developmentofnursinginfrastructureinindia-210620132559.pdf

Nursing infrastructure in india

1. Development of Nursing Care infrastructure in India & Future
perspective
AsokanR
Associate Professor
KINS, KIIT (DU), Bhubaneswar.
20-06-2021 1

2. Focus on,
•Visionof Nursing profession
•Understanding of the heritage behind Nursing
•Highlights the contributions towards development of the nursing
profession & future perspective
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3. NURSING
Nursingencompassesautonomousandcollaborativecareof
individualsofallages,families,groupsandcommunities,sickorwell
andinallsettings.Itincludesthepromotionofhealth,thepreventionof
illness,andthecareofill,disabledanddyingpeople.
-WHO
20-06-2021 3

4. NursingEducationshouldnotbe
linkedwithPara-MedicalEducationand
neitherbeclubbedwithPara-Medical,
asNursingProfessionitselfisan
independentprofessionwhichis
approvedbytheW.H.O.and
InternationalCouncilofNurses.
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5. Florence Nightingale
•“MotherofModernNursing”
•1854,leftwith38womenfortheCrimeanWar—
Britishcasualtieswerehigh;within6months,death
ratecutinhalf
•Maderoundsatnightwithalamp“Ladyofthe
Lamp”
•Firsttostressonasepticprecautionswhilecaring
forthepatient.
•Nightingale developed basic philosophy: the
profession of nursing different from other existing
programs.
(12May1820–13Aug1910)
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6. Her accomplishments at Crimea in two years included
•Death rate decreased drastically
•She established cleanliness and sanitation rules
•Patients received special diets and plenty of food
•Improved water supply
•Patients received proper nursing care
•Nightingale established a reputation which allowed her to
improve nursing standards at home
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7. NURSING IN MODERN INDIA
•Military nursing was the earliest type of nursing.
•Florence Nightingale had a great influence over nursing in India especially in
the army.
•St Stephens Hospital at Delhi was the first one to begin training the Indian
girls as nursesin 1867.
•1871, the first School of Nursing was started in Government General
Hospital, Madras.
•1897, Dr.B.C.Roydid great work in raising the standards of nursing and that
of male and female nurses.
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8. •1908, the trained nurses association of India was formed
•In 1926, Madras State formed the first registration council
•The first four year basic Bachelor Degree program were established in 1946 at
the college of nursing in Delhi and Vellore.
•The Indian Nursing Council was passed by ordinance on December 31st 1947.
The council was constituted in 1949.
•First master’s degree course, a two-year postgraduate program was begun in 1960
at the College of Nursing, Delhi.
•1963, the School of Nursing in Trivandrum, instituted the first two years post
certificate Bachelor Degree program.
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9. NURSINGININDIA
⚫1935onwards-State-wisecouncils
starteddeveloping
⚫NowIndia has23StateNursing
Councils
⚫Nursing education in the country integrated
into thesystemofhigher education.
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10. Men in Nursing in India
GreatBritishGovernmenthasbroughtthereformations
inbringinguptheworkingstandardsofmalenurses.
Thereformationandrevivalofmalenursesstartedin
1938,anditreachedalevelofrecognitionin1950.
Themalenurseswererecruitedin1938,butthey
reachedthepositionofaheadnurseby1950.
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11. 20-06-2021 11

12. NURSING IN INDIA
Nursesaretwo-thirdsofhealthworkforceinIndia.
AimoftheNursing.
AchievingUNmillenniumdevelopmentgoals(MDG)andsustainabledevelopment
goals(SDG)areverycrucial.
Achievinguniversalcoverage,increasinghealthfinancing,recruitment,trainingand
retentionofhealthworkforceinIndia.
Nurseshavewidenedtheirscopeoftheirwork,&rolesandresponsibilitieshave
multiplied,stillhaveconcernswithdevelopmentofnursing,workforce,selectionand
recruitment,placementasperspecialization,preservice,inservicetrainingandhuman
resource(HR)issuesfortheircareergrowth.
