nursing seminar teheran, 9-19 november 1966

NURSING SEMINAR

TEHERAN, 9-19 NOVEMBER 1966

WORLD HEALTH ORGANIZATION

EASTERN MEDITERRANEAN REGION

WORLD HEALTH ORGANIZATION -, Regional Office for the Eastern Mediterranean

REPORT ON 'IHE NURSING SEMINAR

Teheran, Iran

9 November - 19 November 1966

Ei'Il/NURS./149 EMRO 0107

FEBRUARY 1968

ENGLISH ONLY

Participants and Observers who attended the Regional Nursing Seminar held in Teheran, Iran, 9 -19 Novem ber 1966

Received in audience by H.I.M. the Empress Farah of Iran

The views expressed in this report do not necessarily reflect the official policy of the World Health Organ~zat~on.

This document has been prepared by the WHO Reg~onal Office for the Eastern Mediterranean for Governments of Member States in the Region and for those who participated in the Seminar. A lim~ted number of copies is available on request for persons officially or professionally concerned with the field of nursing.

WHO EMRO

INTRODUCTION

CHAPTER I

CHAPIER II

CHAPTER III

CHAPIER IV

CLOSING SESSION

ACKNOWLEDGEMENT

ANNEX I

ANNEX II

ANNEX III

ANNEX IV

ANNEX V

EM/NURs./l49 page i

TABLE OF CONTENTS

· ....... " " . " ... " ". . ............. " ....... , .. . THE NURSING SITUATION IN THE REGION ••••••••••

~ 1

5

SrnIMARY OF PRESENTATIONS AND GROUP DISCUSSIONS 13

1. Nursing: Its Nature and the Needs of this Region ..... """"""""" .......... " •• " •..• ,,.. 13

2. The Achievement of Understanding, Cooperation and A Desirable Working Relationshlp Between Nursing Service and Nurs~ng Education •••.•••.•.•••.•.••••.•• 17

3. The Criteria for Suitable Field Practice Areas for the Education of Nursing Students ."".,," to • • • • • • • • • • • • • • • • • • • • • • • • • 23

4. The Responsibilities of the Hospital Auxiliary and Institutional Services for Meeting the Criteria ••••.••••••••••••••• 31

5. The Role of the Nursing and Other Professional Staff in Meeting the Criteria for SUltable Practice Areas for the Education of Nursing Students ••••••••••••• 39

SUMMARY OF RECOMMENDATIONS 41

EVALUATION OF THE SEMINAR AND SUGGESTIONS FOR FUTtJRE SE1JIllJ'ARS ••••••••••••••••• "............ 43

• ••••••••••••• .s ••••••••••••••••• " •••••••••••••

• ••••••••••••• a " ••••••••••••••••••••••••••••••

AGENDA

LIST OF PARTICIPANTS, OBSERVERS AND WHO SECRETARIAT

OFFICERS OF '!HE SEMINAR

LIST OF DOCUMENTS

ORGANIZATION OF '!HE SEMINAR

47

50

WHO EI>1RO

INTRODUC1'ION

E}II/NURS./l49 page 1

The second WFO Hursing SeJTIlnar ~n the Eastern Mediterranean RegiDn

\-las held in Teheran, Iran, from 9 - 19 November 1966 in cooperat~on

wi th the Goverl1!:lent of Iran. The~e were twenty-eight participants

from Afgh~stan, Cyprus, Ethiopia, lran, Iraq, Jordan, Kuwa~t, Lebanon,

Pakistan, Somalia, Sudan, Syr~an Al'ab RepubliC, Tunis~a and the U=ted

Arab Republic. In add~tion there were twelve observers from the host

country, two observers from United Nations Organizations, three observers

from other organizat~ons, and the Resource Group which consisted of the

five members of the Regional Panel of Nurses, f~ve World Health Organization

nurse educators, Mr. Khosrow Madidi, Director, Pahlavi Hospital, University

of Teheran, Dr. G. Rifka, Pubhc Health Administrator, WHO Regional Office

for the Eastern Mediterranean, M~ss Evelyn Matheson, Regional Nursing

Adviser and Miss Margaret D, McLean, WHO Special Seminar Consultant.

The central objective of the seminar was "to strengthen and improve

the learning exper~ences afforded the nurs~ng student ~n the field

practice areas."

Contributory object~ VI'S "Iere:

(i) To promote better understanding of the relationship between

nursing education and nurs~ng service;

(ii) To ach~eve ~ncreased understa.nd~ng of the necessity of full

cooperation between nurs~ng service and nursing education;

(11i) To determine factors ~n the field practice areas which

influence student le~ng.

(iv) To define the req~rements necessary fop meaningful lear=ng

in the field practice areas;

EMjNuRs./149 page 2

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(v) To determlne the ways in which nurse educators and nurslng

serVlce personnel can work together towards the effective

educatlon of students In the field practice areas.

The maln topics for the presentations and study group sessions were:

1. Nurslng: It's Nature and the Needs of thlS ReGlon.

2. The Relatlonshlp Between Nurslng Educatlon and NurSlng Services.

3. The Achievement of Understanding and Cooperation between Nursing

Servlce and Nursing Educatlon Personnel.

4. The Crlteria for Suitable Fleld Practice Areas for the Educatlon

of Nursing Students in relatlon to:

a. The organlzation and administration of nursing and

other instltutlDnal servlcesi

b. Personnel;

c. Physical facilities;

d. Equipment and supplies.

5. The Responslbllities of the Auxillary and Institutional Servlces

in Meetlng the Crlteria.

6. The Role of the Nurslng and other Professional Servlce Staff In

the Educatlon of Nurslng Students in the Fleld Practice Areas.

At the inaugural sesslon, Hls Excellency Dr. M. Shahgholi, Minister of

Publlc Health, Imperlal Iranian Mlnlstry of Public Health, His Excellency,

Dr. J. Saleh, Chancellor, University of Teheran, and Dr. A. H. Taba,

Regional Director for the Eastern Mediterranean Region of the World Health

OrganlZatlon addressed the meetlng. Hls Excellency Dr. M. Shahgholi

discussed the changes In mediclne and nurslng In the Region since the first

re~onal seminar in 1960. He emphasized that the primary purpose of

the Semlnar was to provlde an opportunlty for nurse educators and nursing

services adminlstrators to study together the improvement of the education

of nursing students as related to all of the fields in whlch these studen~

WHO EMRO

receive their practical experiences.

EM/NURS./l49 page 3

He expressed the wish that the

participants would find better ways for nurs~ng to achieve its sc~entific

objectives and its human~tar~an ends. fus Excellency Dr. J. Saleh

gave a brief history of nursing ~n Iran during the past thirty years.

He pointed out that pat~ents are benefiting from advances in medicine

but that at the same t~me they are receiving less personal care from

health personnel. He emphasized that patients st~ll need reassurance,

relief, sympathy and solace and that nurses must supply these. He went

on to say that although nurses with degrees, cl~ical nursing specialists,

qualified nurses and ass~stant nurses are needed in larger numbers,

quality must not be sacr~ficed to quantity. Dr. Taba then addressed the

assembly. After thanking the Government of Iran for welcoming the

Seminar to Iran and for their cooperatwn in the planning of the Seminar,

Dr. Taba pointed out that the agenda of the seminar was planned to

stimulate thought and discussion on the field practice areas for the

education of nursing stUdents. He expressed the hope that the recornmend-

ations of the seminar would lead to the provision of nursing best designed

to meet the needs of the peoples of the Region, in the promotion and

restoration of health and in the prevention of disease.

FJ!!/NTJBB./149 page 4

EMRO WHO

WHO EMRO EM/NURS./149 page 5

CHAPTER I

THE AURS1NG SITUATION IN '!HE REGION

Six years ago, at the t~me of the first Reg~ona1 Nursing Seminar

in Lahore, West Pald::;tan, it was stated that among the weaknesses and

inadequacies impeding T~e progress of nurs~ng in this Region were the

"insufficient numbers of quahfied teaching and adm~nistrative staff;

inadequate cl~nical and f~eld facil~t~es for productive learning; lack

of underst~ng by professional workers and the publ~c about nurs~ng;

the dearth of literature ••• wr~tten by nurses for nurses; outdated 1 nurse practice acts or the abeence of an act altogether ll

•

The participants at th~s Seminar concluded that, if professional

nurses were to make a significant contribut~on to the development and

strengthe~ng of the health situation and serv~ces of this Region,

cons~stent effort on their part was essential. They envisaged that

necessary for the attainment of this contribut~on were:2

1

- the estabhshment or strengthening of nursing dHisions wi thin M~~str~es of Health;

- the establ~shment of reg~stration of nurses and legislation for nurs~ng;

- the formation of nat~onal nurses' association~with the goal of membership in the International Counc~l of Nurses;

- the organizat~on of ndt~onal nurs~ng seminars or meet~ngs;

- the constant evaluat~on, review and improvement of nursing education programmes, des~gned to provide nurs~ care and attention based on the health needs of the nation;

Jeanette A. P~tcherella and A. Dorothy Potts. Development of Nursing in the Eastern Me~terranean Region of the World Health Or anization Alexandria: EM NUBS. SEM. 21, 5 November 1960. p. 7

~orld Health Organ~zation Reg~onal Off~ce for the Eastern Mediterranean. Nursing Seminar, Lahore, Pakistan, 23 November - 3 December 1960. Final Report. Allexanc.ria: 1961, p.31

EM/NURS./149 page 6

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- the establishment of a regional programme by the World Health Organization for post-bas~c preparat~on ~n nurs~ng education;

- the establ~shment by the World Health Org~zat~on, at the reg~onal level, of refresher courses for nursing personnel w~th many years of serv~ce to the~r credit.

How well have been overcome, ~n the past s~ years, the weaknesses

and ~nadequacies impedinG the progress of nurs~ ~n this Reg~on? How

significant has been the contribution of profess~onal nurses to the

health of this Region? How many of the env~saged necessary developments

have taken place?

present time?

What is the nurs1ng s~tuation 1n the Region at the

Whereas many of the nurs~ng resources, needs and problems are similar

~ the twenty countries of the Region, there is not a s~ngle "nurs~ng

situation" but rather many "nursing situations" in a region in which

countries vary so much 1n their socio-economic development, their geography

and their human and phys~cal assets and potential.

There is great divers~ty 1n the preparat10n and act~vit1es of nurses

in this Region today.

The first graduate of the Higher Inst~tute of Nursing, University

of Alexandr~a, to rece~ve a doctoral degree, returned to the faculty of

this programme in November 1965; at the same time, plans were being

made in Dammam, Saudi Arab1a, to replace the on-the-Job tra~ning which

had been g~ven to-date by an organized educat10nal programme for aux1l~ary

nursing students.

The future nurses of Yemen are rece~v~ng an e1ghteen-month programme

of nursing studies, follow~ng a s~-month course which ass~sts them to

become adequately literate in the Arabic language; selected students

are undertaking bas~c nurS1ng stud1es lead1ng to a bachelor's deGree 1n nursing

in Iran, Iraq, the Lebanon and the United Arab Republic.

In Tunisia, the graduates of the two-year basic nurs1ng educat~on

programmes are afforded a year's post-basic course which qualifies them

WHO ENRO EM/NURS./149 page 7

to assu~e pos~tions as nurs~ng ~~strators or educators; in Iran,

plans are being made to establ~sh a two-year univers~ty-level programme

for graduates of the three-year diploma schools, which w~ll provide for

specializat~on ~n clinical nurs~ng specialities, in nursing services

admin~strat~on and ~n nursing educat~on, and will lead to the granting

of a bachelor's degree.

In certain of the Reg~onal countr~es, special and simple in-service

courses are provided to prepare otherw~se untrained workers to function

as "nurs~ng personnel II in rural heal th, tuberculos~s and communicable

eye disease programmes; in others, nurses trained to the auxiliary level

only are carrying out functions, and accepting responsibilities, which

by r~ght belong to the medical irofess~on; ~n many areas, professional

nurses are spending much of their time in messenger, clerk and reception

ist activities.

In recent years, nurses have functioned in this Region as consultants

w~th national health planning projects and as advisers ~ other top-level

nat~onal health programme activities; during this same period, nurses

have been designated and treated as health or medical auxiliaries, with

:1:) provJ.sion made for a voice in the planning and conduct of even the

nursing programmes.

