Dr Shailla Cannie
Nurses are two-thirds of health workforce in India. Their central roles in health care delivery in terms of promotion, prevention, treatment, care and rehabilitation are highly significant. Health care is the most fast growing industry in the country with increase in both educational institutions and health care facilities. There are virtually 300,000 annual seats available in nursing schools and colleges. While on the one hand the annual increase rate of nursing institutions and nursing graduates has been impressive, on the other, the gap between demand and supply of nurses remains wide.
INTERNATIONAL NURSES DAY
This year the theme for International Nurses Day is Health is a Human Rights. This can only be achieved by bridging the gap between demand and supply of healthcare human resources and updating the nursing education system in countries like India. “Nurses have come a long way in a few short decades. In the past our attention focused on physical, mental and emotional healing. Now we talk of healing your life, healing the environment, and healing the planet, that is called holistic health.”
The characteristics of nursing inculcation and teaching in the developed world are entirely different from the methodology being practiced in India. It has been observed that the course distribution in UK is predicated on many rudimental courses, few practical courses and prophylactic medicine whereas the USA maintains the standard of few fundamental courses with humanities and includes prophylactic medicine courses. Similarly Australia provides few in rudimentary courses, many professional and an option of humanities and life sciences courses. Besides that one can opt for geriatric, adult and child nursing with ample of opportunities. The edification guiding ideology is structured on patient centred holistic nursing in all developed countries.
Nursing education in Canada is divided into several stages. (1)Someone who finishes 2 or 3 years of education in technical secondary school can only be an assistant nurse. (2) Someone who completes the 3-year junior college education program can qualify for the registered nurse examination to qualify as a registered nurse. (3) After 4 years of bachelor’s education or continuing education to obtain a bachelor’s degree, they are eligible to participate in community medical care services. In USA, the classification of nursing education programs is Associate Degree Nursing Program, Bachelor of Science in nursing, masters of Science nursing program with varied specialities and the doctoral program. These seven levels of program range from low to high and all levels are connected to each other. Students have the opportunity to increase their educational level to continue learning with a variety of choices.
The developed countries pay more attention to the multicultural development of students, teaching those more about humanities and community nursing. On the other hand a reform in the structure, program and syllabi is required to be revised in the developing countries like India.
The evaluation system in developed countries is predicated on the course outline and course content. The contents of the curriculum are well understood and analyzed through comprehensive evaluation scheme. The nursing evaluation in USA is evaluated by National League for Nursing Accreditation Commission and Commission of Collegiate Educational Assessment which are responsible for implementing inculcative assessments. On the other hand, the State Government Departments of Education and the Association of State Boards of Nursing jointly review the nursing scholastic standards. Canada withal offers standardized training including participation in sundry academic nursing activities to amend professional skills. The courses are conventionally upgraded in the developed countries.
In India, nursing educational programs such as Auxiliary Nurse Midwifery, General Nursing and Midwifery, BSc(N), MSc(N), MPhil and PhD(N) exist. Indian Nursing Council prescribes uniform standards and syllabi for every educational program to be implemented across the country. However, the implementation by educational institutions having varied capabilities is not uniform resulting in graduates with varying knowledge, attitude and competencies.
State Nursing Councils and universities inspect and recognize training institutions, conduct examinations, monitor rules of professional conduct and maintain an active register. Almost 90% of institutions are private and at present, the quality of education in private and government institutions is very different. The execution of syllabi and curriculum across the states is fragmented and varies from one to another. There is an overt need for up gradation of curriculum, outcome-based training, specialized trainings, standardized exams and licensing procedures and the uniform availability of nursing education across the country.
Despite the fact that nurses form the most immensely colossal proportion of workforce in the health care sector, nursing is losing its appeal as a career of choice. Nursing as a sector in India perpetuates to experience challenges in terms of Availability, Distribution and Retention. Some of the key reasons for this are lack of a rewarding vocation progression, welfare, income parity, convivial status, inadequate work environment, work life balance and empowerment. In integration, alternative vocations with better pay-outs and less stressful work environments and opportunities to migrate overseas incline to magnetize nurses preponderant. Within India, nurses take up the profession with a clear goal: to use it as a bridge to get international placements, or, if they work in India, get placements in government hospitals as the compensation there is much better, and job security and working hours are much better managed.
There is a scope for improving living and working conditions of nurses in the future. The short term and long term solutions are required for the transformation and shaping the future health care distribution system in both regime and private sector of nursing inculcation. From the ordinant dictation perspective, it is one of the most expeditious growing vocation and thus offers a vigorous vocation opportunity for today’s aspiring youth. This transformation can transmute and expand current nursing roles and engender incipient ones and open up opportunities for nurses to participate in shaping the future.
A reform based on the need with more practical approach could be implemented to bridge the gap and meet the standards at national and global level of healthcare industry. Formal Public Private partnerships between private schools/ colleges of nursing and public health facilities, PHCs and CHCs Taluk hospitals, district hospitals, medical colleges and specialty hospitals where the rich clinical resources/study materials are available. This should be shared to enhance and correlate nursing education with practice within the state. The centres of excellence, accreditation, benchmarking and ranking of nursing education institutions should be introduced and recognized through a robust accreditation and ranking processes. Nursing colleges should also be subjected to accreditation and benchmarking and ranking by Quality Council of India/ National Assessment and Accreditation Council.
It’s the time that every nursing professional should pledge on this day to raise the standard of nursing education and practice to cater the current industry needs with high quality and standard.
(The author is Dean Faculty of Nursing, SMVDU Principal, SMVD College of Nursing Kakrayl, Katra)
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