Nursing Education In India: Anm, Gnm, B.sc And Pbb.sc

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INTRODUCTION Florence Nightingale is credited with founding modern nursing and creating the first educational system for nurses. After hospitals came into existence in Western Europe, and prior to the influence of Florence Nightingale, hospital care was given by women such as prisoners and prostitutes, who were held very low regard by the society. These women learned to give care by doing it. There was no organized programme to educate nurses. Florence Nightingale stressed that nursing was not a domestic, charitable service but a respected occupation requiring advanced education. She opened a School of Nursing at St. Thomas Hospital, London, in 1860 and established basic principles for the school.

PATTERN OF NURSING EDUCATION AND TRAINING PROGRAMMES IN INDIA Nursing Council Act came to existence in 1948 to constitute a council of nurses who would safe guard the quality of nursing education in the country. The mandate was to establish and maintain uniform standards of nursing education. Today, Indian nursing council is a statutory body that regulates nursing education in the country through prescription, inspection, examination, certification and maintaining its stands for a uniform syllabus at each level of nursing education. The strive for maintenance of a uniform standards and pattern of nursing education has curbed creative development and experiments for expansion of nursing in to newer horizons of nursing education. There are seven levels of nursing education in India today. They are: •

Auxiliary Nursing and Midwifery (ANM) or Multi Purpose Health WorkerFemale (MPHW-F)



General Nursing and Midwifery (GNM)



Basic Bachelor of Nursing (B.Sc. Nursing)



Post Basic Bachelor of Nursing (P.B.B.Sc. Nursing)



Masters in Nursing (M.Sc. Nursing)



Masters of Philosophy in Nursing (M.Phil)



Doctorate in Philosophy in Nursing (Ph.D) The ANM and GNM courses are conducted in schools of nursing. Rest of the

programmes is university level courses and the respective universities conduct the examinations. Beside there are several certificated and diploma courses in specialties.

AUXILIARY NURSING AND MIDWIFERY (ANM) OR MULTI PURPOSE HEALTH WORKER- FEMALE (MPHW-F) The ANM training was for 2 years and mainly covered maternal and child care and family welfare. In keeping with the policies of the Government of India to have multipurpose health workers, the Indian Nursing Council revised the ANM’s syllabus in 1977 and reduced the duration to 18 months. The focus of training is on community health nursing. In some states, nursing is offered at the higher secondary school level or after class ten as part of vocational training. The employment opportunities are that can work as multipurpose health workers. The minimum qualification for teaching is B.Sc. (N) and M.Sc. (N) candidates are preferable. To provide clinical experience in fundamentals of nursing, medical surgical nursing and maternal and child health nursing, institutions should have with general hospital with a minimum of 160 beds covering all the general conditions.

Objectives: General: At the end of the training programme, the student health worker should demonstrate ability to plan and carry out job responsibilities assigned to her under the multipurpose worker scheme. Specific: •

Perform basic health care activities in community and institutional setting



Plan and carry out nutrition and health education activities in the home, clinic and community



Provide immunization services, family health care and family planning services.



Participate in prevention and control of communicable disease, promote environmental sanitation.



Promote community development activities.

Duration: Training duration is 18 months (1 ½ years)

INC Norms for ANM: Minimum Standard Requirements: •

A school for training of the ANMs should be located in a community health centre (PHC annex) or a rural Hospital having minimum bed strength of 30 and maximum 50 and serving an area with community health programmes. The school should also be affiliated to a district hospital or a secondary care hospital in order to provide experiences of secondary level health care and an extensive gynae-obstetrical care.



An organization having a hospital with 150 beds with minimum 30-50 obstetrics and gynecology beds, and 100 delivery cases monthly can also open ANM School. They should also have an affiliation of PHC/CHC for the Community Health Nursing field experience.



Existing ANM schools attached to District hospitals should have PHC annex (accommodation facility for 20-30 students) for community health field experience.

