INTRODUCTION-

Professional organizations provide a mean through which professional development can be channeled with authority
because of their representative character. It provides an opportunity to express our viewpoints, develop leadership
qualities and abilities and keep well informed of professional trends and news. All nurses must participate in their
professional state and national organizations to keep themselves informed of new developments and for upgrading the
profession.

DEFINITION-
o Profession -
R Louise; Mc Manur in1952, defined it as “ an occupation based on specialized intellectual study
and training the purpose of which is to supply skilled service with ethical component to others for
a definite fee or salary.”

o Organization –
According to L White, organization is the arrangement of personnel for facilitating the
accomplishment of some agreed purposes through the allocation of function and responsibilities.

o Regulatory bodies –
Regulatory body is the formal organization designated by a statue or an authorized government
agency to implement the regulatory forms & process whereby order, consistency and control
are brought to the profession and its practice.

Some of the organization discussed below are recognized at national and international level and have a

great role in uplifting the nursing profession :

 Regulatory bodies
 Professional associations

OBJECTIVE OF REGULATORY BODIES AND PROFESSIONAL

NURSING ASSOCIATION -
1. To ensure the public’s right to quality healthcare service.
2. To support and assist professional members.

Health professional such as nurse, doctors, pharmacists and many others are regulated and licenced

by regulatory bodies as required by provincial/territorial legislation.

ROLE/PURPOSE OF REGULATORY BODIES AND PROFESSIONAL
NURSING ASSOCIATIONS-
Nursing regulatory bodies are responsible for licensing of nurses within their respective territory And
receive their authority from legislation, which gives them the ability :

1. To set and enforce standards of nursing practice ;

2. To monitor and enforce standard of nursing practice ;
3. To monitor and enforce standard of nursing education ;
4. To set the requirements for registration of nursing professional.

All of these activities are vital to ensure protection of the public interest.

PRINCIPLE OF REGULATION-
Efficiency and Economy-

There is a need to use resources in the most efficient and economy way. The non-executive committee of

board is required to oversee allocation of resources and to report to the Treasury every year.

Role of management –

The body’s senior management is responsible for its activities and for ensuring that its business complies

with regulatory requirements. Senior management is responsible for risk management and controls within

the body.

Proportionality –

The restrictions imposed must be proportionate to the benefits that are expected to result from those

restrictions.

Innovation –

This involves, allowing scope, and not to unduly restrict participants from launching new ideas and services.

International character -

This involves cooperating with overseas regulators, both to agree international standards and to monitor

global activities effectively.

Competition -

Competition and innovation consideration play a key role in its work.

 ROLE OF ICN IN NURSING

o INTERNATIONAL COUNCIL OF NURSES ( ICN )

The International council of nurses is a federation of non-political and self- governing national
nurse’s association (NNAs), which seeks to attain high standard of nursing service and nursing education,
to develop nursing as a profession and to safeguard the social and economic welfare of nurses in their
own countries. ICN representing nurses in more than 128 countries. Founded in 1899, ICN is the
oldest international professional organization in the health care field operated by nurse for nurses. ICN works
to ensure quality nursing care for all, sound health policies globally, the advancement of nursing
knowledge and the presence of world wide of a respected nursing profession and a competent and
satisfied nursing workforce. The headquarters of ICN are placed at Geneva, Switzerland.

MISSION –

To represent nursing worldwide, advancing the profession and influencing health policy.

PURPOSE AND SCOPE –

ICN is a federation of nurse’s association around the world which have bonded together to better
develop nursing’s contribution to the promotion of health and care of the sick. It was one of the health
care organization to adopt strict policy of non-discrimination in matters regarding nationality, race,
creed, colour, politics, sex or social status. ICN accepts into membership of one association of nurses
per country.

GOALS AND OBJECTIVE –

1. To promote the development of strong national nurse’s association.

2. To assist national nurse’s association to improve the standards of nursing and the competence.
3. To assist national nurse’s association to improve the status of nurses in their countries.
4. To serve as the authoritative voice for nurses and nursing internationally.