In the SUdan, after more than ten years of WHO assistance, the

programme of the Khartoum Nurs~g College is under the sole administration

and direct~on of qual~fied national nurse educators, and there are but two

WHO nurses assisting with the development of the nurs~ng services of the

oountry; in Libya, the Organization is assisting with two schools of

nursing, plans to ass~st with the development of a third, and there are

at present t~rteen WHO nurses partic~pating ~n the development of these

and other health programmes, with prov~sion for the assignment of nine

additional WHO nurses.

E1!t/NURS. /149 page 8

WHO F}l]RO

The divers1ty that exists in the Region today does not mean that

nurses have not bcen playing an appropriate and significant role in the

development and improvement of the health of their countr1es. Rather,

it 1S an indication of the many "faces" that nursing presents to its

public and emphasizes the many factors to be consldered in relation to

the "nursing Sl tua tlon ln tne Region".

Probably the most signlficant factors ln the contlllued progress

made by nursing in this Reglon during the past few years have been the

increaslng acceptance of lt as a career and the lncreasing recognition

of ltS importan~ role ln the health and health services of the nation.

To no little extent, the acceptance and recognition have been based on

the quality of the nursing serVlces rendered, the nursing education

programmes afforded and the courage and determination of the Region's

nursing leaders. However, to a greater extent, these have been based

on the continued emancipatlon of women throughout the Region, the con

comitant recognitlon and demand that women must play an active role in

the public life of developlng societies, and the increased support given

by Governments to nurslng.

The emphasl~ rylq~ed 0n developing and strengthening programmes for

the education and training of nurslng personnel, at the basic and post

basic levels and of the professional and auxiliary categories, has in

creased unquestionably the quantity and quality of nursing services

ava1lable in tne countr1es of thls Reg:l.On. However, in view of the

rapidly expandlng and increaslngly nore speciallzed national health

servlces,have the quant1ty and quality increased sufficiently?

It lS suggested that assessment of the nursing servlces of any of

the Region's countries does not reflect the lllterest and lmportance whioh

have been placed on nursing education and training and that there remains

much to do to provide for the quantlty, varlety and quality desired and

desirable.

WHO EMRO EM,/NURs./149 page 9

There ~s conttnu~d need ~ this Region to further expand and improve

the theoret~~al and pna~tical aspects of the nursing education programmes,

for the betterment; 01:' t''1e n 'r:,nn3; serv~ces provided.

Increased em}L.~s} s has been placed on the nurs~ng services and on

nurs~ng serv~ce', &~w·.' .3tro.tjon dUl'ing the past few years. The nurses

of Cyprus have . III ~jate0 spec' al at'tivi t~es U1 this respect and the

Government of l<u'u.i" hove requested consul tant serv~ces in assess~ng and

advising on the~~ nUl's~ng servcce pol~c~es, personnel and standards.

This emphas~s h?s also been seen in the appointment to schools of

nursing, in J.l'aQ, ';ordan, Libya, the Un~ted Arab Republic and else1fhere,

of nurse educacors qual~f~ed in nursing services admi~stration.

Further, the awareness of the Reg~onal Panel of Nurses of the pressing

need for ~mprovement in respect to the nurs~ng services led to the provi

sion of the opportunity to d~scuss, at the second Regional Nursing

Seminar, the mutual ~nterests and act~vities of nurs~ng administrators

and educators wh~ch are d~rected towards the imprOVement of the health

of the nation and of the preparation of nursing students to help meet the

health needs of t~e2r people.

When cons ... ' ... "," a v ... Ull ... " <>.l. voll to what tne par-::'~cipants at the Nurs~ng

Seminar in Lahore in 1960 envisaged as being necessary accomplishments

if profess~onal nurses were to play sign~ficant and appropriate roles ~n

the health programmes of their countries, it would appear that the nurses

of this Region have fallen far short of making this contribution. There

has been l~ttle s~gnif~cant increase ~n, or strencthen1ne of, national

nurses associat~ons-~"d nurslnc d~v~sions within Ministries.of Health.

The process of establ~Ehin6 registratjon of nurses and legislation for

nursing in the Reg~onal countries has yet to galn momentum. The World

Health Organizatlon has not established regional programmes for post-basic

preparatlon in nursing educatlon or refresher courses for nursing

EM/NURS./149 page 10

WHO EMRO

personnel with a long record of serVlce. There have not been the

number of national nursing seminars and meetlngs whlch would have

proVlded for adequate review, evaluation and improvement of both

nursing educatlon and serVlces. Required are sound and effective

proposals for better meetlng the objectlves of nursing and nurses In

thls Region in the future.

The revlews presented at the Semlnar, of the nurSlng situatlon In

each of the fourteen countrles represented, showed that there have been

noteworthy accompllshments durlng the past six years but the tasks still

confrontlng the nurses of this part of the world were clearly lndicated.

A summary of the statlstics presented revealed that:

1. In all fourteen countries there appears to be a shortage of

quallfied nurses, lncluding nurse-teachers.

2. All but one country appear to have lnsufflcient funds for

nursing programmes.

3. Three countries only have leglslation for nurslng.

4. Six countries have natlonal nurses assoclations, flve of

these having membershlp In the International Council of

Nurses.

5. Flve countries have a Nursing Councilor Board which is

responsible for the admlnlstration of examlnations and the

reglstratlon of nursing personnel on completlon of baslc

studles.

6. There are nurses functlonlng at the Central level of the

Minlstries of Health of sIx of the countrles. In another

country, a senior nurse admlnistrator acts in an advisory

capaclty to the central health admlnistration, when re

quested to do so.

WHO EMFD EMjNuRs./149 page 11

7. The number of ~ategor~es of tr~ned personnel in the

fourteen countr~es varies f~om one to six. In addition,

there are untral~ec a~des or servants working within

the nurs:'L!g systeTJ :in most, if not all, of the countries.

8. Four countrlSG nave educational programmes in nursing

leading to a bachelor's degree. One country reported

plans for the establishment of a master's degree programme.

9. For th8 most part, there is provis~on for training in m1d-

wifery follOi'ling basic nur~ng studies. Post-basic educa-

tion in ward administratlon, in teaching and supervision

and in public health nursing is provided in certain

countries. Training in anaesthesiology and operating

theatre technique is provided for graduate nurses in

several countries.

It was interesting to note that one country only mentioned that the

utilization of nursing personnel and the ~nadequacy of physical facili-

ties presented problems. '!his same country was the only one to report

the need for better qualifled personnel in the nursing service department.

No mention was made in thp presentat~ons of lack of support from the

other professional, the auxiliary and the ~nstitutional services. Only

one country reported that the shortage of reference material in the mother

tongue was a problem.

The maJor objec~ves of nursing, as brought out in the presentations,

were:

1. Improvement of field practlce areas, with the goal of

improving nursing care and attention.

2. Increase of L1ursing services in rural areas.

3. Provision of staff education.

4. Improvement of the position of nursing in the country.

EMjNuRs./149 page 12

WHO EMRO

CHAPI'ER II


SUMMARY OF PRESENTATIONS AND GROUP DISCUSSIONS

1. NURSING: ITS NATURE AND THE NEEDS OF THIS REGION

Mr. A. Daly Mrs. E.I. Kamel Mrs. L.I. Kamel Ml.ss A.J. Musallam

Mrs. A.A. Osman Mrs. A. Sultan Mrs. A. Wolderufael Mrs. A. Zalat

Mrs. Glor1a Press - Moderator

The panel described the nature of nursing, highlighted the ~eeds

and problems existing 1n the Region and gave some suggestions for action.

The nature of nursing was described as a service to people in which

technical knowledge and sk1lls and sympathetic and compassionate caring

are combined and are based on an interest in and acceptance of the

individual patient and his family as they are.

The needs of the Region, based on the country reports, were for

addi tional and better qualified nursing personnel at all levels, addi

tional and more adequate physical faci11ties, adequate supplies and

equipment and finances. Common problems brought out in the panel dis-

cussion were a lack of understand1ng and cooperation between nursing

service and nursing education; a lack of a sense of respons1bility in

many persons who give nursing care; an inadequate level of general edu

cat10n of many of the nurs1ng students; the placing d! new graduates

in pos1tions in which the responS1bility 1S greater than that for which

they have been prepared; lack of understanding,of the role of nursing on

the part of physicians and other health professionals.

The panel members emphasized that while nursing must set lugh goals

of education and serV:1ce, a start must be made with what is available


WHO EMRO

and the situatl0n must be improved realistically. For instance,

lnstead of comniserating on the shortage of nursing personnel, it must

be ensured that the personnel avallable are being used optimumly;

lnstead of complalnlng about low budgets, the budgets available must

be utl11Zed wlsely. Panel members emphaSlzed the need to plan at

all levels; for reallstlc job descriptlons; for qualified nurses to

demonstrate the role of nursing by the excellence of the nursing care

provided; to prepare new graduates, by orlentatlon prograMmes, in-service

educatlon and short courses, for the responslbilitles they must carry.

In the small dlscussion groups and in the general discussion on

thlS tOP1C, the folloWlng aspects of the topic were studled:

1. Making more effective use of existing nursing personnel.

While the need for additional and better qualifled nurse teachers,

adminlstrators and practitioners and for additional assistant nurses

is great, all particlpants emphaslzed the importance of USlng all exist-

lng nursing personnel optimumly.

the better utilization of nurses:

A number of ways were suggested for

a. Better selectl0n of students: thls should be done by

selectlng students who are lnterested in people and in

helping people, Wlth an aptitude for nurslng and Wlth

a level of general educatlon that wll1 permit them to

be successful in the educational progr~~e.

b. The conduct of a survey of eXlsting nursing personnel,

to determ1ne the numbers of fully quallfied and

auxiliary nur~es. As a result, a number of nurses

might be located who could work part-time and facts

would be known on which to base refresher and post

basic courses whlch would lncrease the competence of

nursing personnel.

WID EMRO ElIljNuRs./149 page 15

c. The preparat~on of Job descriptions, which would delineate

the nursing act~vit~es of all levels of nursing personnel.

d. The removal of non-nursing actIvities from nurs~ service.

e.

Suggestions of ways to do th~s ~ncluded the employment

of ward secretar~es and the preparat~on of enough technicians

for radiology, cli~cal laboratory and similar activit~es.

Better placewent of new graduates, The new graduate should

be placed in a staff nurse pos~tion for one year before she

becomes a head nurse, instructor or director of nursing.

If this is not poss~ble, the new graduate should be helped

to carry out the respons~bil~t~es of administration or

teaching by a good orientation and through in-service

education, after a short concentrated course in teaching

or administrat~on.

f. Salaries based on qualificat~ons and ab~l~ty, with increments

given for excellence of performance as well as length of

service.

g. Due recognition to nurses who have given long service but

who have not had the opportunity for formal advanced

preparation.

2. The effective presentat~on of nursing to other professional

health workers, the public and personnel of related social agencies.

It was believed that th~s could best be done by:

a. qualif~ed nurses demonstrating that they are a well

prepared profess~onal group, giving an excellent and

needed service to people.

b. a Division of Nursing be~ng established in Ministries of

Health.

c. a Nursing Council being established in each country.

EM/NURS ./149 page 16

WHO EloffiO

3. The close collaboration of nursing serv~ce and nursing educat~on,

to improve the nurs1ng care of patlents and the clinical experiences of

nursing students in field practice areas.

4. The establishment of post-basic programmes which will enable

qualified nurses to become cl~ical nursing special~sts, teachers and

administrators.

WHO EMRD EM/NURS. /149 page 17

2. THE ACHIE\TEMF",'IT' OF UNDERSTANDING, COOPERATION AND A DESIRABLE

WOruaNG RELATIONSHIP BE'IWEEN NURSING SERVICE AND NURSING

EDUCATION

There were two panel presentations on th~s topic.

