Nursing as profession

SMT. DAKUBEN SAREMALJI SANCHETI NURSING
INSTITUTE, SUMERPUR
Management of Nursing
Services & Education
Nursing as a
Profession
Kuldeep Vyas M.Sc. CHN
2020
Page 1Kuldeep Vyas M.Sc. CHN

Nursing as a Profession
INTRODUCTION
Nursing is a professional service devoted to promoting health care and social welfare,
nursing care helps to implement gained scientific knowledge and skills on the nursing care
service for those who are sick and require good quality health care, resulting in rejuvenation
of health and eradication of illness.
PROFESSIONALISM AND THE NURSING PROFESSION
The concept of profession was described as early as 1915 and discussed by professional
sociologists who established certain criteria:
1. Using a body of specialized knowledge on the level of a practice
2. Constantly enlarging the body of Knowledge and improving its service through scientific
methods
3. Educating its practitioners in institutions of higher education.
4. Offering services that are vital to human and social welfare
5. Making policies and controlling its own activities
6. Attracting those who put service above personal gain and accept their occupation as their
life work
7. Try to provide freedom of action and opportunity for continued professional growth and
economic well-being

Characteristics of Professionalism
Houle (1980) identified characteristics of professionalization:
1.Ability to solve problems
2.Application of theoretical knowledge
3.Continued seeking of self-enrichment by its members.
4.Official training.
5.Authorization system to certify competence.
6.Development of a subculture.
7.Legal Improvement of professional standards,
8.Ethical practice
9.Penalties against incompetent or unethical practices.
10.Public acceptance.

ESSENTIAL QUALITIES OF A NURSE:
Politeness

REGULATORY BODIES

REGULATORY BODIES
Indian Nursing Council
The Central Government has established Indian Nursing Council
(INC), by an act of parliament in 1917.
The INC is a self-governing body under the Government of India.
Under Section 3(1). this INC under the act of parliament in year 1917
has framed regulatory body of the Ministry of Health and Family
Welfare, which was constituted by the central government in order to
establish a uniform standard of training for nurses, midwives and
health Visitors.

The main goals of the INC are as follows:
1. To accomplish and evaluate a fixed standard of nursing education
for the nurse midwife, auxiliary nurse-midwives and health visitors
by performing regular appraisal of those institutions
2. To recognize registered nurses and midwives belonging to different
nursing courses and their qualifications under Section 10(2)(4) of
the Indian Nursing Council Act, 1947 for the purpose of
registration and job placement in India and abroad
2.To provide approval for the registration of Indian and foreign
nurses having foreign nursing qualification under Section 11(2a) of
the Indian Nursing Council Act, 1947.
3.To frame the nursing syllabus rules and regulations for nursing
programmes
4.To provide guidelines to the state nursing councils.examining
boards, state governments and central government to upgrade the
nursing education with good standards of nursing care.

Purpose of INC
1.To formulate a national policy for training and practice of
nursing depending mainly on the culture and philosophy
of the country
2.To prescribe the syllabus for the training of nurses of all
levels
3.Nursing personnel have to be identified with an
appropriate educational programme for each level in the
system of the country
4.The council has the authority to inspect the training
institutions periodically to ensure that its functioning
follows the prescribed standards.

Amendment of the Act of INC
The steps or process to amend the INC Act are as follows:
1.A proposal is to be sent to the Government of India,
Ministry of Health and Family Welfare
2.The above ministry will consult the Ministry of Law.
3.It will then go to the cabinet (legal cell),
4.When it is approved by the cabinet (legal cell), it will be
placed before the Lok Sabha.
5.When the amendments are approved by the Rajya
Sabha, then it will be gazetted and notified.

Functions of INC
1.Recognizes nurses as a separate branch in health services.
2.Regulates nursing training sets uniform standard or types of training
for nurses throughout the country
3.Recognizes qualifications (basic to higher). Any recognized
qualifications shall be sufficient for enrolment in any state register.
4.Seeks information on course of study and training and examination
from any state from time to time as required.
5.Inspect schools and colleges of nursing
6.Can withdraw recognition of nursing institutions.
7.Maintains Indian nurses' register.
8.Has the power to make regulations
9.Permits title, badge and uniform for registered nurses
10.Upholds the standard of profession
11.Brings out publications.