IN SHORT, 3MAIN GOALS –

1. To bring nurses together worldwide.

2. To advance nurses and nursing worldwide.
3. To influence health policy.
CORE VALUES –

1. VISIONARY LEADERSHIP
2. INCLUSIVENESS
3. FLEXIBILITY
4. PARTNERSHIP
5. ACHIEVEMENT

ORGANIZATION OF ICN -

The ICN was founded in 1899, with the united states, Great Britain and Germany as its charted members.
The ICN is governed by a council of national representative (CNR). The CNR is governing body of ICN
and sets policy, admit members, select a board of directors, and set dues. National member are selected by
each member association. The CNR meets every two years. Between meetings of the CNR, the ICN
is governed by a15 member board of directors. Members of the board include the ICN president, and
14 director elected on the basis of proportional representation from the ICN’s seven geographic areas.
The board meets at least once a year, although it usually meets three to four times a year. The ICN has
four officers. They include a president and three vice presidents. The officers function as an
executive committee for the board, and as the board’s budget and finance committee. The president is
elected by CNR. The vice president elected from among the board members. The highest vote getter, is the
first vice president, and then second and third. Day to day operations of ICN are overseen by a CEO.
In practice, the CEO exercise most of the power within the ICN.
MEMBERSHIP is limited to one nursing organization per nation. In most cases, this is the national

nurse’s association( such as the American nurses association, the Slovak chamber of nurses and

midwives, trained nurses association of India or the nursing association of Nepal).

ICN IS ACTIVELY WORKING FOR -

1. PROFESSIONAL NURSING PRACTICE –

o Advance nursing practice
o HIV/TB and Malaria
o Women’s health
o Primary health care
o Family health and safe water
2. NURSING REGULATION –
 Code of ethics, standard and competencies
 Continuing education
3. SOCIO-ECONOMIC WELFARE FOR NURSES -
 Occupational health and safety
 Human resources planning and policies
 Carrier development
 International trade in professional service

FUNCTIONS OF ICN –

1. To provide policy direction to fulfil the objective of ICN.

2. To establish categories of membership and determine their right and obligations.
3. To act upon recommendations of the board of directors relating to admission and
Readmission of member association into ICN.
4. To receive and consider information from the board regarding ICN activities.
5. To receive nominees for the board and to elect the board.
6. To act upon recommendations of the board of directors for the amount of NNA’s dues.
7. To act through mail or any written communication on ICU business that requires
immediate attention.

CONFERENCE AND PROJECTS –

The ICN host a quadrennial conference every four years in conjunctions with the meeting of the CNR.

The conference hosts a large number of professional practice workshop, poster session, luncheons,

speaking events, plenary session. ICN hosts other conferences on as need basis. Recently conference

have cover topic such as international nurse migration issues, regulation of the nursing profession,

rural nursing, leadership issue, advance practice, workplace violence. The ICN sponsors international

nurse’s day on every may 12.

The ICN is an official supporting organization of HIFA 2015 ( healthcare information for all by 2015 ).
 REGULATORY BODIES
Regulatory body is the formal organization designated by a statue or an authorized government agency
to implement the regulatory forms & process whereby order, consistency and control are brought to
the profession and its practice. They provide valuable resources for both nurses and public and they serve
as forum of communication with consumer, business, industry and government on matters affecting
nursing and nursing practice.
There are two regulatory bodies in nursing in India are as follows :
o Indian nursing council
o State nurse’s council

o INDIAN NURSING COUNCIL (INC )

The Indian nursing council is an autonomous body under the government of India, ministry of health and
family welfare constituted by the central government under section 3(1) of the Indian Nursing
Council Act,1947, of parliament in order to establish a uniform standard of training for nurses, midwives
and health visitors. As the council was constituted to establish uniform standard, it has power to
prescribe curricula for the various courses for nursing personnel and to visit teaching centre and to
recognize qualification, or withdraw such recognition. The power to give recognition to such bodies is
vested in Indian nursing council alone, but before recognition is given, the council board must be
recognized by the state government.
ESTABLISHMENT- The Indian nursing council act was passed by an ordinance on December 31, 1947.
The council was constituted in 1949 to establish a uniform standard of education for nurses, midwives,
health visitors and auxiliary nurse midwives.

AMENDMENTS IN INC ACT 1957 -

The Act was amended in November 1957 to provide for the following things:

Foreign qualification-

a) A citizen of India holding a qualification which entitles him or her to be registered with any
registering body may, by the approval of the council, be enrolled in any state register.
b) A person not being citizen of India, who is employed as a nurse, midwife, ANM, Teacher

or administrator in any hospital or institution in any state, by the approval of president of council,
 be enrolled temporarily in state register. In such case foreign qualification are recognized temporarily
for a period of 5 year. If one continues to practice in India, an extension of recognition should be
sought from INC.

