital, the Antenatal Clinic was invaded by Nurses who decided to consult patients and make prescriptions; the Doctors left the clinic and the patients were confused. Patients who sought to see their Doctors were told that there was a “Consultant Nurse” who does whatever a Consultant does.

 

In the University College Hospital, Ibadan, a Consultant Plastic Surgeon was barred from reviewing the surgical wound he created post-operatively because a “Consultant Nurse” had reviewed the wound earlier and was satisfied with her findings.

 

Suffice it to say that these are unbelievably new results as they are scenarios that were not created anywhere else in the world and could only have occurred in Nigeria being uniquely Nigerian; read: JOHESU.

 

Now the questions the NMA asks are, If a pilot study showed chaos, would you, sane as you are, go ahead and implement the full-scale design? If some insane elements insisted that a chaotic model be implemented nonetheless, wouldn't you oppose such brainless act to the extent of your strength and resilience, especially if you took an oath to only act in the best interests of your patients?

 

And the best JOHESU can see fit to do, rather than apologise for the apologetic actions of its members, is sue the NMA to court since "only trade unions can go on strike." Ignoring the sensibility, or otherwise, of the suit, one still finds himself proceeding to wonder if Nigerians were a trade union when we protested the non-installation of GEJ as President following the obscure demise of Yar'Adua, if we are a trade union in protesting the abduction of our girls, if we need to be a trade union to stand for commonsense, which regrettably, but not unexpectedly, is not so common– and, particularly so, in some quarters...

 

Part 2