1. The Relationsh~p between Education and Service ~n Nursing:

Mr. G. Avraam M~ss F. D~narband M~ss R. McEwan Mrs. K. Mowla Mrs. W.R. Shaya

Mrs. N.A. Roboobi - Moderator

2. The Ach~evement of Understanding and Cooperation between

Nursing Service and Nursing Education Personnel:

Miss B. Amiri Miss K.N.A. Jal~l Miss E. Mitchell Miss A.S. Sa'ad Miss B.M. Saad

Mrs. F. Salsal~ - Moderator

Both panel presentat~ons used role-playing to bring out the points

whiob were considered to be important in achieving understanding, cooper

ation and an effective work~ng relation~p between nurs~ng education

and nursing service.

goals:

The following were suggested to achieve the desired

1. Mutual understanding and compatib~l~ty in respect to

philosophy, object~ves, programmes, responsib~l~ties

and problems. This could be achieved by nursing

service and nursing education personnel meeting to

gether regularly to keep abreast with each other's

programmes.

2. .Cooperation in setting up nurslllg procedures and policies,

in planning the clinical experience of nursing students,


WHO FlIIRO

and ~n solv~ng problems, Both the nursing students

and the nUls~~g u~~t personnel should be prepared for

the students' fiel~ p~actice befo~e lt begins. All

must understanu the purpose and content of the cl~n~cal

expe~ience ln the f:teld oractlGe area if ~t ~s to

provlde m~alllng[ul learnlr-g ~or the students.

Partlcipation III each other's programmes. Quahfled

nurses lD tne nursing serv~ce department could part~cipate

La the formal teachlng programme by demonstrating a

procedure or an aspect of nurslng care ~n wh~ch they have

SpeClal competence. In a simllar manner, the instructor

could help or support the head nurse ~n the provision of

nursing serv~ce to pat~ents.

4. Both nurs~ng education and nurs~ng serv~ce personnel should

set a bood example for the nurSlng student. They should

demonstrate deslrable attitudes towards patients, respect

for author~tYI profess~onal conduct and good nursing care.

In the small group d~scussions, the follow~ng aspects of the topic

were studied"

1. How to develop a prac~~cal plan for nurs~ng students' exPerience

in a field prdct~ce area. The steps to be kept in mind in

plannLng were cD~sidered to be:

a. To deflne what the qual~f~ed nurse needs to know and be

able to do.

b. To determ~ne the learn~ng exper~ences necessary to pro

duce this nurse.

c. To consult with the author~tles in each field practice

area on:

i. Phys~cal facil~t~es - clinical, llbrary, etc.

WHO EMRO Ji1IljNuRs • /149 page 19

ii. Transportation to the field practice area.

iii. Student health serv~ces.

iv. Student disc~pl~e and supervision.

v. Procedure and pol~cy manuals.

vi. Kinds of assignments ava~lable.

d. To prepare students for the experience through assisting

them to an understand~ng of:

~. Nursing and hospital ethics.

ii. Desirable behaviour.

~~i. Interpersonal relat~onships in nursing.

iv. Economy of t~rne. effort, material and money.

e. To plan for the evaluation of student performance, with

nurs~ng service personnel participating ~n this.

f. To provide for regular meetings of nursing education and

nursing serv~ce personnel; to identify and discuss

problems, to seek for the~r solut~on and to evaluate the

experiences afforded students.

2. How nurs~ng students and nursing serv~ce personnel can he~helped to

develop an understand~ng of comprehens~ve nursing care.

The groups def~ned comprehens~ve nurs~Db care to be that which meets

the physical and psychosocial nursing needs of patients and suggested the

following ways to help nursing students and nursing service personnel to

develop this concept:

a. The f~rst part of the curr~culurn should ~nclude study of'

normal growth and development and human behaviour and

should emphasize nurs~ng ethics. To acquire the

necessary understanding, the student should be in con

tact with people and patients early in her educational

experience.

m/NURS./149 page 20

b.

WHO EMRO

student-patient asslgnments should be long enough

to enable the student to know the patient as a

person, to know his health probl~~s, his nurS1Dg needs

and the nurslng care reqU1red.

c. Quallfied nurses should partlcipate In glving nurslng

care to patlents 1n o~e~ to demonstrate to students

comprehenslve care and effectlve nurse-patlent

relatlonsmps. The Job descriptl0n of a staff nurse

must lnclude the givlng of nurslng care to patients.

d. The non-nurslng activltles carrled out by nurses

should be re-allocated to ward secretaries and train-

ed persons in other depart~ents.

e. In-servlce educatlon should be established for all

nursing personnel.

f. There should be standardization of nursing procedures

In the school and fleld practlce area.

g. Adequate equipment and supplies should be provlded.

3. How to develop good interpersonal relationsmps between nurslng

service and nurslng education.

The followlng Means of achleving thlS were suggested:

a. Knowledge and understanding of the pmlosophies of both

serVlce and education.

b. Orientation of all personnel, both service and educatl0n.

An organizational chart could be used to explaln lines

of authority ~~d channels of communicatl0n witmn the

serVlce organization.

c. Study of work situatl0n so that people and t1me can be

better used.

d. Better teaching of students ln psychology, human

relationships and communlcatlon skills.

WHO EMRO

e.


The subjects ment~oned ~mmediately above should

also be included in staff educational programmes

and refresher courses for nursing service personnel.

4. How to ensure that standards and procedures in field pract~ce

areas are compatible w~th those used ~n the school.

The groups believed standard~zed procedures ~n field practioe areas

were important to student learn1ng and suggested:

a. A committee of head nurses, staff nurses and

instruotors to draw up nursing procedures.

b. The use of establ~shed nursing procedures by

all nursing service personnel.

c. That nursing students should be helped to adapt

prooedures, while maintaining scient~fic principles,

if all necessary equipment is not available.

5. The value of gu~ded experience in rural areas for nursing

students.

There was consensus that experience in a rural health agency would

be valuable for senior nursing stUdents as it would give them a better

knowledge of the heal t.h needs of the country.

6. The developMent and ~mplementat~on of in-service education

for nursing service personnel.

There should be planned in-service education for all levels of

nursing personnel. Th~s should be planned ~n the light of the learning

needs of personnel, the obJectives of the nursL~g service department and

the nurs~ needs of pat~ents. It would ~nclude orientation, on-the-job

training in skills, specif~c programmes of instruction and staff develop-

ment for all personnel. Programmes could be of two types: one

conducted on topics of interest to all personnel ~n a single category;

the second planned and carr~ed out for all nursing personnel in a single

EM/NURS./l49 page 22

WHO EMRO

unit. Although it is difficult to find t1me for staff education, the

groups stressed that the quieter periods of the day should be used and

activities could be repeated so that all day, eVening and night staff

could attend. It was emphas1zed that it is imperative to start in-service

education, however simple and limited, as it is one of the most effective

methods of helping personnel to improve their performance.

WHO EMRO EM,/NURs./149 page 23

3. THE CRITERIA !'DR SUITABLE FIELD PRACTICE AREAS FOR 'lHE EDUCATION OF

NURSING STUDENTS

Mrs. A.J. Anton lv'JI's. N.M.H. El Hagrassy Mrs. L. Kamel Mrs. G. Mirkamal1

MJ.ss E. MJ. tchell fiJI's. F. Moustafa f.lrs. N.S. Nureddin Miss A. Riahi

Miss R.D. Hill - Moderator

The panel presented seven essential criteria for field practJ.ce

areas:

1. A well organized field practice area, with a philosophy

compatible with that of the school.

Lines of authority and channels of communication should be clearly

defined and understood by all. There must be agreement upon the areas

of responsibility of nursing service and nursing education. Ideally,

the administration should be democratic, as students learn better in a

democratJ.c atmosphere.

2. An adequate number of qualified staff in both service and

nursing education.

It was agreed that there should be qualified nursing service personnel in

numb~_s~fficient so that nursing students could see GOod nursing care

being given. There should be a sufficient number of competent teachers

to supervise the nursing students in all of their field practice experiences

- on days t evenings and nights. The ratio of instructors to students would

vary depending upon the year of the programme in whJ.ch are the students.

If there are not enough teachers to guide all students having experience

at night, an instructor should deflnitely be with students durfne;

the first of such experiences. Selected, coopetent qualified nur~es

on the nursing service~staff can~participate ~ the eoparviston of

nursing students' field practice, ±f necessary.

m/NURS. /149 page 24

WHO EMRO

3. Good worLing relationships between nursing education and

nursing service personnel.

This relat1ons~p must be based on mutual understand1ng and respect.

It can be built if plann1ng for student exper1ence, problem solv~ and

evaluation of student and programme are done together and 1f all levels

of nursing service and nursing education personnel have good communacat1ons

with each other. W1thou~ good interpersonal relationships between all

concerned, no field pract1ce area can be cons1dered a good place for

student learn1ng.

4. Suff1c1ent var1ety, quantity and qua11ty of experience.

There should be various areas in wh1Ch the student may practice, to

ensure a broad education but with t1me enough in each for learn1ng to

take place. Experience must be provided 1n normal growth and develop-

ment, and 1n prevent1ve, curat1ve, rehabilitative and social health

serVices, 1n order that the student be well prepared for her role as a

nurse. Pract1ce areas should be the best available but opportunity

should be given for stUdents to apply bas1c principles 1n less than ideal

s1tuations. The ava11able pract1ce areas May not meet the cr1ter1a

but they can be usee 1n the best poss1ble way, while action is being

taken to improve theM.

5. Accessib1:1ty of f1eld practice areas.

Considerable emphasis 1s placed by many scnools on the field prac-

t1ce areas be1ng 1U close proxim1ty to the school. It was agreed that

the maJor field practice experiences must be afforded in areas close to

the school but that spec1al experiencns such as obstetric, paediatriC,

psych1atr1c and publ1c health nurs1ng could be provided farther away,

if transportation 1S re11able and/or supervfsed liv1ng accommodation

available .. If all the essent.l.t,l f1eld practice areas are not

WHO EJI1PD EMjNuRs./149 page 25

available then a school should not contlnue its programme or the curriculum

should be approprlately modified.

6. Adequate supplies, eqU1pment and physlcal facillties.

Sufficlent supplles and equipment should be available for the nurslng

students to give good nursing care and to enable them to observe nursing

service personnel doing so. The supplies and equipment provided for

nursing students should not be atYPlcal for the institution or tbe country.

A library and conference room are deslrable but, if non-exlstent, some

reference material should be provlded and some place found where nurs~g

students can have nurslng care conferences.

7. Standardized nursing procedures.

The nursing procedures used in the field practice area should be

the same as those taught in the school. The procedures should be drawn

up by a committee of nursing serVlce and nursing education personnel

and will need periodic revision. The procedures should be written in

the mother tongue and easily accesslble to all persons giving nurslng

care.

The small study groups discussed the following aspects of the

topic;

1. An adequate number of quallfled staff in both nursing service

and nursing educatlon.

The groups agreed thnt lt was difficult to decide how many nurslng

service personnel were sufficient. It was believed that a qualified

nurse should be in charge of the fleld practice areas and that stUdies

should be undertaken in each country or acency to deelde on the

number of nurSlng personnel of each category required to give good nurs-

ing care to patlents. It was recognized that the number in each

category would vary according to patients' nursing needs. The nursing


WHO EMRO

students should be under the supervision of a qualified instructor at

all times. To meet thls goal in-service educat10n must be established.

2. How to afford experience for students in the areas of normal

growth and deve10pnent and mental health nursing.

a. Practice areas related to normal growth and developments

It was suggested that nurs1ng students could acquire an understand

ing of normal growth and development early 1n the educat10nal programme

by having guided experience in home V1S1ting, maternal and child health

centres, paediatric out-patient c11nics and wards, orphanages, nursery

schools, kindergartens and pr1mary schools. Students should not only

observe but also part1c1pate 1n the services provided for the children.

b. Mental Health Nursing:

The stUdent should be introduced to the principles and pract1ces

of mental health nursing early in her experience. The teaching of

mental health nursing should start with normal behav10ur and should be

lntegrated in all clinical nursing courses. Specif1c experiences in

psychiatr1c nurS1ng should be afforded later 1n the educational programme.

If it 1S not possible to provide such an experlence a short course on

mental illnesses and on the care of the mentally ill patients should be

included.

3. The preparat10n of a nurslng procedure book.

The s~eps in setting up a nurSlng procedure book were outl1ned as

follows:

a. Invest1gate the service area 1n relation to needs,

eqUlpment and poss1ble but safe standards of prac-

tice.

b. Form a jOlnt committee of nursing serV1ce and nurs

ing educat1on.