Indian nurses register –

a) The council shall maintain a register of nurses, midwives, ANM, and health visitors to be known as
the Indian nurse register, which shall contain the name of all persons who are for the time
being enrolled on any state register.

b) Such register shall be deemed to be a public document within the meaning of Indian Evidence Act .

COMPOSITION / CONSTITUENTS -

INC is composed of representative of :

 State registration council

 Central and state health department
 Military nursing service
 Indian red cross society
 College and school of nursing
 Health school
 Post certificate school
 TNAI
 Medical council of India
 Indian medical association
 Members of parliament

Indian nursing council act, 1947, provides constitution of the council consisting of the following :

 One nurse enrolled in state register elected by state register council.

 Two members elected from among themselves by the head of institutions recognized by the council
for the purpose of these clause in which training is given :
- For obtaining a university degree in nursing
- In respect of a post certificate course in teaching of nursing and in nursing administration

 One member elected from among themselves by the head of institution in which health visitors
are trained.

 One member elected by the medical council of India.

 One member elected by the central council of the Indian medical association.
  One member elected by the council of TNAI.

 One midwife or auxiliary nurse midwife enrolled in a state register, elected by each of the state
councils in the four groups of state mentioned below, each group of states being taken in rotation
in the following order :
- Kerala, Madhya Pradesh, Uttar Pradesh and Haryana
- Andhra Pradesh, Bihar, Maharashtra and Rajasthan
- Karnataka, Punjab and West Bengal
- Assam, Gujarat, Tamil nadu and Orissa

 The director general of health services, ex-officio.

 The chief principle matron, medical directorate, army headquarter.

 The chief nursing superintendent, office of the director general of health services.

 The director of maternity and child welfare, Indian red cross society.

 The chief administrative medical officer of each state other than a union territory.

 Four members nominated by the central government , of whom atleast two nurses, midwives or
health visitors enrolled in a state register and one shall be an experienced educationalist.

 Three member elected by parliament, two by the house of the people from among its members and
the other one by the council of states from among its members.

COMMITTEES –

1. Executive committee to deliberate on the issue related to maintenance of standards of nursing

programs.

2. The nursing education committee to deliberate on the issue concerned mainly with nursing
education and policy matters concerning the nursing education.

3. Equivalence committee to deliberate on the issue of recognition of foreign qualification which

is essential for the purpose of registration under section 11(2) (a) or (b) of the nursing council act,
1947, as amended.

4. Finance committee : This is another important committee of the council which decides upon the
matters pertaining to finance of the council in term of budget, expenditure, implementation of
central govt. Order with respect to service condition etc.
FUNCTIONS OF INC -

1. To establish and monitor a uniform standard of nursing education for nurses, midwife, auxiliary
nurse: midwives and health visitors by doing inspection of the institutions.

2. To recognize the qualifications under section 10(2)(4) of the Indian nursing council Act,1947, for
the purpose of registration and employment in india and abroad.

3. To give approval for registration of Indian and foreign nurses possessing foreign qualification
under section 11(2)(a) of the Indian nursing council Act,1947.

4. To prescribe minimum standards of education and training in various nursing programme and
prescribe the syllabus and regulations for nursing programs.

5. Power to withdraw the recognition of qualification under section 14 of the Act in case the
institution fails to maintain its standards under section 14(1)(b) that an institution recognized by a
state council for the training of nurses, midwives, ANM or health visitors does not satisfy
the requirements of council.

6. To advise the state nursing council, examining boards, state governments and central government
in various important items regarding nursing education in the country.

7. To regulate the training policies and programs in the field of nursing.

8. To recognize the institution /organizations/universities imparting master’s degree/bachelor’s degree

/PG diploma/diploma/ certificate course in nursing.

9. To maintain Indian nurses register for registration of nursing personnel.

10. To improve the quality of nursing education.

11. Prescribe code of ethics and professional conduct.

GUIDELINES FOR ESTABLISHMENT OF NEW NURSING SCHOOL/COLLEGE IN

INDIA APPROVED BY INC -

1. Any organization under the central government, state government, local body or a private or
public trust, mission, wishes to open a school of nursing should obtain no objection
/essentiality certificate from the state government.

