Hospital

Sanjeevini Superspeciality Hospital Bijapur

“ A Closer Look at Nursing Profession ”

INDEX

EXECUTIVE SUMMARY

ORGANIZATION PROFILE

HISTORYOF NURSING

RESEARCH METHODOLOGY

OBSERVATION

CONCLUSION

BIBLIOGRAPHY

ANNEXURE

EXECUTIVE SUMMARY

B.L.D.E.A’s A.S.Patil College Of Commerce PGDHM Vijaypur.

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Organization Profile About Hospital

Sanjivani Hospital was Founded on February 6, 2008 by Dr. Baba Nagannavar & Dr. Vinay & Dr. Siddu Sonnad. Through our dedicated efforts towards noble career, we were able to expand our hospital from Sanjivani Hospital to Sanjivani Super Specialty Hospital, in 2009. Now our hospital is known for multi functionality. At Sanjivani Hospital we have set new benchmarks in quality standards in healthcare delivery, by keeping with the tradition of delivering healthcare at par with the best in the world.

Sanjivani Hospitals, Ahmedabad provides noble healthcare that includes prevention, treatment, rehabilitation and health education for patients, their




families and clients by touching their lives. We have a good team of expert doctors who dedicated their life towards society.

Earlier our hospital was situated at Laxmi Temple area but now with new infrastructure we have our multi speciality hospital at Vijaypur. With 100 bed capacity at Vijaypur. near RNS MOTORS sholapur road. Darga jail cross, Bijapur 586101

Phone : 08352-250950/250954/323639

Email : [email protected]

Website : www.ymail.com

Activities

Medical Camp Gynec Camp Eye Camp Test : Pathology, Blood Test, Urine Test General awareness camp in surrounding areas Hypertension Camp Health Camp Diabetes Camp Homeopathic Camp Ayurvedic camp



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Facilities

Physiotherapy Centre

Physiotherapy is a health profession concerned with optimizing mobility and function and helping the body heal itself. The physiotherapist does that through use of clinical reasoning to choose and apply appropriate treatment to achieve the desired goal.

Sanjivani Super Speciality Physiotherapy center is well equipped with latest equipments, technology and skilled staff to provide effective treatment for all kind of injuries and pains in Ahmedabad. We offer affordable and timely services for orthopaedic injuries and other major injuries.

At Sanjivani Physiotherapy center we perform a comprehensive evaluation to come to the conclusion for the assessment of the condition and then plan out the specific treatment. We try to locate to the root problem and help you recover in the most natural way without any side-effects.

With our experienced and active team we can manage to provide Physiotherapy treatment for all types of sports injuries, from the initial acute stage immediately after injury until the athlete is ready to return to play.

Facilities

Active Physiotherapy Passive Physiotherapy Cardiac Physiotherapy Wax Bath




Ultrasonic Stimulation of nerve Feradic Stimulation of nerve

Colour Doppler Echocardiography

Sanjivani Super Speciality Hospital has advanced and dedicated colour Doppler Echo machine.

Treadmill Stress Test (TMT) TMT is a special feature of our hospital by virtue of vast

experience. Ours is the only hospital with TMT done by DM cardiologist and special attention to accuracy as well as patient safety.

Intensive Coronary Care Unit (I.C.C.U) The ICCU at Sanjivani Super Speciality Hospital is one of the

best and latest equipped ICCU in Ahmedabad. I. C. U. Ward Our I.C.U. Ward consists of Channel Cardiographic Monitors attached, a Defibrillator Machine,

A.B.G. Analyser and round the clock attendance of a Resident Doctor and a Staff Nurse and the rounds of the consultants to monitor the condition of the patients admitted in the ward.

N. I. C. U. Ward We have well-equipped N.I.C.U. Ward with latest equipments for Neonatal patients. We also have a

provision of Radiant Warmer and Pulse-Oxymeter. Ultra Sonography Ultrasound Sonography tests are done under the supervision of experienced and dedicated doctors.



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Other Facility

Backup Generator for Whole Hospital In House Laundry Roof Top Cafeteria ( Food )Services with

o Indiano Gujaratio Punjabio Mughalaio Chinese Dishes

Special feeding advised to ICU Patients by Qualified Dietician

Separated Parking Plot Closed Circuit Camera Monitoring for any Un-

toward Activity 5 Beautiful Designed Consulting Rooms for

Maximum patient comfort. Spacious Waiting Rooms. Well equipped casually for 24 hour Emergency. Pharmacy 24 Hours Ambulance Service

Interventional Pain Clinic

Clinic run by renonwed aneasthetic Dr. Dipak




Desai. Treatment for relief from various intractable pain. EXP.

o Cancer Paino Nerve Paino Organ Paino Pain of spinalcanal stenosis and latrealcanal stenois of spine.o Trigeminal neuralgia.

Thermochoice Baloon Therapy

Treatment done by eminent doctor Dr. Siddu Sonnad ablation of internal urinal wall by high tempereture of 87o degree centigrade which is controlled by computer

This is a nonsurgical technique of treating of treating disfunctional utrerine bleeding.

ICCU

10 Bedded ICU & ICCU. 16 Bedded Well Equipped ICCU with Central

Station. Bed side multi para monitors with invasive

pressure monitoring, Infusion pumps, pacemakers. ICCU is managed by highly trained doctors. Defibrillators, Ultrasonic Nebulisers, Bed side

oxygen, Vaccum, Air Lines. 4 Bedded Separate Post Operative Cardiac CCU. All Beds equipped with Multi Para Monitors with

ECG SPO2 NIBP RESP



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Invagive BP Temperature 2nd Invasive Line

10 State of art ventilators. Intra Aortic Balloon Pump. Bedside Digital X- Rays. Defibrillator (BPL) Ultrasonic nebulizer. Bedside Oxygen, Vacuum Line. Capnography Monitor Available. Muscle Pulsator To Prevent DVT. Facility For Bedside Dialysis. Special Air Beds . Availability of Pacemaker. Infusion Pumps----Syringe Pumps, Volumetric Pumps. Latest Crasn Carts. BIPAP ventilators Available. 2 Beds to 1 Nurse Ratio. ICCU Managed Round the Clock by Qualified Intensivists. Diet Planned By Qualified Dietician. Multiple Parameter central Station.

