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&lth 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 «

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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*

»•»