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I CHAPTER OUB i
CBAPTXR 1
IITBOOOGtIOS
All kuMtfi k»iac0, right Sx9m thm Ximm of blrtb t U l
aoeiaX elMuamE»«* Xr^rj •t«c« la Xif« IM«<UI •^••ial car**
Is thm himtovf of aOTliliK Xttraiac luid Ita start • • «
braiMh ot aotlMr ezmft «&d contlau** to too oao of tho aoa/
art* oorriod on kgr tlio aoaboro of tho houooliold* Aaeac thm
Miaboro vho hmA oliova ak.iULo in ooriac for tho olokt thoir
•orriooo voro daooadod toy tho aoodj nolchtoowro* Thoy ho4 no
fonwl propomtioay tout tho kaovLoAKO vhioh thoy had wao
paoood Aovn la tho faaily* fhoro hao toooa on arl of aarolac
aad oarins for tho ourvlvol of tho hvaaa raoo*
"ihurolBc hao to«oa ooooatiol to tho prooerratloa of Ilfo*" (4 i 1}
India lo tho oocond aoot populoao oouatry In tho vorld<
Yho otatlotloal data of 1984 ohoicthat,
"fhoro lo a population of 796 ailUoao and toy 2000 A*I>*, i f tho proooat crovth rata oontlauoot It lo Xlkoly to tooooMi oao thooooad a lUlon; " (21 i 39)
At tho ond of oaoh q[iiotatioa/roforoaoo» tho dotallo of oourooo of roforoaoo hao tooaa proooatod toy tho oorlal ataihor of tho hooft/Joaraol/Aoooaont/anpatollohod aatorlol ( la a ooooolldatod blhUo^raphy at tto ond of thoolo) along with the pago nnatoor of tho roopootlvo qaotatloV*foroaoo o«g*(4 i I) ho.4 lo tho oorlal nuatoor of tho hook la tho hltollogmpliy and Xo.1 roforo to tho pago nvKtoor la tho mamm hook.
Due to the population explosion it ie rather difficult
to provide care on time* Peoi Le need more promotivet
preventive and curative care« Hoepitale play an important
role in this aepect of the care*
"The total number of the hospitals as indicated in the statistical outline of India in 1964 was ^66. This data is related to Harch 1979 and of which 1.477 vcre in rural areas. The total number of beds amounted to 466*6 thousands and out of which 53*4 thousand beds were in rural areas and the number of beds per 10,000 population was only 6*6"* (41 i 175)
At the Alma Ata Conference in 1978, delegates from
over 100 States and many members of international health
organisations agencies committed themselves to work tot arde
the objective of "Health for A H by 2000 A.D*" (60 j 157)*
To meet the above health slogan, we need to educate
the population on all aspects of health and enhance them to
achieve the target*
Under the same goal, the Oovemment of India has
specified the following targets t
1. "Keduetion of infant mortality rate from the
present level of 125 (1978) to below 60 by
the year 2000 A.S*
2* To raise the expectation of a life at birth
from the present level of 52 years to 64
by the year 2000 A*D*
3* To reduce the crude death rate from the preeent
level of 14 per 1000 population to 9 per 1000
by the year 2000 A»D*
4* To reduce the crude birth rate from the preeettt
level of 53 per thousand population to 21 by
the year 2000 A.D,**
(71 t 175)
Nov it is universally accepted that the above targets
can be achieved through primary health care. It means to
provide preventive, promotive, curative and rehabilitative
health services from womb to tomb, to every individual
residing in a defined geographical area« If we want to achieve
the above mentioned targets, then ve need to increase the
number of health personnel, prominent among them being the
nurses* We also need to change their role and introduce
innovations in their status and in their training programmes*
Before discussing the nurses* role and their training
progrcouoG it is essential to understand the basic concepts
and the development of the nursing profession.
The vord "Hurse" is derived from the Latin "Ilutricus
meaning, to nourish, to conserve, to foster and to protect."