WHO EMRO EMjNuRs./l49 page Z7

Suggested members were: DirecGor of Nursing Service3

D~rector of Nurs~ng Education, Clinical Instructor,

Supervisor, Head Nurse, Staff Nurse.

c. Con5ul~ w1th the hospital admi~strator and medical

perso~El. as required.

d. Plan for a procedure book wb2ch would have:

all procedures, ~n alphabetical or subject order

- a standardized procedure outline:

- object~ves

- equipment necessary

- points of emphasis

- steps ~n the procedure

- after care of the patient

- after care of equipment

- recording

- loose leaf pages so that ~ndividual procedures

can be revised as necessary

- procedures written in the mother tongue and in

the language of instruction.

4. How to obta~ adequate physical facilities, supplies and

equipment.

The groups d~scussed the subJect in relation to quality, quant~ty

procurement and distr~bution and concluded that:

a. A survey of needs and resources is necessary and

based on the results of this survey, standards for

qual~ty, quantity and type of equipment and supplies

shoUld be set up.

b. Nursing should be represented on the appropriate

committees and must be able to advise on, predict

EN/NURS./l49 page 28

WHO EMRO

and Justl.fy requirements for fac~li t~es, suppl~es

and eq~pment.

c. Nurs~ng must be able to accept new ideas and be

w~lling to relinquish trad~ t~onal " jobs" and

responsibilit~es that are of a non-nursing nature.

d. A central supply room for ster~le and non-ster~le

equ~pment and suppl~es should be set up, staffed by

tra~ned, non-nurs~ng personnel who would deliver

supplies to the nursing areas and p~ck up so~led,

used supplies. If a s~ngle central supply room is

not poss~ble then a small area for storing and pre

paring supplies can be set up in each nurs~ng unit,

with a non-nurse in charge.

e. It is important to have trained hosp~tal adm~n1stra

tors with a philosophy that enables all departments

to plan the best for the patients' well-being.

f. There is a need to evaluate the cost of maintenanoe,

repa1r and renovation of old buildings and compare

th~s w~th the cost of constructing new, more func

tionally des~gned bu~l~ngs.

g. Nurs~ng administrators should be able to understand

b~ld~ng plans and ~tell~gently present and Just~fy

the needs of nursing. Although new well-designed

bu~ld~ngs w~th adequate supplies and equ~pment do not

automatically produce better patient care, they do

help good doctors and nurses to do a better job.

5. How to attain suffic~ent var~ety, quality and quant~ty of public

health nursing experience.

The groups considered the organizat~on of ~nstruct~on and field prac~

tice in public health nursing. Students need to acquire: pos~t~ve health

WHO EMRO a.1/NURS. /149 page 29

attitudes, knowledge of health programmes, a knowledge of and skill in

using community resources, skill in teaching heal til and a knowledge of

how to participate l.n planru.ng, deVeloping, improving and evaluating

health programmes.

The above could be acquired by the students ~f there is emphasis

throughout the curr~culum on the promotion and maintenance of health,

prevention of disease and accidents, rehabilitation and public health

nursing; if students have GUided experience in cJ.lnic, home vis~t1ng,

school health, well-baby, industrial and mental health progranmesj by

using the services of all health and other social agencies.


WHO EMRO

WHO :WID EM/NURS./l49 page 31

4. THE RESPONSIBILIT'! OF THE HOSPITAL AUXILIARY AND INSTITUTIONAL

SERVICES FOR MEETING THE CRITERIA FOR SUITABLE FIELD PRACTICE

AREAS:

Mrs. M. Demissie M~ss A. Goevderelian Miss F. Hargett Miss A. Nasab M~ss M.B. PoorkaJ Miss B. Saad

Miss M.D. McLean - Moderator

The panel believed that the responsib~l~ty of the Hospital Auxiliary

and Institut~onal Serv~ces for meet~ng the criteria for s~table field

pract~ce areas could be fulfilled most effectively by these services

supporting the professional care serv~ces, includ~g nursing.

Many examples of the poor ut~lization of nurses were given. Head

nurses spend a great deal of t~me on non-nursing act~vities suoh as

writ~ng requ~sit~ons for food, X-ray, laboratory, drugs and other suppl~es;

filling in ~dentifying ~nformation on patients' charts;

telephones; looking for doctors; directing visitors;

answering

acting as

messengensand s~pervis~nb and direct~ng housekeeping and dietary staff.

Qual~f~ed nurses spend time in looking for, collecting and preparing

supplies and equ~pment to g~ve nursing care; ~n cle~ng up eq~pment

after use; ~n serv~ng meals and nour~shments; in cleaning beds and

bedside tables when pat~ents are disc~'ged and mak~ up the clean bed;

in making out d~et l~sts, charting temperature, pulse and resp~ration,

counting soiled l~nen and acting as messengers. Ass~stant nursing

personnel are also poorly util~zed as in many places they carry out many

housekeeping, dietary, messenger and supply functions. In several

places qualified nurses work as laboratory and X-ray technicians. Thus,

the time available to nursing personnel for g~ving and supervising nurs

ing care is decreased by the necessity of carrying out many non-nursing

EMjNTJRS.jl49 page )2

actJ. vi t~es.

WHO EMRO

A descr~ption of the relationship of hospital services was given -

see chart on page )C(. The patl.ent is the centr~ of hospital actJ.vity.

Around the pat~ent are the profess~onal care services (A) and supporting

these are the hosp~tal auxil~ary services (B), wh~ch ex~st because the

~nstitut~on is a hospital, and the Inst~tutional Serv~ces (C) which

exist in any ~nst~tution where a grou~ of people are housed and fed.

The hospital auxil~ary and ~nst~tut~onal serv~ces should carry out their

responsibilit~es fully so that the profess~onal personnel can spend all

of the~r time on patient care. For example:

a. The Admitting Department should ~dent~fy the patient and

send his f~le ready for use, including routine requ~sit~ons,

to the nurs~ng = t.

b. Housekeeping should carry out all housekeeping activities

including clean up of discharge units and making up of

clean beds.

c. Supply departments (l~nen, central stores, ster~le supplies)

should provide supplies at the time needed in the place

needed and ~n the most usable form, on a quota basis, and

should p~ck up, decontaminate and re-process all used

suppl~es and eq~pment.

d. X-ray and the cl~n~cal laboratory work should be done by

appropr~ately tra~ned techn~cians.

e. The d~etary department should prov~de meals and nourish

ment at the pat~ent's beds~de.

f. The pha~acy should supply all medications, ~ncluding

narcot~cs and dangerous drugs, to the nursing units on

a quota system.


g. All recept~onis" and cler~cal activ~t1es should be

carried out by a ward secretary.

It was suggested that hosp~ta1 plann~ng co~ttees give consideration

to placing the follow~ng un1ts contiguous in the physical plant: receiv-

ing, central stores, laundry, central decontamination, central packaging

and ster~lizing and processed stores. ~s would allow for the function-

al operation of a completely centralized supply service. Pharmacy could

also be contiguous to the supply area. Then, sterile supplies and

equipment, housekeeping suppl~es, clean linen and stock drugs could be

delivered by the personnel of the centralized supply area and all used

supplies could be p~cked up by them. In commenting on the presenta-

tion, a hospital ad~nistrator stated his belief that low budget and

shortage of trained personnel is not as great an obstacle as the attitudes

of nurses who do not want to g~ve up non-nursing activities. He pointed

out that hospital administration expects nurses to decide on what is

nursing and what is non-nurs:mg and to make their decisions known.

The panel and the small group d~scussion members recognized 'that it

might not be poss~ble to set up a completely centralized supply system

and to remove all non-nursing act~vities from the Nursing Service

Department at once. However many excellent suggest~ons of steps to be

taken toward this object~ve were given:

a. To help the authorities and nursing persaneel to become aware

of the wastage of nurs~ng care time:

~. Outl~ne nursing act~vities.

ii. Conduct work stu~es on the activit~es of nurs~

personnel to cbta~n facts on the percentage of

total time spent on nursing act~vit~es and on non

nursing activ~t~es.

EMft/J'RS./149 WHO EMRO page 34

iii. As a demonstra~~on proJect, tra~n personnel in

onehosp~tal to carry out non-nurs~ng act~vit~es.

Study th~s s~tuat~on, before and after the re

allocat~on of non-nursing activit~es, to demon

strate the increased quant~ty and quality of

nurs~ng care received by pat~ents.

i v • Ra~se the status of the staff nurse I to emphasize

the importance of qual~fied personnel Biv~ng

nursing care to patients.

v. Demonstrate the necessity of a minimum anount

of suppl~es and equ~pment. Try to discontinue the

practice of personnel pay~ng for loss or breakage

of eq~pment so that ava~lable equipment w~ll be

used for patient care. Trust personnel to use

supplies and eq~pment well, after staff education

in its cost and proper use.

b. Interim centralization of supply activ~t~es.

i. Linen should be centralized, with laundry personnel

completely resPOns~ble for keep~ng the clean linen

supply up to the agreed upon quota, and for remov-

ing soiled linen. If laundry workers cannot do

this, housekeeping could handle the linen.

ii. Ster~le supplies - the decontam~nation, packag~ng,

ster~llzat~on. delivery of ster~le suppl~es and

the p~Ck-Up of so~led could be central~zed ~n one

area. More eq~pment would be required but the

cost of operat~on would be less and the process~ng

would be better.


i~i. Non-sterile ""ed1 C'11.1-surgj "al 'luPl"llies and sundries

could be del~ve!'ed on a quota bas~s. A conunittee

of nursjng, med~(al and pharm~cy personnel should

adv~se on purcuasing.

i v. If supply act~ vi t~es cannot be centralized in a single

uni t, they could all be p:'aced in one area of each

ward, with a non-nursE' in c.large. The best

phys~cal arrangement is one room for all clean and

ster~le supPl~es and equ~pment and one small room

for the clean up or holding of used supplies and

eq~pment, if decontamination is centralized.

v. Many partic~pants believed that a qual~fied nurse

should be ~n charge of the process~ng of sterile

supplies in this Reg~on, at least until all pro-

cedures and t~ays are standardized. Others thought

a non-nurse could be tra~ned immed~ately to super

vise the decontam~nation; packaging and steriliza

tion of supplies.

c. The activities of delivering stock medications and narcotics

on a quota basis could be the respons~b~l~ty of the pharmacy.

Stock medicatlons could be delivered by a pharmacy employee

and narcotlcs and dangerous drugs could be dellvered to the

head nurse by a pharmacist. Standard stoc.~s for each unit

would be established by the nurs~ng, pharmacy and wedical

personnel.

d. The activities of del~verlng and servll1g food could gradually

be taken over by the dletary department. Since dietitians

are in short supply, food serv~ce managers who have had a

hotel food serVlce course could direct the dletary department.

EMjNuRs./l49 page 36

WHO EMRO

Aides could be glven on-the-Job trainlng in serving food and

delivering it to patlents. A qualifled nurse would continue

to superVlse the therapeutic diets un~il qualified dietitians

are available. Th1S transfer of dletary activ1ties could be

fac1l1tated 1f d1etit1ans were employed in the M1nistries of

Health.

e. Nurses could be relleved of clerlcal activ1ties by employing

lnterested and lntelllgent glrls as ward secretar1es and

glVlng them a good on-the-job training programme.

f. Housekeeplng activitles could be reallocated by employing a

mature person, as chlef housekeeper, to be respons1ble for all

such actlvities and for the maids who carry these out. The

housekeeper could take the same course as hotel housekeepers

and be glven addltional on-the-Job preparation in the control

of infectl0n and aseptic techniques.

It was agreed by all that reallocatl0n of non-nurslng act1vit1es to

the appropriate departments must be done gradually and only when the

appropriate departmental personnel are adequately tr~ned to carry them

out. It was believed that this is more easl1y done when there is a

trained hospltal adminlstrator to work wlth nurs1ng service personnel.

As thls reallocatlon lS carrled out, nurslng serV1ce personnel must have

in-service educatlon on what are true nursing activ1tles and how to

1mprove nursing care.

I

I

I

WHO ENRO

I

RELATIONSHIPS OF HOSPITAL SERVICES

1\ c. Transport'ltion

\ \

- - - .. -._ ..


