Nurses, Midwives Dragged to Court Over Procedures Outside Their Mandates

Nurses and midwives across Uganda are increasingly facing legal battles after being forced by staff shortages to perform medical procedures outside their official mandates, the Ugandan Nurses and Midwives Union has said.

Ambrose Ocen, the vice president of the union, said understaffing in health facilities, especially Health Centre IIs, has left nurses and midwives carrying out duties meant for clinical officers, pharmacists, storekeepers and doctors.

Ocen said the situation has exposed many health workers to lawsuits, arrests and interdictions whenever complications arise during treatment.

“We have our job descriptions that are very clear,” Ocen said. “A nurse is not supposed to prescribe medicine, and some procedures are not within our mandate. But at Health Centre IIs, a nurse becomes everything.”

According to the union, nurses are currently dispensing drugs, managing medicine stores, conducting deliveries, suturing wounds, handling administrative duties and prescribing medication due to the shortage of qualified personnel in rural health facilities.

Ocen revealed that the union handled more than 50 legal cases involving nurses and midwives across the country in 2025, with 27 active cases recorded in the Acholi sub-region alone.

He said midwives account for the majority of the cases because many work long shifts under extreme pressure.

“You find somebody working day and night. Public standing orders require eight hours of work, but some midwives work 24 hours because there is nobody to replace them,” he said.

Ocen noted that exhaustion and overwhelming workloads often contribute to mistakes that later result in criminal or civil cases against health workers.

He cited incidents where midwives were arrested after mothers or babies died during delivery, while other nurses faced disciplinary action following thefts at health facilities.

In Agago District, six nurses were interdicted after thieves broke into a health facility and stole medicines, despite store management officially being the responsibility of storekeepers.

The union also criticised the outdated Nurses and Midwives Act, which was last revised in 1996, arguing that it no longer reflects realities in Uganda’s healthcare system.

Ocen said many procedures nurses perform daily to save lives are technically outside what the law permits them to do.

“Take an accident victim who comes bleeding to a health centre. By law, I may not be allowed to stitch that wound, but I cannot leave the person bleeding to death,” he said.

The union is now demanding government recruitment of at least 24,000 nurses and 13,000 midwives to bridge staffing gaps nationwide.

According to Ocen, the World Health Organization recommends that one nurse should serve about 25 patients, but many Ugandan nurses currently attend to more than 100 patients.

He urged nurses and midwives to properly document their work and remain professional despite the difficult conditions.

“Our names are everywhere. People say nurses steal drugs, nurses are harsh, midwives torture mothers in labour wards,” Ocen said. “We must do our work well and document everything because those records protect us in court.”

Meanwhile, Dr. Pamela Atim, the Medical Director of St Joseph’s Hospital Kitgum, encouraged nurses and midwives to continuously improve their skills and professionalism.

“Be that nurse, that midwife that is outstanding,” Dr. Atim said. “You make yourself outstanding by getting additional skills and improving yourself every day.”

She also cautioned parents against forcing children into nursing careers against their wishes, saying passion is essential in healthcare service delivery.

“Sometimes parents force children into courses they are not interested in, and that can produce bad professionals,” she said.