CAMEROON NURSES ASSOCIATION and COMMONWEALTH NURSES FEDERATION

1. CAMEROON NURSES ASSOCIATION and COMMONWEALTH NURSES FEDERATION 5th -6th July 2010-Yaounde 8th -9th July 2010- Bamenda CAMEROON

2. SAFE CARE , SAFE PRACTICEA Safe Nurse, A Safe Patient, A Safe Workplace, A Safe Profession A SAFE PROFESSION

3. PRESENTED BY NJINI FUTRIH NGONG ROSE, PGD Hosp Adm., TSSI, SRN SECRETARY GENERAL, CNA

4. PRESENTATION OUTLINE • INTRODUCTION AND BACKGROUND • DEFINITION OF A PROFESSION • CHARACTERISTICS OF A PROFESSION • NURSING AS DISCIPLINE • NURSING AS PROFESSION • DOES NURSING QUALIFY AS PROFESSION? • THREATS AND CHALLENGES TO NURSING PROFESSION • THE WAY FORWARD,(ASSURING SAFETY OF THE PROFESION • AN OVERVIEW OF THE CAMEROON SITUATION • CONCLUSION

5. INTRODUCTION AND BACKGROUND • When it became apparent that love and nurturing alone were not enough to cure disease, an educated framework for Nurses began to form. Nursing is in fact the oldest arts and one of the youngest of professions • Although taken for granted, it has been one of the most respected professions in history. • History of modern Nursing can trace its roots back to nuns and the military. • Florence Nightingale during the Crimean War ,in 19th Century ,laid the foundation of Professional Nursing. • Nursing is worthwhile especially for those who pursue this profession and the society.

6. FLORENCE NIGHTINGALE, THE LADY WITH THE LAMP

7. What is Nursing • According to ICN, • “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles”. • Nursing is therefore an autonomous, self governing profession, a distinct scientific discipline with many autonomous practice features.

8. WHAT IS A PROFESSION ? • A profession is a disciplined group of individuals who adhere to ethical standards and uphold themselves to, and are accepted by, the public as possessing special knowledge and skills in a widely recognised body of learning, derived from research, education and training at a high level, and who are prepared to exercise this knowledge and these skills in the interest of others. ( Australian Council of Professions(2004).

9. WHAT IS PROFESSION? • Inherent in the definition of a profession ,is a code of ethics , that governs the activities of each profession[al]. Further, this code is enforced by the profession and is acknowledged and accepted by the community

10. CHARACTERISTICS OF A PROFESSION • A clearly defined, highly developed, specialized, and theoretical knowledge base; • Preparation for the profession includes an extensive period of training to apply that knowledge in an institution( professional school or university campus), and internship.

11. Provides a specific service and demonstrates a commitment to public service and receives compensation through limited fees rather than direct profits. • Professional autonomy. This is by members in decision making and practice.

12. They deal with problems primarily from an intellectual than from the physical or manual labour plane. Professionals are also responsible for the control of training, certification after test of competency, and licensing of new entrants.

13. Code of Ethics • Professional Association or societies within social accountability, be a self -governing and self- policing authority, especially with regards to professional ethics and the actual work of the profession.

14. Performance Standards and Professional discipline. • Strong service motivation and lifetime commitment to competence by individual professionals.

15. NURSING AS A DISCIPLINE • Nursing falls under professional disciplines • Nursing is an Art – It is the creative use of knowledge in service to others • Nursing is a Science – It is a body of knowledge based on scientific research and analysis

16. NURSING AS A PROFESSION • Body of knowledgethat describes phenomena • Members add to the body of knowledge and remain current (research component). • Members are educated in institutions of higher education • Application of knowledge in practical service to society;older members shape the skills of new members. (Socialization). • Autonomousformation of professional policy and in monitoring of its practice and practitioners

17. Autonomy • The quality or state of being self-governing; especially: the right of self-government or self regulating. However government set nursing laws to protect the public. Nurses are given the authority to carry out the mandate thro` professional associations. • Self-directing freedom and especially moral independence

18. Profession (continued) • Guided by a code of ethicsthat regulates relationships between professional and client • Common culture, norms and values between members. • Clear standard of educational preparationfor entry into practice • Members value service above personal gain • Compensation for members • Joel & Kelly (2002)

19. Does Nursing qualify as Profession? YES, WHY?, • Unique/specialised body of Knowledge and values, e.g., nursing theory and science , social, physical, pharmacological sciences and maths. • Controlled entry, at least in most countries have legally enforced registration. • Variable degree of autonomy. ( protocols). • Code of ethics (ICN) and Nursing Acts (Laws).