(38 1 72)
The concept of nursing took a wider meaning in the
year 1633, when St. Vincent de Paul established the visiting
aursing eervieo called *The Siistere of Charity** St. Vincent
initiated the training of nureee and encouraged the eistera to
etudy the art of nursing and to attend lectures given by
phyeiciana* The nineteenth century heralded the consolidated
efforte to Improve the hospital services and the quality of
nursii: *
"Nursing is primarily assisting, individuals (sick or veil) with those activities contributing to health» or recovery (or to a peaceful death) that they pcrfoxm unaided vhen they have the necessary strength* will or knowledge. Cursing also helps individuals to carzy out prescribed therapy and to be independent of assistance as soon as possible.** (13 t 14)
The true meaning of a nurse would be as shown under :
" K «. flobleet profession,
a - Uncomparable to any other profession.
H « Respectable profession coupled viith
devotion and sacrifice.
S -> Sentiioental profession to the sick*
B « Educational profession if activated properly .
(48 » 45)
Florence Nightingale called "Nursing the finest of
fine arts." (20 i 3)
JNursing has been defined as :
"a science .« k science is a body of knowledge, based on a large number of carefxilly collected facts which have been arranged and classified in such a way as to establish certain laws and principles." (20 j 4)
She occupation of nttreing ie becoalni; lacreaeingly
complex* Nursing draws on many disciplines, the humanities,
the social and pessrchological Boiencee» the natural sciences,
the medical sciences and the allied arts* 7here has heen a
continuing expansion of knowledge in all the disciplines, as
well as advancement of medical innovation* Besides this we
are no more confined to the hospitals serving the ultra elite.
Community nursing is now so well developed that with the
necessary improvising, nursing is carried to the people in
their very homes, in their natural hahitat*
This requires to change the role^ the concepts of the
occupation and the functions of nursing* this will affect
the various nursing perscmnel, their knowledge and their image
in the society*
Recently in India the trend of nursing profession is
slowly changing and is adapting itself to meet the changing
health needs and expectations* If one states that nursing is
an important aspect of the health programme, then why has it
not been raised to the level to i^ich It ought to have been?
One thing Is certainly clear that there has bean a felt need
to uplift the nursing profession as a whole and to give it its
due recognition In the society*
Medicine and nursing have common goals, the preservation
and restoration of health. To provide medical care the nurse
plays a very Important role* In India we have different
categoriee of nurees' vorkizig In different posit ions in the
hospitals and in the cosnmunity* The nursing profession in
Zndia started as follows i
Development of Kursing Profession
The nations of the C(»am<Hi Wealth have, by their
h is tor ical association with Bngltiad, been inspired hy the
practice of the lady with the lamp - Florence Ni^t inga le of
Great Britain. Althottgh she never v i s i t e d India, but soon
after the Crimean Mar due to her comtaitments and ta lents to
the force, nurses were sent to a l l Bri t i sh Military Cantonments
in India, and t h i s led to the beginning of organized Nursing in
India.
The appearance of hospitals exclusively for women and
children in the la te nineteenth century gave a further
impetiuLOue to the training and requirement of nurses. By the
end of the nineteenth century, ful l - f ledged Hurses Training
Schools appeared in the pr^aier c i t i e s of India, as adjuncts
to hospitals , such as the Gama Hospital in Bombay, The
Aitchieon Hospital at Lahore, the Victoria 2>enana Hospital in
Delhi and the Oosha Hospital in Madras.
Pevelownent of Educational Services for Nursing Personnel
The early years, 1860-1920, the f i r s t step to organise
a nursing service by training women for the pxirpose was taken
In Hadras in the seventies of the l a s t century. In the
following years nuraes were Introduced in an Ineresteing number
of hospltftle* $be service being eetabliohed as a general rule
with the help of nursos from Western countries* For tbe
Qovemffient hospitals nurses were reciuited direct ly from
£ngland«
A number of nurece frcxa Europe and America also c&ae to
India to work in mission hiepitals* Sheir largest contribution
to nursing in addition to the ir example of devotion to duty,
has been the training of nurses and midvivcs vhich they carried
out in the Isngtiage of the region*
By the beginning of th i s centiucy a number of training
centres were establiabed mainly in the Presidencies of Madras*
Bombay and Bengal* Recruitment to nursing was more or l e s s
l imited to the Anglo Indian and Christian communities*
The f i r s t world war opened another f i e l d , the Indian
Military Hursing 8ei-vice« Preparation of nursing personnel for
the Public Health Field was undertaken only in 191B by the
establisteaent of training health v i s i t o r s .