STATE NURSING COUNCIL (SNC)

State Nursing Council (SNC)
The SNC is constituted in respective states. The main purpose is to regulate better
training for nurses, midwives and health visitors.
Salient Features
1.Has provision for autonomous body, comprising the majority of nurses, and is
endowed with decision-making powers
2. Carries out compulsory registration for all nurses and midwives practising
within the state
3.Has provision for nurses, midwives and public health nurses to elect their own
represents tives to the respective state
4.Has a power to regulate nursing education through prescribed curriculum and
to enunciate examination policies
5.Has provision for recognition of educational institutions of nursing and
withdrawal of such recognition if necessary
6. Different types of basic as well as post basic nursing training programmes are
conducted by some of the SNCs.

Functions of SNC
1. Registration carries out student registration after admission to a basic nursing
programme And final registration after completing the course.
2. Exotirations are conducted for the different courses throughout the year
3. Changing surname after marriage, the surname of the trained nurses are changed if
wanted
4. Inspection of training institution and granting recognition or withdrawal of recognition
5. Maintenance of different register for different categories of nurses.
6. Change of address of the trained nurse if wanted by the nurse.
7. Issue of duplicate certificate for loss of original certificates
8. Additional qualifications registration for up-to-date statistics for higher qualifications
9. Renewal of registration
10.Reciprocal registration
11.Abroad verification
12.Publication
13.Construction of syllabus including required courses in state.
14.In-service education programme.
15.Research.

CURRENT TRENDS
AND
ISSUES IN NURSING

CURRENT TRENDS AND ISSUES IN NURSING
Forces that have affected Development of Professional
Nurse, continue to affect significant issues these include:
1.Societal Images and Expectations of Nurses
2.Degree of the nursing profession. Control over the
Quantity and Quality of practitioners
3.Impact of Technology and Theory on nursing practice
its roles and setting
4.Professional Self Images of Nurses.
5.Source of financing for Health Care Services
risky lifestyle, economics of health care and governmental
regulation of health care. These will affect changes in both
nursing practice and nursing education.

Issues Affecting Nursing Practice
1.DEMOGRAPHICAL CHANGES: It include the rising number of
elderly people continuing increase in poverty, increasing cultural
diversity in the population and a continuing urbanization. Each has
implications for nursing.
1)Many older persons are healthy, but the likelihood of illness becomes greater as
people age. it indicates that Nurses must be prepared to work effectively with a
rising number of elderly persons.
2)People living below the poverty line (BPL) is increasing. When basic needs for
food clothing and shelter are unmet or uncertain, health care becomes a luxury/
Expensive.
3)Immunization for children, care for pregnant women, nutritious meals and other
health maintaining factors are Neglected.
4)Poor people tend to put off seeking care until illness is advanced and thus harder
to treat.
5)Preventable conditions are often not prevented due to lack of education, lack of
sanitation, and crowded living condition, improper shelter, homelessness and a
host of other poverty-related factors.
6)Nursing as an profession is committed to provide care to all people, regardless of
social and economic factors

2. ENVIRONMENT CHANGES: Such as Nuclear
Power Accidents, Burning Oil Wells, Tsunamis, Gradual
decline in the Purity of the Air, Water and Animal Life of the
universe lead to many Social and Health Problems.
3. CHANGES TO HEALTHY PRACTICES: Obesity,
Lack of Exercise and Stress & Contact with Multi-Partners for
Sex, which leads to HIV/AIDS. Substance abuse. it is clear that
nurses will play an important role in educating people about
wellness and self- care.
4. EMERGING BIOETHICAL ISSUES: That prevent
conception or terminate pregnancy as well as processes that enable
conception and pregnancy etc.

