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Trends in Development of Nursing Education in India
Trends in Development of Nursing Education in India
INTRODUCTION
Nursing had originated independently and existed many centuries without contact
with modern medicine. The members 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.
Women were protecting and caring for their children, aged and sick members of the
family. 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. These love and hope were expressed in empirical practice of nursing.
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 wrote
a book on surgery and years later 'Charaka' wrote a book on internal medicine. By these
writings we can learn that those days surgery had advanced to a high level, also had 4 wings
of treatment 'Chatushpada Chikitsa'.
1. Physician - Bhishak
2. Nurse - Upacharika (Attendent - Anuraktha)
3. Therapeutic drugs - Dravya
4. Patient - Adhyaya
'Unani' system of medicine developed during the Arab civilization. It was practiced
in Indo-Pakistan subcontinent. The basic framework are consists of blood, phlegm, yellow
bile and back bile. Temperament, strengthening of body and nature are the real physician.
Not believed in eradication of disease greatly depend on defense mechanism of the body and
self-care and positive health habits. Therefore, it becomes part of Indian medicine practice.
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 paves the way to develop one of the best nursing in
the world. 1894 regular system of training for men for hospital work (orderliness) started.
Medical officers given lecturing to them. Some men were voluntary did the course and
applied for the nursing certificate. After two months of practical posting to ward, on the
account of supervised sister's report, first time hospital 'orderliness' issued certificate and had
official status. This system laid the possible foundation to existing system of training and
higher education.
1927 - Description of Indian Military Nursing services formed with 12 matrons, 18 sisters, 25
staff nurses. They are 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 sent to military hospital for 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. Basic training for 6
month in selected civil hospital after passing examination at military hospitals in India sent to
overseas to serve in the capacity of 'Assistant Nurses' 3000 women given auxiliary training.
1664 - East India company built Government General Hospital at Madras for civilian.
1871 - this hospital undertook training of nurses. On 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. Those days there were several
obstacles for nursing development.
Frequent disappointment, degradation difficulties nursing training came into existence and
look its own shape. In the beginning there is not uniformity in nursing education. There is
no particular standards were given. After the course of lecturing 18 months to two years,
written examination conducted. If failed training extended to 3 years.
From 1888-93 five years various experts like doctors, surgeons, nursing superintendent,
pharmacists - draw up a curriculum for training. 1907-10 North India united Board of
Examiner formed to maintain nursing administration and standards. 1928 - Hindi Text book
for nurses developed. 1939 - helped to develop post graduation school for nurses.
Dais was unwilling to train and patients will to accept the old customary methods. In 1926 -
Midwives Registration Act formed for the purpose of better training of midwives. Slowly
Community Nursing Training needs felt by the Government. In 1946 - Community Health
Nursing was integrated in Basic Nursing Programme at Delhi, Vellore and Madras.
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
June 16th under the Registration Act No:XXI of 1860 - TNAI got registered. In 1922 - SNA
formed.
INTRODUCTION
Nursing Council Act came to existence in 1948 to constitute a council of nurses who
would safe guard the quality of nursing education in the country. The mandate was to
establish and maintain uniform standards of nursing education. Today, Indian nursing
council is a statutory body that regulates nursing education in the country through
prescription, inspection, examination, certification and maintaining its stands for a uniform
syllabus at each level of nursing education. The strive for maintenance of a uniform
standards and pattern of nursing education has curbed creative development and
experiments for expansion of nursing in to newer horizons of nursing education.
TNAI helps the initiation of university level education in India. Recommendations of the
Bhore committee were implemented within year.
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.
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 constituted in 1949.
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
The state registration council is autonomous except they do not have power to prescribe the
syllabi for courses.
Three grades of nurses viz. The basic nurses (4yrs), auxiliary nurse midwife
(2yrs) and nurses with a degree qualification.
For GNM minimum entrance qualification is matriculation.
For degree course passed higher secondary or Pre University.
Medium of instruction preferably English in General nursing.
Degree course should be taught only in English.
Emphasis could be laid on education for nursing and supervision in the public health
field.
The programme of expansion of facilities for the training of nurses and para-medical
personnel will be related broadly to the requirements of these categories of personnel
in connection with medical, public health and family planning programmes.
The expected increase in number of nurses to 61000 and auxiliary nurse-midwives to
34000
The Government of India and the Indian Nursing Council proposed to take various
measures to integrate psychiatric nursing in the basic nursing curriculum throughout
the country.
Full financial assistance was provided to the states to train Para-medical professionals
including nurses and ANMs.