20. Does Nursing qualify as a Profession? • Accountability, variable . There are many areas where nurses are responsible for “ nursing”. Many professions have emerged from nursing including, physiotherapy, respiratory and speech therapy etc. • Disciplinary team in most countries. • Recognition and respect from a wider community. There is benefit to the public.

21. The debate continues but the fact is that Nurses are the backbone of any health care system. • Nursing is a lifelong learning process. Nursing has evolved over time. • For those who work the work and talk the language, • Nursing is one of the most rewarding of all professions

22. THREATS /CHALLENGES • Globalization- Factors contributing to this are, advances in information technology and communication, international travels, commerce, growth in multinational industry and a possible redefinition of the concept “ community”. • Rising cost of health care and need for separate nursing budget.

23. Threats/ Challenges • Health care Complexities- requires plethora of knowledge and skills to provide effective and efficient care( team based collaboration) • Advances in Technology-explosive growth e.g. instead of conventional mode of documentation, now is electronic medical records, current issues of tele-healthcare.

24. Demographic changes, Nurses should consociate with governments and organisation for creative solutions. • Nursing Shortage/ brain drain in developing countries. • Leadership, Need for especially transformational leadership • Nurse Image • Deregulation, i.e. eliminating administrative requirements.

25. THE WAY FORWARD • REGULATION of the nursing profession means that certain standards and rules are in place under specific legislation that governs the profession.

26. Regulation means • Professional standards • Regulate entrance to the nursing profession. • Regulate nursing programs. • Provide professional practice support for members. • Discipline practising members

27. Quality assurance, a method used assure quality of care and safety • Nursing Education – regulated Curriculum development and specific career ladder. • Criteria for entry into the profession • Credentialing- can be a simple document of an individual`s qualification or signify a person`s performance e.g. A transcript, SRN, BSC, BSN. • Accreditation – approving and granting status to institutions and programs which have met established standards of quality and benchmark according to the standards. This can be individuals or institutions. It is not certification.

28. Quality assurance, cont. • Certification: It is credential beyond licensure and has the following interpretations: • Defined competences have been attained. • Experience and performance on examination, an individual achievement higher than levels required for licensure. • It is an incentive for those who are certified. • Designate a person`s professional speciality. • Is offered by some legal and governing body.

29. Quality assurance, cont. • Registration – Is the listing of names of individuals in the official roster when they meet pre-established criteria e.g. Passing examinations. • Licensure- Mechanisms ,often, tests are established to recognise minimal competence in a profession. It is a type of legal certification • It is usually conducted by a governing body and enforced by the state to protect the public`s health, safety and welfare.

30. Licensure Licensure may be by examination or endorsement(-by reciprocity between states). Types include permissive licensure, No RN used by unregulated RNs but can practice. Mandatory licensure- can practice only must pass the licensure examination.

31. Nursing Practice Acts • State legislation regulates the practice of nursing. • Standards for professional practice to ensure accountability for Nurses` actions. • Ensure power to deny or revoke license in case of crime or irresponsible behaviour.(discipline) • Nurse/patient ratio: In areas where laws to this effect are enacted, benefits include, improved nurse retention, willing of more qualified nurses to work, reduced burn-outs, and improved morale

32. Nursing Research • Indicates the profession advances its own knowledge base. • Nursing practice has a sound scientific base (evidence based, on which to build nursing theory). • Demonstrates cost- effective measures. • Actions are predictable • Has measurable outcomes.

33. Leadership • Members assume responsibility for the education and professional development of future members. • Cultivation of a culture of mutual respect, reaching excellence and inspiring others. • Demonstrate the aspect of social influence on the achievement of common goals

34. Nurse Image • By demonstrating that the choice of nursing ,is because of professional status, to make a difference in patient care, and the pride in the profession. • When communicating with other allied professionals, to stay on the issue, not personality. • To be addressed in a professional manner on formal issues.