Laundry r/r " \

B. I &: Linen

'\ Electro- ,/ " , Clerical

/~ Central

Stores

I .... , I

I

/

Medical

,cardiogram

X Ray

Therapy

\ - .......... /' A Medical ""'-

"'ursin!! Care j " /

X-Ray

Stores \~, "/ \ f ,Care. ./ Admi tting

'\ i ,-'--__ \ Radio- ~ --. Soc1al,- --" .... " \

--- , Laboratory Special Oooupa-, Patient Pathology !

~ork (" -.....~:::.~~/ \ Clinical

\ Equipment tional' !a .. i Therapy , ____ I

\ \ _",/ ',,-. Spiri tual -,---... f , Physical I -, - , care I '---_ Housekeeping I

/ ,I" I i

Therapy ' • ../ ,l'harmar Nutrl,\ / Radio- I

\ "."" ... /

' Sterile : cology, tiO: \.. / isotopes ;

supplies &: I - ~ /~, -'1---- \ ! \ ,Decontamina-/ l I

'",. , tlon /Pharmacy Diet \ / ~ ... . ' ..... j \ Purchasing / I '\ // ' ~ Stores Therapy ~"Engineering /11

" '''1- --- -\ \ ",,/ I Food Services \ \ /

'<;. Maintenance '\? ~ i Personnel ",.-

........... I \ ~r

~L l---~ ---- - --


WHO EMRO

WHO EMRO PlII/NURS./l49 page 39

5. THE ROLE OF '!HE NURSJNG AND O'lHER PIDFESSICNAL STAFF IN MEFl'ING

'!HE CRITERIA FOR SUITABLE FIELD PRACTICE AREAS FOR THE EDUCATION

OF NURSING STUDENTS.

Mr. J. Amin Mrs. M.P. Khan Mrs. B. Mengesha Miss K.I. Raffai M~ss A. Riahi

M~ss F. Hargett - Moderator

The panel presentation was in the form of role playing. Depicted

was a meeting in which the d~rector of a school of nursing, the matron

of a hospit~ an ~nstruotor, a doctor and a physiotherapist were dis

oussing situations in which a nursing student was performing poorly in

her clinioal experience on a nursing unit. The effect of the attitudes,

actions and reactions of nurs~ng service and other professional personnel

on the student and her learning was clearly demonstrated. The lack of

support received by the student in carrying our nursing procedures was

shown to interfere with her appl~cation of pr~noiples in the nursing care

she gave. A student looks to qualified nurses as an example of how she

should behave and when they carry out procedures with poor techn~ques the

student tends to do so also. Some of the professional personnel were

viewing the student as another pair of hands to do the work, not as an

individual and a learner. The positive effeots of the professional

personnel respeoting the student as an ~ndiv~dual and treating her as a

learner were demonstrated. The importance of good interpersonal relation-

sbjps among professional personnel, of their understanding the purposes

of the student's experience and of cooperating in providing pat~ent care

were emphasized. The group believed that suudents need assistance in

applying the~r knowledge of the social scienoes to acquire an under-

standing of human behaviour. The great advantage of all the profession-

al disoipl~es sitting down together to d~scuss the obJect~ves, to

EM/NURS./149 pc.ge 40

WHO EMRO

become oriented to the cl~~cal nursing exper~ence of the student, to

plan the experience and to solve problems was clearly brought out. In

conclusion, the panel stressed that only by worldng together can nursing

education, nursing servioe and allied professional personnel develop

f~eld practice areas ~n which the nurs~ng student can learn to give,

and the patient will rece~ve, effect~ve nurs~ng oare.

WHO El>1RO

CHAPTER III

SUMrrlARY OF RECOMMENDATIONS


Recommendat~ons were proposed in the study group sessions. These

were st~ed and summarized by the Corrunittee on Recorrunendations, m

consultat~on with the Resource Staff. The following recommendations

were accepted by the part~c~pants in the last plenary session of the

seminar:

1. That a regional workshop be convened on how to conduct nursing

stud~es through us~ng s~mple research methodology such as

problem solving techniqUes, for the improvement of health

services through better nurs~ng education and nursing service;

that this workshop be held w~thin two years.

2. That there be conducted stud~es and evaluation of national

nursing needs, nursing resources and the utilization of

nursing personnel, with the purpose of finding ways to pro-

vide for the optimum util~zation of professional and auxiliary

nurs~ng personnel and the reallocation of non-nursing activities

to other tra~ned personnel. This would mvolve both study

of nat~onal needs and resources by a national body as well as

work sampling stud~es to show the ut~lization of nursing

personnel in one nursing service department.

3. That practical programmes of in-service and post-basic education

be established to improve current situat~ons.

4. That there be nurse members on all corrunittees which are respon

sible for planning, setting standards of, and evaluating nursing

education and nursing serv~ce.

5. That two or more countries, wi th sim~lar problems and resources,

plan workshops for head nurses and instructors to study ways of

EM,/NURs./i49 page 42

WHO EMRO

improv1ng nurs1ng care of pat1ents, and the f1eld practice

experiences of nurs1ng students, 1n one or more of the

following areas:

a. Med1cal-Surgical Nursing

b. Maternal and Ch1ld Health NurS1ng

c. Public Health Nursmg

d. Methods of Teaching

e. Adm1n1strat10n of the nursing un1t

f. Supervis10n of nursing care and of nursing personnel

6. That central nurs1ng d1visions, na~ional nurses associat1ons

and legislat10n be estab11shed as soon as poss1ble.

7. That nurses with potential be encouraged to perfect writing

skills, w1th the a1d of fellowships as necessary, so that

textbooks, Journals and teach1ng a1ds can be prepared in the

mother tongues of the countr1es of the Reg1on.

8. That procedures be established so that information on programme

changes and new developments 1n nursing 1n any s1ngle country

of this Reg10n can be known by the nurses of other countries.

WHO E:4RO

CRAnER IV


EVALUATION OF THE SE1>UNAR AND SUGGESTIONS FOR Ft1I'URE SENlNARS

Evaluation of the seminar was discussed by the Resource Staff. This

group decided to conduct an evaluation at the close of the Seminar and

recommended that two follow-up questlonnaires be sent to participants.

A committee of four was selected to draw up the questlonnaire for use

at the close of the Seminar.

Fifty-eight questionnaires were distrlbuted and 7~ of these were

returned. The questlonnaire asked for answers to:

1. How much did you learn?

2. How much can you implement when you go home?

3. How much did you enjoy the Seminar?

The respondents were also requested to comment on the content and

conduct of the Seminar and to present suggestions for future regional

nursing seminars.

Eighty-eight percent of the total number of people attending the

Semlnar learned a conslderable amount or a great deal. The learnings

included:

a. An appreclatlon of the need for nursing service and nursing

education personnel to cooperate in plannlng, programming

and evaluatl0n.

b. A beginning understanding of the ways by which problems are

id~ntifled and solved.

c. An appreciation of the value of the exchange of ideas and of

discussion of the causes and possible solutions of mutual

problems.


WHOEMID

d. An lntroductlon to new ldeas and trends and a realistic

approach to developing and lmprovlng nurslng sltuations.

e. An understandlng of the need to free nurses for nurslng

by reallocatlng non-nurslng activltles to others.

f. An ldea of writlng Job descrlptlons and nurs~g procedure

manuals

g. An understandlng of the role of the auxlllary and

lnstltutl0nal serVlces.

The 12% of the total partlclpants whlch learned a little belleved

lea~ng to be llmlted because of:

a. the language barrler

b. the scope of the materlal presented belng too llmited.

Slxty-five percent of the total attendants believed that they would

be able to implement a great deal or a conslderable amount when they

returned home. They thought they could:

a. Improve working relatlonships between nursing education

and nurslng serVlce personnel;

b. Improve the utillzatlon of nurslng personnel;

c. Ga~ more support from governmental and medlcal authoritleSj

d. Begln In-service educatlon;

e. Establish central supply serVlces and nurslng procedure manuals;

f. Work further towards the establlshment of legislatlon for

nursing and a nurslng dlvlSlon at the cen~ral level.

The 28% of the total group which thought it posslble to lmplement

only a Ilttle on return home belleved the barriers to lmplementation

were:

WHO EMRO EM/NtJRS./l49 page 45

a. lack of leg~slation and a nat~onal nursing association;

b. lack of understand~ng and support on the part of the allied

profession::;;

c. lack of effect~ve relationship between nursing education

and service;

d. inadequate basic educat~on of nursing recruits;

e. the ~ll-def~ned nat ure of nurs~ng.

Ninety percent of all those attend~ the seminar enjoyed it

oonsiderably or a great deal.

The suggest~ons made for future seminars were in relation to:

a. Length - the maJority favoured a two-week seminar.

b. Content and conduct.

i. The programme should be less crowded.

ii. Plenary sessions should not be interrupted.

iii. Included should be panel mscussions, presentations

of material by experts, addresses by specialists,

small group discussions.

~v. The meet~ngs and accommodation for participants

should be at the same place.

v. Resource staff should give more guidance to parti

cipants.

vi. Other levels of nurs~ng personnel should be calSidered

as partic~pants. depend~ng on the topic.

vi~. There should ce more observers from allied ~sclplines.

vii~. The prov~sional programme should be sent out in advance.

ix. There should be more time for small group and general

discussions •


c. Topics

were:

i.

ii.

iii.

iv.

v.

v~.

v~i.

WHO ]l.lRO

- the suggested top~cs wh~ch received the most support

In-service education.

Def~nition of nursing and non-nursing respons~b~lities.

Relat~onship between nurs~ng and medical personnel.

Research in nurmng.

Post-basic and degree programmes in nurs~g.

Interpersonal relat~onships ~n nursing.

The development and implementat~on of legislation for

nurs~ng.

v~~i. The basic nursing curriculum.

WHO El'IIRO

CWSING SESSION

EMjNuRs./l49 page 47

Among those who honoured the Sem~nar with their presence at the

elosing Session were ~s Excellency Dr. M. Shahgholi, Minister of Public

Heal th, Imperial Iranian M~nistry of Public Health and Dr. A.H. Taba,

Director, Eastern Med~terranean Reg~on of the World Health Organizat~on.

Dr. Taba addressed the assembly briefly, thanking the Government

of Iran and Dr. M. Shahghol~ for their cooperation in the conduct of the

Seminar and for all they had done to make the experiences of the parti-

cipants in Iran so worthwh~le and enJoyable. Dr. Taba then expressed

his confidence that the Seminar discussions would bear fruit in all coun

tries in the Region and wished the part~cipants well as they further

improve nursing educat~on and the nursing care of patients on their

return home.

Gratitude and apprec~ation were expressed by Mrs. L. Kamel on behalf

of the Reg~onal Panel of Nurses and by Mrs. M.P. Rban on behalf of the

part~cipants.

The participants dec~ded unanimously to request that a cable be sent

to Her Imperial Majesty Queen Farah thanking her for her grac~ousness in

granting them an audience.

The closing remarks of Miss Margaret D. McLean, WHO Se~nar Consultant

were:

"Since we met together for the f~rst time on 9 November we have been

very busy - have worked hard, slept l~ttle and have learned many things.

We know each other better than we d~d. We have seen more beautiful

Jewels than we could have ima~ned in our most fanciful dreams, when we

viewed the Crown Jewels; we have experienced the great hospitality and

kindness of groups of Iran~ans at the receptions, teas and dinners given

to us by Iranian associations, companies and the Min~stry of Health; we

EM,/NURS./149 page 48

WHO a-mO

have appreciated the thoughtfulness of ~ndividual Iran~ans who helped

us in so many ways. We have learned more about nursing in Iran by

the professional vis~ts which were arranged for us. We have learned

about the ~queness and beauty of Pers~an art and architecture, at

the Golestan Palace and in Isfahan. We saw the majesty, fr~endl1Dess

and naturalness of Persia ~n the person of her Imperial MaJesty the

Queen Farah. We have found ways to ~mprove the education of nursing

students ~n the field practice areas and to improve the nursing care of

patients. We will not forget any of these things. But we have not

achieved the stated obJective wh~ch was 'to strengthen and ~mprove the

learning exper~ences afforded the nurs~ng stUdent ~n the field practice

areas' nor have we ~mproved nurs~ng care of patients in the hospitals,

the maternal and c~ld health centres, the publ~c health centres and the

dispensar~es of this Region. ~s you have to do.

start to do this when you return to your own country.