District and regional level training institutions were strengthened for providing
continuing education for all categories of nursing staffs.
Under graduate and post graduate training reoriented to enable student nurses to
become competent professionals.
The ANM training schools reopened in the government sector to meet the shortage in
some states.
It is proposed to open new ANM and GNM Schools in the country during the XI th
Plan period.
It is also proposed to establish 4 Regional Colleges of Excellence with state of art
facilities to improve the quality of Nursing Education in the country.
A provision of Rs. 319 crores has been proposed for XI th Plan for the strengthening of
Nursing Education in the country.
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.
1946 - Four year B.Sc nursing programme started in RAK college and CMC, Vellore.
1986 - Curriculum change for GNM programme from three and a half years to three years.
M.Phil programme started in RAK, Delhi.
2004 – Curriculum changes for GNM programme from three years to three and a half
years.
There are six levels of nursing education in India today. They are:
5. MSc. nursing
The ANM, HV, and GNM are conducted in schools of nursing. The last 3 are university
level courses and the respective universities conduct examinations. Beside there are several
certificate and diploma courses in specialties.
The Dai training continued past independence. The goal was to train one Dai in each village
and ultimate goal was to train the entire practicing Dais in country
Duration of training was 30 days. No age limit was prescribed, training include theory and
practice, more emphasis on field practice. This training was done at sub centre and
equipments provided by UNICEF.
In 1950 Indian Nursing Council came out with some important decisions relating to future
patterns of nursing training in India. One of the important decisions was that there should be
only two standard of training nursing and midwifery, subsequently the curriculum for these
courses was prescribed.
The first course was started at St. Mary’s Hospital Punjab; 1951.The entrance qualification
was up to 7/8 years of schooling. The period of training was 2 years which include a 9 month
of midwifery and 3 months of community experience.
Training of LHV course continued post independence. The syllabus 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.
The general nursing and midwifery course is conducted in 477 centres in the country. The
syllabus has undergone many revisions according to the change in the health plans and
policies of the Government and changing trends and advancements in general education,
nursing health sciences and medical technology. The latest revision of syllabus by INC in
2004 has increased the duration of the course from three year to three and half year. The
basic entrance has become intermediate or class 12 instead of earlier class 10. Both science
and arts students are eligible. The focus of general nursing education is the care of sick in
the hospital. Schools of nursing are generally attached to teaching hospitals. Three Board
examinations are conducted, one at the end of each year. On passing the candidates are
registered as registered nurse and mid –wife by the respective state nursing councils.
PHILOSOPHY
The Indian Nursing Council believes that the basic course in nursing is a formal educational
preparation which should be based on sound education principles. The council recognizes
that the program as the foundation on which the practice of nursing is built and on which
depends further professional education. It also recognizes its responsibility to the society for
the continued development of student as individual nurse and citizens.
Purpose
The purpose of general nursing programme is to prepare general nurse who will function as
member of the health team beginning with competence for first level position in both
hospital and community. The programme is generated to the health needs of the society, the
community and the individual and will assist nurses in their personal and professional
development so that they may take their maximum contribution to the society as individual
citizens and nurses.
Objectives
1. Demonstrate awareness of and skills required in the nursing process in the provision of
health care and nursing of patients
2. Apply relevant knowledge from the humanities biological and behavioral sciences in
carrying out health care and nursing activities and functions.
3. Show sensitivity and skill in human relationship and communication in his or her daily
works
5. Gain knowledge of health resources in the community and the country
Students’ admission
1. Age for the entrance shall be 17 years to 35 years, provided they meet the minimum
educational requirement ie 12 years of schooling.
2. Minimum education all students should pass 12 classes or its equivalent, preferably with
science subjects
Training programme
The course in general nursing shall be of three and half years duration as follows, --- two
years practice in general nursing, one year community health nursing and midwifery and six
months internship which includes nursing administration and nursing research classes.
There will be alternate course for male students in lieu of midwifery. The ANM who wishes
to undertake general nursing course will not be given any concessions. The maximum hours
per week per students shall be 36 hours, which includes instructions and clinical field
experiences.
Graduate nursing education started in India in the year 1946 in CMC, Vellore and in the
RAK College of nursing at Delhi University. At present several universities in India offer
the course.
3. obtained at least 45%of total marks in science subjects in the qualifying exam, if belongs
to a scheduled caste or tribe , should have obtained not less than 40 % of total marks in
science subjects.
4. completed 17 years of age at the time of admission or will complete this age on or before
31st December of the year of admission
5. is medically fit
Objectives of study
2. to enable a student to become a professional nurse practitioner who has self direction and
is a responsible citizen.