"She training in nursing for men was also inst i tuted in
the early years of t h i s century*
In 1906» the fozmation of nurses professional
organisation^ the Trained Nurses Association of India» and
the Publication of the Cursing Journal of India from 1910
gave nursoo an opportunity for pooling their experiences and
6
exchanging ideae« Since i t s iaceptlon, the association hae
been active In India* The standard and status of nursing has
been the fox*ce behind moot of the educational reforms*
One of the ear l i e s t measures to obtain a uniform
standard of entrance to training sohooXs and of examinations
vere talcen in Bombay by the formation of the Bombay Presidency
Hurelng Association {B*P,B,A.) in 1905* Proa 191If unti l the
constitution of the Bombay Nursing Council i n 1933t t h i s
Association vas responsible for Iziepection and recognition of
training schools, prescribing of the currlculua, conduct of
exttDHlnatione and registration of nurses and mldwlves*
During these years the training of nurses and midwivee
and the health v i s i t o r s became more standardized and training
schools iirere established.
(The f i r s t Surees* Registration Act vas passed i n Madras
in 1920 and by 1939 Hureing Councils vere established In a l l
the provlncee except Assam*
The course In general nursing hae been of three years
duration since the early years of th i s century, but two
standards were established In many of the States known as
"Senior" or 'A' Grade, and "Junior" or 'B* Grade. The 'A*
Grade cour.eo vas to those who did their training in Biglleh,
idiile the *B* Grade vas given to those who did the ir training
in the loca l language*
Some of the Indlem States e t tab l i ehed a two years
couree in aui'slng. In North India, there were coureee for
Nurse - Dale, which combined IJureing and Midwifery. Iheee
havB been discontinued.
The period from 1920 to 1940 wae one, in which many
developmentr. xxi nui-eli^g had taken place abi'oexl, ^uraee in
India bad a l i o a&pix«d tov<ard& a wider ecope for ntu^eixig and
oppoi-tunitieb for hii^hfer education* iiB tlicre wcr^ no
f a c i l i t i e s for iarther atuaiea i n i a a i a , u noabcr of Indian
nureee went to xjx^ana for courses i n i«urciu^ Luucatxou,
r u b l i c Health iiureiti^ anu hidwifery.
The shortage of nureee became mazicedly appai^nt during;
the war yeare . There was an acute ehox'tage of candidates for
t ra in ing due to more a t t r a c t i v e conait iona offci-^d by the
»>oiaen*a Auxil iary Bervicee* The Auxilic^ry uurce*e coxirse was
etai^ed in 1942 and was cons t i tu ted by woi&ene who were ^iven,
at f i r e t ) uoiiths and latei^ 9 mouths t r a i n i n g . But the
i-eci*uitiafciit oi Auxil iary iJOi-'ecs wtaS stouptd in 19t>5, as i t was
f e l t that the Auxiliary Uurse-e «^o had been out of touch with
nursing tra in ing lor ten or aort; ycare would rt quire the f u l l
period for t r a i n i n g ,
Chort courses i n Aominietration were i^iven to the
l i s t e r s of the Indian i ' l i l i tary Purees and at the saxoe t ime, a
one year course to px'cptirc nursing teachers was started*
Courses for nureing teachers were a l s o e s tab l i shed i n the
10
Central HospitaLf Ka(ir«e and the Christian MedicaX ColXese,
Vellore* This clevelcpment gave r i se to the nev category of
nureing pereonneX vie* e i e ter tutors .
In 1946| coureee leading to B*Sc« Bursing vere
eetabliehed by the Universit ies of Delhi and Madras at the
College of liureln^, Nev Belhi and the Chrietion Medical
College Hospital at Vcllore, The echool of IJurcing
Adminietration in Delhi was merged vi th the Collc»-e of Hursing.
(57 : 129)
7he repoi^ on the Bbore Coofflittee published in 1946
made many valuable rocoaxnendations on nursing* One of the
ear l ieet to be implemented was the "Indian Bursing Coimcil**,
which talces decisions from time to time on number of matters
related to nursing*
There has been considerable development in nureing
during t h i s period corresponding to development in other
f i e lds of health, though nursing s t i l l f a l l s short of being
an adequate serv ice .