NURSING EDUCATION
the future nurses will need broad-based education And the ability to deal with rapid
change. The knowledge base and technology used in providing nursing care for
increasing the skill and ability in:
1. Intensely acute aspects of care,
2. diagnostics and decision-making
3. patient teaching,
4. coordination of less-skilled workers and
5. Collaboration with patient and health care professionals to improve the quality of
health.
PROFESSIONAL ETHICS: Ethics means a set of laws or principles that
govern the right conduct or behaviour. Nursing ethics means a set of principles that
govern the nursing behaviour, which leads to a healthy profession.
1. At international level, the nurse’s code was first established by the International
Council for Nurses (ICN) at Sao Paulo, Brazil, in the year 1953. The code of
ethics was revised in Frank furt, Germany, in the year 1965, where it was named
as The ICN Code of Ethics. The INC adopted the ICN code of ethics for nurses in
the year 1973.

2. Importance of Ethics:
1. Provides Profit
2. Protection
3. Decision Making
4. Basic Human Need
5. Create Credibility to Public
6. Credibility to EmployeePage 19Kuldeep Vyas M.Sc. CHN

CODES OF NURSING ETHICS:
The International Code of Nursing Ethics:
1.The fundamental responsibility of a nurse is to Save life and to Promote Health.
Every nurse is a teacher of health by example.
2.A Nurse must be adequately prepared to practise nursing and be willing to continue
to learn new ideas by reading and attending meetings
3.The nurse must learn to respect authority.
4.The nurse must carry out the doctor's orders accurately and sustain confidence in
the doctor, and all members of the health team.
5.The nurse should report any unusual condition or symptoms to the doctor or the in-
charge nurse.
6.The religious beliefs of a patient should be respected.
7.The nurse should hold confidential all information given to her/him.
8. When a patient requires continued nursing care, the nurse must remain with the
patient until adequate relief is available.
9.The nurse has the Duty to give Nursing service and, in return, is entitled to just
remuneration.
10.A patient should always be called by his/her full name.
11.Punctuality is very important for every nurse.
12.Obedience is very important in observing rules and regulations.

PRACTICE STANDARDS FOR NURSING
Standards ensure practicing things the right way and doing things how they
should actually be done Standard and quality go hand in hand, and standard of care
is bound by ethical values A standard has its own scientific background for any type
of nursing care.
Sources of Nursing Care Standards
There are many Nursing Associations that strictly establish the standards of nurseing
care.
1) The ICN
2)The INC SNCs and the Medical Council Of India-the regulatory bodies that
control the in institutions to follow the ethical laws and regulations
3)Professional organizations like Trained Nurses Association of India (TNAI),
Rajasthan Private Nursing Schools & College Federation (RPNSF) and American
Nurses Association (ANA)
4)Directorate of Health and Family Welfare, Ministry of Health and Family
Welfare--repressible for health for all
5)Universities and institutes, e.g. Rajasthan University of Health Science (RUHS),
National Institute of Health and Family Welfare (NIHFW), etc.

Classification of Standards
Standards of nursing can be classified into the following
1)Ends standards
2)Means standards
3)End standards: This means that it is always oriented to the patient.
This describes the change in the expected behaviour of the patient or desirable
change of behaviour as expected
1)Means standards: This explains performance of the nurse or care given by
the nurse to the Patient: how good and effective was it and the best way in
which it could have been delivered. Standards in nursing care are established
to evaluate and improve the care; therefore, standards of nursing care will
always be understandable, measurable and achievable.

