SCHEME OF SERVICE FOR THE NURSING CADRE CIVIL SERVICE OF THE GAMBIA PERSONNEL MANAGEMENT OFFICE OFFICE OF THE PRESIDENT

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1 SCHEME OF SERVICE FOR THE NURSING CADRE CIVIL SERVICE OF THE GAMBIA PERSONNEL MANAGEMENT OFFICE OFFICE OF THE PRESIDENT MARCH 2014

2 CONTENT 1. Introduction 2. Objectives 3. Functions of Cadre 4. Grade Levels and Duties 5. Entry into Cadre 6. Career Progression and Training 7. Administration of the Scheme 2

3 1. Introduction This scheme of service defines a grade and career structure for staff working in the Nursing Services under the Ministry of Health & Social Welfare. It covers both professional nurses and para-professional nurses employed in state-run hospitals, clinics, health centres, dispensaries, health posts, training schools etc. A nurse is an individual who has successfully completed a nursing education program of studies in a recognised training institution and is licensed and authorised in his or her country to practice nursing. A midwife is an individual, having been regularly admitted to a midwifery education program duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualification to be registered and/or legally licensed to practice midwifery. In The Gambia, there is no direct entry into midwifery education and as such, all midwives are either Registered or Enrolled Nurses (of the professional and sub-professional group respectively). The head of the nursing cadre is the Chief Nursing Officer and he/she is responsible for the overall management and administration of nursing operations. The existence of this cadre implements the Nurses & Midwives Act of Objectives The main objectives of this Scheme of Service are: a. to attract professional, dedicated, well-motivated, well-trained and qualified nursing staff by offering them attractive incentives and well-defined career prospects as nursing staff in Government Service; b. to create a unified sub-cadre in Nursing specialisms that ensures uniform standards, procedures and quality of work and promotes flexibility, coherence and equivalence for the effective and efficient delivery of service in the profession; c. to provide and rationalise job descriptions and job specifications for each position within the nursing cadre; d. to provide and rationalise specifications on training requirements for both professional and subprofessional nurses; e. to provide an outline of career progression within the nursing cadre. 3. Functions of Cadre The functions of the cadre include: Professional Nurses a. Manage the basic care of patients entrusted to their charge in health institutions; b. Supervise and manage hospital wards, health centres or dispensaries; c. Supervise health workers in villages by giving professional and skilled support; d. Manage nursing operations in hospitals; e. Oversee and coordinate nursing policies, teaching and training plans; f. Perform duties as Registered Nurses; g. Perform duties as Nursing Officers. 3

4 Para-Professional Nurses a. Act as auxiliaries in supporting registered nurses in the execution of their duties; b. Provide basic nursing care to patients; c. Provide health education and assistance to nursing operations at the regional community level; d. Assist in managing hospital wards under the supervision of registered nurses; e. Perform duties as Nurse Attendants; f. Perform duties as State Enrolled Nurses; g. Perform duties as Community Health Nurses. 4

5 4. Grade Levels and Duties Professional Nurses GRADING POSITION TITLE DUTIES 11 Chief Nursing Officer Coordinates the preparation / implementation of the work plans and budgets of the Nursing and Midwifery Services Sets / monitors performance targets for staff Takes responsibility for the management, deployment, development and discipline of nursing staff Formulates relevant policies for the advancement of nursing personnel and services Acts as the Chief Adviser to the Government on all issues pertaining to nursing matters in the country Prepares departmental performance reports 10 Deputy Chief Nursing Officer of Coordinates the preparation / implementation of the work plans and budgets of the nursing and midwifery services in hospitals, clinics etc. (Upper) Clinical Services Sets/ monitors performance targets for staff Determines staffing requirements in hospitals, clinics etc. Monitor and evaluates nursing and midwifery service and standards in hospitals, clinics etc. Prepares departmental performance reports Deputy Chief Nursing Officer of Coordinates the preparation / implementation of the work plans and budgets of nurse and midwifery training programmes Education & Research Sets / monitors performance target for staff Determines the staffing and human resource requirements of nurse training institutions Monitors and evaluates the training of nurses and midwives Prepares departmental performance reports Deputy Chief Nursing Officer of Coordinates the preparation / implementation of work plans and budgets of nursing and midwifery services in Health Divisions (HDs) Community Health Services Sets/ monitors performance targets for staff Determines the staffing requirements in Health Divisions (HDs) Monitors and evaluates nursing and midwifery service and standards in Health Divisions (HDs) Prepares departmental performance reports 10 Principal Nursing Develops/implements work plans for nursing and midwifery services in hospitals, clinics, HDs etc. (Lower) Officer/Administrator Sets/monitors performance targets for nursing staff, in addition to providing them with professional guidance Takes responsibility for the general management and administration of nursing and midwifery in hospitals, clinics, HDs etc. Assist the Deputy Directors in determining staffing requirements Prepares performance reports Principal Nursing Tutor Develops / implements training curricula for nurse and midwife training institutions, in addition to performing teaching duties Sets/monitors performance targets for nurse and midwife training staff Takes responsibility for the general management and administration of nurse and midwife training matters Assisting the Deputy Directors in determining staffing requirements and placing students in practical areas Prepares performance reports 9 Senior Nursing Officer Sets down nursing policies and manages units that cover between one to four wards Supervises nursing standards and prepares annual evaluations of staff 5