Each of you must

To a great extent

it will not be done unless you do it, and I am very confident as ~s

Seminar closes that ~mprovement of cli~cal nursing exper~ences for

s~udents and nursing care of patients w~ll come. I am conf~dent because

I know more about you than I did, I know more about the Re~on than I

did. You can accomplish th~s and I bel~eve that there w~ll be more

cooperation between nurs~ng educat~on and nurs~g service in planning,

carryil.ng out and evaluatL.!(3 the cr~ ter~a for cl~ical nursing education

and nurs~ care. I believe you w~ll ~mprove the relationship of nurs~ng

w~th the allied professional, ~st~tut~onal and other health services. I

am sure you ~ll each be more consc~ous of what ~s a nursing activity and

what ~s a non-nursing activ~ty. You will all do someth~ng; you may even

make mistakes. Humans do make errors. If you do, recognize the ~stake

and correct it for if you do not correct a mistake, you have made another ,

~stake. Yes, you will all achieve some steps toward your obJect~ve for

your mistakes w~ll be few, far less than your successes.

WHO m.mo EM/NUR'3 • /149 page 49

And now let us all keep the following anonymous quotation in our

minds:

'God give me courage to change the things I can, serenity to

accept the things I cannot change and the wisdom to know the difference.

Finally, thank you all for what you have ~ven to me.

and all the best to you."

Au revoir

WHO EMRO

ACKNOWLEDGEMENr

.!'>1/NURS./l49 page 50

Sincere appreciation is expressed to the Government of Iran for

their collaboration in the planning and organization of the second

Reg~onal Nursing Sem~nar and for the provis~on of physical fac~l~ties,

without which the Seminar could not have been held. Thanks are due

especially to His Excellency Dr. M. Shahgholi, the Minister of Public

Health, Imperial Iranian Ministry of Public Health, Mrs. F. Salsal1,

Ch~ef Nurse, Nursing Division, Ministry of Publ~c Health,

I"'ir. A.N. Amirahmam, Procurement Officer, M~~stry of Publ~c Health,

and the members of the National Planning Co~ttee for their able

assistance ~ planning the Seminar, the provision of supplies and

equipment, the arrangement of f~eld trips and for their most generous

hospitality, and to all those compan~es, associat~ons and individuals

who made the sOJourn of participants in Iran such an enjoyable and

memorable one.

WHO EIv1RO

AGENDA

1. Operung of the Seminar.

EMjNuRs./l49 ANNEX I page i

2. Election of Officers: Chairman, two Vice-Chairmen and a Rapporteur.

3. Adoption of the Agenda.

4. Nursing: Its Nature and the Needs of this Region.

5. The Achievement of Understanding, Cooperation and a Desirable Work~ng Relationship Between Nursing Service and Nursing Education.

6. The Cr~teria for Suitable Field Practice Areas for the Education of Nursing Students, in Relation to:

a. The organization and administration of nursing and other services;

b. personnel;

c. physical facilities;

d. equipment and suppl~es.

7. The Responsibilities of the Hospital Auxiliary and Institutional Services for Meeting the Criteria.

8. The Role of the Nursing and Other ProfessiOnal Staff in Meeting the Criteria.

9. Other Business.

10. Acceptance of the Prov~sional Report of the Seminar.

11. Closing Session.

WHO EMOO

PARTICIPANTS

AFGHANISTAN

CYPRUS

E'lllIOPIA

LIST OF PARl'ICIPANTS AND OBSERVERS

Miss Barawar Amiri Nursing Supervisor AV1cena Hosp1tal Kabul

Mr. Christoforos Avraam Nurse Tutor School of Nursing, Nicosia General Hospital Nicosia

Miss Arax Goevderelian Matron Famagusta Hospital Famagusta

Mrs. Bisrat Mengesha Chief and Supervisor

1iN,/NURs • /149 ANNEX II page i

Hosp~tal Nursing Service Section Ministry of Public Health Addis Ababa

Mrs. Negede Dem1ssie Director Red Cross School of Nursing Addis Ababa

Mrs. Abeba Wolderufael Public Health Nursing Supervisor Ministry of Public Health Addis Ababa

Mrs. Fatemeh Salsali Chief Nurse Nursing D1vision Minl.stry of Health Teheran

Mrs. Nassereh A. Roboob1 Chief Techn1cal ~ffairs Section and Nurse Consultant for Mental Health Nursing Divis10n Ministry of Health Teheran

EMjNuRs./l49 ANNEX II page ii

IRAQ

JORDAN

KUWAIT

WHO EMRO

Miss Fatemeh D~narband Nurs~ng Services Adm~nistration Section Nursing D~vision Min~stry of Health Teheran

Mrs. Ghat'1ar' Mirkamal1 Chief Nurse Health Department Teheran Prov~nce Mi~stry of Health Teheran

Miss Nahim Banou PoorkaJ Hospital Nurs~ng Service Consultant Nursing Div~sion Mi~stry of Health Teheran

Miss Khair~ya N.A. Ja1il Ass~stant Matron Republ~c Teaching Hosp~tal Baghdad

Miss Adele J. Anton Nurse Supervisor Republ~c Teaching Hosp~tal Baghdad

MlSS Loutf~ya Noori Matron Republlc Teaching Hosp~tal Mosul

Mlss Adeebeh J. Mussalam Chief Nurse M~n~stry of Heal th Amman

Miss Nlamati S. Nureddin Cmef Publlc Health Nurse Mlnlstry of Health Amman

M~ss Asma S. Sa'ad Director Kuwai t College of Nur~ng Sabah Hosp~tal Kuwait

WHO EMRO

LEBANON

PAKISTAN

SOMALIA

SUDAN

SYRIAN ARAB REPUBLIC

*D1d not attend

Mrs. Wadad H. Shaya

EM/NURS./l49 ANNEX II page 11i

Assistant Professor of Nursing American University of Beirut Beirut

Mrs. Mantonguni Ba~ragya S~ster Tutor Medical College Hospital Rajshahi*

Mrs. Mumtaz ~nds Khan Nursing Superintendent Sir Ganga Ram Hospital Lahore

Miss Shafali Biswas Sister Tutor Medical College Hospital Dacca"f

Mr. Jibr~l A~n

Nurse Tutor School of Nurs~ng Medical Department Hargeisa

Mrs. Awatif A. Osman Director Khartoum Nursing College Khartoum

Miss KhMiga I. Raffa! Acting Ass~stant Matron El Shaab Hospital Khartoum

M~ss Aisha Nasab Nursing Instructor Nat~onal Nursing School Damascus

Miss Moufida Zalat Nursing Instructor National Nursing School Aleppo

EM/NURS./l49 ANNEX II page iv

TUNISIA

UNITED ARAB REPUBLIC

OBSERVERS FROM HOST COUNTRY

Mr. Amar Daly Nurs~ng Superv~sor

Charles Nicolle Hosp~tal ~s

Mrs. Fathia Moustafa Chief Nurse M~~stry of Public Health Cairo

Mrs. Effat I. Kamel Director of Nursing Services Ahmed Maher Hospital Cairo

Mrs. Nagwa M.H. EI Hagrassy Nurs~ng Superv~sor

Ahmed Maher Hospital Ca~ro

Dr. Mohamed Sadr~ Professor Faculty of Medicine and Superv~sor of Hospital Administration Course Un~versity of Teheran Teheran

Dr. Ahmad Rahirnzadegan Deputy D~rector-General Techn~cal Training Sect~on M~nistry of Health Teheran

Miss Talieh Agah D~rector

Nemazee School of Nursing S~raz Med~cal Centre Shiraz

M1SS I. Bararsanl Dlrector Nurslng Dlvislon Khorassan Province and of JorJani Nurs~ng School Meshed

Mrs. Nayereh M. Fotoohi Director

m.1jNuRs./149 ANNEX II page v

Reza Shah Kabir School of Nursing Teheran

Miss Bhafigeh Herovabadi Director High Institute of Nursing Teheran

Miss Sara Kavati Nursing Instructor High School of Nursing Kermanshah*

Mrs. Fatemeh Khalatbari D~rector of Nursing Ashraf School of Nursing and Pahlavi Hospital Teheran

Mrs. A. Dargahi Director School of Nursing Rasht

Mrs. Mansoureh Shagaf~-Rhademe Director Razi School of Nursing Kerman*

Mrs. A. Mobed Director Midwifery School University of Teheran Teheran

Miss F. Salili Educational Sect~on Nursing Division Ministry of Health Teheran

IRANIAN NURSES ASSOCIATION Mrs. Atefeh BiJan Nurse Adviser

* Did not attend

Faculty of Medicine Univers~ty of Teheran Teheran

EMjNuRs./149 ANNEX II page V1

NATIONAL IRANIAN OIL COMPANY

REPRESENTATIVE'S OF UNITED NATIONS ORGANIZATIONS

Un1ted Nations ~ldren's Fund (UNICEF)

Un1ted Nations Relief and Works Agency for Palestine Refugees (UNRWA)

M1ss Sedaghat f.1atron N.I.O.C. General Hosp1tal Teheran

Mr. W.S. Pawl1k UNICEF Representative Teheran

Miss Gerda Karnstrom Clnef Nurs1ng Divis10n UNRWA Headquarters Museitbeh Quarter Beirut

WHO EMRO

OBSERVERS FROM O'IHER ORGANIZATIONS

Internat10nal Council of Nurses

M1ss T. Hagh1ghat Assistant Director High School of Nursing National Iran1an Oil Company Abadan Iran

United States Agency for M1ss Elizabeth H1lbOrn Internat10nal Development Nurse Adv1ser (US AID) Office of International Health

Public Health Serv1ces Department of Health

American ~nivers1ty of Beirut (AUB)

Educat10n and Welfare Bethesda Maryland USA

Miss Esther L. Moyer D1rector, Bchool of Nurs1nG Amer1can Un1versity of Beirut Be1rut Lebanon

WHO EMRO

REDIONAL PANEL OF NURSES

RESOURCE STAFF

Miss Azar RJ.alu

EM/NURs./H9 ANNEX n page vii

Nurs~ng Education Consultant Nurs~ng_D~vision

Ministry of Health Teheran Iran

Mrs. Karu.z Jl'lowla Nursing AdViser Ministry of Health, Labour and Sooial

Welfare Islamabad Pakistan

Mrs. Leila I. Kamel Demonstrator Higher Institute of Nursll'lg University of Alexandria AlexandrJ.a United Arab Republic

Miss Batool M. Saad Nursing Instructor Khartoum Nursing College Khartoum Sudan

Mrs. Aida Sultan D~rector

Red Cross School of Nursing Beirut Lebanon

Mr. Khosrow Majidi Director Pahlav~ Hospital Faculty 0;: i'adic~ne Teheran University Teheran Iran

Miss Florence Hargett WHO Senior Nurse Educator Col1e~ of -Nursing Baghdad Iraq

EMjNuRs./149 ANNEX II page vih

Dr. A.H. Taba

Miss L. Creelman

Dr. G. Rlfka

Miss M.D. McLean

M1SS E. Matheson

WHO EMRO

Miss Rita D. Hill WHO Senior Nurs~g Advlser High Institute of Nursing Unlversity of CalrD Cairo United Arab Republic

Miss Rl ta McEwan WHO Nurse Educator Mental Health Servlces Teheran Iran

Miss Elizabeth Mltchell WHO Senl0r Nurse Educator National School of NurSlng Damascus Syrian Arab RepubllC

Mrs. Glorla Press WHO Senl0r Nurse Educator Jordan College of Nurslng Amman Jordan

WHO SECRETARIAT

Dlrector

Chief, Nursing

Publlc Health Admlnlstrator, Educatl0n and Training

WHO SpeCial Seminar Consultant

Regional Adviser on Nursing

Reglonal Office for the Eastern Mediterranean

WHO Headquarters, Geneva Switzerland

Regional Office for the Eastern Mediterranean

Consultant, Hospital NurSlng, Department of Natlonal Health and Welfare, Canada

Reglonal Offlce for the Eastern Mediterranean

Miss C. Cartoudis Conference Officer

Miss A. Hetata Information Officer

Miss A. Papadopoulo Secretary

Miss M. Stylianides Secretary

EMjNuRs./149 ANNEX. n page 1.x


Reg~onal Office for the Eastern Mediterranean



EM/NURS./l49 ANNEX III page i

OFFICERS OF THE SEMINAR

GENERAL CHAIRMEN AND GENERAL RAPPORTEUR

ChairMan:

Vice Chairman:

Rapporteur:

Ml.sS F. Salsali

Mrs. B. Mengesha

Mrs. F. Moustafa

Mrs. N.S. Nureddin

(Iran)

(Ethiopia)

(U .A.R.)

