TRANDES AND ISSUES

IN
NURSING PROFESSION

Pro. DR NILIMA SONAWANE

Institute Of Nursing Education
Mumbai-08
Who were..

THE FIRST
‘NURSES’?
HISTORY …..
 Pre Historic Period
God, evil ,Sin Cause Disease
Making Holes In Body To Ward Off
Disease
 Middle Age
-Care was provided primarily by religious
orders , mainly by Nun Sisters
NURSING FROM ANCIENT TO
MODERN ERA ….
 IN INDIA
 King Ashoka, Charaka,Susrutha
are important persons
 East India company introduced
Nursing
 Kashibai Ganpat first trained
nurse.
How Are Nurse’s Portrayed In The
Media? ….Social Status
NURSING AS A PROFESSION
Emerged in late 19th century
Credit is given to Florence Nightingale
 NURSING AS A PROFESSION
Profession is an occupation based
on specialized intellectual study
and training, the purpose of
which is to supply skilled service
with ethical components to
others, for definite fee or salary
 KELLY’S CRITERIA OF
PROFESSION
 The services provided are vital to humanity and the
welfare of the society.
 There is a special body of knowledge which is
continually enlarged through research.
 The services involve intellectual activities,
individual responsibility (accountability) is a strong
feature.
 Practitioners are educated in institutions of higher
learning.
 Practitioners are relatively independent and control
their own policies and activities (autonomy).
 KELLY’S CRITERIA OF
PROFESSION
 Practitioners are motivated by service and
consider that work on important component of
their lives.
 There is a “code of ethics” to guide the
decisions and conduct of practitioners.
 Thee is an organization (association) which
encourages and supports high standards of
practice.
 TRENDS

 Trends:-It denote changes taken place

 Nursing trends:-refers to direction towards
which the different nursing events have moved
or are moving.
 These do not occur independently but each one
has a basis of related changes in other fields.
 Trends in nursing that is changes currently
taking place in any area of nursing
 TRENDS
 Nursing profession serves to meet the need of
the society particularly the needs related to
health
 The changes in society will influence to bring
about changes in nursing profession.
 At present, efforts are made by government of
India to deliver the health care to the
community especially in rural area.
 Overall improvement in the education of
people with ever growing awareness about
health, well being and health need.
 TRENDS
 After independence, government began to
make serious efforts to meet health need of
nation by implementing recommendation of
Bhore Committee.
 Advancement of technology e.g.
Automatization, Industrialization,
Urbanization etc.
 TRENDS
 Medical profession is fastly changing profession.
 Trends in nursing profession are closely related
to those in medical profession.
 The era of specialization & Biomedical science
have far advanced resulting in newer diagnostic
equipment such as scanner, New drugs,
monitoring system in field of health care all over
the world.
 Modern health care facility like ICU, ICCU,
renal unit, organ transplant unit etc super
specialization has come.
TYPES OF TRENDS IN NURSING
 Nursing practice
 Nursing education
 Nursing service
 Nursing administration
 Ethical views
 Legal views
 Health care delivery system
TRENDS IN NURSING PRACTICE
 Comprehensive nursing care in hospital setting
 Primary health care
 Progressive patient care
 Team nursing
 Palliative nursing care
 Self care concept
 Domiciliary care
 Specialized care
 Quality care
 Public Awareness
TRENDS IN NURSING PRACTICE
 Accreditation
 Trauma care
 Medical technology
 Staff development and creation of new post
 Nursing Audit
 Image building
 PRO ( Personal Relation Officer) Concept
 Implication of Laws
 Political influence
 Social media
TRENDS IN NURSING PRACTICE
 Biomedical waste management
 Disaster management
 “Clean India” concept
 Implementation of new National Health
Program and the services
 Paper less hospital and Records and reports
 HMIS
 Patients Bill of Rights
 Multidisciplinary approach
 Emergency care
 TRENDS IN NURSING PRACTICE
Health Personnel
 Staff nurse
 Ward sister
 Supervisor
 Assistant Nursing Superintendent
 Nursing superintendent
 Director nursing
 In service Education Director
 Clinical Nurse Specialist (Pediatric, Oncologist etc. )
 Nurse Anesthetist
 Nurse Research
TRENDS IN NURSING SERVICES
 Private Duty Nurse
 Community Health Nurse
 Nurse educator
 Nursing professor /clinical instructor
 Clinician
 Advanced Practice Nurse
 Nurse Administrator
 Nurse Researcher
 Military Nurse
 Forensic Nurse
 TELE-MEDICINE CLUSTER
FOR VILLAGES
Internet
Kiosk Telemed Internet
Solution Kiosk
Village A
Village B
Healthcare Connectivity
Provider
(Consultation- Connectivity Teleme
Pri/Sec; Delivery of d
Medicines,) Solutio
n
SERVER Internet
at Central Kiosk
Connectivity
Connectivity
Location Village C