Depr^e programmes t
There arc 23 Colleges of Bursing a f f i l ia ted to or
conducted by various univers i t ies in India awarding B.Sc*
(Hons) Poetobasic Degree in Dursing (10) and Masters in
Nursing ( 5 ) . Specialization in Community Rureing, Medical
11
Surgical Nursing* Peychia t r ic tmrsing and Administration in
Uureing can be otfeve& only a t the poet-graduate l eve l* There
are aleo Diploma courcee offered in Public Health Kurslng,
Psychia t r ic Kursing and in Administrat ion.
The following Table depict© the present pos i t ion with
reference t o Nureing Education.
TABLE 1.1
TlPilS AiTD DURATION OP COURSES III IJURSIl G EDUCATION
I Sr.BOti Type of Course
Duration Of
Course
AdmieBion requiixmonta
Ce r t i f i ca t e General Cursing and Hidvifezy
IXa I Degree B«Sc. Htirsing I
3^ years
A I f^
12 years of schooling.
l i b
I
Poet-baeic Nursing
4 years
2 years
12 years with science subjec ts
Registered nurse and midwifery with 2 years experience,
I l l I Flaoterc in Nursing
I J.
2 yeai's | B.Sc* £}ursing with 2 to 3
I years ej^erience.
IV I M.PhU (Master of } Philosophy in Hursing) 1 I I
..»..J -L-
I I I I
J.
Pull- t ime wi l l be one
yearJs programme* Part-tinte wi l l be two years programme• |
Master ' s degree in nursing or en equivalent qua l i f i ca t ion .
Table 1.1 . . . contd.
12
Sr.Qo. I Type of Course Duration of
Course t
Adaieslon fiequlreaozite
Va
Vb
Vd
Diploma in Psychiatric | 10 aontbs
Nursing
Registered Nuree.
Hegietered
f idwifery,
I Hursicg Adainis t ra t ion i I I I
4
^ 4 „„
Vo { Nursing Education "T-
10 months i
» I I I
Kegietcred Nurse.
Registered
Midwifery.
I t I I
I
I 1C months | i
\
Public Health Nursing { 10 months {
Ve S i s t e r Tu to r ' s Course
Registered Nurse. Registered Nidvifery*
10 months I I I I I
I
Registered Nurse* Registered Midwifery,
Registered Nurse. Registered Midwifery.
The following is a brief description of the functions
and duties of various nursing personnel.
gunctions and Duties of Various fittrsing Personnel
A hospital Nursing Development is headed by the Nursing
Superintendent/Matron who is assisted by the Assistant Matron.
At the ward level, the nursing services art provided by staff
nurses and ward sisters* The sister tutors are mainly
vs
i-eepoueible tox^ teachizxg the e tudea te .
The centi'ril Council of rc<h has r- solved t h a t ,
"JuiBC* bed r a t i o be 1:5 lii teachiwg hoEpltale and 1t5 In non«t«aohing hospi ta ls* Thie r a t i o in i t s e l f i s not very effect ive due to the fact that nursing oervicee are to be rendered 24 hours a day l o r 365 days a jetiV, la vox*k s i tua t ions one would find a nur^e loolcing a f t e r i>0-1G0 o a t i e n t s . The r a t i o at present vax^iee Iroa 1»5 to 1:25 in d i f ferent s t a t e s . " (57 : 151;
xhe a^ iu i s t i -o t i vc eiinicture of aui-eiii^; eei-^ices i s ao
fo l io vfs :
I'be Hpepital iPatttrn of liux'sirjf> icx-yicibg
Matron / Nursing Superintendent
;iEBietant KatrDns S i s t e r Tutors
Kai'd Sietex-B
t 'taff Nurses
The person In each of the catcfrories in the adminietratise
s t ruc ture plays a specif ic r o l e , TV-e dut ies and ro l e
spec i f ica t ion of each one of them are shovn as under i
Duties of Matron/iiurBing Superintendent
The :«'iatron/Kureia(/ ;:.uperinteudeat i s answerable to the
Medical Supei'intendent/Dean in a hosp i t a l , J»he i s accountable
for the safe :ina e f f ic ien t running of the various Huraing
14
department8 in the hosp i ta l • She io ass i s t ed in carryilig out
her du t i e s , by the aee is tan t oatrone, ward s i s t e r s , s t a f f
nurses and domestic s t a f f .