(Jordan)

CHAIFMEN AND RAPPORTEURS OF STUDY GROUPS

Chairman Rapporteur

GROUP A Mr. C. Avraam (Cyprus) Miss F. Dinarband

GROUP B Miss M.B. PoorkaJ (Iran) Mrs. N.M.H. El Hargrassy

GROUP C Miss A. J. Musallam (Jordan) Mrs. A.A. Osman

GIDUP D Mrs. H.P. Kh:m (Pakistan) Miss A. Goevderelian

GROUPE Mrs. N.A. Roboobi (Iran) Miss K.I. Raffai

(Iran)

(U.A.R.)

(SUdan)

(Cyprus)

(Sudan)

WHO EMRO

LIST OF DOCUMENTS

PROVISIONAL AGENDA

PIDGRAMME OF 'lHE SEMINAR

LIST OF PARTICIPANTS

BIBLIOGRAPHY

lNTRODUCTION TO THE SEMINAR

THE NURSING SITUATION IN '!HE REGION

ntE PUBLIC SEES THE NURSE'S IDLE

by Zahia A. Marzouk, Under-Secretary of State for Social Affairs, Alexandria Governorate, United Arab .Republic

'!HE DOCTOR SEES '!HE NURSE I S ROLE

by Anis M.A. Shamy, WHO Visiting Professor of Public Health and Social Medicine, Univers~ty of Baghdad, Iraq

THE NURSE INTERPREl'S HER ROLE TO OTHER DISCIPLINES AND TO THE PUBLIC

by Awatif A. Osman, D~rector, Khartoum Nursing College, Khartoum, Sudan

PERSONNEL MANAGEMEI-lT: A FORCE IN PERSONAL GROWTH AND SATISFACTION

by G.B. Rosenfeld, Senior Consultant Adm~nistration, Department of National Health and Welfare, Ottawa, Canada

HTJVlIl.N COMMUNICATION IN 'lEE SERVICE OF REAL'!H

by Akbar Moarefi, Adviser on Health Education, Eastern Mediterranean Region, World Health Organization, Alexandria, United Arab Repubhc

FM.jNuPs./149 ANNEX IV page i

EM/NURS. SEM./l

EMjNuRs.SEM./2/REV.2

FM./NURS.SEM./3/REV.3

.J<l.1/NURS.SEM./4

EMjNuRs .SEM/5

EM,/NUFls. SEM. /6

.J<l.1/NURS.SEM ./7

EMjNuRs. SEM./8

EM/NURS.SEM·/9

FM./NURS.SEM./lO

EN/NURS./149 ANNEX rv page 11

NURSmG EDUCATION AND NURSING SERVICE: COOPERATION OR CONFLICT IN COMMUNICATIONS?

by J. Shellish, Matron, Nicosia General Hospital, and L. Burke, WHO Nurse Educator, Nursing Education Project, Nicosia, Cyprus

MENTAL HEALTH: THE PIVOT OF HUMAN RELATIONSHIPS

by Nassareh A. Roboobi, Consultant in Mental Health and Psyc~atric Nursing, Chief of Registration and Leg~slation, Nursing Div~sion, Mi~stry of Health, Teheran and R1 ta McEwan, WHO Psychiatric Nurse Educator, Mental Health Serv~ces ProJect, Teheran, Iran

'lHE_ PREPARATION OF '!HE NURSING TEACHER FOR DEGREE PROGRAMMES m THE MIDDLE EAST

by Aleya Bindar~, Lecturer, H~gher Institute of Nurs~g, UniVersity of Alexandria, Un~ted Arab Republ~c

THE PREPARATION OF THE NURSING TEACHER FOR DIPlJJMA PROGRAMMES m THE MIDDLE EAST

by Adeebah Mussalam, Matron, Surg~cal Hospital, Amman, and Glor~a Press, WHO Nurse Educator, College of Nursing, Armnan, Jordan

IN-SERVICE EDUCATION PREPARES NURSING SERVICE PERSONNEL FOR THEIR OONTRlBUTION 'ro THE STUDENT PROGRAMME

by Ann Beckingham, WHO Nurse Educator, Nursl.ng Education ProJect, Ahmed Maher Hospital and School of Nurs~ng, Cairo, United Arab Republic

THE HEAD NURSE AS AN EDUCA'roR

by H. Stefanska, WHO Nurse Educatur, Tra~ng of Health Personnel Project, Tunis, and MJB. Jezierska, WHO Nurse Educator, Nursl.ng Education ProJect, T~s, Tunisia.

WHO EMRO

HM/NURS.SEM,/12

ENjNuRs.SEM./13

EM/NURS.,sa.,./14

EN,/NURs.SEM./15

EN/NURS.SEM./17

WHO EMRO

THE NATIONAL ORGANIZATION OF NURSING SERVICES ~fi ,THE BE'i'l'ERMEMT OF NURSING EDUCATION

by the Nurs~ng D~vis~on, Ministry of Public Health, Addis Ababa, Eth~opia

HOSPITAL NURSING S~VICES: THEIR ORGANIZATION, ArMINISTRATION AND ROLE IN NURSlNG EDUCATION

by fu. ta Hill, Senior WHO Nurse Adnser, fugher Inst~tute of Nursing, University of Cairo, Un~ted Arab Re~ub1ic

PUBLIC HEALTH NURSING SERVICES: T'rlEIR ORGANIZATION, ADMINISTRATION AND ROLE IN NURSING EDUCATION

by Leonor A. Deus, WHO Nurse Educ-ator, College of Nursing, ~versity of Baghdad, Iraq

NUTRITIONAL AND DIETARY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAINING OF HEAJi.,TH PERSONNEL

by Houri Besherat, Dietician, National Iranian Oil Company Hosp~tal, Abadan, Iran

FHYSIO'lHERAPY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAlNlNG OF HEALTH PERSONNEL

by Gladys Johnson, WHO Phys~otherapy Tutor, School of Physiotherapy, Teheran, Iran

HEALTH LABORATORY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAINlNG OF HEALTH PERSONNEL

by H.R. Husseini, Adviser on Health Laboratory SerVices, Eastern Mediterranean Region, Alexandria, Un~ted Arab Republ~c

THE CENTRAL SUPPLY ROOM: f\. SERVICE AND A TEACHING UNIT

by Effat Kamel, D~rector of Nurs~g Services, Ahmed Maher Hospital, Ca~ro, and Ruth Burstahler, WHO Nurse Educator, Nursing Education Project, Cairo, United Arab Republ~c

EM/NURS./149 ANNEX IV page ni

EMjNuRs. SFl1. /18

El'IIjNuRS.SFl1./19

EM/NURS.SEM./21

EM,/NURS.SEM./23

EM/NURS. SEIvl. /24

EMjNuRs. /149 ANNEX IV page l.V

'!HE SUPPORT:rnG SERVICES IN 'IRE HEALTH PROGRAMME: THEIR ROLE m PROVIDING SUITABLE FIELD PRACTICE AREAS FOR EDUCATION AND TRAINING

by Fakhry F. Kawar, WHO Hospital Administrator Basic Public Health and Medl.cal Care Servl.ces, Dammam, Saudi Arabl.a

HOSPITAL PLANNING AND PROVISION FOR EDUCATION AND TRAmmG ACTIVITIES

by D. Goldfinch, Hospital Consultant Architect, and AIm C. Crighton, Nurse Planning Consultant of Donald A. Goldfl.nch Assocl.ates, United Kingdom

DRAFl' REPORT OF 'IRE SEMmAR

WHO EMf«)

EM/NURS.SEM./25

EM/NURS .SEM. /26

EM/NURS.SEM./27

WHO EMRO EM/NUFS./149 ANNEX V page i

ORGANIZATION OF THE SEMmAR

INTRODUorION

The f~rst WHO Nursing Senunar to be organized ~n the Eastern

Mediterranean Region of the World Health Organization was held in

Lahore, West Pakistan, from 2;; November to ;; December 1960, in

collaborat~on with the Government of Pak~stan. This Seminar was

convened at a time when constant expansion and ~mprovement of health

services were t~ng place throughout the Region. The part~cipants

were aware that the changing health services would demand consistent

effort on the part of the professional nurse if she were to make a

s~gn~ficant and appropriate contr~but~on. Included ~ the recommendations

made at the Seminar was "to constantly evaluate, review and ~mprove

nursing educat~on programmes so as to provide the comprehensive nurSing

care in keeping w~th the needs of the expanding health services of the 1

country."

Efforts to expand and strengthen the national and international

health services of the Regional countries were cont~nued increasingly

5~nce 1960. The profess~onal nurses of the Region contributed valuably

to these efforts.

In his Annual Report to the Fifteenth Session of the Reg~onal

Committee in 1965, the Director of the World Health Org~zation

Regional Office for the Eastern Mediterranean stated:

"The horizons of nursing are cont~nu~ng to enlarge as schools are expanding and ~ncreasing in numbers, as the role and function of the nurse are ga~n~ng understand~ng and recognition, and as nat~ona1 nurse leaders - capable of shap~ng the profess~on according to the needs of the~r countries - are emerging.

~orld Health Organization Reg~onal Office for the Eastern Mediterranean. Reg~onal Seminar, Lahore, Pak~stan, ~3 November - 3 December 1960, Final Report. Alexandr~a: ElilRO, WHO, EMjNURS.SEM.j22, 1961. p.;;l

m4/NURs./149 ANNEX V

WHO Elv1RO

page ii

It is espec~ally on th1S emergence of nurse leaders that this Reg10n is placlng ltS maln emphasis, to ensure that what does develop becomes an integrated par! of the general growth of health serVlces 1ll each country."

To aSSlst in ach1evlng thlS goal, the Regl0nal Panel of Nurses was

created, w1th nurses from f1ve of the twenty countries of the Re~on

being apPo1nted as members at this stage.

The flrst meetlng of the Panel was held from 9 - 13 August 1965, with

all five members attendlng and M1SS JeW" Barrett, Professor of Nurs1llg,

Yale Unlverslty, actlng as Consultant.

The members of the Panel are:

Mrs. L.I. Kamel, Demonstrator, Hlgher Inst1tute of Nursing, UniversiLy of Alexandrla, Unlted Arab Republic;

Mrs. K. Mowla, NurSlng Adviser, Health Dlvlsl0n, !VIlnlstry of Health, Labour and Soclal Welfare, Islamabad, Pakistan;

!VI1SS A. Rlabl, Nurslng Educatl0n Consultant, M1nistry of Heal th, Teheran, Iran;

Miss B.!VI. Saad, Instructor, Khartoum NurS1ng College, Khartoum, Sudan;

IvIrs. A. Sultan, Director of the Red Cross School of Nurs1ng, Beirut, Lebanon.

One of the purposes of thlS f1rst meetlng was to perm1t the members to

engage 1ll prelimlnary plannlng for the second Reglonal NursLng Se~inar.

which was convened In Teheran from 9 - 19 Nove~ber 1966, 1n collaboratlon

with the Government of Iran. The del1berations of the P~~el in thlS

regard resulted 1n the def1~t1on of the purpose, theme, obJectives and

the maln topics for study.