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13. Nursing and Nursing Education
Intheancientera,until17thcentury,formalizednursingwasnottraced.
Everyvillagehadadai/traditionalbirthattendanttotakecareofmaternaland
childhealthneedsofthepeople.
Militarynursingwastheearliesttypeofmodernnursingintroducedbythe
Portugueseinthe17thcentury.
FlorenceNightingalewasthefirstwomantohavegreatinfluenceover
nursinginIndiaandbroughtreformsinmilitaryandcivilianhospitals.
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14. Thefirstfour-yearBasicB.Sc.programwasestablishedin1946atRAK
CollegeofNursinginDelhiandCMCCollegeofNursinginVellore.
In1960,M.Sc.wasestablishedinRAKCollegeofNursing,Delhi.
In1951,atwo-yearANMcoursewasestablishedinSt.Mary’sHospitalat
Punjab.
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15. In1908,theTrainedNursesAssociationwasformedtoupholdthedignity
andhonorofnursingprofession.
ThefirststateregistrationcouncilatMadrasNursingCouncilwas
constitutedin1926andBombayNursingCouncilwasconstitutedin1935.
In1949,IndianNursingCouncil(INC)wasestablishedtomaintaina
uniformstandardoftrainingfornurses,midwivesandhealthvisitorsand
regulatethestandardsofnursinginIndia.
INCactwaspassedin1947thatwasamendedin1950and1957.
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16. Thenursingscenarioatthetimeofindependencewasnotbrightandtherewereabout7000
nursesforthepopulationof400million.
Thehospitalsweregrosslyunderstaffed,nursinglackedprofessionalandsocialstatus,
andtheworkingandlivingconditionsofnurseswerefarfromsatisfactory.
Inthefifties,morenumberofgirlsfromdifferentpartsofthecountryjoinednursing.
By2000,Nursingadvisorpostwasinstitutedatthenationallevel;threenursingpostswere
increasedtofivewiththeintroductionofAsst.DirectorGeneralNursingandDy.Asst.
DirectorGeneral(recentlychangesin.
TheCollegeofNursingPGI,ChandigarhandCollegeofNursing,CMCVellorewere
designatedasWHOcollaboratingcentersfornursingandmidwiferydevelopmentin
2003.
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17. ThegovernmentofIndia,
healthandfamilywelfare
departmenthasissueda
noticeon9sep2016for
nomenclatureofnursing
cadre,nursewillbe
replacedbynursingofficer.
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18. ThedevelopmentofvariouscommitteessuchasBhoreCommittee(1943),Shetty
Committee(1954),MudaliarCommittee(1959-61),KartarSinghCommittee(1973),
SrivastavaCommittee(1974),HighPowerCommittee(1987)alongsidefiveyear
planshavebroughtaboutatransitioninthestatusofnursingandmidwifery.
Therecommendationsmadewereinrelationtostaffinginhospitalnursingservice,
publichealthsettings,andschools/colleges,workingandlivingconditions,
infrastructureandequipment,regulations,andintensificationoftraining
programmestomeetthestaffshortage.
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19. ThereportsoftheabovementionedallCommitteesandNationalHealthPolicy(NHP,2002)
haveputforwardverysoundrecommendationsfornursingmanagementcapacity.
TheNHPlaidemphasisonimprovingtheskill-levelofnursesandonincreasingtheratioof
degree-holdingnursesvis-à-visdiploma-holdingnurses.
Italsorecognizedtheneedforestablishingtrainingcoursesforsuper-specialitynurses
requiredfortertiarycareinstitutions.However,gapexistedinactualimplementation.
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20. Followingindependence,reorganizationofthehealthservicestookplaceinthe
lightoftheBhoreCommitteerecommendations(1946).
Healthserviceswereprovidedintheruralareasthroughtheestablishmentof
primaryhealthCentre(PHC)toprovideanintegratedcurativeandpreventivehealth
careforthepopulation.