6 Acts as a Senior Lecturer at nurse training institutions Registered Midwife (BSc) Provides and manages care to women during pregnancy, labour, birth and postnatal periods Provides and manages the basic care of patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Assists in the supervision and management of wards Supervises and helps teach junior staff Senior Ophthalmic Medical Performs cataract surgery on affected patients Assistant Takes responsibility for Regional Secondary Eye Units, eye health of regions and community outreach programmes, screening and training Supervises Community Ophthalmic Nurses on all eye-related services in their respective communities Participates in the general health service delivery/administration in basic health facilities Provides and manages the basic care of patients Educates patients in health matters and assists in their rehabilitation 8 Nursing Officer Manages a ward or health centre and assists the Senior Nursing Officer in his/her duties Assesses the needs of patients and staff, plans patients care and organises the allocation of resources and placement of orders Performs teaching duties and organises the teaching of student nurses and education of the public Registered Nurse (BSc) Provides and manages the basic care of patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Assists in the supervision and management of wards Supervises and helps teach junior staff Ophthalmic Medical Assistant Takes responsibility for patients with eye disorders Participates in community screening programmes to detect treatable and avoidable eye disorders Performs pre- and post-operative assessment of clients with eye disorders Carries out health education programmes for communities, in collaboration with other health care providers in their respective regions Provides and manages the basic care of patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Perioperative Nurse Assists and works closely with surgeons, nurse anaesthetists and other surgical team members in performing operative procedures Provides and manages preoperative, intraoperative, and postoperative care to patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Assists in the supervision and management of wards Supervises and helps teach junior staff Nurse Anaesthetist Specialises in the administration of anaesthesia Provides and manages the basic care of patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Assists in the supervision and management of wards Supervises and helps teach junior staff 7 Registered Nurse Provides and manages the basic care of patients entrusted to their charge Educates patients in health matters and assists in their rehabilitation Assists in the supervision and management of wards Supervises and helps teach junior staff 6

7 Para-Professional Nurses GRADING POSITION TITLE DUTIES 8 Senior Enrolled Nurse/Tutor Oversees all State Enrolled Nurse/Midwife work and undertakes public health education activities Writes simple reports on activities in his/her area Performs teaching duties to State Enrolled Nurse trainees and assists in the training of the latter Takes care of wards under the supervision of a Nursing Officer or Registered Nurse as the need arises Perform duties as State Enrolled Nurses/Midwives Senior Community Health Supervises and provides support to Community Health Nurses/Midwives, Village Health Workers and Traditional Birth Attendants Nurse/Tutor Writes simple reports on activities in his/her area Performs teaching duties to Community Health Nurse trainees Perform duties as Community Health Nurses/Midwives 7 State Enrolled Midwife Initiates preventive measures and provides medical assistance during emergencies and the postnatal period Provides health counselling/education to patients /families on issues regarding parenthood, gynaecology, family planning and childcare Assists other senior nurses in the management of basic care for patients Participates in health education activities on various health issues Participates in the supervision of junior workers such as nurse attendants and Enrolled Nurse Trainees Community Health Midwife Initiates preventive measures and provides medical assistance during emergencies and the postnatal period Provides health counselling/education to patients /families on issues regarding parenthood, gynaecology, family planning and childcare Gives effective health education to individuals, families, schools and communities Carries out community diagnoses of health problems, in addition to administering necessary treatments and making appropriate referrals Participates in community activities and development projects Provides and conducts counselling services and immunisation sessions Community Ophthalmic Nurse Participates in community screening programmes to detect avoidable eye conditions Conducts surgeries for trichiasis patients in communities Works to disseminate eye health messages for the prevention of blindness Participates in national immunisation campaigns 6 State Enrolled Nurse Assists other senior nurses in the management of basic care for patients Participates in health education activities on various health issues Participates in the counselling of individuals, families and communities on health matters Participates in the supervision of junior workers such as nurse attendants and Enrolled Nurse Trainees Community Health Nurse Gives effective health education to individuals, families, schools and communities Carries out community diagnoses of health problems, in addition to administering necessary treatments and making appropriate referrals Participates in community activities and development projects Provides and conducts counselling services and immunisation sessions 5 Senior Nurse Attendant Assists in certain aspects of patient care and in the maintenance of an orderly and healthy environment Acts as auxiliary support to the professional nurses in the execution of their duties Supervise the work and undertakes training of nurse attendants 7

