The question is simple. The answer is not.
For days now, the proposed introduction of Consultant Nurse and other advanced nursing cadres has sparked heated debate, protests and social media battles between doctors and nurses.
But what exactly is happening?
What is a Consultant Cadre in Nursing?
A cadre is simply a professional rank or level.
In nursing, it means creating clear, advanced career pathways such as:
- Clinical Nurse Specialist
- Nurse Practitioner
- Consultant Nurse
These are highly trained nurses with master’s or doctoral degrees, years of specialist experience, and the authority to diagnose, prescribe (within scope), lead teams and make independent clinical decisions in their area of expertise.
This is not new.
The UK has had Consultant Nurses since 1999.
The US, Canada, Australia and many European countries have Nurse Practitioners and Clinical Nurse Specialists working at the highest levels of patient care.
So Why the Resistance in Nigeria?
Doctors, through JOHESU and NMA statements, have strongly opposed the move. Their main fears:
- Loss of monopoly on advanced clinical decision-making For decades, only doctors have held “consultant” titles. Many see the new nursing cadres as nurses “trying to become doctors”.
- Fear of shared power and authority A Consultant Nurse can lead a unit, run specialist clinics and make high-level decisions without always needing a doctor’s approval. Some doctors view this as erosion of traditional hierarchy.
- Economic concerns Higher nursing cadres mean higher salaries, better allowances and new promotion structures. Doctors worry this will affect the current pay gap and resource allocation.
- Professional identity threat The title “Consultant” has always been associated with medicine. Using it in nursing feels, to some, like encroachment.
The Nursing Side of the Story
Nurses argue this is long overdue professional growth, not rivalry.
- Nursing is a distinct profession with its own body of knowledge
- Advanced practice nursing improves patient outcomes worldwide
- It reduces doctor workload, especially in underserved areas
- It gives nurses clear career progression instead of stagnation at “Chief Nursing Officer”
Nr. Okwete Precious, a nurse who has been vocal online, sums it up:
“Nursing is not trying to be medicine. We are trying to be the best version of nursing.”
The Global Reality
In countries with advanced nursing roles:
- Mortality rates in certain specialties are lower
- Patient satisfaction is higher
- Waiting times are shorter
- Doctors focus on complex cases while nurses handle stable, specialist care
No country has collapsed because nurses advanced.
The Way Forward
Healthcare is a team sport.
Suppressing one profession does not elevate another — it weakens the entire system.
The creation of consultant cadre in nursing is not a threat.
It is evolution.
When nurses grow, patients win.
The question should no longer be “Why are doctors threatened?”
It should be: “Why are we still holding nursing back in 2025?”
Goooooo Nursing! 🩺💪
Fellow Nurses Africa is the independent voice of African nursing. We educate, inform and support nurses across Africa.