CT Scan

Sanjivani Hospital also provides facilities like CT Scan and ultrasound and using modern technologies like:

Sub second spiral scanning World’s slimmest gantry design Rapid scanning facility with reconstruction facility 3-D reconstruction Virtual Endoscopy, Bronchoscopy reconstruction

facility

In house pharmacy



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Sanjivani Hospital has a 24x7 in house pharmacy within hospital premises which provides round-the-clock service to inpatients and also to the patients who are coming into the hospital on an outpatient basis.

The pharmacy is stocked with critical life saving medicines and surgical products as also routine prescription drugs.

The pharmacy is equipped with the optimum inventory of the medicines which ensures the availability of all the medicines prescribed by the Doctors. The trained professionals in the pharmacy help our patients for the better care and advices in taking medicines. Utmost care is taken in dispensing medicines and also in giving advices to the patients and hence the pharmacy at our becomes the best.

Dialysis

3 Latest Dialysis Machine (Nipro manufactured). Doing Dialysis in ---- CRF , ARF Patients. Doing SLED in Critically ill Patients. Separate Double RO Filtration Plant of Dialysis

Water. Round The Clock Availability of Dialysis

Technician. Bed Side Multi-Para Monitors Available in

Dialysis Department. Water usedine dialysis is

Bacteria Free Zero TDs Periodically cultures clone for removing contamination

Theatre



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3 State of Art Operation Theatre. Theatre with class 100 laminar air flow facility. Theatre equipped with boyles Anasthesia Machine.

Ventilators, Cauteries, Heart Lung Machine, ABG Machine, Invasive Monitors.

GI Surgery Neurosurgery All General Surgery Urosurgery Plastic Surgery Peadiatric Surgery ENT Surgery Unco Surgery Special Gynec and Obesity Facilities

o Painless Labouro High Risk Pregnancyo Infertilityo All Laproscopic Procedures

2 Theatres has Laminar Air Flow System. All Theatres are Equipped with 2 Vertical Sterilisers.

Latest Anesthesia Trolley with Ventilators. LED Light. Cutlery. ABG Machines. Multi-Para Monitors available in all OTs. Availability of defibrillator . Balloon Pump.

Laparoscopy Set With Camera And all Instruments available (WOLF). 2 Operating Microscopes. Sensara 7 For.

Neurosurgery. ENT. Plastic.



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Vascular. OPMI1 FR For Ophthalmic Surgery. SAARNS-8000 , SAARNS-7000 - Both available for Cardiac Procedures. Hemotherm available in Cardiac OT. Facility of Thermachoice for Gynae Patients (Till now carried out more than 600

Procedures). Facility of Office Hysteroscopy & Colposcope. Special Software & Hardware for Recording Procedures. 9 Inch Digital IITV. Thermachoice Machine for Uterine Ablation (Maximum Procedures done in City). Facility for

Upper GI Endoscopy. Colonoscopy. Side Viewing Scope Used For ERCP.

Specialised Equipment for Advanced NeuroSurgery. Facility for Office Hysteroscopy. Ultramodern A/C Labour Room with Systems of Fetal Monitoring.

Rooms

Deluxe Rooms

Average Area 180 sq. ft/Room with facilities:

A/C Attached Bathroom Fridge Cable TV Channel/Music Telephone Nurse Calling System



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Pantry Dedicated Nursing Staff and a Doctor for Deluxe Rooms

Special Room

Average Area-150Sq f/Room with facilities

A/C Attached Bath Cable TV Channel/Music Nurse Calling System Dedicated Nursing Staff and a Doctor 5 Patients per 1 Nurse Ratio

Semi Special Room (Twin Sharing)

Average Area - 170Sq f/Room with facilities

A/C Optional Attached Bathroom Cable TV Channel/Music Telephone Nurse Calling System

General Ward

A/c Optional 3 to 4 Patients /Room Cable TV Telephone Nurse Calling System

All Rooms Have Pipe Oxygen And Vacuum

Consulting Room




Beautifully Designed 5 Consulting Rooms with waiting area for 50 Patients

Pathology

With Round the Clock Service and Fully Equipped with

Cell Counter (Trans Asia) ABG Machine (Trans Asia) Coagulometer (Trans Asia) Electrolyte Machine (Roche) Chemistry -----Trans Asia , Abott ELISA Microbiology Sophisticated Microscope Specialised Technique For Coding Samples Vacutainer for sample collection Regular Updates and Checks For Quality Control Tie-Up with Centers of Excellence for Maintaining Quality. 24hrs Facility Home visit Available

Cath Lab

Latest Version of Cath Lab Facility for providing

Coronary Angiography Coronary Angioplasty Peripheral Angiography Balloon Mitral Valvotomy Temporary & Permanent ( Single & Dual Chamber

) Device Closure of ASD & VSD Electro Physiological Studies



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Implantation of Automated Defibrillator Peripheral Angioplasty Procedures Done By - Femoral - Radial - Route Round the Clock Services of Cath lab

History of Nursing

“Life is not a problem to be solved ,but a mystery to be lived” There are many conflicts in nursing

profession with a new challenge every day in terms of different illness that Patient comes up with.

Each different type of illness requires different forms of treatment including medicines. This

makes the practice of nursing a mystery to be lived. Social attitude and each individuals view

towards nursing commonly makes it a less desirable profession to be in. The root cause of these

individuals needs to be identified and resolved.




Nursing originated independently, existed many centuries without contact with modern medicine.