35. Nurse Image • Value Nursing and protect the name “ Nurse”. Only Nurses should bear the name Nurse • Be serious and dress the part. • Believe in themselves and their colleagues. • Recognise the value of caring. • Advocacy: educate the public and policy makers on the scope of nursing practice and skills.

36. Political action in Nursing • Politics is about influence, (power) on the allocation of scarce resources and decisions that control situations and events. • It is a means to an end ,also it influences both personal and professional activities. • Building coalitions with organisations of common interest. • Networking • Lobbying and advocacy • Consider the laws that have been passed and their effects on nursing.

37. Collective Bargaining • Professional associations are logically bargaining agents for professional nurses. • However most people join associations in response to a particular incentive or when coerced. • Otherwise they enjoy collective goals obtained without paying for them

38. Nursing Associations • They need the participation and membership of all nurses in order to claim they truthfully represent the profession. • A large membership allows the organisation to speak with “one voice”, to politicians and other supporting organisations

39. The case of Cameroon • Nursing Education. BSc is the most commonly acquired highest level, provision has been made for MSc and PhD programs and graduates are in the workforce; • The educational paths of Nursing include; • 4 years after advanced level GCE , in a University for a BSc and 2 years with an SRN for TSSI. • 3 years after advanced level in Professional school, for an SRN. • Nursing Speciality in Midwifery, Reproductive Health Paediatrics, Mental Health, Anaesthesia etc, takes 2years training after the SRN acquisition and the credential given before speciality is the “State certified “, e.g. SCM

40. 1 year after Ordinary level GCE for the NA, in Cameroon they are not considered professional nurses, and are therefore, not legible for registration, however they can registered in the association as associate members • Licensure examination is not conducted but all professionals have an obligation to be registered in the NANMHT • Approval of training programs are done by Ministries of Public Health, Higher Education , Vocational Education. However there are many clandestine schools offering certificates which are, however not recognised by the state. Nurses are waiting for the day they will be given the mandate to do this themselves.

41. Autonomy and accountability- Professional Associations- National Association for Nurses, Midwives and Health Technicians, Cameroon Nursing Society, Cameroon Nurses Association. • Registration- Into the NANMHT, is supposed to be mandatory. • Legislation- Famous decree 80, decree No 89/354 of March 1989 on the code of ethics for Nurses, Midwives and Health Technicians, Various decrees for allowances, for various cadre of the Public health and an article in labour code, on health and safety of workers, but many are still not fully respected. Presently allowance has been made for internal certification for advancement to an immediate higher level. • Collective Bargaining: By SYMPEMS, the syndicate for health personnel .

42. Conclusion • To quote President Obama of USA on 16th June 2010 to ANA, • “ Nurses are the beating heart of our health care system. Because you know the health system so well, that is why you have become such fierce advocates for reform”. • Nurses have the responsibility to shape the future, rather than merely reacting to shifts in tides.

43. Conclusion • They should be proactive in approach to anticipatory needed changes ,and develop strategies to shape the future • Today job security in the Nursing industry is said to be iron clad. So what do we want? • Nursing is a choice, if we don`t like something in our situation, do something, leave, follow, or get out of the way. This is more true when applied to today`s nurses, on ensuring the Safety of our Profession.

44. THANK YOU

45. References • BOOKS • Catalano Joseph T,(1996),Contemporary Professional Nursing, F A Davis Company, Philadelphia, Pg,4,7,93.171-174 • Craven Ruth F et al,(1996), Fundamentals of Nursing, Human Health and Function, 2nd Edition, Lippincott-Raven Publishers,Pg,40,105 • ZerwerkhJoAnn et Al, (1997),NURSING TODAY, Transition and Trends , 2nd Edition , WB SAUNDERS Company, Philadelphia, Pg,299-323,53-55 • Unpublished Books • Amungwa A Nche/Anyigwi Gabriel, RIGHTS AND OBLIGATIONS OF NURSES,MIDWIVES AND HEALTH TECHNICIANS, NANMHT, North West Branch, MPH, Cameroon

46. Internet Sources • www.linkinghub.elservier.com/retreive • www.medshape.com/viewarticle • www.britannica.com/EBchecked/...Nursing • www.allnurses.com/...Nursing • www.ultimatenurse.com/nursingprofession • www.nursingworld.org • www.nursingadvocacy.org • www.nursingcrib.com/nursing • www.registered-nurse-canada.com/nursing_profession • www.commonwealthnurses.org/documents