Functions of the Nursing Council of Kenya

Nov 06, 2025 0

The Nursing Council of Kenya (NCK) was established under the Nurses Act, Cap 257. Operations began in 1985 to regulate the nursing and midwifery professions.

Mandate and Core Functions

The core functions of the Nursing Council of Kenya are to establish and improve standards of all branches of the nursing profession in all their aspects and to safeguard the interest of all nurses. The council establishes and continues to improve the standards of professional nursing and of health care within the community. The NCK is mandated to ensure the delivery of safe and effective nursing and midwifery care to the public through quality education and best practices.

Its mandate includes:

Overseeing the training of nurses.
Registration of nurses.
Licensure of nurses.
Ensuring quality care standards.
Enforcing ethical practices.

Additionally, the NCK:

Accredits nursing schools.
Develops curricula.
Conducts licensing exams.
Monitors compliance with healthcare regulations.
Advises the government on nursing and midwifery policy.

Before the establishment of the Nursing Council of Kenya (NCK) under the Nurses Cap 257 of the Laws of Kenya, the activities of the council were governed by Ordinances.

The role of private nurse training institutions in the production of nurses in Kenya

Historical Context

Nursing in Kenya began in 1908 and was conducted without a formal framework until 1950. Before 1950, nursing in Kenya was conducted without a formal framework. Most health care institutions provided in-service training for healthcare workers, to assist the whites in the provision of required healthcare, thus making it difficult to identify healthcare workers according to their level of training and scope of practice.

In 1950 meeting of the Nurses and Midwives Council of Kenya members passed a resolution that formally described the different cadres of nurses who were practising nursing in Kenya at that time. In 1952, the Examination Sub-Committee held its first examination for Assistant Enrolled Nurses Grade I and II. The King George Hospital Kenyatta National Hospital became the first hospital to start the Kenya Registered Nurse training programme.

In the 1980s there was a marked growth in the population of Kenya. As a result of the rapid development going on in the country at that time, there was an increase in rural-urban migration, resulting in an uneven distribution of resources, with particular reference to human resources.

Structure and Operations

The council is composed of 22 members. They meet monthly to discuss issues under their mandate. Decisions are informed by the six standing committees.

Key Responsibilities

The NCK's responsibilities include:

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Liaison with the training institutions.
Presenting the results to various committees and Full Council.
Council ratifies the examination results.
Registering nurses for nursing practice.

Investigations are carried out by the investigations standing committee, legal advisor and a representative of the Chief Nursing Officer.

Challenges and Realities in Nursing Practice

There is a growing attention towards nursing roles in the contemporary healthcare setting, with debates about nursing roles and why nurses struggle to meet their professional standards. The dilemmas and struggles nurses face in meeting individual patient care needs and consequent failure to meet their professional expectations of care are well documented. Nursing in resource‐constrained settings is typified by daunting working conditions characterized by high workloads to inadequate resources, high nurse‐to‐patient ratios, poor physical infrastructure and inadequate supplies.

Further, nurses often find themselves burdened with non‐nursing duties including administrative tasks, transporting patients and housekeeping duties which take them away from specific nursing duties. Cumulatively, these have been shown to contribute to ‘missed care’ where fundamental aspects of nursing work are delayed or neglected as nurses grapple with competing work demands and this may result to a compromise in the quality and safety of patients. Relatedly, intensification of nursing work is also related to a phenomenon described as ‘busyness’-involving nursing tasks being performed in a hectic manner with the aim of task completion, leading to a task‐based nursing approach to care over knowledge‐based care and this has been shown to limiting the provision of holistic patient care.

Nursing Training and Education

Nursing training in Kenya is offered in three entry levels; certificate, diploma and degree, as well as specializations offered in higher diploma, masters and PhD levels. To improve the status of nursing as a profession, the Nursing Council of Kenya (NCK) has been making efforts to advance nurses training in Kenya, with fewer certificate programmes being offered in favour of diploma and degree in nursing. Kenya has also been scaling up training of nurses; the NCK which regulates nursing training reports there are 121 accredited nursing/midwifery training institutions in Kenya.

Under a devolved system of government in Kenya, health was devolved to be managed at the county level. The national government allocates block grants to the county governments, who decide how these finances are appropriated. Therefore, huge disparities exist on the available human resources for health across the counties.

The country has made several advancements aimed at transforming and professionalizing nursing, with increased investments in both expanding nursing training and developing a professional scope of practice for nurses. Additionally, to bridge theory-practice gap and to offer a scientific and systematic approach to deliver high‐quality patient‐centred care, the Kenya‐Nursing process was operationalized in public hospitals and incorporated in the training curricula for nurses, the framework for nursing care and the nurses' scheme of service.

Nonetheless, Kenyan nurses still struggle to provide the appropriate care and practise to the full extent of their training and education due to staffing shortages and huge workloads. Further, the practice of nursing care to full capacity depends on conducive work environments where nurses have the liberty to make fundamental decisions and autonomous clinical actions.

A study explored how nurses navigate competing work demands in resource‐constrained settings and how this shapes the enactment of nursing roles. The study was conducted in three purposively selected county referral hospitals offering inpatient, outpatient care and referral care according to the Kenya Essential Health Package guidelines. Participants were purposively selected based on their work experience (ranging 1‐ over 20 years' experience), different areas of specialization, gender, varying ages and professional designation based on grades, that is, nurse managers (ward in‐charges) and frontline nurses (junior nurses) and national level nurse managers to ensure diversity.

Findings from a Qualitative Research Study

A total of 47 nurses participated in the study. Three major themes arose:

Rationalization of prioritization decisions, where nurses described prioritizing technical nursing tasks over routine bedside care, coming up with their own ‘working standards’ of care and nurses informally delegating tasks to cope with work demands.
Bundling of tasks describes how nurses were sometimes engaged in tasks seen to be out of their scope of work or sometimes being used to fill for other professional shortages.
Pursuit of professional ideals describes how the reality of how nursing was practised was seen to be in contrast with nurses' quest for professionalism.

Participants described being burdened with enormous workloads and limited resources, such that daily nursing tasks became negotiated and crafted in ways that enabled normalization of care rationing decisions. Thus, medical tasks were prioritized over physical and emotional caring tasks. Technical tasks such as giving medication, dressing, documentation in the nursing Kardex, monitoring of patients with critical conditions and taking patients for investigations were thus viewed as ‘must do tasks’ and were prioritized.

Nurses also described adopting informal task‐shifting strategies. Nurses felt delegating tasks to patients' relatives dented the image of nurses, especially when relatives felt those were nursing duties. These improvisations were so deeply internalized that it impacted on how students are mentored and socialized into the profession. It was observed how common it was for nurses to use students to cover the wider staffing deficits.

NCK's Role in Addressing Challenges

The NCK is mandated to establish and improve the standards of nursing and midwifery and of health care through:

Regulation of nurses and midwives training syllabi and institutions.
Conducting of licensing examinations.
Compilation and maintenance of registers, rolls and records required to be kept under the Nurses Act, Cap 257.
Having regard to the standards of nursing care, qualified staff, facilities, conditions and environment of health institutions.
Undertaking disciplinary measures as may be necessary to maintain a proper standard of conduct and nursing care.
Advising the Cabinet Secretary on matters concerning all aspects of nursing and midwifery.

The Nursing Council of Kenya plays a vital role in regulating and improving the standards of nursing and midwifery in Kenya, ensuring quality healthcare for the community. Despite challenges such as resource constraints and workload issues, the NCK continues to strive for excellence in nursing education, practice, and ethical conduct.