Kursinff functions s
Pai*ticipates in the foiroulation of the philosophy of
the hospi ta l in ^ n e r a l and those spec i f ic t o the
nursing se rv i ces .
Determines goals , aims, ol>;jcctiveB and p o l i c i e s of the
Nursing Services•
- Implements hospi ta l po l i c i e s and ru les thix)ugh various
nux*oing u n i t s .
« Decides and recommends personnel and mater ia l required
for running various l^ursin^ Service Departments of the
h o s p i t a l .
Interviews and r e c r u i t s Nursing e taff .
- Ass is t s in student se lec t ion and recruitment of o ther
aux i l i a ry e ta f f whose dut ies ai'e r e l a t ed to Nursing.
* Ensures the safe and e f f i c i en t CAre rendered i n the
var ious Nursing Depai-tioente of the h o s p i t a l .
•» Hakes regular hosp i ta l rounds in hosp i t a l s and wards.
Takes hospitcO, rounds with Medical Superintendent.
Se lec t s and. secures proper equipment needed for the
hosp i t a l or nursing home.
15
•» juooke a l ter the welfax't; of the patieute, the ir r^lativee
and the i«ur0in^; Staff.
-> Prepuree budgets for the Hurein^; Lenricee Departments*
•> Punctione ao a member of the condemnation board for
l inen and other hospital or Bursing Home equipments.
- Prepares duty roster, plans staff leave, and disburses
sal a l i o s .
• Gives coun8elling and guiuance to the subordinate staff .
<-> Haintains di&ciplinc among liurccs and other auxiliary
staff*
Enforces implementation of the hospital rules and
regulations.
Participates in hospital and intra-Hocpital meetings/
conferences.
~ Invt^^sti^ates complaints and takes necessary steps*
- I>.v&luate8 confidential staff reports and recommends for
pixuaotiun or higher studies*
•» Plans staff development programmes and other necessary
programuies*
" ^^rraoges stud«xts* c l in i ca l experience and council
examinations*
16
General and office dutiep i
« Attends to the general correapondence.
- Maintains necessary recordo concerning the Dxirsin Staff,
QtudentB, confidential reports and health x*ecords etc.
- Subiaite annual reports of the Ijurcing Services
departments to Medical Superintendent/Dean, Indian
nursing Council and Hurses* Registration Council,
• Participate in professional and comaunity activities.
- Maintains cordial relations vith public and volunteer
workers.
Assistant Matron
She is aneverable to the Katron and aseiote hei* in the
nursing service administration of the hospital,
Hurslnf^ fimctions i
<-. Officiates in the absence of I uroing Superintendent,
- Participates in the fonaulation of nursing services,
philosophies, objectives and policies.
- Assists in the reczuitiaent of Nursing Staff and students*
selection,
- Makes laaster duty roster of the Nursing Staff.
- Keeps records and repoarts of the Hursing Services,
17
Aseiets In planning and organissing the now un i t s in the
hosp i ta l , for example intenoive care un i t s e t c ,
- Maintaiao confident ia l repor t s and records of the Nursing
Staf f .
- Tals:cB regiilur hosp i ta l rounds.
•> Supervises care given in VGa ious departments.
- Serves on several hospi ta l coiamitteee, for example
Purchase Comaittoe, Class IV Employees Conanittees, e t c ,
- Acts as a l i a son of f ice r between the imrsing Suporintendeast
and the Nursing Staff of the hoep i to l .
Receives night imports frcwa the night supervisor .
- Maintains the attendance and leave r e g i s t e r for nurses .
«- I n i t i a t e s condeionation of old and vom-out a r t i c l e s and
procurement of new a r t i c l e s .
- Attends to emergency c a l l s in ro t a t i on concerning
hosp i t a l or hos te l problems.
Edacational functions s
ABsists in plannin^i s t a f f development progi-anuaee.
fineuree c l i n i c a l experience, f a c i l i t i e s for student
nurses in var ious c l i n i c a l ax'eas of the h o s p i t a l .