2. The Indian nursing council on receipt of the proposal from the institution to start nursing
programme , will undertake the first inspection to asses suitability with regard to
 physical infrastructure, clinical facility and teaching faculty in order to give permission to start
the program.

3. After the receipt of the permission to start the nursing program from INC , the institution shall
obtain that approval from the state nursing council and examination board.

4. Institution will admit the students only after taking approval of the state nursing council
and examination board.

5. The INC will conduct inspection every year till the first batch completes the program. Permission
will be given year by year till the batch completes.

INSPECTION DONE BY INC FOR VARIOUS NURSING PROGRAMS –

First inspection –

The first inspection conduct on receipt of the proposal received from the institute to start any nursing

program prescribed by INC.

Re -inspection –

Re-inspection are conduct for those institutions, which are found unsuitable by INC. The institution and
the government are informed about the deficiencies and advised to improve upon them. Once the
institution takes necessary steps to rectify the deficiencies, institution should submit the compliance report
with documentary proof of the deficiencies pointed out and re-inspection fees. On receipt of the
compliance report and fees from the institution, it will be considered for re-inspection.

Periodic inspection –

INC conducts periodical (after 3 years) inspection of the institution once the institution is found suitable by
INC to monitor the nursing education standards and adherence of norm prescribed by INC. Institutions
are required to pay annual affiliation fee every year. However, if the institution does not comply with
the norms prescribed by INC for teaching, clinical and physical facility, the institution will be
declared unsuitable.
RESOLUTIONS –

i. Maximum period for students to complete revised ANM and GNM course is 3 and 6 years
respectively.

ii. INC resolved that maximum age for teaching faculty is 70 years subject to the condition that
he/she should be physically and mentally fit.

iii. Admission to married candidate for all nursing program allowed to the condition that they
should produce medical fitness certificate.

iv. Relaxation of norms to establish MSc(N) programme : as per INC norm, only those institution can
start MSc program where at least one batch of students has qualified BSc(N) program. INC
resolved apart from these institution, the superspeciality hospital can also open the MSc(N)
program. Even though institution is not having BSc (N) program.

v. Relaxation of student patient ratio for clinical practice: 1:3 instead of 1:5

vi. Relaxation of teaching faculty qualification to start a BSc(N) programme. At least 2 MSc(N)
qualified faculty to be available for next 4 years in order to combat acute shortage of nursing
and teachers till the position of MSc(N) qualified teaching faculty improves.

vii. To maintain quality of postgraduate in nursing, INC resolved not to have MSc(N) program
through distance education.

viii. Institution should have its own building within 2 years of establishments.

ix. Maximum no. Of 60 seats can be sanctioned to those institution which are having less than 500
bedded hospital and 100 seats can be sanctioned to those having 500 bedded hospital.

x. Registration of additional qualification.

INITIATIVES BY INC -

 Teaching material for quality assurance model (QAM) :

QAM in nursing is the set of elements that are related to development of objectives
setting, communicating standards, developing indicators, setting thresholds, collecting data to
monitor compliance with set standard for nursing practice and applying solution to improve care.
QAM projected implemented in 2 hospital in New Delhi and PGI.

 Princess srinagarindra award:

It is international award to individual registered nurse in honour of princess srinagarindra, her
royal highness and in recognition of her contribution towards progress and advancement in field
 of nursing. Mrs.sulochana Krishnan, Ex principal of RAK college of nursing was awarded by this
award and her name was proposed by INC.

 Development of curriculum for HIV/AIDS and training for nurses :

INC in collaboration with NACO and Clinton foundation is developing a curriculum for training
of nursing in HIV/AIDS areas. It will be a 6 days training program.

 National consortium for Phd in nursing constituted 6 study centres :

MOU has signed between INC, WHO and RGUHS that national consortium for Phd in nursing has
been constituted by INC and RGUHS and WHO, under the faculty of nursing to promote
doctoral education in various field of nursing.

 Memorandum of understanding (MOU) :

Signed between INC and sir Edward Dunlop Hospital Ltd for advancing standards of nursing
education and practices in India to meet challenges currently faced by nursing with the
following objective :

1. Provide training

2. Graduate, postgraduate and Phd course

3. Organizing research activities

4. To help fill gap in India and international standard of nursing education and practice, so that
Indian nurses can directly be accepted to meet international standards.

