Chapter 44: Nursing

Introduction

It hardly needs any emphasis that the nursing profession is a very important component of the health care system of a country. They tend the sick and the injured using procedures that require education and training. They work in hospitals, nursing homes, clinics and homes. They not only nurse the sick but also educate the patients about preventive care. Florence Nightingale (1820-1920), the daughter of a wealthy British family, dedicated her life to improving conditions within hospitals beginning in an army hospital during the Cremean War. She was called “Lady with the Lamp”, because she walked the halls of the hospital with a lamp in her hand. The light carried came to mean care of sick. She is thus considered the founder of the nursing profession and epitomises the ideal nurse.

Educational Opportunities

Nursing education is available at six levels:

1.  Auxiliary Nurse Midwife (ANM)/Multipurpose Health Worker (MHW) Courses;

2.  Diploma Courses in General Nursing and Midwifery (GNM),

3.  First Degree Courses in BSc (Nursing)-Post-Basic, Post Certiicate or Condensed;

4.  Postgraduate Courses (MSc Nursing);

5.  Research Degree Courses (M.Phil/Ph.D); and

6.  Specialised Courses.

The schools of Nursing attached to a large number of hospitals offer the ANM/MHW and GNM courses. Besides, a number of independent Schools and Nursing Colleges also offer the GNM courses. Other courses are offered only by Colleges of Nursing affiliated to universities. The Indian Nursing Council is the regulatory authority for nursing education. Qualified nurses are also required to register themselves with the council. Students must ensure that they are seeking admission to institutions that are approved by the Council.

In many institutions stipends are given to selected students on condition that after successfully completing the programmes they would serve the concerned organisations for a specified period. While a small number of courses at the lower level are open to male candidates (Male Nurses), nursing is basically a women’s profession. Today nurses constitute the largest single group of female health workers in world. One of the basic requirements for first entry is that the candidates should either be unmarried or widows, legally separated or divorcees without encumbrances.

ANM/MHW Courses

The eligibility requirement for admission to the courses of 18 months duration is a pass in Class 10 examination. Admissions are generally based on the results of the Class 10 examination.

GNM Courses

The three-year diploma courses are open to candidates who have passed the 10+2 examination preferably in the science stream. The entry age limit is generally 17-24 years. In some States admissions are made on the basis of the results of the 10+2 examinations, while some others States conduct entrance test. Candidates possessing the Diploma can acquire BSc (Nursing) degree provided they fulfil certain specified conditions.

First Degree Courses

There are two categories of courses leading to the award of (1) B.Sc (Nursing), B Nursing or BSc (Hons) Nursing of four-year duration and (2) BSc (Nursing)-Post-Basic, Post-Certificate or Condensed of two-year duration. The four-year course is open to candidates who have passed the 10+2 examination in the science stream with biological science. Many universities insist on 45-55% aggregate marks as one of the eligibility requirements. The minimum age should be 17 years. Admissions are generally based on entrance tests.

The course is offered by over 80 Colleges of Nursing affiliated to universities. Kerala University offers a unique BSc (Nursing) course in Ayurveda. More than 60% of the Colleges are located in Tamil Nadu (31) and Karnataka (23). While the admissions are by and large restricted to candidates domiciled in the concerned States. 14 Colleges admit students on an all-India basis ( Annexure 1).

The two-year programes are offered by over 21 colleges. They are open to candidates who have passed the 10+2 examination, and possess GNM qualification. They should also be registered “A” grade nurse with 2-5 years of experience.

Postgraduate Courses

MSc (Nursing) or M Nursing courses of two-year duration are offered by 18 colleges ( Annexure 2). The eligibility requirement is BSc (Nursing) degree with experience. The areas of specialisation include Medical Surgical Nursing, Community Health Nursing, Psychiatric Nursing, Mental Health Nursing, Maternity & Child Health Nursing, Paediatric Nursing.

Research Degree Courses

M.Phil and Ph.D courses are offered by the following colleges: (1) Rajkumari Amrit Kaur College of Nursing-M.Phil; (2) Manipal Academy of Higher Education, College of Nursing-M.Phil and Ph.D; (3) SNDT Women’s University, Leelabai Thackersey College of Nursing-Ph.D; (4) Institute of Health Sciences (Mangalore-575013)-PhD. The eligibility requirement is MSc (Nursing).

Specialised Courses

A small number of specialised courses are offered by several colleges. They are open to candidates holding BSc (Nursing) degree while some others to Diploma holders. An illustrative list of some institutions along with the courses is given in Annexure 3.

Courses Through Distance Learning Mode

The Indira Gandhi National Open University (School of Health Sciences) and the Madhya Pradesh Bhoj (Open) University (Department of Nursing and Health Sciences) offer B.Sc (Nursing) courses of three-year duration. The eligibility requirements for the IGNOU course are: (1) 10+2 with three-year diploma in General Nursing and Midwifery (GNM) with a minimum of two years experience in the profession; or (2) Tenth Class (Matriculation) or its equivalent with three-year Diploma in General Nursing and Midwifery with a minimum of five years experience in the profession. If the candidates with the above mentioned qualifications have not done Midwifery in the GNM course they must submit a Certificate of course of 6 to 9 months duration approved by the Indian Nursing Council in lieu of midwifery. There is no age bar. Selection is based on merit which takes into consideration the total marks obtained in GNM and working experience.

Other Courses

Four other courses are also open to qualified nurses:

1.  Tata Institute of Social Sciences (Mumbai-400088)-Diploma in Hospital Administration (Part-time) open to B.Sc (Nursing) degree holders;

2.  Rajkumari Amrit Kaur College of Nursing, New (Delhi-110024)-Diploma in Nursing Education and Administration;

3.  Rajendra Medical College, College of Nursing (Ranchi-834009)-Diploma in Nursing Education and Administration; and

4.  All India Institute of Hygiene and Public Health (Calcutta-700073)-Certificate in Public Health Nursing Supervision.

Career Opportunities

The demand for qualified and skilled nurses never diminishes but continues to grow with the expansion of health care facilities. Apart from jobs in hospitals, clinics, nursing homes, orphanages, old age homes, there is also scope for private practice. With the expansion of educational and training institutions in nursing, the demand for teachers is also increasing. Nurses spend much of their time on their feet, either walking or standing. Nursing is also an emotionally demanding job, involving long and strenuous working hours. They are often exposed to health hazards. In many organisations the salary levels are very low. For those who feel that caring for the sick and disabled is the motto in life, they will find the profession satisfactory and more often than not financially rewarding as well.