Physical Facilities: Office Room Classroom Nursing Laboratory Nutrition Laboratory Library cum Study Audio Visual Aids room

1 2 1 1 1 1

Clinical Facilities: •

School has to be affiliated to district hospital or a secondary care hospital with minimum 150 beds



Bed occupancy on the average to be between 60% - 70%

Teaching Facility: (Teaching faculty for 20-40 annual admission) Category Principal

Nursing Tutor

Minimum qualification and experience M.Sc. Nursing with 3 years of exp or B.Sc. (N) with 5 years of teaching experience B.Sc. Nursing/Diploma in Nursing Education & Administration/Diploma in Public Health Nursing with 2 years clinical experience

GENERAL NURSING AND MIDWIFERY (GNM) In 1918, Diploma Nursing Programme has been started in Lady School of Nursing. The International Council of Nurses believes that a basic in nursing should prepare nurses for first level positions in nursing both in the hospital and community. It gives importance for restoring and maintaining health, and in preventing disease and also helps to develop a deep pride in the nursing profession among students to enable further professional growth. The general nursing and midwifery course is conducted in 477 centers in the country. The syllabus has undergone many revisions according to the change in the health plans and policies of the Government and changing trends and advancements in general education, nursing health sciences and medical technology. The latest revision of syllabus by INC in 2004 has increased the duration of the course from three year to three and half year. The basic entrance has become intermediate or class 12 instead of earlier class 10. Both science and arts students are eligible. The focus of general nursing education is the care of sick in the hospital. Schools of nursing are generally attached to teaching hospitals. Three Board examinations are conducted, one at the end of each year. On passing the candidates are registered as registered nurse and mid –wife by the respective state nursing councils.

Philosophy:

The Indian Nursing Council believes that the basic course in nursing is a formal educational preparation which should be based on sound education principles. The council recognizes that the program as the foundation on which the practice of nursing is built and on which depends further professional education. It also recognizes its responsibility to the society for the continued development of student as individual nurse and citizens.

Purpose: The purpose of general nursing programme is to prepare general nurse who will function as member of the health team beginning with competence for first level position in both hospital and community. The programme is generated to the health needs of the society, the community and the individual and will assist nurses in their personal and professional development so that they may take their maximum contribution to the society as individual citizens and nurses.

Objectives: •

Demonstrate awareness of and skills required in the nursing process in the provision of health care and nursing of patients



Apply relevant knowledge from the humanities biological and behavioral sciences in carrying out health care and nursing activities and functions.



Show sensitivity and skill in human relationship and communication in his or her daily works



Demonstrate skill in the problem solving methods in nursing.



Gain knowledge of health resources in the community and the country



Demonstrate skill in leadership



Demonstrate

awareness

of

necessity

of

belonging

to

professional

organizations. •

Promotion of health, precaution against illness, restoration of health and rehabilitation.

Eligibility: •

Age for the entrance shall be 17 years to 35 years, provided they meet the minimum educational requirement i.e. 12 years of schooling.



Minimum education all students should pass 12 classes or its equivalent, preferably with science subjects



Admission of students shall be once a year.



Students should be medically fit.



The selection committee should comprise tutors, nurse administrators, and educationalist/psychologist. The principal of the school shall be the chairperson.

Training programme: The course in general nursing shall be of three and half years duration as follows- two years practice in general nursing , one year community health nursing and midwifery and six months internship which includes nursing administration and nursing research classes. There will be alternate course for male students in lieu of midwifery. The ANM who wishes to undertake general nursing course will not be given any concessions. The maximum hours per week per students shall be 36 hours, which includes instructions and clinical field experiences.

INC Norms for GNM: Physical Facilities: Teaching Block S. No. 1

2 3 4 5 6 7 8 9 10 11

Teaching Block Lecture Hall (i) Nursing foundation lab (ii) CHN (iii) Nutrition (iv) OBG and pediatrics lab (v) Pre-clinical science lab (vi) Computer lab Multipurpose Hall Common room Staff room Principal room Vice principal room Library A.V aids room One room for each Head of Departments Faculty room Provisions for toilets Total

Area (Sq. ft.) 4 @ 1080 = 4320 1500 900 900 900 900 1500 3000 2000 1000 300 200 2400 600 800 2400 1000 23720 Sq. Ft.

Hostel Block S. No. 1 2 3 4 5 6 7 8

Hostel Block Single room Double room Sanitary Visitor room Reading room Store room Recreation room Dining hall Kitchen & store

Area (Sq. Ft.) 24000 One latrine and bathroom(for 5 students)- 500 500 250 500 500 3000 1500 Total 30750 Sq. Ft.