In1952,apost-certificatePublicHealthNursingprogrammewasinstitutedatthe
collegeofNursing,NewDelhi.
CommunityHealthNursingwasintegratedinthecurriculumofGNMandBSc
Nursingcourses.
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21. IntroductionofMultipurposeHealthWorker’sfollowingKartarSingh’sCommitteereport
in1973.
MostofthehealthservicesinthehomeswereprovidedbytheHealthworkers,health
visitors,ASHAsandTrainedDaiswhoseactivitieswereandarestillconcernedprimarilywith
maternityandchildwelfare.
Theauxiliarynursemidwife(ANM)graduallyreplacedtheDaistoserveinthevillage
throughtheprimaryhealthCentreanditssub-centres.
UnderNRHMschemein1996,everyPHCwasmannedwith2staffnursestoprovideRCH
services.
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22. Theformulationandadoptionoftheglobalstrategyfor“HealthforAll”bythe
34thWorldHealthAssemblyin1981throughPrimaryHealthCareapproachgotof
agoodstartinIndiawiththetheme“HealthforAll”by2000AD.
In1987,TheGovernmentofIndiaappointedaHighPowerCommitteeon
NursesandNursingProfessiontogointotheworkingconditionsofnurses,
nursingeducationandotherrelatedmattersandsubmittedmanpowerrequirements
fornursingpersonnel.
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23. Contemporary Perspectives
Thecomplexityofthehealthcareinfluencedbytheincreasinglongevity,
shorteningofhospitalstays,scientificandtechnologicaladvances,equality,poverty,
discrimination,disasters,violenceandculturaldiversityleadstoseveralchallenges
thatthreatenthehealthandwellbeingoftheIndianPopulation.
CurrentlyIndiahasonly0.7doctors(Globalaverageis1/1000)and1.7nurses
(Globalis2.5/1000)availableperthousandpopulation.
Theratioofhospitalbedstopopulationin0.98/1000againsttheglobalaverageof
3.5beds/1000population(WHO).
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24. Therolesofnursesareevolvingandchanging.
Nursesundertakingresearch.
Nursescontributingtowardsstrengtheningsystemstoworkefficientlyin
interdisciplinaryteams.
Effectivelyparticipatingandinfluencingpoliciesrelatedtonursingatlocal,stateand
nationallevels.
SpecializedandhighlyskilledNurses.
Thenumberofregisterednurses/midwiveswas6.7lakhsin1998andhasreached
17,91,285nurses/midwivesin2014.
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25. InIndia,NursingeducationalprogramssuchasAuxiliaryNurseMidwifery,
GeneralNursingandMidwifery,BSc(N),MSc(N),MPhilandPhD(N)exist.
Thegrowthinnursingeducationsisphenomenal.From2000to2016,ANM
schoolshaveincreasedfrom298to1927,GNMschoolsfrom285to3040,B.Sc
collegesfrom30to1752,andM.Sccollegesfrom10to611.
The12thfive-yearplansuggestedestablishing24centersofexcellencein
Nursing.
Upgradationofschoolstocolleges,strengtheningofexistingschools,faculty
development,andestablishmentof6AIIMslikeinstitutionsaretakingplace.
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26. INCinitiativesincludecapacitybuildingof55nursingeducationalinstitutions,
trainingof1,20,000nursesand3500facultyinHIV/AIDS&TBthroughGFATM
project.
ELearningmodulewasdeveloped.
EveryregisterednursewillbeprovidedwithanurseuniqueID(NUID)afterlive
registrationinINC.
LicenselinkedwithCNE.
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27. AnationalconsortiumforPhDinnursingwasconstitutedbyINCin2006to
promoteresearchactivitiesinvariousfieldsofnursing.
INCisincollaborationwithJHPIEGOhastakeninitiativetostrengthenthe
foundationofpre-serviceeducationresultinginbetterpreparedserviceprovider.
InordertopromotecompetencybasedtrainingINCincollaborationwithJHPIEGOis
goingtosetupstateoftheartsimulationcenterinIndia.
