NARD Recommends 48-Hour Work Week, Two Calls For Doctors

The Nigerian Association of Resident Doctors (NARD) has announced new recommended work-hour guidelines aimed at addressing excessive workloads, burnout and fatigue among healthcare personnel in Nigeria.

In a statement posted on X on Monday, NARD said the recommendations followed deliberations by the Federal Ministry of Health and Social Welfare’s Ministerial Committee on Work Hour Regulation and Casualization of Doctors, which conducted a nationwide situational assessment involving 6,350 healthcare personnel across the six geopolitical zones.

NARD said the assessment “clearly demonstrated the urgent need to address excessive work hours, burnout, fatigue, inadequate rest, and the associated risks to healthcare workers and patient safety.”

Under the recommended framework, healthcare personnel would work a maximum of 48 hours per week, including weekends, while any authorised excess hours would be compensated.

The association said: “Healthcare personnel shall work a maximum of 48 hours per week, including weekends. Any authorized excess hours shall be appropriately compensated.”

The proposed guidelines also set a maximum of eight hours for day shifts and six hours for afternoon shifts, while extended shifts exceeding 12 hours would be restricted to emergency situations.

On call duties, NARD recommended a maximum of two calls per week, including weekend calls, with duties equitably distributed among eligible personnel. It also proposed a maximum of one weekend call per month.

“There shall be an absolute maximum of 24 continuous hours of duty, inclusive of call duty,” the association stated.

NARD further recommended a minimum of 12 hours between regular shifts and mandatory 24-hour post-call rest following weekday calls, Saturday calls, Sunday calls and public holiday calls.

The proposed framework also provides for a minimum one-hour break after six hours of continuous work, including shift and call duties, with NARD saying breaks should be appropriately staggered to ensure uninterrupted patient care.

On excess working hours, the association said: “Authorized excess work hours must be properly documented and adequately compensated above the normal hourly rate, or appropriately balanced through structured time-off. This provision must not be abused by institutions.”

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NARD also recommended protected time for research and professional development for healthcare personnel in all institutions, subject to approval by the appropriate National or Institutional Health Research and Ethics Committee.

The association clarified that the recommendations are “without prejudice to the stipulated maximum shift, call and rest durations, particularly in genuine emergency situations where patient safety and continuity of care may require exceptional arrangements.”

NARD said the recommended guidelines had been forwarded to all Medical Directors and Chief Medical Directors for implementation across health institutions.

“Hospital Managements and Heads of Departments are expected to take appropriate steps towards full compliance of these guidelines,” it said.

The association urged its centre leaderships to engage their respective managements and monitor implementation, while encouraging members to document cases of non-compliance and channel legitimate concerns through their leadership for necessary action.

NARD also disclosed that it was awaiting the release of a second document addressing casualisation and what it described as “abusive locum appointments.”

The association expressed appreciation to the Coordinating Minister of Health and Social Welfare, Prof. Mohammad Ali Pate, and the Minister of State for Health and Social Welfare, Dr Iziak Adekunle Salako, for their roles in the process.

NARD said it hoped the National Council on Health would also approve the recommendations, adding that the development reflected its commitment to protecting “the dignity, welfare, rights and professional interests of every Nigerian doctor.”