Guides and counsels Nursing Staff .
18
- Maintains descipl ine among nursing pereonnel,
- Urgsmisee experience prograsuneo for poct-gredxiate
etiidcntD frca different h o s p i t a l s .
General dut ies t
- ii.ecoi.'tB specia l v i s i t o r s , for hospi ta l rounds.
- Arranges and p a r t i c i p a t e s in professional and soc ia l
functions of the s t a f f and studentG.
- Carr ies out the other du t ies assigned to her toy
Matron*
Hursing Tutor
- Keeponeible for planning and implementation of teaching
programme.
- Teaching subjects in the curriciilum.
- Overall supervision of c l i n i c a l teaching programme of
subjects i n hosp i ta l /pub l ic heal th f i e l d .
-> Assis t ing in the administrat ion of the school of bursing*
-» Supervision and guidance of junior teaching staff*
Supervision of student^s hea l th , vel fare and securi ty*
- Assis t ing in the se lec t ion of s tudents and admission.
- Assis t ing in examination, t e s t s e t c .
-* Supervision of l i v i n g condit ions of s tudents in the
h o s t e l .
19
- Preparation of reporte on e tuden t ' s pi'Ogrees.
~ Aeeietin^ in ifiaiutunance of school x'ecorUo.
- Pa r t i c ipa t ion i n student'& guidance progroouaes*
- Assis t ing i n the general adminis t ra t ion of the school*
- Adeleting i n the procurement of echool supplies and
equipment*
- Aa&ietln^ in the l i b r a r y ,
- Planning) implencntation and evaluation of speci f ic
courses ,
- Re{?ponsihility for organiaing workload of s t a f f
including teaching assigniaents.
- AdisinistrativB arrangemente for s t u d e n t ' s c l i n i c a l
experience- and teaching in hosp i t a l s and public hea l th
f i e l d s .
- Preparat ion of budgetary proposals ,
- Supervision of hos te l and off ice s t a f f .
Preparat ion of budgetary proposals .
- Pa r t i c ipa t i on in teaching programme.
- Supervision of l i b r a r y s e rv i ce s .
- Planning for development of the school .
20
The nursing J>iotex^ i s accountable for the nursing care
management of a ward or a unit assigned to her . She i »
answerable to the Matron and Assiotaat Matron for her vard
manageiaent• She taiccs f u l l charge of the vard and aeeigne
woi'k for various categoriee of nureing and non-nursing personnel
working with her* She i e reaponeible for the safety and
comfort of the p a t i e n t s in her ward* In a teaching hosp i t a l
she i e expected to ensure good learning f i e l d s , ^
Direct patient, c^re i
- Ensux^e proper admiseion and discharge of her p a t i e n t s .
-> Plans nursing care and raakes pa t ients* assignsient as
per t h e i r nursing needs.
- Ass i s t s in the dlx^cct care of the pa t i en t as and when
req.ulred.
- Ensures eaiefcy, comfort and good personal hygiene of
her p a t i e n t s .
- Ass i s t s in planning and adminis t rat ion of the- therapeut ic
d ie t to her p a t i e n t .
- Maintaining of records of the p a t i e n t s and necessary
in fomat ion imparted to the concerned a u t h o r i t i e s .
•> Takes nursing rounds with s ta f f and s tuden t s .
21
•> Makee rouncLa u l th doctoi*8. Ass i s t s hio in diagaoeis
and tx^eatacnt of the p a t i e n t s .
- Implement© doc to r ' s inu t ruc t ions concerning p a t i e n t ' s
treatment•
- AesiatD pat ient and her /h ie r e l a t i veo to aci;jur.t to the
hoopital and i t e r ou t i ne .
~ Co-ordinatec pa t ien t caro with other depar taente .
Gupervieion and adminietrat ion j
- Bnsuree safe and clean environment for the vrard.
IlaKce duty and wox>ls: aaeiipimento*
" Indents ward s tore and keeps necesDary recorde .
- Coee regular inventory checking of her /h ie vard.
Makes l i o t for condemnation of a r t i c l e s euid oubmite
i t to a l l concerned.
- ABsiste in making wax*d roquireioente.