The member of the family at home met the nursing needs of the sick. Evolution of medicine,

surgery and public health into complicated technical area requiring many procedures by persons

specially trained and having understanding of scientific principles, which brought two professions

closer and together.

Development of Nursing Education in India- Pre-Independence

1. Nursing in Pre-historic Times

There is no historical evidence available on ancient history on nursing care of sick in primitive

times discovered through myths, songs and archeologist.

Role of Nurse in primitive period




1. Nursing evolved to response to the desire to keep healthy as well as provide comfort to

sick. This was reflecting in caring, comforting, nourishing and cleansing aspect of the

patient. This love and hope was expressed in empirical practice of nursing.

2. Nursing – Vedic Period (3000 B.C – 1400 B.C) Indian medicines are found in the sacred

books of “Vedas”. The ‘Ayur-veda’ is thought to have been given by Brahma. 1400 BC

Sushruta, known as ‘Father of Surgery’ in India, years later ‘Charaka’ wrote a book on

internal medicine. In those days surgery had advanced to a high level, also had 4 wings of

treatment ‘Chatushpada Chikitsa’.

1. Physician – Bhishak

2. Nurse – Upacharika (Attendant – Anuraktha)

3. Therapeutic drugs – Dravya

4. Patient – Adhyaya

Characters of Upacharika (Nurse)

• Shuchi – Pure or clean in physical appearance and mental hygiene.

• Daksha – Competency

• Anuraktha – Willing to care

• Buddhiman – Co-ordinator with the patient and doctor / intelligent.

• Hospitals are large and well equipped. “Siddha” system of medicine was also practiced in India.

2. Nursing Post Vedic Period (600 BC`– 600 AD)

Medical education introduced in ancient Universities of ‘Nalanda’ and ‘Thakshashila’. King

Ashoka (272-236 BC) constructed hospitals for the people and animals... Doctors and midwives




were to be trust worthy and skillful. The nurses were usually ‘men’ or ‘old women’. Women are

restricted activities at home and cared for sick members in the family during 1 AD period

superstition and black magic replaced more in daily practices. Other religious restriction and

superstitious practices probably declined the development of nursing.

3. Nursing in Mogul Period (1000 AD)

‘Unani’ system of medicine developed during the Arab civilization. It was practiced in Indo-

Pakistan subcontinent.

4. British period (16th Century onwards)

After the Mogul period the nursing in India hindered due to various reasons like low state of

women, system of “pardha” among Muslims, caste system among Hindus, illiteracy, poverty,

political unrest, language difference and nursing looked upon as servants work. During the 16th

century, nursing development in India had taken three dimensions.

1. Military Nursing

2. Civilian Nursing

3. Missionaries Nursing

1. Military Nursing:

Military nursing born during 1st world war but developed very slowly. British officers informed

need of nurses to take care British officials and soldiers in India.

On 1888 Feb. 21st – 10 fully qualified certified nurses from Florence Nightingales, arrived to

Bombay to lead nursing in India. This paved the way to develop one of the best nursing in the

world. 1894 regular system of training for men for hospital work (orderliness) started in 1927 –

Description of Indian Military Nursing services formed with 12 matrons, 18 sisters, 25 staff nurses.

They were responsible for supervision, instruction and training of nursing services for entire Indian

hospital corps.




2nd world war expanded nursing services to India and overseas under the direction of chief

principal matron. 3 year training carried out in selected military hospital preliminary training

schools. After completion, they were sent to military hospital for practical training. After

successful training certificate issued as “Registered Nurse” and they are members of Indian

Military Nursing Services Auxiliary Nursing Services.

Shortage of trained nurses in India after the 2nd world war, the Govt., initiated short course of

intensive training in 1942 which led to the Auxiliary Nursing Services.

2. Civilian Nursing in India

1664 – East India Company built Government General Hospital at Madras for civilian. 1871 – This

hospital undertook training of nurses. In 1854 midwives training school granted certificates of

‘Diploma in Midwifery’ for passed student and ‘sick nursing’ for failed students. First time 6

nurses came out as Diploma in Midwifery Nurses.

3. Missionary Nursing:

Missionary nursing started training for Indian people as nurses. Various other countries supported.

This brought fully qualified Indian nurses.

After the course of lecturing 18 months to two years, written examination was conducted. If the

individual failed training was extended to 3 years.

From 1888-93 five years various experts like doctors, surgeons, nursing superintendent, and

pharmacists – draw up a curriculum for training. 1907-10 North India united Board of Examiner

was formed to maintain nursing administration and standards. 1928 – Hindi Text book for nurses

developed. 1939 – Helped to develop post graduation school for nurses.




Community Health Nursing :

William Rathbone formed Visiting Nurse’s Association at England. She emphasized on charity

free care etc. Florence Lees improved the Visiting Nurses by giving specialized training for their

work.

In 1926 – Midwives Registration Act formed for the purpose of better training of midwives.

Slowly Community Nursing Training needs were felt by the Government. In 1946 – Community

Health Nursing was integrated in Basic Nursing Programme at Delhi, Vellore and Madras.

Trained Nurses Association of Indian (TNAI)

In 1908 – TNAI formed to uphold the dignity and honor of the nursing profession. Florence Mac

Haughton was the first president of TNAI. In 1910 TNAI published journals. In 1912 – TNAI

affiliated to international Nursing Council as a 8th Association in the world. In 1917 on June 16th

under the Registration Act No:XXI of 1860 – TNAI got registered. In 1922 SNA was formed.

Registration Council: In 1947 Indian Registration Council was formed.

NURSING EDUCATION - POST INDEPENDENCE




Introduction

On 15th August 1947 India became independent. 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. The 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 auxiliary nurse midwives. The INC act was passed following an ordinance on

December 31st 1947. The council was then 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 prescribe and specify minimum requirement for qualifying for a particular course in nursing.