Proportionately the size of the built-up area will increase according to the number of students admitted. Clinical Facilities School of Nursing should have a 120-150 bedded parent/affiliated hospitals for 40 annual intakes in each programme: •

Distribution of beds in different areas  Medical - 30  Surgical - 30  Obst. & Gynaecology - 30  Pediatrics - 20  Ortho - 10



Bed occupancy of the hospital should be minimum 75%



The size of the hospital/nursing home for affiliation should not be less than 50 beds



Other specialities/facilities for clinical experience required are as follows:

 Major OT  Minor OT  Dental  Eye/ENT  Burns and plastic  Neonatology with nursery  Communicable disease  Community Health Nursing  Cardiology  Oncology  Neurology/Neuro-surgery  Nephrology  ICU/ICCU •

Affiliation of psychiatric hospital should be of minimum 30-50 beds



The nursing staffing norms in the affiliated hospital should be as per the INC norms



Affiliated hospitals should be in the radius of 15-30 kms



1:3 student patient ratio to be maintained.

Teaching Facility: Category Principal

Qualification and experience M.Sc. Nursing with 3 years of teaching experience or B. Sc

Vice-Principal

Nursing (Basic)/Post Basic with 5 years of teaching experience M.Sc. Nursing or B.Sc. Nursing Basic/post basic with 3 years of

Tutor

teaching experience M.Sc. Nursing or B.Sc. Nursing(Basic/Post Basic) or Diploma in

nursing education and administration with 2 years of professional experience

BASIC BACHELOR OF NURSING (B.Sc. NURSING) Graduate nursing education started in India in the year 1946 in CMC, Vellore and in the RAK College of nursing at Delhi University. At present several universities in India offer the course.

Eligibility: A candidate seeking admission should have: •

Pass the 2 year of pre university exam or equivalent as recognized by concerned university with science subjects i.e. Physics, biology and chemistry.



Students of vocational courses



Obtained at least 45%of total marks in science subjects in the qualifying exam, if belongs to a scheduled caste or tribe, should have obtained not less than 40 % of total marks in science subjects.



Completed 17 years of age at the time of admission or will complete this age on or before 31st December of the year of admission



Is medically fit

Objectives: The programme is designed: •

To provide a balance of professional and general education



To enable a student to become a professional nurse practitioner who has self direction and is a responsible citizen.

Through planned guided experiences students are provided with opportunities to develop: •

A broad concept of the fundamental principles of nursing care based on sound knowledge and satisfactory levels of skill in providing care to people of all ages in community or institutional setting



Understanding of the application of principles from the physical biological and social sciences for assessing the health status



Ability to investigate health care problems systematically



Ability to work collaboratively with members of allied disciplines towards attaining optimum health for all members of the society



Understanding of fundamental principles of administration and organization of nursing service



Understanding of human behaviour and appreciation of effective interpersonal relationship with individuals families and groups



Ability to assume responsibility for continuing learning



Appreciation of professional attitudes necessary for leadership roles in nursing appreciation of social and ethical obligations to society.

Course of study: The course of study leading to bachelor of nursing degree comprises 4 academic years.

INC Norms for B.Sc. Nursing Physical Facilities: Teaching Block S. No. 1

2 3 4 5 6 7 8 9 10 11

Teaching Block Lecture Hall (vii) Nursing foundation lab (viii) CHN (ix) Nutrition (x) OBG and pediatrics lab (xi) Pre-clinical science lab (xii) Computer lab Multipurpose Hall Common room Staff room Principal room Vice principal room Library A.V aids room One room for each Head of Departments Faculty room Provisions for toilets Total

Area (Sq. ft.) 4 @ 1080 = 4320 1500 900 900 900 900 1500 3000 2000 1000 300 200 2400 600 800 2400 1000 23720 Sq. Ft.

Hostel Block S. No. 1 2 3 4 5 6 7 8

Hostel Block Single room Double room Sanitary Visitor room Reading room Store room Recreation room Dining hall Kitchen & store

Area (Sq. Ft.) 24000 One latrine and bathroom(for 5 students)- 500 500 250 500 500 3000 1500 Total 30750 Sq. Ft.

Proportionately the size of the built-up area will increase according to the number of students admitted. Clinical Facilities School of Nursing should have a 120-150 bedded parent/affiliated hospitals for 40 annual intakes in each programme: •

Distribution of beds in different areas  Medical - 30  Surgical - 30  Obst. & Gynaecology - 30  Pediatrics - 20  Ortho - 10



Bed occupancy of the hospital should be minimum 75%



The size of the hospital/nursing home for affiliation should not be less than 50 beds



Other specialities/facilities for clinical experience required are as follows:

 Major OT  Minor OT  Dental  Eye/ENT  Burns and plastic  Neonatology with nursery  Communicable disease  Community Health Nursing  Cardiology  Oncology  Neurology/Neuro-surgery  Nephrology  ICU/ICCU •

Affiliation of psychiatric hospital should be of minimum 30-50 beds



The nursing staffing norms in the affiliated hospital should be as per the INC norms



Affiliated hospitals should be in the radius of 15-30 kms



1:3 student patient ratio to be maintained.

