(Written by Nurse Josiah Jackson-Okesola)

Recently, I followed closely the controversial issue of the rightness or wrongness of standing up to greet or collecting bags in the name of SHOWING RESPECT for older colleagues, nurse leaders and managers as part of observing the ETHICS OF THE PROFESSION.

I initially refrained from commenting because I feel such kind of mundane issues is the least of all the problems of Nursing that should drain our energies as forward-thinking Nurse leaders.

For younger and older generation of Nurses alike, the issue of standing up to greet older colleagues or collecting bags from them is supposed to be a non-issue because we all know that the right thing to do as an African child is to respect people older than us.

As a responsible young adult brought with proper home training, we all are already aware that issues such as bowing down for older people, kneeling or prostrating for elders, not directly calling them by names is a culture passed down to us from generations.

And we know we have an obligation to preserve such values and ideals for our children and future generations no matter how learned, exposed or westernised we have become.

However, as professional nurses, it is high time we stop mixing up issues related to ETHICS OF NURSING with the demands of culture or with personal sentiments, a trend that has been left unchallenged for years.

READ THIS: Professional Code Of Conduct For Nurses In Nigeria

In the last 24 hours, I was really struggling to understand how the mundane issue of standing to greet or collecting bags from colleagues should generate any sort of controversy in the first place.

This is because I felt strongly that the state of Nigerian nursing as we speak is very delicate, especially with far crucial issues begging for attention hence, some issues are better passed over than dissipate energy on them.
Moreover, there is no single place in the Code of Ethics of Nursing that such is stated as an ethical or professional obligation for professional nurses.

Fortunately, thinking deeply about the line of thoughts of some of the respectable leaders who see something seriously wrong in not observing the ‘stand up rituals’, and citing ETHICS OF NURSING and PROFESSIONALISM as basis, I have come to learnt a lot on the mindset and mentality of the average Nigerian Nurse.

Having gained a deeper depth of understanding our dilemma as Nigerian Nurses from the PSYCHOLOGICAL ANGLE, and analysing the issue on hand more as a practicing psychotherapist than as a Nurse, I must unrepentantly say that:


So rather than dissipating energy on shattering the two-legged table by dwelling on the rightness or wrongness of one of the shallowest issues that affect the current state of affairs of nursing in Nigeria, I will rather proffer a way forward by identifying a root cause of the unnecessary controversy and hoping that one or two of the elders reading will take personal responsibility to follow up on a NATIONAL CALL TO ACTION.

Nurture and the Nursing Mentality, in the almost 10 years I worked in the Oil and Gas sector, and not just for any company, for one of the foremost medical system run at the American standard of practice, I worked under Nurse leaders who are not only professionally sound but also financially loaded.

All through the years that I had the opportunity of coordinating the mental health department cutting across 5 different locations – 2 in Lagos and 3 in the Niger Delta regions, working with highly ranked Nurses leaders from different cultures and tribes all who trained in traditional nursing schools, it will be shocking to know that: NOT FOR ONCE, NOT FOR A SINGLE TIME in work career in the clinical setting did the issue of standing up to greet senior nurses come up as a controversial issue nor was a single nurse questioned or queried for such as an ethical issue.

It was simply a non-issue!

In 2005, I was pressured to leave my job in Critical Rescue International (a corporate emergency outfit) for the Neuro Psychiatric Hospital, Yaba (a decision that almost completely messed up my mental health).

I spent 5 years managing to survive in the nursing system of civil service and also watched colleagues in other civil service settings struggle to keep their sanity during those years, especially in terms of the high level of energy many Nurse leaders put into the issue of RESPECT, always bullying a few assertive subordinates, unnecessarily picking on them and condemning these ones as DISRESPECTFUL NURSES LACKING ETHICS.


I could also recall some of the shocking experiences I had as a student nurse on clinical postings between 1997 and 2000, in which many Matrons and Senior Matrons who were always jittery and standing up for Consultants whenever they step into the wards will insist that it is disrespectful and unethical not to stand up for consultants or senior colleagues each time they step into the wards.