3. Advisory role in the state nursing council

4. To collaborate with state nursing councils, schools and colleges of nursing and examination

board.

STATE REGISTRATION COUNCIL.

Functions.

1. Inspect and accredit schools of nursing in their state .

2. Conduct the examinations

3. Prescribe rules of conduct.

4. Maintain registers of nurses, midwives, ANM and health visitors in the state.

The state registration council is autonomous except they do not have power to prescribe the

syllabus for courses.

DEVELOPMENT OF NURSING EDUCATIION.

Basic General Nursing And Midwifery Education (GNM)




1. Training of Dais(Birth Attendant)

The Dai training continued past independence. This training was done at sub centre and

equipments provided by UNICEF.

2. Auxillary Nurse Midwife (ANM)

In 1950 Indian Nursing Council put forward some important decisions relating to future patterns of

nursing training in India. They decided 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. Mary’s Hospital Punjab in 1951. The entrance qualification was

up to 7/8 years of schooling. The period of training was 2 years which included 9 months 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 independence. The syllabus was prepared and prescribed

by INC in 1951.The entrance qualification was matriculation. 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. In 1954 public health was integrated into basic

nursing course.

First revision of course was done in 1963. In 1964-65 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 pediatric 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 the entire 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 has 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.

In 1985 Indira Gandhi National Open University was established. In 1992 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. From 1992 Ph D in nursing is also

available in India. MAHI is one of the universities having PhD program.

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.

SUMMARISED EVOLUTION OF NURSING EDUCATION IN INDIA

We can summarize the history of nursing education in India as follows:

1871 – School of nursing started in general hospital Madras.

1886 – School of nursing in a full-fledged form was started in J.J. hospital, Bombay.

1892 – Many hospitals in Bombay started nursing associations which were intended to provide

additional facilities for the training of local nurses.

1908 – TNAI established.

1909 – Bombay presidency nursing association was formed.

1910 – United board of examination for nurses was organized.

1913 – South India Board was organized.

1926 – First nurses registration act passed in Madras.

1935 – Madras and Bombay nursing councils were established.

1942 – ANM programme started.

1943 – School of Nursing at RAK college, New Delhi.

1943 – Diploma programme in nursing administration started in New Delhi.

1946 – Four year B.Sc nursing programme started in RAK college and CMC, Vellore.

1947 – INC act was passed.

1949 – INC was established.

1959 – MSc Nursing started in RAK college.

1963 – Post basic B.Sc programme started in various institutions

1968 – M.Sc nursing at CMC, Vellore




1972 – Basic degree programme started in Kerala

1985 – M.Sc nursing stated in CMC Ludhiana.

1985 – IGNOU established.

1986 – Curriculum change for GNM programme from three and a half years to three years.

1986 – M.Phil programme started in RAK, Delhi.

1987 – MSc Nursing started in Kerala

1987 – Separate directorate of nursing was created in Karnataka State.

1988 – M.Sc Nursing at Nimhans

1992 – Ph.D in RAK College, New Delhi

1992 – Post basic programme started under IGNOU

1994 – M.Sc nursing at MAHE, Manipal

1994 – Basic B.Sc programme under school of Medical education in Mahatma Gandhi University,

Kottayam.

1996 – M.Phil and Ph.D at MAHE, Manipal.

2001 – Ph.D at NIMHANS




Conclusion

Nursing education has expanded considerably post independence. University education in nursing

brought about changes in nursing education. University Education in Nursing provided the depth

of knowledge which is required for current Health Services in India.

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.

Current document involves in assessing the contribution of our education service in creating

Professional Nurses who are self sufficient and intellectually empowered to perform the duties

trusted to them.




RESEARCHMETH

ODLOGY

Objectives:

The broad objectives of the study were

1. To study the perceived limitations which hamper their growth in nursing field.

2. To identify the problems faced by nursing students in their day to day life.

3. To examine the consequences of their thoughts and beliefs on their profession and the new

comers into the profession.

Sample Design:

A questionnaire was administered to the students at the Apollo school of nursing ,Hyderabad. The

total numbers of students were 154 among which 54 students from the 3rd year were chosen and

administered a questionnaire. The reason for choosing the 3rd year student was to have the

respondents who had gone through practical session on the shop floor. Thus the sampling design

became, SIMPLE RANDOM SAMPLING.

Sample Size : A total of 54 third year students were taken as the respondents out of the whole




population, thus the sample size became 54.

Data Collection Tools:

Primary Tools:

The primary tools involved administering a structured questionnaire. The objective was to validate

inputs and address the survey objectives stated above. The questionnaire is shown in Annexure1.

The outcome of the answers received for the questions were aggregated and analysed. These

results are captured with recommendations where ever possible.

Some of the answers could be perception and not necessarily the truth, however perceptions if not

managed well tend to become reality in the long term.

Table-1 Does Nursing profession require specialized knowledge and hence specialized

training is required?

Particulars No of respondents Percentage

yes 52 96

Sometimes 2 4

No 0 0




Total 54 100

Observation:

Majority of them believed that Professional competence is important for being in the

nursing profession.

As we move further down with some more questions, this belief somewhere down the line

gets diluted when they move around in the practical world.

Recommendation: It is recommend that this belief is upheld when the nurse move into practical

world. Else when any new candidate refers for guidance before taking up the nursing profession

will only get a negative feedback. We will discuss the options available with the institution to

improve this perception.




Observations:

It is seen that about 41% of people are not sure if this profession offers Economic security.

This surely is impacting more people from taking up this profession. With other sunrise

industries offering glamorous roles and money nursing profession does not feature on the


Table 2 Do you feel Nursing profession provides the Economic security that is required for

yourself and your family.


yes 32 59

Sometimes 15 28

No 70 13

Total 54 100



minds of the young people who come out of colleges to choose a profession.