Teaching Facilities Qualification & Experience of teachers of college of nursing S. No.

Post, Qualification & Experience

1

Professor-cum-Principal •

Masters Degree in Nursing



2

Total 10 years of experience with minimum of 5 years of teaching experience Professor-cum- Vice Principal •

3

Masters Degree in Nursing

• Total 10 years of experience with minimum of 5 years in teaching Reader/Associate Professor •

Masters Degree in Nursing

4

• Total 7 years of experience with minimum of 3 years in teaching Lecturer

5

• Masters Degree in Nursing Tutor/Clinical Instructor •

M.Sc.(N) or B.Sc. (N) with 1 year experience or Basic B.Sc. (N) with post basic diploma in clinical specialty

POST BASIC BACHELOR OF NURSING (P.B.B.Sc. NURSING) Philosophy and Aims:

The faculty believes that nursing is an integral part of the health care delivery system and shire responsibility in collaboration with other allied health professions for the attainment of optimal health for all members of the society. The faculty conceives education as a lifelong learning process. It seeks to render appropriate behavioral changes in students in order to facilitate their development, which assists them to live personally satisfied and socially useful lives. The goal of post certificate degree programme leading to Bachelor of Science in nursing is the preparation of the trained nurse as a generalist who accept responsibility for enhancing the effectiveness of nursing care

Eligibility: The candidate seeking admission must: •

Hold a certificate in General nursing.



Be a registered nurse



Have minimum of two years of experience



Have passed pre university exam in the arts /science/commerce or its equivalent which is recognized the university



Be medically fit



Have a good personal and professional record



Have working knowledge of English

Duration: The programme of the study is two academic years from the date of commencement of programme. Terms and vacations shall be as notified by the university from time to time.

Objectives: The goal of the post certificate programme leading to the bachelor of nursing is the preparation of the trained nurses as a generalist who accepts responsibility for enhancing the effectiveness of nursing care •

Administer high quality nursing care to all people of all ages in homes , hospitals and other community agencies in urban and rural areas



Apply knowledge from the physical, social and behavioral sciences in assessing the health status of individuals and make critical judgment in assessing the health status of the individuals and make critical judgment in planning ,directing and evaluating primary, acute and long term care given by themselves and others working with them



Investigate health care problems systematically



Work collaboratively with members of other health disciplines



Teach and counsel individuals , families and other groups about health and illness



Understand human behavior and establish effective interpersonal relationships



Teach in clinical nursing situations



Identify underlying principles from the social and natural sciences and utilize them in adapting to , or initiating changes in relation to those factors



Acquire professional knowledge and attitude in adapting for leadership roles

INC Norms are same as that of Basic B.Sc. Nursing.

SUMMARY  Florence Nightingale is credited with founding modern nursing and creating the first educational system for nurses.  Nursing Council Act came to existence in 1948 to constitute a council of nurses who would safe guard the quality of nursing education in the country.

 There are seven levels of nursing education in India today. They are: •

Auxiliary Nursing and Midwifery (ANM) or Multi Purpose Health WorkerFemale (MPHW-F)



General Nursing and Midwifery (GNM)



Basic Bachelor of Nursing (B.Sc. Nursing)



Post Certificate Bachelor of Nursing (P.C.B.Sc. Nursing)



Masters in Nursing (M.Sc. Nursing)



Masters of Philosophy in Nursing (M.Phil)



Doctorate in Philosophy in Nursing (Ph.D)

BIBLIOGRAPHY •

B.T. Basavanthappa; NURSING EDUCATION; 2nd Ed; 2004; Jaypee Brothers Medical Publishers; Page No: 8-12



K.P. Neeraja; TEXT BOOK OF NURSING EDUCATION; 2nd Ed; 2005; Jaypee Brothers Publications; Page No: 40-78



B.T. Basavanthappa; NURSING ADMINISTRATION; Jaypee Brothers Publications; Page No: 450-473

Net Reference: www.currentnursing.com www.indiannursingcouncil.org

Seminar

On

Patterns of Nursing Education & Training Programmes in India Submitted to,

Submitted by,

Mrs. Thilagavathi M.Sc.(N),

Mr. Prasanth Kurien Mathew,

Lecturer, SCON, Salem

1st Year M.Sc.(N), SCON, Salem

Submitted on, 24th September 2009

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