8 4 Nurse Attendant Assists in certain aspects of patient care and acts as auxiliary support to the professional nurses in the execution of their duties 2 Trainee Nurse Attendant Serves as a trainee and an assistant to (Senior) Nurse Attendants 5. Entry into Cadre Professional Group Grades in Cadre Basic Requirement Entry Method Minimum Qualification & Experience Recruitment Process 11 Chief Nursing Officer Direct or In-service entry Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, in addition to possessing 15 years of prior work experience (for direct entry); Qualify as a Registered Nurse and Midwife, in addition to possessing a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, with 15 years of prior work experience (of which 3 years are served as a Deputy CNO or 5 years as a Principal Nursing Officer) (for in-service entry); Certificate in Management 10 (Upper) Deputy CNO of Clinical Services Direct or In-service entry Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, in addition to possessing 12 years of prior work experience (for direct entry); Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, with at least 2 years experience as a Principal Nursing Officer (for in-service entry); Certificate in Hospital Management Deputy CNO of Education & Research Deputy CNO of Community Health Services Direct or In-service entry Direct or In-service entry Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, in addition to possessing 12 years of prior work experience (for direct entry); Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, with at least 2 years experience as a Principal Nursing Officer (for in-service entry); Certificate in Nurse Training Management Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, in addition to possessing 12 years of prior work experience (for direct entry); Possess a Master s Degree in Nursing, Public Health, Community Health Nursing or related fields, with at least 2 years experience as a Principal Nursing Officer (for in-service entry); Certificate in Management (Psychiatry and Anaesthesia are added advantages) or Meritbased per or Meritbased per or Meritbased per or Meritbased per 8

9 10 (Lower) Principal Nursing Officer/Administrator Direct or In-service entry Possess a Master s Degree in Nursing or related fields with at least 8 years nursing experience (for direct entry); Possess a Master s Degree in Nursing or related fields and serve satisfactorily as a Senior Nursing Officer for at least 4 years, 2 of which must have been in an administrative capacity or Possess a Master s Degree in Nursing or related fields and serve satisfactorily as a Registered Midwife (BSc) or a Senior Ophthalmic Medical Assistant for at least 7 years (for in-service entry); Certificate in Community Health Service Management; Diploma in Community Health Nursing Principal Nursing Tutor Direct or In-service entry Possess a Master s Degree in Nursing or related fields with at least 8 years nursing experience (for direct entry); Possess a Master s Degree in Nursing or related fields and serve satisfactorily as a Senior Nursing Officer for at least 4 years, 2 of which must have been in an administrative capacity or Possess a Master s Degree in Nursing or related fields and serve satisfactorily as a Registered Midwife (BSc) or a Senior Ophthalmic Medical Assistant for at least 7 years (for in-service entry);certificate in Nursing Education 9 Senior Nursing Officer Direct or In-service entry Possess a Bachelor s Degree in Nursing or related fields with at least 6 years nursing experience (for direct entry); Possess a Bachelor s Degree in Nursing or related fields with at least 3 years satisfactory service as a Nursing Officer or 6 years satisfactory service at any other Grade 8 position (for in-service entry) Registered Midwife (BSc) Direct entry Qualify as a Registered Nurse with a Bachelor s Degree in Nursing, Midwifery or related fields. In the absence of a Bachelor s Degree in Midwifery, he/she must have completed a recognised midwifery education programme Senior Ophthalmic Medical Assistant Direct or In-service entry Possess a Bachelor s Degree in Nursing or related fields and a Certificate in Ophthalmic Nursing with at least 6 years experience in Ophthalmic Nursing (for direct entry); Possess a Bachelor s Degree in Nursing and serve satisfactorily as an Ophthalmic Medical Assistant for 3 years (for in-service entry) 8 Nursing Officer Direct or In-service entry Post-basic diploma or a Bachelor s degree in nursing or related field with 6 years experience (for direct entry); Serve satisfactorily as a Registered Nurse for 3 years and show evidence of specialisation and ability in an area of nursing (for in-service entry) or Meritbased per or Meritbased per or Meritbased per or Meritbased per or Meritbased per Registered Nurse (BSc) Direct entry Bachelor s of Science degree in Nursing or related field Ophthalmic Medical Assistant Direct entry Qualify as a Registered Nurse and possess a certificate in Ophthalmic 9