~o Reglonal Offlce for the Eastern !VIedlterranean. Annual Report of the Re lonal Dlrector to the Flfteenth Session of the Re ·onal Committee, Alexandrla: EMRO, WHO, 1 July 1964 - 30 June 1965, p. 56 (EIvI RC15 2)

WHO .EMRO

PURPOSE

EMjNuRs ./149 ANNEX V page iii

The major and immediate goal of an educational programme for health

personnel is to assist the student to acquire the understanding and

s~lls to prov~de for the optimum level of health of the ~d~vidual and

the commuruty. The major goal of the health services is to provide

imme~ately for the promot~on and restoration of health and the preven-

tion of disease. If provision is to be made to meet these goals,

especially in an age in which health services are expand1ng so rapidly

and involve so many specialities, it is essential that personnel in the

health service and educational programmes work closely together, with

mutual interest, understanding and support. Therefore, in thinking of

the needs of the Region in respect to the 1mprovement of nursing services

and nurs1ng education, the Regional Panel of Nurses determined the purpose

of the Seminar to be:

"To provide an opportunity for nurse educators and nursing service adm1nistrators to study together the education of nurs1ng students as related to the fields in w~ch these students rece~ve the1r practical exper1ences."

~ AND OBJECTIVES

The theme chosen for the Seminar was "held Pract1ce Areas for the

Education of Nursing Students", with the central objective being to

strengthen and improve the lea~ng experiences afforded the nurs1ng

student in the field practice areas.

defined as:

Contributing object1ves were

"1. To promote better understanding of the relationship between nursing educat10n and nursing service.

2. To achieve increased understanding of the necessity of full cooperation between nurS1ng service and nursiUb education.

3. To deter~ne the factors 1n the field practice areas whiab influence student learn1ng.

~or1d Health Organization. Report of the First SessioJ;1. of the Reg100al Panel of Nurses, 9 - 13 August 1965. Alexandria: EMRO, WHO, October 1965,

p.4

EMjNuRs./149 ANNEX V page iv

WHO EMRO

4. To de~~ne the requirements necessary for meaningful learning ~n the field practice areas.

5. To determine the ways in w~ch nurse educators and nursing serv~ce personnel can work together towards the effective ed~cation of students ~n the f~eld practice areas."

Main Topics for Study:

To enable the part~cipants at the Sem~nar to work towards meet~ng ~ts obJeot~ves, the topics selected for study were:

1. Nursing: Its Nature and the Needs of this Reg~on. 2. The Relationship between Educat~on and Service ~n Nurs~ng. 3. The Achievement of Understanding and Cooperat~on between

Nursing SerV1ce and Nursing Educat~on Personnel. 4. The Cr1ter1a for Suitable Field Practice Areas for the

Educat10n of Nurs1ne Students, in Relatlon to:

a. the organization and ad~lnistration of nursing and other services;

b. personnel; c. phYS1Cal fac1Jitiesj d. equipment and suppl1es.

5. The Respons1bil1t1es of Nurs1ng Eduoation and of the Inst1tutional Serv~ces in Meet1ng the Crlteria.

6. The Role of the Nursing and Other SerVlce Staff in the Education of the Students 1n the Field Pract1ce Areas.

Participants, Observers, Resource Staff and WHO Secretariat.

Particlpants:

Fifteen of the countries of the Region were lnvited to partlclpate in

the Seminar. In addltion, the World Health Organizatlon Regional O~flces

for Europe and South East ASla were requested to sponsor part~cipants from

Turkey and A~ghanistan respectively. The crlterla established to guide

the goverru'ents in their selection o~ participants were:

~orld Health O!'ganiza tion. ;;.;R..;.e":-po.;;..r:-:t~o=,f"--th=.;:e"::-,-F....;i..;.r.;;;;s-:t-7S..;.e;;;.ss;;.1,,:o=n=o:,,f,-:,th=e;...;;;R,:,:e ... g";"i_o:-nal--. Panel of Nurses, 9 - 13 August 1965. Alexandria. EMRO, WHO, October 1965, p. 5

'WHO EMRO EMjNuRs./149 ANNEX: V page v

1. Graduat~on from a recoGll~zed school of nurs~ng.

2. Employment ~ a responsible position in nurs~ng service or

education.

3. If only one part~cipant was to attend, he/she was to be engaged

currently in either the preventive or curative branch of the

nursing serv~ces, or be respons~ble for both the formal and

field practice aspects of a nursing course ~n an educational

programme. If two participants were to attend, one was to

represent nursing servicee, being engaged in either the pre

ventive or the curat~ve branch, and the second was to represent

nursing education, being currently respons~ble for both the

formal and field practice aspects of a nursing course.

4. Prof~ciency in English.

5. To be available for the entire period of the Seminar and be

prepared on return to hiS/her country to communicate ideas

acquired to nurses and others concerned.

Twenty-eight partit:lipants attended the Seminar, having been nominated

by the Governments of Afgh~stan, Cyprus, Ethiopia, Iran, Iraq, Jordan,

Kuwai t, Lebanon, Pa..~istan, Somalia, the Sudan, the Syrian Arab RepubliC,

Tunisia and the United Arab Republic.

in Annex III.

Observers:

The~r names and titles are given

The host Government nom~ted twelve observers, ten of whom attended

the Seminar. Also nominated were observers representing the Iranian

Nurses' Association, the NatjonaJ Iraniar. Oil Company, the United Nat~ons

Children's Fund, the Urn ted f,Jatiorz Relief and Works Agency for Palestine

Refugees, the International Council of Nurses, the United States Agency

for Interna~~onal Development and the Amer~can Univers~ty of Beirut. The

observers' expensec were born€ by their respective organizat~ans.

EM/NURS./l49 ANNEX V page vi

WHO EMRO

All observers were welcomed to attend both plenary and study group

sess~ons. Those who attended are listed in Annex III.

Resource Staff and WHO Secretar~ato

The Seminar was pr~vileged to have in attendance, throughout ~ts

sessions, Dr. A.H. Tabu D~rectorJ Eastern Mediterranean Regional Office,

World Health Organ~zat~on. Included in the Resource Staff Group were

f~ve members of the Reg~onal Panel of Nurses, a short-term WHO Nursing

Consultant, flve WHO nurses from field projects, a hospltal admlnistrator,

the Regional Public Health Admimstrator (Education and Training), the

Chief, Nursmg, WHO Headquarters and the Reglonal Nursing Adv~ser. The

names and tltles of the Resource Staff and other WHO Secretariat members

are given in Annex III.

Background Papers and Reference Material

Twenty background papers, on subjects related to the maln topics

for study, were wrltten by speclalists in the nursing, medical, health

education, hOSPltal admlnistratl0n and architecture, nutrltion, physio-

therapy and social work fields.

are listed m Annex ri. The titles and writers of the documents

A blbllograpny was prepared by the Nursing Unit, Eastern Mediterranean

Regional Offlce, World Health Organlzation and avallable at the Seminar

were reference books and other documents provided by the EMRO and WHO

Headquarters Librarie~. Also available for use in the presentation of

the topics were a number of fllms on nursing.

The partlcipants brought wlth them various dlsplay Materials, copies

of curricula, nurs~ng manuals, etc.

Briefing for Participants

Upon belng nornnated by their governments, partic~pants in the

Seminar were provided with ~nf~rrnat~on on the theme, central aim,

objectives and maln topics for study.

WHO EMRO EN/NURS./l49 ANNEX V page vii

So that each participant could become acqua~nted with the Seminar

methods and organization, the follow~ng guidance was provided:

"The Seminar w~ll be organized on an infor~al, small study group

basis, with emphasls placed on the indivldual participant's contribution

and problems becoming a ~art of the sroup's th1~ng. A typical seminar

day may include the followin8:

1. A General (Plenary) Session

a. Reports by Rapporteur's of study groups of previous day's discusslons.

b. Introduction of tOP1~ for study.

c. General discus~lon.

2. Study Group Meetings, of one and a half to two hours in duration.

J. Meeting of Group Cl1alrrnan, Rapporteurs and Resource Staff to

prepare summary reports of small group discussions.

Time will be reserved for: the study of reference materials;

individual conferences; discussion of topios of spec~al interest; and

field Visits.

At the end of the sessions, a draft report wlll be presnnted to the

Seminar for acceptance. "

It was recommended that preparat~on for attendance ~nclude pre

Seminar meetings with other participants from the ind2vidual country,

members of the nursing council and/or assoc~ation, and groups of nurses

representing various nursing actlvities and services. It was suggested

that such meetings l'ould be helpful in ldentify1Dg local problems related

to the theme of the Semlnar and ~n formulating possible solutions to

these problems. Further, that on the particlpant~s return to hiS/her

country arrangements could be ~ade to discuss with these same associates

the ways in which +lle idoas ~? ~ecommendat~ons presented at the Seminar

could be put into effect.

EM/NURS. /149 ANNEX V pagevhi

WHO EMRO

It was requested that one part~cipant from each country be prepared

to present a br~ef summary of the overall nurs~ng situa~~on in hiS/her

cotmtry and that the data be c cmp~led under the following headings:

I Resume of nat~onal health planning and maJor problems which influence nurs1Ug.

II Legislation for Nurs~ng.

III The central organization for nurs~ng - nurs~ng section or ~ t w~ thlil the Ministry of Health - and its functions.

IV The nurs~ng council and the nursing assoc~at~on: their obJect~ves, ftmctions and act~v~ties.

V Nurs~nG Services: typeR of lilst~tutions and health services in which nurses and aux~liary nursing personnel are employed; system of nurs~ng services administrat~on; general pol~cies, practices and procedures; nomenclature and numbers of nursing personnel; programme for staff development (in-serv~ce education, refresher courses}; etc.

VI General Educatlon in the country, as it ~nfluences nursing education.

VII Bas~c Nursinr; Educahon: number, level (type) and size of schools (profess~onal and auxiliary); entrance requirements; curr~cula; length of courses; teaching staff; student health and simllar servlces; budget; etc.

VIII Post-bas~c Nursing Education: type; durat~on; adm~strat~ve

control; etc.

IX Plans for the future

X Any other items of special interest or importance.

It was suggested that the partlcipants might w~sh to include COPleS

of the followlng among the materials brought for reference purposes:

laws cove~r{'; the pract~ce and profession of nursl!1b;

constitutlons of nursing council and nurs~ng assoclat~on;

prospect~ of schools of nurs~ng;

proerammes of studlesi

- locally produced v~sual aid materials.

WHO ElYlRO

Administrat~ve Arrangements

EMjNuRs./149 ANNEX V page 1x

In February 1966 a Nat~onal Planning Committee was establ~shed by

the Mirustry of Health, Iran. The members of this Comm~ttee were:

Dr. A. Nozar~, Chief, International Health Relations Department

Dr. K. Shayan, Chi3f, Health Educat~on D~vision

M~ss F. Salsali, Ch~ef Nurse, Nursing Divis~on - CHAIRMAN

Mr. A.N. Amirahmadi, Procurement Offioer - LIAISON OFFICER (Administrative) w~th EMRO

Miss A. Riah~, Nurs~ng Educat~on Consultant, Nursing Divis~on and member of EMRO Panel of Nurses

Dr. L. Lapeyssonnie, WHO Representat~ve, Teheran

Miss R. McEwan, WHO Nurse Eduoator, Mental Health Sernces project (IRAN 0028)

Th~s Committee, to WhlCh additional members were added as necessary,

worked arduously 1n preparing for the Sem1nar and throughout the sessions

proper.

Information bulletins were forwarded ~n advance of the opening of the

Seminar to acqua~nt participants with Iran and to assist in making travel

aooommodat10n and other arrangements. The Nursing Education Unit,

Nursing Divis10n, Min1stry of Health prepared an ~nformation bulletin

on serv1ces available ~n Teheran and the Min~stry of Health

presented to all attendlng the Seminar a specially prepared attraotive

folder whioh contained further ~nformation on Iran and served as a con-

tainer for pr1Uted materlals. The M~nistry also pronded 1dentifying

badges for the partioipants, observers, resource staff and WHO Secretariat.

The members of the Resource Staff Group met for three days prior to

the opening of the Sem1nar, to discuss planrung and organizational matters.

During this period, the prograMme of the Seminar was finalized and

decisions made in relation to the composition of the study groups, the

EM/NURS./149 ANNEX V page x

WHO EMRO

presentation of the topics, setting up the library, developing the eva

luation quest~onna~re and various other individual and committee

responsibilities. Thu group met for two days follow~ng the closure

of the Sem1nart to summarize proceedings, discuss the preparation of

the final report and evaluate the f\mctiomng of the Resource Staff.

nursing seminar teheran, 9-19 november 1966

Documents