Connectivity Teleme
d Teleme
Solutio d
n Solutio
n
Internet
Kiosk
Healthcare can reach every village with Tele-medicine
 ETHICAL TRENDS IN
NURSING
Ethics compromises distinction attitudes,
cultural outlook of professional group.

Ethics are distinction between right and

wrong based on a body of knowledge, not
just opinion.
Tran cultural nursing
 TECHNOLOGY - TRENDS

 Robotics in OTs
 Robotics in Path-labs / Research.
 Laser Technology in surgery
 Instrumentation in medical and surgical
practices.
 Biotechnology, Genomics, Molecular Biology and
Stem cell research.
 TRENDS IN NURSING
EDUCATION
 Auxiliary Nurse Midwife (ANM)
 General Nursing and Midwifery (GNM)
 Post Basic B.Sc Nursing
 M.Sc.
 M. Phill
 PhD in Nursing
 Specialty care
 Nurse practioner
 Expanded and extended education
 TRENDS IN NURSING
EDUCATION
SPECIALIZATION
 Pediatric Nursing
 Oncology Nursing
 Thoracic Nursing
 Operation Theater Nurse
 Certified Registered Nurse Anesthetists
(CRNA)
 Technology in education
 TRENDS IN NURSING
ADMINISTRATION
 Participative administration
 Delegation of responsibilities
 Departmentalized administration
 Separate nursing directorate
 Right to information Act
 Consumer protection act
ISSUES IN NURSING PRACTICE
 Status of nursing profession in society
 Nurse patient ratio
 Diploma Vs degree in
 Nursing care standards
 Values reflected in our nursing performances.
 Attitude, human approach
 Quality in nursing v/s education and practice.
 Legal implication
 Media
ISSUES IN NURSING
ISSUES IN NURSING PRACTICE
 Separate Directorate
 Higher education for senior positions in
nursing
 Different levels of nurses that we need in our
country.
 Non involvement of nurses in nursing matters.
 No political involvement
 Poor pay structures.
ISSUES IN NURSING PRACTICE

 Many hospitals in India had no nurses at all.

 Lack of security and safety.
 Less promotional opportunities
 Harassment by other personnel
 Influence by the medical fraternity
 Inadequate health supplies
 Internal conflict and influence by others
 Disorganization
 ISSUES IN NURSING
EDUCATION
 Nursing Training schools multiplied.
 Lack of independent building for schools and
colleges
 Lack of independent principal for schools and
colleges
 Inadequate hostel facilities for students
 Shortage of qualified teachers in nursing
 Inadequate library facilities
 No UGC pay scales for college teachers in
nursing
 ISSUES IN NURSING
EDUCATION
 Very less or no stipend for nursing students
 Less supply of A.V. aids
 Less promotional opportunities for teachers of
both schools and colleges
 Insufficient efforts to prepare nurses for the job
they are accepted to perform in their work field
in terms of appropriate skills, knowledge and
right attitude and the desired behavior patterns
reflecting the values for caring.
 Non attending education
 ISSUES IN NURSING
ADMINISTRATION
 Non involvement of nursing administrators in
planning and decision making in hospital
administration
 Lack of knowledge in management among
nursing administrators
 Interference of non nursing personnel in
nursing administration
 No written nursing policies or manuals
 No separate budget
 ISSUES IN NURSING
ADMINISTRATION
 No proper job description for various nursing
cadres.
 No organized staff development programs for
nurses like orientation, in-service education,
continuing education etc.
 No special incentives
 Inefficiency of nursing councils of state and
union to maintain standards in nursing
LEGAL ISSUES IN NURSING