Through planned guided experiences students are provided with opportunities to develop
understanding of the application of principles from the physical biological and social
sciences for assessing the health status
Course of study
The faculty believes that nursing is an integral part of the health care delivery system and
share responsibility in collaboration with other allied health professions for the attainment
of optimal health for all members of the society. The faculty conceives education as a
lifelong learning process. It seeks to render appropriate behavioral changes in students in
order to facilitate their development, which assists them to live personally satisfied and
socially useful lives.
The goal of post certificate degree programme leading to Bachelor of Science in nursing is
the preparation of the trained nurse as a generalist who accept responsibility for enhancing
the effectiveness of nursing care
2. be a registered nurse
5. be medically fit
Programme of study
DURATION –the programme of the study is two academic years from the date of
commencement of programme. Terms and vacations shall be as notified by the university
from time to time.
Administer high quality nursing care to all people of all ages in homes , hospitals and
other community agencies in urban and rural areas
Apply knowledge from the physical, social and behavioral sciences in assessing the
health status of individuals and make critical judgment in assessing the health status
of the individuals and make critical judgment in planning ,directing and evaluating
primary, acute and long term care given by themselves and others working with
them
Teach and counsel individuals , families and other groups about health and illness
Identify underlying principles from the social and natural sciences and utilize them in
adapting to , or initiating changes in relation to those factors
Philosophy
Nursing faculty presents the following beliefs about the master of nursing programme:
1. the master of nursing programme is offered by institution of higher education and is built
up on a recognized bachelor’s curriculum in nursing (in India-by Indian nursing council)
2. the programme prepares nurses for leadership position in nursing and other health fields
who can function as specialists nurse practitioners, consultants ,educators ,administrators
and investigators in a wide variety of professional setting in meeting the national priorities
and the changing needs of the society
3. the programme prepares nursing graduates who are professionally equipped ,creative, self
directed and socially motivated to effectively meet with the needs of the social change
4. further the programme encourages accountability and commitment to life long learning
which fosters improvement of quality care
Objectives
increased cognitive ,affective and psychomotor competencies and the ability to utilise
the potentials for effective nursing performance
expertise in the utilization of concepts and theories for the assessment ,planning and
intervention in meeting the self care needs of an individual for the attainment of
fullest potentials in the field of specialty.
Eligibility
1. have passed BSc. Nursing/post certificate BSc, or nursing degree of any university
2. have a minimum of one year of experience after obtaining BSc, in hospitals or nursing
educational institutions or community health setting
3. for BSc, nursing post certificate, no such experience is needed after graduation the
candidate shall be-a registered nurse or registered midwife for admission to medical
surgical nursing, community health nursing, paediatric nursing obstetric and gynaecological
nursing.
4. the candidate shall be selected on merit judged on the basis of academic performances
in BSc nursing, post certificate BSc, or nursing and selection tests.
Specialties
5. branch5-psychiatric nursing
Four common papers are there included in the syllabus. They are:
In 1980 RAK college of nursing started an MPhil programme as a regular and part time
course. Since then several universities started taking students for the MPhil course in
nursing. Prominent among these are: MGR Medical University, Rajiv Gandhi University of
Health Sciences, SNDT University and Delhi University and Manipal Academy of Higher
Education.
Philosophy
Nursing shares with the whole university a main focus of preparing its students for service
and assisting them to achieve a meaningful philosophy of life. The student is encouraged to
develop judgment and wisdom in handling knowledge and skills and achieve mastery of
problem solving and creative skills.
Objectives
Duration
Duration of the full term M.Phil course will be one year and part time course will be two
year.
Course of study
At the time of admission each candidate will be required to indicate her priorities in regard
to the optional courses .a candidate may offer one course from M Phil programme from the
department of Anthropology, education, sociology and physiology or any suitable
department. The M.Phil studies will be into two distinct parts, part1 and part 2.
A candidate for admission to the course for the degree of doctor of philosophy in the
faculties of medical science must have obtained an M Phil degree of a university or have a
good academic record with first or second class master’s degree of an Indian or a foreign
university in the concerned subject.
The candidate shall apply to the University for the Admission stating his qualifications and
the subjects he proposes to investigate enclosing a statement on any work he may have done
in the subject. Every application for the admission of the course must be analyzed by the
board of research studies.
Three persons nominated by the medical faculty( for their special knowledge in the
medical science
Eligibility criteria
The candidate should be post graduate in nursing with more than 55% of aggregates
of marks
The course duration is far regular PhD course is 3 years and for part time is 4 years
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.