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28. SomestateshavedevelopedmechanismtoconductCNEthroughStatenursingcouncils.
IntegrationofserviceandeducationmodelthatispracticedinCMCVelloreisalso
introducedinafewmoreinstitutions.
FlorenceNightingaleawardsinstitutedbyMOH&FWin1973torecognizeandhonorthe
meritoriousservicesofoutstandingnursingpersonnelinthecountryaregivento35nurses
everyyearonMay12,theInternationalNursesDay.
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29. ManyuniversitiesarerunningPhDprogrammesinnursingandmanycollegeshave
beenrecognizedasresearchdepartments.
INCisintheprocessofdevelopingapracticalmodelforthecountry.
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30. Public Health Nursing
AccordingtotheINC(Snapshots,2016),789,740ANMsand56,096LHVsareregistered
inthedifferentstatenursingcouncilsoftheCountry.Theyareresponsiblefor
implementingallnationalandstatehealthprogrammesatgroundlevel.
Criticalactivitiesrelatedtomaternalandchildhealth,diseasecontrol,immunization,
epidemicmanagementandhealthpromotionarecarriedoutbyperipheralpublichealth
nursingpersonnel.
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31. Future Perspectives
ThefutureofhealthyIndialiesinprimary,secondaryandtertiarycareservicestoserve
therural(70%)andurban(30%)population.
NHP2017recommendssettingupnewNursingInstitutions,standardizationofclinical
training,revisitingentrypoliciesintoeducationalinstitutions,ensuringqualityofeducation,
continuingnursingeducation,strengtheninghumanresourcegovernance,regulationof
practice,establishingcadreslikeNursePractitioner,HRpolicyforfaculty,centersof
excellenceinnursingineachstate,andcareerprogressiontonursingcadre.
Useofmid-levelserviceproviderstoprovidecomprehensiveprimarycare.
Nationallicenseexitexamforentryintopractice,periodicrenewaloflicenselinkedwith
continuingnursingeducation.
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32. •TheWorldHealthOrganizationdeclared2020tobethe“YearoftheNurseand
Midwife”.
•Insubsequentdecades,nursesansweredthecallagainandagain,servingasfrontline
providersduringsomeoftheworld’smostrecentinfectiousdiseaseoutbreaks,including
H1N1SwineFlu,Ebola,severeacuterespiratorysyndrome(SARS),MiddleEast
respiratorysyndrome(MERS),andCovid-19.
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33. Nursing in 2021
•Self-Care for Nurses
•Increased Specialization and Career Path Options
•Traveling Nurses
•The Rise of TeleNursing
•Nurses are retiring later
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34. Online nursing education programs more popular
Increasing need for nursing educators
Increasing need for doctoral education programs
Bilingual nurses in more demand
Holistic Care become more popular
Nurses need to be technology savvy
Value-based care is the new model
Patients become more educated
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36. CONCLUSION
Todaywethinkofourhealthcaresystemasmoresophisticatedthanthatof
previousgenerationsbecauseitisbasedontechnologyandscience.
Muchofthecarenursesprovideforindividualsandcommunitiesisbasedon
theneedsofsocietyandisdrivennotonlybyneedandtradition,butbychangesin
societybroughtonbyenvironmentalchanges.
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37. Bibliography
1.https://healthyindiachronicle.in/shri-t-dileep-kumar-president-indian-nursing-
council-growth-nursing-india/
2.Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses : A
call for radical transformation. Danvers, MA: Wiley
3.FICCI Report, 2016
4.Indian Nursing Council, 2016
5.Indrani, TK (2004). History of Nursing, New Delhi: JaypeeBrothers
6.National Health Policy, 2002 & 2017
7.Trained Nurses’ Association of India (2001). History and Trends in Nursing in
India, New Delhi: TNAI
8.https://www.altus-inc.com/blog/nursing-trends-for-2020
9.https://blogs.scientificamerican.com/observations/nurses-are-playing-a-
crucial-role-in-this-pandemic-mdash-as-always/
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