5. Train the faculty so high quality teaching staff can be provide to institutes in the country.

6. Steps taken up to enter into MRA under the Comprehensive Economic Cooperation
Agreement (CECA) between India and Singapore which was signed in june 2005 and come
into force 1st august 2005. In that , it has been agreed that India and Singapore would enter
into mutual recognition agreements (MRAs) in medical, dental and nursing services in
the healthcare sector.

7. All state Registrars were invited to attend the two day meeting. The objective was to ensure
the uniformity and maintain the quality of nursing education in the country. It was also aimed
to understand the problem /issue of each state nursing council and evolve consensus between
INC and SNRC.
 o STATE REGISTRATION COUNCIL
The first step towards the establishment of registration council was taken in Bombay, where in July 1903,
the surgeon-general with the government of Bombay put up an approval to his government for
the establishment of the nursing service and appointment of an experienced nurse to be at the head of
the service and responsible to the surgeon-general. For various reason this proposal was not accepted,
but it was followed by further discussion which led ultimately to the establishment of the Bombay
Presidency Nursing Association in December 1909.
The state nursing council is independent and recognized as a body which can make state regulation for
trained nurses and nurses who are undergoing various courses of studies. Though the state nursing

council functions independently , it has to obtain approval from the state government for the by-laws

passed by it and decision taken.

OBJECTIVE-

1. To obtain uniform standards and system of training and examinations, and

2. To provide for the registration of nurses and midwives who qualified under this system.

POWER OF THE STATE REGISTRATION COUNCIL –

The state registration council has power to prescribe regulation and syllabi for the various training courses,

to recognize examining bodies and to negotiate reciprocity.

FUNCTION OF THE STATE REGISTRATION COUNCIL –

1. To accredit and inspect schools of nursing in their states.

2. Conduct examinations.
3. Prescribe rules of conduct, take disciplinary action etc.
4. Maintenance of register of nurses, midwives, auxiliary nurse midwives and health visitors.
5. Registration of nurses and midwives in their state.

REGISTRATION –

A register is maintained by each state registration council. Registration system helps to maintain the high

Standard amongst the professional nurses. It serve as a legal protection to the nurse and also to the public

as it prevents practicing of unqualified and incompetent persons.

PROCEDURE -

 The institute where the student has received education usually initiate the registration process.
The examining authority usually the state nursing council, issue a diploma to nurses after
successfully complete the recognized educational programme. Then they should apply to the
registration council with properly filled form along with the certificate from the hospital authority

stating that she has completed the course, and a xerox copy of the certificate has to be attached to

the form while applying for registration.

 After going through all the details in the form and attached documents, the name of the nurse
is extended in state register maintain in the council and registration certificate is issued to her which
bear registration no. and part of the register in which her name is registered.

 If the nurse is wishes to obtain registration in foreign country, she takes the help of the state
Registration council and her application is channeled through this body.

RENEWAL OF REGISTRATION –

 The state nursing council makes a rule that the nurse should renew her registration so that the
council can keep the control on registered person practicing the profession in the state.

 The renewal is also obtained by filling an application form which is sent along with the xerox copy
of the original registration certificate and necessary renewal fees. The state council after checking
them with the registers and confirming , issue the certificate.

 The diploma certificate, registration certificate and renewal certificates must be preserved by
every nurse for future references.

 The registration certificate serve as a legal proof of professional identity and renewal certificate
indicate that she is still in active practice.

ORGANIZATION –
All state nursing councils is administratively headed by a registrar who is a nurse. There is also a
deputy registrar who is also a nurse. The ministerial staff consist of superintendent, accountant, and other
staff as a clerk and peons to help the registrar in her daily work and functions.
BIBLIOGRAPHY –
1. Navdeep Kaur brar, HC Rawat. Text book of advance nursing practice. 1st edition, New Delhi: jaypee
brothers medical publishers ; 2015.
2. BT Basvanthapa. Nursing administration. 3rd edition, New Delhi: jaypee publishers; 2000: pg.474-510.
3. Potter & Perry. Fundamental of nursing. 5th edition, Mosby ; 2001 : pg no. 401-23.
4. http://www.shutterstock.com/search/icn
5. http://www.icn.ch/
6. www.indiannursingcouncil.org/
7. https://timesofindia.indiatimes.com/topic/indian-nursing-council
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