Main components of standard of care are as follows
1)Structure standard
2)Process standard
3)Outcome standard
1. Structure standard: It means the Blueprint of the Organization or the entire set up of the
institution. The goals objectives and philosophy of the institution are the main
components. It also means the quality that is maintained in constructing the institution,
materials used, tactility provided to the patient and all equipment, et Entire institution in
bounded and fully equipped with standard resources to provide a high-quality care
2. Process standard It includes the performance of nurses functions and rule leech quality
care has been followed by the nurses in all procedures towards patient care The nurses
completely assess the patient, collect data required from patients relative family and
friends, record the collected details, frame nursing diagnosis plan goals for nursing action,
complete doctor's order in time and implement the core efficiently keeping in mind the
scientific principles In this process, standard degree of practice skills estimated
In this process standard, there is an important competent of professional judgment that has
been used to evaluate the standard and the extent of skills in implementation of care
3. Outcome standard: This involves determining the results of the patient care how
effectively the care was given what is the improvement in patient's health, etc. The
outcome standard measure the change or improvement in patient in health due to effective
nursing care.

Consumer Protection Act

CONSUMER PROTECTION ACT
The Consumer Protection Act (CPA) was implemented by the parliament
in the year 1986 to protect the interests of the consumers. This act
concentrates on justice through consumer council authorities that
finalize the related disputes. The scope of the act is wide enough to
include avast variety of services. Under this act the consumer can
complain in a redressal forum Patients can also make a complaint to a
redressal forum in respect of defective service provided in their care
Rights of a Consumer/Patient
1.Rights to ensure safety
2.Rights to be intimated
3.Rights to be selected
4.Rights to get listened to
5.Rights to get relief
6.Rights for the person who trades money for goods

The Act
Legal Action to get injustice for negligence and claims of damages is time consuming It is also
expensive
This act provides accomplishment of consumer council to create awareness among the public and
settle the financial disputes regarding the same. Consumer Protection Act does not confer any new
right to the patient for the relatives The Act is designed to provide for a quicker and cheaper
remedy when there is deficiency in service and claims for damages are made arising from such
deficiency in service
According to Section 2(1) (d(ii) of the Act a consumer in a person who gets the service or work for
which he/she has been paid or promised to be paid or partly paid and partly promised or is under
any other system of deferred payment.
Salient Features
1. Through CPA, services rendered by medical practitioner for consultation and treatment are kept
free of charge
2. Under CPA, service charges are borne by the insurance company where relevant and claimed
by the affected person.
3. CPA is not applicable in case of free health care service where no charge is made to any per
son, whether rich or poor.
District forum:
1. District judge who will be the President of the forum
2. Two members, who are specialists in Law, Commerce, Eonomics, Accounting Industry or
Administration. At least one of them must be a woman.

Functions of district forum are as follows:
1. Welcomes filing of complaints by consumers and tries to get compensation for the
affected party. The compensation claimed must not be more than 5 lakh INR.
2. Appeal against the order of the district forum must be made to the state commission
within 30 days from the date of the order
State Commission:
1. High court judge, who will be the president of the state commission
2. Two members (at least one of them should be a woman who is specialists in
industry commerce law, accounting, administration or economics
Duties of the state commission include accepting complaints and providing
compensation total affected persons in case of cars between 5 and 20 lakh INR. Appeal
against the judgment of the state commission must be made within 30 days and can be
made by the national commission.
National Commission: (5 Member)
1.A Supreme Court judge, who will be the president of the commission
2. Four members who are specialists in economics, commerce, law, accounting
administration or industry. At least one of them should be a woman

1. Compassion: It means the capability of the nurse to empathize with the sensation of pain and
weakness in the patient and to understand the patient's illness and suffering and plan the
nursing care effectively.
2. Competence: Possessing enough knowledge and developing good attitude towards nursing
care, evaluating skills and interest and getting enough exposure to the nursing practice in
order to respond adequately to the needs and demands of the nursing care.
3. Confidence: It is a kind of courage that each nurse has to develop, with strong faith in the
application of nursing knowledge integrated with scientific principles that foster a trusting
relationship.
4. Conscience: It is possessing good morality and abiding by the ethical principles of nursing care
that is nurtured along with the exposure to nursing practice.
5. Commitment: It is a kind of selfless sincere dedication towards provision of nursing care that
explains the attributes towards providing satisfactory quality nursing care.
PROFESSIONAL CARING: (The Five Cs)

Thank You …

Nursing as profession

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