As observed only 59% gave a positive answer it means the rest of them are not sure of the

financial security offered by this profession. This could be the outcome of:

o Salary levels for the nurses as compared to the Retail, Airline and Insurance sectors

(Sunrise Industries.)

o Salary structures may need to be revised to make the nurses get the feeling of

financial security.

Recommendations:

It is recommended that the salary structures for the nurses are assessed to give them long

term secured feeling. Salary levels for noble professions like nursing, teaching and military

is lower than other professions.

Hospitals can conduct some financial planning session which helps them plan their limited

finances for long term security.




Table 3 : Do you feel your profession is a mechanical exercise .


yes 38 71

Sometimes 12 22

No 4 7

Total 54 100

Observations

71% of the respondents felt Nursing is a mechanical profession.

They are probably getting this feeling by working in the hospital as a routine and without

any variety of experience or it’s the absence of learning curve in their day to day life as a

nurse.




Its important to remove this perception and get the nurses to understand that this profession

is not just a mechanical one but involves lot of learning and intelligence to serve the patient

in the rightful manner.

Recommendation:

Nursing is surely not a mechanical exercise given the fact that every patient handled is a

new case every time even though the sickness may be the same.

Nurses should be allowed to prepare case study documents (confidential) which is further

discussed with appropriate senior doctors. With this they will be provided an opportunity to

interact with patients more closely and document their observations for review by the

senior member of staff in the hospital. This will ensure that there is learning curve on a

daily basis and hence remove the mundane part out of their daily duties.

There should be criteria to produce minimum number of case studies before the individual

is promoted to the next level. This will tie in their aspirations to learning and developing

themselves. This whole aspect of discovery will remove the mundaness from the day to day

to nursing practice




Table 4 : Does the education framework provide you the opportunity to share your

experience either through

Group discussion or through some means


yes 21 39

Sometimes 33 61

No 0 0

Total 54 100

Observations: Almost 61% of Students (Nurses) feel that there is no exchange of experiences




which enriches their knowledge.

Recommendations:

Hospitals should plan their work force capacity is such manner that gives their nurses free

time to collaborate and exchange ideas/share experiences.

Encourage nurses to do research by reading books, case studies and come up with white

papers.

With the above approach it will help the Hospitals in 2 way.

o Hospitals get nurses who are knowledgeable and motivated by virtue of having a

constantly rising learning curve.

o Hospitals get the recognition of having a workforce which is highly knowledgeable.

o With case studies approach mentioned in observations for table 3 will allow the

senior staff to review the documents prepared by the junior staff and give their

expert opinion, which in turn puts a formal process for knowledge sharing.




Table-5: Does the education framework provide time and means to attend seminars

related to medical profession.


yes 14 26

Sometimes 37 69

No 3 6

Total 54 100

Observations: This is in line with the observation in the previous question.

• Only 26% felt they were allowed to attend seminars.




Recommendations

Given the cost consideration for the seminar cost, travel and stay cost, hospitals might find

difficult to sponsor their nurses to attend seminars therefore they could potentially adopt

following route

Identify subjects of concern / knowledge development and create seminar within the

hospitals which can be presented by the nurses themselves or depend on the senior doctors

to present their experiences or expert opinion.

Table 6 : Does the working environment and processes provide you the facility to take all

precaution of safety and hygiene


yes 19 35

Sometimes 27 50

No 8 15

Total 54 100

Observation:

a. Almost 65% of the nursing students feel that they don’t have the facilities to practice their

profession in safe and hygienic manner.




b. Potential causes for this problem could be:

1. This could be a result of not being aware of the facilities provided by the hospital

and not necessarily the absence of safe and hygienic environment.

2. This could be actually the issue at the hospital which does not provide the necessary

processes and material / equipment for practicing the profession in safe and

hygienic manner. It could also be an inventory issue of not having the material at all

times.

3. This could also be a result of lack of discipline to follow the process. This is a much

large problem to handle given the change management required around the attitude

of the staff to follow safety and hygienic process.

Recommendations:

Assess if the point b. mentioned above is true, wherein the facilities exists but the nurses

are not aware. If its true that the hospital does have the facilities for following safe and

hygienic practice, then in that case Hospital should run an awareness program with

executive sponsorship from the management team.

Re-assess the situation after 3 – months of running the awareness program about the

facilities available at the hospital. This could be done by conducting a survey amongst the

staff nurse.

If point b.2 is true then the management of the hospital needs to have an internal audit in

place to ensure timely stock is available for all the necessary materials and equipments.

If point b.3 is true then one has to assess if work pressure does not permit the nurses to

follow the processes or its sheer lack of discipline. This can be measured by getting the

senior staff to observe the staff and correcting them in an amicable manner. Once again this

should be measured by conducting another round of survey




Table-7: Please describe in brief the challenges which prevents you from being polite in

handling day to day nursing duties.


Lack of time 15 28

More work load 18 33

Non co-operation 11 20

Stress 10 19

Total 54 100




Observation:

Lack of time, Excess Work Load, Stress is all inter-related to each other. It appears that the

hospitals are under staff or potentially have processes which are a waste not adding value.

The problem could be just real capacity issue.

Stress Management

Recommendations:

It’s important that the hospitals conduct a review of all its processes and come up with

“Lean Processes” eliminating waste. This will release additional bandwidth for the staff to

handle the day to day duties more efficiently. It may be important to mention that the

recommendation for “Lean Processes” is not at the cost of compromising on the safety and

hygiene conditions that have to be maintained for the lives of the patient or the medical

staff. Lean Processes could be a reality with introduction of technology pieces in the right

departments.

Hospital should conduct a study to identify peak pressures during various time slots and

allocate the capacity across the time slots to maintain right balance of work load for the

nurses. For example: You have additional routine during day time of the doctors visit to the

ward, Discharge processes, hence additional staff may be required during day time as

compared to the night time.