- Establ ishes and reinforces ward standards prescribed
in the h o s p i t a l s .
- Acts as a l i a i s o n off icer bet\<ecn xard s ta f f and
hospi ta l adiQiniotratlon.
- Maintains good public r e l a t i o n s in her ward.
KaintaJins d i sc ip l ine aaong the ward workers, for exeople
s t a f f nurses , s tudents and domestic stuff-
22
Deals appropriately with ai>y adverse s i t u a t i o n tha t hae
occulted in the ward and repor t s to the concerned
au thor i t i e s*
«• Reports about any medico-legal cases in the i^ard.
- Wx*itfcs ond eubai te confident ial I 'eports of the e taf f .
- Sees tha t s tudents get desired learn ing experience in
the vard«
gducational function :
- Organises oi ' ientat ion proerammee for nev; s t a f f .
- Organises formal and informal vrard teaching, conducts
hedside c l i n i c s and demonstrations.
•> Conducts ward conferences/meetings.
Gives incidenta l teaching to the p a t i e n t s ' r e l a t i v e s ,
s ta f f nurses , s tudents and domestic s t a f f .
Guides in f e m u l a t i o n of Nursing Care Studies and
Hursing Care Plane e t c .
- Evaluates the students* performance and submits repor t s
t o the school a u t h o r i t i e s .
« iiACourages s ta f f development progx'amae in her ward.
Staff Nurse
Staff liurse i s a f i r s t - l e v e l professional nui'sc who
provides d i rec t pa t ien t core t o one pa t i en t or a group of
23
patients aoeigncd to her daring duty shift. Assi&te in ward
management and supeivieion. She iu dii'ectly reeponsible to
the ward eieter.
Direct Patient Care :
" Adiaita and dischargee the patient.
- Haintaine personal hygiene and comforts of the patient.
• Attends to the nutritional needs of the patient,
pi-eparco invalid*a diet and feeds helpless patients*
- Maintains clean and aafo environment of the patients.
- Maintains vard routines.
Co-ordinates pa t i en t care v i th var ious hea l th team
members.
~ Follows doc to r ' s rounds.
Perfonas technical t a s k s , for example, adminis t rat ion
of medication, a s s i s t i ng doctors in var ious meaical
procedures, preparing a r t i c l e s and the pa t ien t for
siedical or nursing procedures, recording v i t a l eigne,
tube feeding, giving enema, bowel vash dressing
stomach wash, eye and ear cai^e, co l l ec t ion and sending
of specimens, pre and post-operat ive care , e t c .
- Ass is t s in administrat ion of t rans fus ion . Pex'ineal
ca res , breast ca re , baby care , e t c .
24
Helps doctoi'E? in diagnosis and treatment«
- Ka iu t a ing Infeaiie and output cha r t*
- Ubeeiveo changua i a p a t i e n t ' s c o n d i t i o n and r e c o r d s ,
t a k e s necessary a c t i o n and r e p o r t s to t h e p a t i e n t and
h i e / h e r f ami ly .
- Accoapaniee very i l l p a t i e n t s sen t t o o t h e r depar tments
or t r a n s f e r r e d t o o t h e r i n s t i t u t i o n s ,
Viard ManoA^ roent :
- Hands over end t a k e s over the p a t i e n t and ward ©(^uipaient
and supp ly ,
«- Keeps the ward nea t and t i d y .
- Main ta ins s a f e t y of t h e ward equipment .
- P r epa re s and checks ward s u p p l i e s *
• A s s i s t s ward s i s t e r s i n ward management and o f f i c i a l s
i n he r absence . Aes ic to i n t a k i n g I n v e n t o r i e s ,
-. Superv i ses s t u d e n t s and othex* j u n i o r nui ' s ing pe r sonne l
\;orkirig with h e r .
-. I l a in t a inn ward i*ecord and r e p o r t e a ss igned t o h e r by
the s i s t e r i n ^ c h a r g e .
Educa t iona l func t ions :
« P a i " t i c i p a t e s i n c l i n i c a l t e a c h i n g , both planned and
i n c i d e n t a l «
25
Teaches and guides domeetlc staff.
HelpG in the orientation of new Btaff•
" Participatee in staff education progranxoe.
