Development of nursing education in india: Post-indpendence

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Introduction

On 15th August  1947 India became  independent   and self  govermentation. Social  changes were taking place rapidly but an alarming absence of public health and sanitary  measures continued.The   ratio of nurse to patient remained dangerously low.The opening of nursing  schools  associated with college    gave nursing profession a  higher social and economic status,than it had previously known.  T he  formation of many commission and committees, establishment of INC  and tremendous work of TNAI brought about change in nursing education post independence.

TRAINED NURSES ASSOCIATION OF INDIA

TNAI helps the initiation of university level education in India.  Recommendations of the Bhore committee were implemented within year .

  1. Passing of the INC act
  2. Deputation of Indian nurses abroad for post basic education

The TNAI made significant achievements in  the field of nursing education.It creates awareness among nurses through Nursing  journal  of India and organizing continuing education programmes.  TNAI  also offers scholarships to deserving candidates to take up studies within the country and abroad.

Establishment of Indian Nursing Council

The INC was constituted to establish a uniform standard of education for nurses,midwives,health visitors and auxillary  nurse midwives. The INC act was passed following an ordinance on  December 31st 1947 . The council was constituted in 1949.

Main proposes of  the council.

  1. To set standards and to  regulate the nursing education  of all types in the country.
  2. To p prescribe and specify minimum requirement for qualifying for a particular  course in nursing.
  3. Advisory role in the state nursing council
  4. To collaborate e with state nursing councils,schools and colleges of nursing and examination board.

STATE REGISTRATION COUNCIL.

Functions.

  • Inspect and  accredit schools  of nursing in their state .
  • Conduct the examinations
  • Prescribe rules of conduct.
  • Maintain registers of nurses,midwives, ANM  and health visitors in the state.

The state registration council are autonomous  except they do not have power to  prescribe  the syllabi for courses.

RECOMMENDATIONS OF VARIOUS COMMITTEES PERTAINING TO NURSING EDUCATION.

The recommendations given by committees and commission provided guidelines for improvement and growth of nursing education.

1.    Health survey and development committee (  Bhore committee 1946)

  • Establishment of nursing college.
  • Creation of an all India nursing council.

2.    Shetty committee 1954

  • Improvement in conditions of training of nurses.
  • Minimum requirement for admission to be in accordance with regulation of the INC.

3.    Health survey  and planning committee  (Mudaliar committee 1959-61)

  • Three grades of nurses  viz.  the basic nurses (4yrs), auxillary nurse  midwife (2yrs)  and nurses with a degree qualification.
  • For GNM minimum entrance qualification  matriculation .
  • For degree course passed higher secondary or pre university.
  • Medium of instruction   preferably English in General nursing.
  • Degree course should be taught only in English.

4.   Mukherjee   committee, 1966.

  • Training of nurses and ANM’S required for family planning.

4.    Kartar singh committee,1972-73

  • Multipurpose health worker scheme
  • Change in designation of ANM’s and LHV
  • Setting up of training division at the ministry of health and family  welfare

7. Sarojini varadappan committee, 1990  (A high power committee on          nursing and nursing profession.)

  • Two  levels of nursing personnel
  • Post basic BSc  nursing degree to continue
  • Masters in nursing programme to be increased and strengthened.
  • Doctorate in nursing programme  to be started in selected university.
  • Continuing education and staff development for nurses.

8.    Working  group on nursing education and manpower,1991.

  • By 2020  the GNM programme to be phased out
  • Curriculum of  BSc  nursing to be modified
  • Staffing norm should be as per INC
  • There should be deliberate plan for preparation of teachers MSc/Mphil  and PhD  degrees.
  • Improvement in functioning of  INC
  • Importance of continuing education for nurses.

DEVELOPMENT OF NURSING EDUCATIION.

Basic General Nursing And  Midwifery Education

1.    Training of Dais(Birth Attendant )

The Dai training continued past independence. The goal  was  to train one  Dai in each village and ultimate goal was to train all the practicing Dais  in country

Duration of training was 30 days. No age limit was prescribed, training include theory and practice, more emphasis on field practice. This training was done at subcentre and equipments provided by UNICE F.

2.    Auxillary Nurse  Midwife

In 1950 Indian Nursing Council came out with some important decisions  relating to future patterns of nursing training in India.One of the important decision was that there should be only two standard of training nursing and midwifery, subsequently the curriculum for these courses were prescribed.

The first course was started at St. Marys Hospital Punjab,1951.The entrance qualification was up to 7/8 years of schooling.The period of training was 2 years  witch include a 9 month of midwifery and 3 months of community experience.

In 1977,  as a result  of the decision to prepare multipurpose health worker& vocationalization of higher secondary education, curriculum was revised a designed to have 1.5 year of vocationalized ANM programme and six months of general education.The entrance qualification  was raised from 7th passed to matriculation passed.

Under multipurpose scheme promotional avenue was  opened to senior ANMS for undergoing six months promotional training for which course was prescribed  by INC.