Stress is today not only applicable to nursing profession it’s in all profession. Stress is




created by the endless desire to lead a better lifestyle, better homes, and cars mobiles. This

has pushed people to take loans which are beyond their means. Now this can be looked

upon as an individuals problem and not the institution where they work, but if we had to be

little caring we could do following:

o Provide seminars which help them understand how to manage financial obligations

and not get trapped into unplanned loans.

o Help them to have a discerning mind to decide what kind of loans are good for

them,

o Conduct stress management courses which helps them identify tools to manage

stress.

o Provide for TV sets in cafeteria which could play light cartoons which diverts their

mind. Instead of looking at the business news which constantly projects crashing

stock market and economic conditions or the latest terrorist attacks. Such news are

depressing and create nothing but stress.

Table 8 : Do you get the freedom to question during the lectures / practical conducted in the

nursing school


yes 39 72

Sometimes 14 26

No 1 2

Total 54 100




Observations:

• This one output is a positive one where 72% people feel they have the freedom to express. This is

an outcome of 2 causes.

a. Resources are bold enough to ask questions. People are not shy or introverts, they

are asking questions till they are satisfied.

b. Conducive environment which encourages people to ask questions.

Recommendations:

• Leverage this positive energy to tackle some of issues identified in the previous question

mentioned herein above.

Table 9: Did you get any Psychiatrist’s support for getting over your frustration in

managing the day to day nursing pressures.





yes 0 0

Sometimes 9 17

No 45 83

Total 54 100

Observations:

Most of the nurses felt that they did not get any Psychiatric support to get over their

frustrations. It’s important that the nurses don’t carry any frustrations while handling

critical cases. The high % of people saying “NO” here is not a reflection that all the people

are frustrated. Therefore one needs to be careful in interpreting this number as frustration

could be work or personal related.

Infact if there is a process of identifying nurses with strong influence of stress or frustration

should be moved out of critical functions in the hospital. It could endanger the life of a

patient.




Recommendation:

Assess the performance of nurses in their day to day work. Identify nurses who are

regularly making mistakes or had the potential of making a mistake. These nurses could be

potentially frustrated with work or their personal life. However they could risk the life of a

patient if they are not free from frustration/ stress.

These identified nurses should be put on to Psychiatric counseling and ear marked to be

posted in departments not requiring critical processes or practice. It may be important to

mention that at times asking a nurse to move out of his/ her current responsibilities may

land up getting them more frustrated. Therefore this has to be handled with care where the

nurse accepts s/he needs a break.

Happy Nurse – Happy patient and their relatives could be the motto for this initiative.

Table 10 : Do your seniors co-operate in helping you manage your day to day

nursing activities


yes 1 2

Sometimes 44 81

No 9 17

Total 54 100




Observation:

While very few people have confidently said a “Yes” to this question, it appears that are

some spots where nurses are not feeling they are appropriately mentored by the senior

nurses. These issues if not resolved, it could only lead to a frustrated employees and result

in high rate of attrition.

This could also be outcome of some circumstances of ragging by the senior staff and needs

to be immediately ascertain if it’s true.

Ragging is the major cause for the juniors not to align with their senior resources.

Recommendation

Re-visit the Exit interviews to find out how many people have quit because of their

senior/managers. This could only confirm the old saying “People don’t quit organizations

but they quit their manager/ seniors”.

Re-visit the performance appraisals to identify if any of the nurses have identified their

senior giving them a difficult time or not being mentor.

Create a mentor development program. Run training programs for managerial skills for the

senior staff

Nursing is a noble profession and if seniors don’t resonate that feeling then we cannot




expect to have nurses who belief their profession is a noble profession and hence give their

100% to serve the patients with a smile.

Create a Rewards Program that recognizes the best mentor for a year, motivating senior

staff to give their best to the juniors.

Table 11: How much time you feel should be given for recreation

(Please mention the time that should be given to you for recreation and what kind of facilities

you expect for recreation.)


Sports 13 24

Quiz 11 20

TV and Music 22 41

Reading 8 15

Total 54 100




Observation:

. A large number of people have voted for TV and Music to be a good form of recreation.

While the idiot box continues to woo people away from good habits of taking reading as a

means for recreation, hospitals have to nurture the habit of reading amongst their staff.

Reading can be enriching as well as provide good means for recreation. This cannot be an

overnight change and has to be managed through a well planned program.

Create events which pushes people to read and present. Let there be not only monetary

benefits but growth opportunities within the organization.

For example: Hospitals could publish a list of topics that requires the nurses to do

research(Read) various books / surf the internet and come with a white paper.

There can be a jury which will decide the best white paper and give a monetary reward to

the person who wrote the white paper.

The above approach not only benefits the staff to find new means of expanding their

knowledge but the hospital also gets staff which is knowledgeable and efficient in their

work.




Table 12 : Do you feel comfortable conducting your assignments on your own or you feel you

need supervision.


yes 19 35

Sometimes 33 61

No 2 4

Total 54 100




Observation:

Only 35% have said “YES” to be able to handle things independently. This might be

interesting aspect to investigate further if the students who have the best marks are at time

nervous in the real life world or it’s the one who lacks knowledge.

There is always the fear of doing something for the first time. Being a fresh batch of nurses

they will lack of confidence in practical world.

There is no short-cut to build the confidence; it will come with experience as time passes

by.

Recommendations

Mentors can be a good sources for confidence building for the fresh batch. People who

have a caring nature only should be appointed as mentors, because mentors can make or

break people.

Having a mentor program, will help in resolving this issue of lack of confidence to

independently handle tasks.

Mentors should closely observe their set of people and identify if its lack of knowledge or

lack of confidence. Incase the nurse has a lack of knowledge then s/he should be sponsored

for re-training instead of being allowed to perform in the hospital. Incase the nurse lacks




confidence then the mentor could work with the nurse on a few cases before s/he becomes

independent.