 Nurse Practice Act

 Standards of Professional Practice
 Licensure
 Good Samaritan Laws
 Public Health Laws
 Physician-Assisted Suicide
 OTHER ISSUES IN NURSING
 Nursing Shortage
 Patient Satisfaction
 National Patient Safety Initiatives
 Evidence-Based Practice
 Information Age
 Genetics
 Globalization of Health
 Aging Population
 Global burden of infectious diseases
 Global burden of non infectious diseases
 Political will
 PATIENTS SATISFACTION

 Good customer service

 Patient Bill of Rights
 Treat patients like
family
 Healthcare is a business
TRANSCULTURAL NURSING
 Nursing has become a
melting pot
 Nurses are challenged
to be more culturally
aware
 Cultural sensitivity
NATIONAL PATIENT SAFETY
INITIATIVES
 Joint Commission National
Patient Safety Goals
 Institute for Healthcare
Improvement
 ROLE OF A NURSE
 ACREDITATION
 Improve the accuracy of patient identification
 Improve the effectiveness of communication
among caregivers
 Improve the safety of using medications
 Reduce the risk of health care-associated
infections
 Accurately and completely reconcile
medications
EVIDENCE BASED PRACTICE
 Goal is to achieve cost-effective, high quality
patient care based on scientific inquiry
 Nurses need to understand research process
involved
 Nursing care should not be based on opinions,
past practices, but on the results of scientific
research
 Clinical journals
 Practice guidelines
 Nursing research
 INFORMATION AGE
 Consumers today are
more computer savvy
regarding healthcare
 More info on internet
 Consumers could
possibly be more
informed than health
care worker
GLOBALIZATION OF HEALTH
 Healthcare has
become a global issue
 People are mobile,
diseases can travel
 Nurses need to have
an understanding of
the issues pertaining
to global health
 AGING POPULATION
 Population is aging
 Growing concerns
regarding the unique
needs of the elderly
 Gerontological nursing
 NURSING ROLES
 KNOWLEDGE
 Caregiver
 Clinical Decision Maker
 Client Advocate
 Rehabilitator
 Comforter
 Communicator
 Collaborator
 Teacher
 PROFESSIONAL ROLES &
RESPONSIBILITIES
 Autonomy & Accountability
 Caregiver
 Client Advocate
 Educator
 Manager/Clinical Decision Maker
 Communicator
 Collaborator
 Career Development
 AUTONOMY &
ACCOUNTABILITY
 Autonomy is the essential element of
professional nursing
 Person is reasonably independent and self-
governing in decision making & practice
 Increased autonomy=Increased responsibility
 Accountability- nurse is responsible
professionally & legally for type & quality of
care provided
 Regulated through Standards of Practice and
Nurse Practice Act
CLINICAL DECISION MAKER
 Utilizes critical thinking skills
and the nursing process

 Nursing Process: Assessment,

Diagnosis, Planning,
Implementation, Evaluation
 CLIENT ADVOCATE
 Nurse protects the clients human and legal
rights
 Providing information to assist in decision
making
 Patient Bill of Rights
 REHABILITATOR ROLE
 Assist client to return to
optimal level of
functioning
 Nurse helps client to adapt
physically and emotionally
to changes in lifestyle,
body image
 COMFORTER ROLE
 Caring for client as a
human being
 Role is traditional to
nursing
 Care is directed to whole
person, not just a body part
 Demonstration of care and
concern
 COMMUNICATOR ROLE
 Role is central to all other
roles
 Involves communication with
client, family, healthcare
team members, resource
people, and the community
 Without clear, concise
communication it will be
difficult to give effective care
TEACHER / EDUCATOR ROLE
 Explains concepts and facts about
health, demonstrates procedures,
reinforces learning, determines
understanding, and evaluates
progress of learning
 Unplanned or informal education
 Planned or formal education
“
By demonstrating their knowledge in
nursing practice , education and
administration nurses can demonstrate
their expert power. This knowledge may
increase the amount of respect that they
are given by physicians and the society as
such along with personal professional
satisfaction.
“Today’s issues are tomorrow’s trends”