10 Nursing Perioperative Nurse Direct entry Qualify as a Registered Nurse and possess certification in Basic Life Support and Advanced Cardiac Life Support Nurse Anaesthetist Direct entry Qualify as a Registered Nurse and obtain certification in anaesthesia 7 Registered Nurse Direct entry Complete a recognised training programme for nurses and pass the professional examination as laid down by the Nurses and Midwives Council of The Gambia or Ministry of Health & Social Welfare; Must be registered to practice nursing Para-Professional Nurses Grades in Cadre Basic Requirement Entry Method Minimum Qualification & Experience Recruitment Process 8 Senior Enrolled Nurse/Tutor In-service entry Serve satisfactorily as a State Enrolled Nurse/Midwife for at least 4 years; Complete a recognised post-basic specialisation training course Senior Community Health Nurse/Tutor In-service entry Serve satisfactorily as a Community Health Nurse/Midwife for at least 4 years; Complete a recognised post-basic specialisation training course 7 State Enrolled Midwife Direct entry Qualify as a State Enrolled Nurse and undergo a recognised programme of midwifery education programme; Must possess licence to practice Community Health Midwife Direct entry Qualify as a Community Health Nurse and undergo a midwifery education programme for at least 1 year; Must possess licence to practice Community Ophthalmic Nurse Direct entry Qualify as a State Enrolled Nurse/Community Health Nurse and complete a course on Ophthalmology 6 State Enrolled Nurse Direct entry 4 O-Level subject passes including English, Mathematics and 2 science subjects; Pass the recognised professional training course for State Enrolled Nurses Community Health Nurse Direct entry 4 O-Level subject passes including English, Mathematics and 2 science subjects; Pass the recognised professional training course for Community Merit-based performance assessment as per Public Service Commission Merit-based performance assessment as per Public Service Commission Health Nurses 5 Senior Nurse Attendant In-service entry Qualify as a Nurse Attendant with 5 years satisfactory work Merit-based performance assessment as per Public Service Commission 10

11 4 Nurse Attendant In-service entry 3 O-Level subject passes including English and a science subject and serve as a Trainee Nurse Attendant for 2 years Merit-based performance assessment as per Public Service Commission 2 Trainee Nurse Attendant Direct entry 3 O-Level subject passes including English and a science subject 6. Career Progression and Training Professional Group GRADE Type of Progression Minimum number of years required in present position Required academic / professional qualifications for progression into the next grade Required training for the grade 11 Chief Nursing Officer Upper Limit of Cadre N/A N/A Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial and personnel management 10 (Upper) Deputy CNO of Clinical Services Deputy CNO of Education & Research Three Three Master s Degree in Nursing, Public Health, Community Health Nursing or related fields Master s Degree in Nursing, Public Health, Community Health Nursing or related fields Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial, personnel and hospital management Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial, personnel and nurse training management Mode of progression into next grade Upper Limit of Cadre Selection interview conducted by the Public Service Commission or Merit-based per Public Service Commission 11