3.    Lady Health Visitor Course

Training of LHV course continued post independance.The syllabus prepar ed and  prescribed by INC in 1951.The entrance qualification was metriculation.The duration was two and a half years which subsequently reduced to 2 years.

4 .  General Nursing And Midwifery Course

GNM course  existed since early years of century.In 1951,syllabus was prescribed by INC.In  1954 a special provision was made for male nurse.In1954 public health was integrated into basic nursing course.

First revision of course was done in 1963. In1964-65 Psychiatric nursing was included in curriculum.The duration of course was reduced from 4 years to 3.5 years. Second revision was done in 1982. The duration of the course reduced to 3 years.The Midwifery training of one year duration was gradually reduced to 9 months and then six months,  finally three year integrated programme of GNM was prescribed in 1982.

5.Post-Basic/Post Certificate Short-Term Courses And Diploma Programmes

During 1948-50 four nurses were sent to the U.K.by Govt. of India for mental health nursing diploma.During 1954 Manzil Medical Health centre,Lucknow gave psychiatric nursing orientation course of 4 – 6weeks duration. In 1951 a one year course in public health was started at college of nursing Delhi.Govt. of India felt urgent need for psychiatric nurses during 1953-54,this resulted in first organized course at All India Institute of Mental Health.

In 1962 diploma in peadatric nursing was established at J.J.Group of Hospitals, Bombay.At present there are many other courses of three months duration which are monitored and recognized by INC.The ultimate aim of all the post-basic/ post certificate programme is to improvement of quality of patient care and promotion of health.

University-Level Programmes.

1.Basic BSc Nursing

First university programme started just before independence in 1946 at university of Delhi.and CMC Vellore. In 1949, on recommendation of university education committee and education commission(1964-66) and conference&workshop held by TNAI,The WHO and UGC,some more colleges came up in different state affiliated to different state university.

INC  prescribes the syllabus which has been revised three times,the  last revision was done in 1981.It was done on basis of the 10+3+2 system of general education.At present the BSc Nursing programme which is recommended by the INC is of  four years and have foundations for future study and specialization in nursing.

2. Post Basic  BSc Nursing

The need for higher training for certificate nurses was stressed by the Mudaliar Committee  in1962. Two years  post basic certificate  BSc(N) programme  was started in December 1962.for nurses with diploma in general and midwifery with minimum of 2 years experience. First started by university of Trivandrum. At present there are many colleges in India offering Pc BSc(N) Course.

3.  Post Basic Nursing by Distance Education Mode.

In1985 Indira Gandhi   National open university was established. In1992  Post Basic BSc Nursing programme was launched, which is three years duration course is recognized by INC.

4. Post- Graduate Education-MSc Nursing

First two years course in masters of nursing was started at RAK  College of Nursing in 1959.and in 1969 in CMC Vellore. At present there are many colleges imparting MSc Nursing degree course in different specialties.

5. M.Phil

INC felt need for M.Phil programme as early on 1977,for this purpose committee was appointed.In 1986 one year full time and two years part time programme was started in RAK College of nursing Delhi.

6. Ph.D in Nursing

Indian nurses were  sent abroad for Ph. D programme earlier. From1992 Ph D in nursing  is also available in India.MAHI is one of the university having PhD programme.

Current Educational Patterns In Nursing

1.Non University Programme

  • Basic – ANM-GNM
  • Advance-Post-Certificate diploma

2. University Programme

  • Basic- BSc(N)
  • Post-Basic BSc(Regular)
  • Post-Basic BSc(N).IGNOU
  • Advance:MSc (Nursing)
  • M. phil
  • Ph.D.

Trends in nursing education changes from basic general nursing service to doctorate education in nursing.

 

Conclusion

Nursing education have expanded considerably post independence. University education in nursing brought about changes in nursing education.The type of nurses required today is an “all round personality”. Education brings changes in behaviour of the individual in a desirable manner.It aims at all round development of an individual to become mature,self-sufficient,intellectually,culturally refined.socially efficient and spiritually advanced.

Bibliography

  1. Wilkinson, A. (1965).  ‘History of Nursing in India and Pakistan’. New Delhi, TNAI.
  2. Annamma, K.V. (189). ‘A New Text book for Nurses in India’. Madras, B. I. Publications.
  3. Honda, U. and Gulani, K. K. (1995). ‘Community Health Nursing’, New Delhi, Ignon Publications.
  4. Sandaranarayanan, B. and Sindhu, B. (2003), ‘Learning and Teaching Nursing’, Calicut, Brainfill.
  5. Neeraja K. P. (2003), ‘Text Book of Nursing Education’, New Delhi: Jaypee Brothers.
  6. TNAI (2000). ‘History and trends in Nursing in India’, New Delhi.
  7. Hurndr, R. and Letiman, B. (183).  ‘Nursing Education in India’, New Delhi.
  8. TNAI (1995). ‘Indian Nursing Year Book’, 1993-95, New Delhi – TNAI.
  9. TNAI (2002), ‘Indian Nursing Year Book’, 2000, New Delhi – TNAI.
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