Oaldes student nureee*
Need for the Study
The profession of nux-eing and nurses as individuals are
facing numerous problems and difficulties throughout their
career in evezy part of our country* The problems are faced at
different levels in the nursing profession such as nursing
administrators, for example, oatrons* assistant matrons*
teaching personnel (sister tutors) and others lilce ward sisters
and staff nurses*
Some of the common problems faced by the different
pei sonnel in the nursing profea8i<m are }•
(1) Social status of nursing in the society is not yet
upgraded.
(2) The general apathy of the public towards nurses and
nursing profession*
(3) Ho autonomy is granted to the nursing profession. In
India* nursing as a profession is still subservient to
the medical profession*
(4) Job specification in different categories of nursing
personnel is lacking.
26
i3) There i s a general laclc of job eatisfactioa*
(6) Pay scalee are not satisfactory as corapai"*©d to the workload.
(7) Vorkixig hours and other f a c i l i t i e s arc not satisfactory*
(8) Staffing; pattern i s not In proportion with the amount of
work expected*
(9) Accotamodation f a c i l i t i e s , that i s hostel as -well as family
quarters, are not a l lot ted to those in need* This in turn
affects the health and eff iciency of the nursing personnel
concerned*
(10) Do creche f a c i l i t i e s are tnrailable for the children of
working nurses*
(11) There are no regular staff development programmes which
can help the nurses in upgrading the ir knowledge and
keeping abreast with the changing times.
(12) Shortage of man-power which affects the quality of
patients care*
(13) Shortage of equixMoent and supplies affect adversely the
smooth functioning in the ward*
(14) Hurees perfozm more non-^nursiog functions instead of
giving patient care and nuxBing functions*
So far no e f forts have been made in t h i s direction to
study the occupation and career perceptions and the specif ic
socio-economic problems faced by the nurcee*
27
There are a £ev factors reeponsible for this eocial
apathy* Under the prevailing clrcumstancee it is eseentlal to
etudy how nureee theaeelTee perceive their ovn role in their
jobe« Vhat is their professionol attitude tovarde nursing?
To what extent do they have eutoncxay in the field of nursing?
Do they know the specific nursing jobe to be performed? To what
extent do they experience job satisfaction?
9 X 9 This etudy'will enlighten various authorities in the '
—^ Ir -field of nursing to have an awareness of the prevailing conditions of services and thereby perhaps it may help in
itaproving the conditions and the image of nursing profession in
our country.
Statement of the Problem
"A Study of Occupation and Career JPerceptione of the
Various ishzreing Personnel Woricing in the Training I n s t i t u t i o n s
of Nursing in the City of Greater Bombay."
Objectives of the Study
^ ^(1) To_know the opinions of the nurses tovrards nursing as
^ a ca ree r . .
(2) To know t h e i r professional a t t i t u d e .
(3) To determine autonomy of indiv iduals working in the
f ie ld of nurs ing .
28
(4) To study the ex ie t ing pa t t e rns of job spec i f ica t lone
of nureee in the hospi ta lc*
(5) To find out the perceptions of nureea i n r e l a t i o n to
job s a t i s f a c t i o n .
(6) To make eugt^eetions to improve the prevai l ing conditions*
Limitat ions of the Study
(1) The stiidy i s l imi ted to only 16 t r a i n i n g hoopi ta l s in
the c i t y of Greater Bombay.
(2) The conclusions drawn are based only on the wr i t ten and
the verbal responses of the var ious nursing personnel
policing in Bombay*
O) The study i s l imi t ed to the nurses who are cur ren t ly
employed in var ious categor ies in the d i f ferent
i n s t i t u t i o n s . Those who are r e t i r e d and those who have
changed the profession are not considered in the present
s tudy.
Defini t ions of the Terms
(1) Occupation ; Uha'v occupies one ' s means of f i l l i n g one ' s
time, temporazy or regular employment, business^ c a l l i n g ,
pursui t • cj
(2) Career : Courses)of progress through l i f e . What one
intends mainly, one ' s professional advancement and
success in l i f e *
29
(5) Perceptions t A vi«w of performance of eelf or others*
past or presentt relative to an idealized aoxm.
In the following chapter review; of related literatare
is discussed in detail*
»•»