What has been the grievous implication of this traditional nursing ideology?

From a psychological perspective, it is heart breaking to note that:

A very worrisome percentage of Nurse leaders who work in Nigeria’s nursing clinical practice (mostly especially in the public health sector and civil service) have suffered for long from LOW SELF ESTEEM, LOW SELF CONFIDENCE AND LACK OF SELF BELIEF because of this ideology!

Is this actually their fault? PARTIALLY NOT! The root of the damage done by this kind of mentality can be rightly attributed to a SYSTEMIC factor more than INDIVIDUAL factor.

From the facts I have on my fingertips having interacted with nurse leaders from many African countries and global nursing leaders from around the world, Nigeria run one of the most archaic, esteem-demeaning, confidence-crushing and bullish hospital based educational system in the 21st century!

In the last 5 decades, we have produced tens of thousands of Nurses from the hospital-based system whose psyche were totally messed up as student nurses because of the way the hospital based education was being run as secondary school designed for train teenagers, with leaders in authority twisting the Code of Ethics as a tool for oppression.

Many of our nurses who are products of the system but had the opportunities of leaving the shores of this country to practice in climates where the nursing profession truly originated from and the CODE OF ETHICS FOR NURSING have not been completely twisted were very fortunate.

These ones have not only been reoriented and EXPOSED to the global standard of practice but have also practice where the value and worth of nursing is truly appreciated.
Hence, they have been able to heal and recover from the terrible effects of the dignity stripping post-secondary school educational system of which they were products.

In the same vein, many Nurse leaders who stayed back in the country and had gone ahead to develop themselves personally, working so much on their self-esteem and confidence, have also been blessed with professional liberation from a few shackles of bondage hidden behind the guise of ETHICS OF NURSING.

We know many Nurse leaders who are currently condemning some of this archaic mentality especially in trivial issues such as standing up to greet every senior colleagues you encounter all through your shift or collecting bags from your Matrons whenever you see them approach.

Unfortunately, there are still just so many nurse leaders and managers in this country, a lot of them who are actually active in practice as leaders and managers, who were not only victims of the bullying and oppression which affected their psychology and mentality as student nurses but have consciously or sub consciously turned to terrors for subordinates.

Many nurses have also been victims of an higher form of dignity stripping tradition synonymous with the Nigerian civil service vis-a-vis terrible and wicked placement of Nurses in the civil service system.

In the Nigerian civil service system, where majority of these bullying take place, many of the current Nigerian nurse leaders have suffered PSYCHOLOGICAL BATTERING!

In the Schools of Nursing where Principals and Nurse Tutors still perpetrate emotional abuse of student nurses on a daily basis, making abnormal demands of respect, many of these tutors themselves were victims of bullying.

The bitter truth is that a sizeable percentage of Nurse Leaders have not only been victims of oppression by their own Nursing administration , they have also been victims of oppression by hospital management, especially those run by mean and oppressive medical directors!

To be truthful and honest, many Nigerian nurse leaders in the civil service have suffered so much and are still suffering from terrible forms of injustice as well as psychological and emotional battering that has persisted in the nursing and civil service system for years.

There are a lot, yes, a lot of nurse leaders and managers who feel so much less professionally relevant in their current career, coupled with the frustration arising from the LOW REGARD and RESPECT accorded to them as Nurses by nursing administrations and heads of hospital management.

As we speak, there are too many tales of woes from nurses especially in relation to the heartbreaking and depressing secular disadvantage suffered by many in the Nigerian federal or state civil service system and many of these cases are still unresolved till date with the victims living with a lot of frustration, dejection, loss of dignity and professional emptiness.

This is where the origin of most demands for abnormal show of respect is deeply rooted in and that is where we need to look to for permanent solutions to the problems.

Is there any way forward?

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