Table 13 : Please specify what you do during your free time while you are

working in the ward.


Reading the case study 20 37

Imparting health education 13 24

Studying the new

equipments11 20

No free time 10 19

Total 54 100




Observation and recommendation

1. Very few people have said there is no free time as most of them have mentioned spending

their free time in doing something productive as shown in the table above.

2. Staff is spending their time on productive areas like Reading the case study and this habit

should be nurtured further to include more and more staff.

3. While the small set of nurses who feel there is no free time may need to understand why

they don’t have free time. Senior staff could work with them to see if there is an issue of

efficiency or time management.

Table 14 What are the major causes for not being able to practice what is

taught in

the classroom? Please describe in brief here below


Fear 22 41

Lack of instruments 10 18

More work load (lack of

time)14 26

Difference in equipments 8 15

Total 54 100




Observations

There is a large percentage of staff contributing “Fear ” as the reason for not practicing

what is taught in the class room. This could be primarily due to lack of confidence in

practicing their learning.

This fear factor could also be due to lack of practical session during their course.

Or this could be a situation wherein the senior staff rebukes the staff who tries to follow the

rule book by claiming that in real world that’s not to be followed.

Lack of time is coming up pretty often in this survey and needs to be thoroughly assessed

by the hospital to check out if there were processes that were not necessary or it is a

capacity issue AND Difference in equipment could be addressed with some minor training

for usage of the equipment.

Table no. 15 Do you think heavy loads of patient care make it necessary to use

shortcuts in procedures?


yes 14 26

Sometimes 32 59

No 8 15

Total 54 100




Observations and recommendations

1. Once again this confirms the capacity issue. Hospitals need to conduct further assessment

to ascertain if the issue is caused due to capacity or processes leading to waste of time.

Table 16: Are the equipments used in wards insufficient?


yes 19 35

Sometimes 24 45

No 11 20

Total 54 100




Observations

1. A majority of them felt the equipments provided were insufficient. Now this could be

caused by

1. Number of equipments is there but the staff is not aware of how to use because of

some minor difference between what they were taught to use versus what is

available in the hospital.

2. There is actually less number of equipments.

Recommendation.

1. Hospitals should check if it’s a situation of what is mentioned in point 1.a above. In that

case hospital should create an awareness program around the equipments available in the

hospital.

2. If the case is of what is mentioned in point 1.b then the hospital should consider ordering

enough number of equipments.




Table-17 : Is there any area of nursing profession which you feel you were not

trained enough?


Intensive Care Units 19 35

Operation Theatres 15 28

Emergency Wards 20 37




Total 54 100

Observation and recommendation

1. A large number of respondents have mentioned ICU as the major component on which they

lacked training.

2. Its important to review the syllabus and ensure that enough training is planned around

Intensive care Units and also the other which have figured on the list above.

Table-18: Do you feel there

is an appropriate HR

department focusing on

managing

your competencies to

handle complex issues as




you progress in age.

Particul

ars

No of

responde

nts

Percenta

ge

Yes 36 67

Sometim

es 11 20

No 7 13

Total 54 100

Observation

1. A majority number of people felt they had an appropriate HR department.

2. 33% of the respondents felt lack of HR department managing their growth and

competencies This means that this set of people are probably not touched by the HR

department in any manner. This is not a good sign if the HR department is in existence but

not touching their lives. It will be good idea if the respective HR manager does a floor walk

to get the visibility with the staff working on the floor.




Table-19: Has the

organization shared with

you a career path and

explained the

competencies that you

need to grow in your

career.

Particul

ars

No of

respond

ents

Percent

age

Yes 20 37

Sometim

es 13 24

No 21 39

Total 54 100

Observations and recommendations.




1. 63% of people are not aware of their career paths. This is not a good sign because people

work for an organization not only to get monetary benefits but also growth in term of more

authority and responsibilities as years pass by.

2. There should be one on one counseling session organized to provide inputs on career path

and development plans which an individual has to undertake to be able to achieve the

desired growth.

Table-20: Do you feel India provides right kind of opportunities linked to

right amount of economic security.


Yes 9 17

Sometimes 13 24

No 32 59

Total 54 100

Observation and recommendations




1. A large number of people don’t feel India offers the kind of money that Job Opportunities

offer abroad. This problem cannot be resolved in the short term.

2. But with the downturn of economy in the developed countries will get these people

attracted to developing countries like India.

3. Organisations have to seize this opportunity to build relationship with their staff by

providing them learning, growth opportunities. If people develop value in themselves then

they can work towards getting higher remuneration in India itself. But the key is to build

competencies which gets them higher pay package.

Table-21:Do you feel you should have an appraisal system


Yes 31 57

Sometimes 23 43

No 0 0

Total 54 100

Observations and recommendations

1. A good number of people feel the need for having a proper appraisal system and an equal

number of people have said sometimes it’s necessary.

2. This again points to the fact that the existence of HR department is probably not visible to

the folks who have said “yes” to having an appraisal system in the nursing profession.

3. Whereas the rest of the people might not be aware of the power of appraisal systems. This

needs to be driven through HR department on building awareness of HR department and a

formal appraisal process.




Table 22: Do you feel there is lack of recognition for work performed.


Yes 21 39

Sometimes 33 61

No 0 0

Total 54 100

Observations

1. A vast majority of the people felt they were not recognized for their work. This becomes a major

concern when people don’t get recognized consistently.

2. Failure to recognize people for their work could lead to high rate of attrition.

Recommendations:

1. Have a recognition program in place which allows people to recognize and appreciate each

others work. This could be very well driven by a web portal. When people start recognizing

others work in the team it builds a feeling of oneness in the team and builds respect for

each other.

2. Have HR department work out a formal process for recognizing people’s contribution to




their personal work or to the organization.

