By Frank Ulom
The National Association of Nigeria Nurses and Midwives (NANNM), Cross River State Council, has issued a 21-day ultimatum to the state government, demanding urgent action over poor remuneration, alleged salary deductions, staff shortages and other unresolved welfare concerns affecting nurses across the state.
The ultimatum was contained in a letter dated October 30, 2026, and addressed to Governor Bassey Otu, in which the association expressed concern over what it described as worsening working and welfare conditions of nurses in Cross River State.
Signed by the State Chairman of NANNM, Comrade Josephine Bassey, the letter called on the government to address the grievances within 21 days of receiving the notice, warning that failure to do so would compel the union to consider lawful and constitutionally permissible industrial actions.
The association identified five major areas of concern, including an acute shortage of nurses, poor and unjust remuneration, improper implementation of the national minimum wage, non-payment of hazard and uniform allowances, and unexplained salary shortfalls.
On the shortage of personnel, NANNM disclosed that the state had only 539 nurses in the State Ministry of Health and 117 in the Cross River State Primary Healthcare Development Agency.
It said the situation had resulted in excessive workloads, prolonged duty hours, inadequate staff strength, physical and emotional exhaustion, and increased occupational stress among the available workforce.
According to the association, nurses are routinely compelled to attend to patient numbers beyond what can reasonably be managed by the available personnel, creating risks for both healthcare workers and patients.
It further expressed concern over reports of nurses whose health had deteriorated under demanding working conditions, as well as reported deaths among colleagues.
On remuneration, the union said nurses in Cross River continued to face payment challenges that did not adequately reflect their professional responsibilities, workload, expertise and contributions to healthcare delivery.
It also expressed dissatisfaction over disparities between the remuneration and welfare provisions available to nurses in the state and those applicable to their counterparts in Federal Government health institutions.
The association called for a review of nurses’ remuneration, including appropriate salary structures, allowances and other entitlements, in line with applicable Federal Government provisions and approved health-sector salary structures under the Consolidated Health Salary Structure (CONHESS).
On the national minimum wage, NANNM raised concerns over reported inconsistencies and shortcomings in its implementation, including consequential adjustments for nurses in the state.
It insisted that the implementation must be transparent and consistent with the applicable legal and administrative framework, adding that nurses should not be subjected to arbitrary interpretations, omissions or payment arrangements that deny them their lawful entitlements.
The union also complained about the non-payment of hazard and uniform allowances to eligible nurses despite their exposure to infectious diseases, biological hazards, hazardous substances and other occupational risks associated with healthcare delivery.
It further said it had received complaints about unexplained reductions and shortfalls in nurses’ salaries, allegedly implemented without prior communication, satisfactory explanations or transparent clarification.
According to NANNM, the deductions have created financial hardship, undermined workers’ confidence in the payroll system and generated avoidable tension between employees and the government.
To address the grievances, the association made six demands, including the recruitment and deployment of 500 additional qualified nurses for state-owned health facilities and another 100 for the Cross River State Primary Healthcare Development Agency.
It also demanded a review and improvement of nurses’ remuneration to ensure fairness, equity and alignment with applicable Federal Government remuneration provisions and approved health-sector salary structures.
Other demands include the proper implementation of the national minimum wage, payment of all lawful consequential adjustments and outstanding arrears, and the settlement of unpaid hazard and uniform allowances.
The association further called for an investigation into all reported salary shortfalls, transparent explanations to affected nurses, correction of identified errors and refunds of any unjustified underpayments.
It also requested an urgent meeting between NANNM leadership and relevant ministries, departments and agencies to establish a clear implementation framework, timelines and monitoring mechanism for resolving the grievances.
In the letter, NANNM formally notified the state government that the 21-day ultimatum commenced from the date the notice was received.
It warned that failure by the government to satisfactorily address the issues within the stipulated period would leave the union with no option but to consider and pursue lawful industrial relations measures to protect the welfare, rights and professional dignity of nurses.
However, the association clarified that the ultimatum was not issued out of hostility towards the government but was intended to secure urgent intervention before the situation deteriorated further.
It reaffirmed its preference for constructive dialogue, mutual respect and timely resolution of the grievances, noting that the welfare of nurses was inseparable from the quality of healthcare delivery in the state.
The letter was copied to the Head of Service, the Commissioner for Health, the Chief of Staff to the Governor, the Accountant-General, the Director-General of the Cross River State Primary Healthcare Development Agency, relevant special advisers to the governor, the state chairman of the Nigeria Labour Congress and the Director of Nursing Services, among other officials.
NANNM maintained that a functional healthcare system could not be sustained when its nursing workforce was overstretched, inadequately remunerated and uncertain about its rightful entitlements.