12 Deputy CNO of Community Health Services 10 (Lower) Principal Nursing Officer/ Administrator Principal Nursing Tutor 9 Senior Nursing Officer Three Two Four Master s Degree in Nursing, Public Health, Community Health Nursing or related fields Master s Degree in Nursing or related fields Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial, personnel and management Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial, personnel and community health management Suitable short courses/seminars; Seniorlevel management courses, seminars, workshops including project, financial, personnel, community health management and nursing education courses General management; Project, Financial, and personnel management courses Registered Midwife (BSc) Seven Master s Degree in Nursing or related fields On-the-job training; Post-basic qualification training with specialisation in the area of midwifery Senior Ophthalmic Medical Seven On-the-job training; supervisory courses Assistant for nurses 8 Nursing Officer Three Bachelor s Degree in Nursing or related fields Registered Nurse (BSc) Three Bachelor s Degree in Nursing or related fields (and/or Midwifery or related fields or undergo a recognised midwifery education programme in the absence of a Bachelor s Degree in Midwifery (for the position of Registered Midwife (BSc))) Ophthalmic Medical Assistant Three Bachelor s Degree in Nursing or related fields On-the-job training; Supervisory/management course for nurses On-the-job training; Post-basic qualification training with specialisation in the area of nursing On-the-job training; Post-basic qualification training with specialisation in the area of ophthalmology Perioperative Nurse Three Bachelor s Degree in Nursing or On-the-job training; Post-basic Merit-based performance assessment as per Public Service Commission Selection interview conducted by the Public Service Commission or Merit-based per Public Service Commission Selection interview conducted by the Public Service Commission or Merit-based per Public Service Commission 12

13 related fields (and/or Midwifery or related fields or undergo a recognised midwifery education programme in the absence of a Bachelor s Degree in Midwifery (for the position of Registered Midwife (BSc))) Nurse Anaesthetist Three Bachelor s Degree in Nursing or related fields (and/or Midwifery or related fields or undergo a recognised midwifery education programme in the absence of a Bachelor s Degree in Midwifery (for the position of Registered 7 Registered Nurse Three Midwife (BSc))) Bachelor s Degree in Nursing or related fields qualification training with specialisation in the area of Basic/Advanced Cardiac Life Support in respect of surgery On-the-job training; Post-basic qualification training with specialisation in the area of anaesthesia On-the-job training; Post-basic qualification training with specialisation in the area of nursing Selection interview conducted by the Public Service Commission or Merit-based per Public Service Commission 13

14 Para-Professional Nurses GRADE Type of Progression Minimum number of years required in present position 8 Senior Enrolled Nurse/Tutor Senior Community Health Nurse/Tutor 7 Senior Enrolled Midwife Community Health Midwife Community Ophthalmic Nurse 6 State Enrolled Nurse Community Health Nurse 5 Senior Nurse Attendant 4 Nurse Attendant 2 Trainee Nurse Attendant N/A Four three three Five Two Required academic / professional qualifications for progression into the next grade Bachelor s Degree in Nursing or related fields 4 O-Level subject passes including English, Mathematics and 2 science subjects 4 O-Level subject passes including English, Mathematics and 2 science subjects 4 O-Level subject passes including English, Mathematics and 2 science subjects 3 O-Level subject passes including English and a science subject 3 O-Level subject passes including English and a science subject Required training for the grade On-the-job training; Post-basic specialisation training On-the-job training; Basic specialisation training On-the-job training; Basic specialisation training On-the-job training On-the-job training On-the-job training Mode of progression into next grade Selection interview conducted by the Public Service Commission Merit-based performance assessment as per Public Service Commission Selection interview conducted by the Public Service Commission Selection interview conducted by the Public Service Commission Merit-based performance assessment as per Public Service Commission Merit-based performance assessment as per Public Service Commission 14

15 7. Administration of the Scheme The head of the cadre is the Chief Nursing Officer and he/she is responsible for developing and monitoring training plans for nurses and implementing such plans jointly with the Director of Health Services and the Permanent Secretary of the Ministry of Health & Social Welfare, in collaboration with the Personnel Management Office (PMO), ensuring that the career progression in the scheme of service is adhered to. The head of the cadre and the PMO also share joint responsibility for ensuring that training schedules for nurses are adhered to and that the scheme is updated regularly as the need arises. Members of the cadre report to their immediate superiors in day-to-day work, but are responsible both professionally and administratively to the head of the cadre. 15

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