ObservationSUGGESSTIONS OF THE STUDENTS OF APOLLO SCHOOL OF NURSING WERE

FORWARDED TO THE RESPECTED PRINCIPAL:

Nearly all students complained of the on-going ragging which is disturbing them a lot

Seniors are not helpful, they are rude.

Timings of duty are not followed strictly

Bond period to be reduced to 1 year 6 months

Proper allocation of staff and students to reduce the work load

Reduce the number of assignments

One exam per day to be taken

During the bond period only same dept is given for a year if they could be posted in

different departments on monthly rotations basis, it could bring in more efficiency and

confidence in the staff.

I feel personally that they should introduce basic study of computers as it is a necessary

requirement in the health industry.




Conclusion

Nursing encompasses autonomous and collaborative care of individuals of all ages, families,

groups and communities, sick or well and in all settings. Nursing includes the promotion of health,

prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe

environment, research, participation in shaping health policy and in patient and health systems

management, and education are also key nursing roles.

Nurse educators face many challenges in the current healthcare environment. Educational methods,

philosophies, and the content of curricula need to be reexamined to meet the needs of professional

nurses who will practice in the next millennium In higher education, faculty advancement is based

on demonstrated productivity in scholarship and service as well as teaching. In nursing, a new

faculty should take the responsibility for their professional development by working with a dean or

department chair to design a 5-year Faculty Development Plan that includes mentoring and

participating in other campus support networks.




Bibliography

1. “Nurse”. The Oxford English Dictionary 2nd edition. 10. Oxford University Press. 1989.

pp. p603-604. ISBN 0198611862.

2. Florence Nightingale (1820 — 1910)

3. Radcliffe, Mark (2000). “Doctors and nurses: new game, same result”. British Medical

Journal 320 (1085): 1085. doi:10.1136/bmj.320.7241.1085.

http://www.bmj.com/cgi/content/full/320/7241/1085. Retrieved on 2007-08-14.

4. Nightingale, Florence (1860) Notes on Nursing Full text online Accessed 14 August 2007

5. International Council of Nurses Accessed August 2007

6. Wilkinson, A. (1965). ‘History of Nursing in India and Pakistan’. New Delhi,

7. Annamma, K.V. (189). ‘A New Text book for Nurses in India’. Madras, B. I. Publications.

8. Honda, U. and Gulani, K. K. (1995). ‘Community Health Nursing’, New Delhi, Ignon

Publications.

9. Sandaranarayanan, B. and Sindhu, B. (2003), ‘Learning and Teaching Nursing’, Calicut,

Brainfill. Neeraja K. P. (2003), ‘Text Book of Nursing Education’, New Delhi: Jaypee

Brothers.

10. TNAI (2000). ‘History and trends in Nursing in India’, New Delhi.




11. Hurndr, R. and Letiman, B. (183). ‘Nursing Education in India’, New Delhi.

12. TNAI (1995). ‘Indian Nursing Year Book’, 1993-95, New Delhi – TNAI.

13. TNAI (2002), ‘Indian Nursing Year Book’, 2000, New Delhi – TNAI.

Annexure

A CLOSER LOOK AT NURSING PROFESSION (THE BACKBONE OF THE HEALTH

SYSTEM)

Dear friends, nursing is a process of recognizing, understanding and meeting the health needs of

any person or society and is based on a constantly changing body of scientific knowledge.

This work is physically and emotionally demanding- yet intrinsically rewarding for those who feel

good about helping others.

So dear friends I have prepared a questionnaire for you all ,please take your time and answer it,

there is no right or wrong its not a test just answer it by being true to your self at the end of the

questions there is space for you to write your suggestions or problems which you face in your day

to day nursing .Thanks a lot for your valuable time.




QUESTIONNAIRE : (Please rate each question between 1 to 3 ,where 1 means No, 2 means

Sometimes, 3 means Yes )

1. Does Nursing profession require specialized knowledge and hence specialized training is

required?

2. Do you feel Nursing profession provides the Economic security that is required for yourself

and your family

3. Do you feel your profession requires intellectual talent ? .

4. Does the education framework provide you the opportunity to share your experience either

through Group discussion or through some means

5. Does the education framework provide time and means to attend seminars related to medical

profession.

6. Does the working environment and processes provide you the facility to take all precaution of

safety and hygiene

7. Please describe in brief the challenges which prevents you from being polite in handling day

to day nursing duties. (As the answer to this question has to be in descriptive form, you are not

required to provide rating for this question) ------

8. Do you get the freedom to question during the lectures / practical conducted in the nursing




school

9. Did you get any Psychiatrist’s support for getting over your frustration in managing the day to

day nursing pressures.

10. Do your seniors co-operate in helping you manage your day to day nursing activities.

11. How much time you feel should be given for recreation

(Please mention the time that should be given to you for recreation and what kind of facilities

you expect for recreation.) ------

12. Do you feel comfortable conducting your assignments on your own or you feel you need

supervision.

13. Please specify what you do during your free time while you are working in the ward. ------

14. What are the major causes for not being able to practice what is taught in the classroom?

Please describe in brief here below ------

15. Do you think heavy loads of patient care make it necessary to use shortcuts in procedures?

16. Are the equipments used in wards insufficient ?

17. Is there any area of nursing profession which you feel you were not trained enough? ------

18. Do you feel there is an appropriate HR department focusing on managing your competencies

to handle complex issues as you progress in age.

19. Has the organization shared with you a career path and explained the competencies that you

need to grow in your career.

20. Do you feel India provides right kind of opportunities linked to right amount of economic

security.

21. Do you feel you should have an appraisal system

22. Do you feel there is lack of recognition for work performed.

So friends here we come to the end of this session, Please double check that you have answered all

the questions mentioned herein above. It will be great help if you could suggest in a few words

how to make nursing profession better and what needs to be done to make more and more people

get attracted to this profession.




Thank you once again.



Hospital

Healthcare

Transcript of Hospital