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Nursing Trend and Issue in Nepal
Sabitri Bhattarai
Introduction
Trends and issues of nursing are directly related to a number of social issues. As our
society becomes increasingly diverse, each trend precipitates new issues and
problems. Trends result from the issues in the past, just as these issues result to
another trend in the future. This is never ending process of change. Changing social
norms and mores, advancing science and technology, the women movements,
political and economical changes, all of them have exerted powerful influence on the
practices of nursing.
Changes in society undoubtedly influence the process of professionalization. Nursing,
as an occupation, is not at all detached from most recent trends and practices and this
is evidently the current vital issue in the field of nursing. Johnson (1972) considers
how the term professionalization can be considered in variety of ways. Firstly it may
be used to refer to broad changes in occupational structure whereby professional jobs
got increased numerically in relation to other occupations. Secondly it may be used in
a way of implying an increase in the number of occupational associations which make
constant attempt to regularize recruitment and practice in a specific occupation.
Another major issue in nursing is viewing nursing profession as only a support
service whose duties are directly dictated by and auxiliary to both physician and the
hospital administration. It is rarely considered as an autonomous body. Despite with
its own skills and area of responsibilities, nursing has constantly suffered
indescribable indignities in our society in the past.
Expanding scientific research and innovations continue to lead to newer dimensions
of complex issues. These issues focus on ethics, bioethical developments, and
personal choice. Expectations of personal freedom of choice raise ethical issues in
certain areas like abortions, right to die, and lifestyle preferences. A number of inter
related trends include the changing characteristics of the population and the political
and the economic influences on health and health care. The two other trends of
nursing education is the increasing shortage of qualified faculty nurse and the
increasing stress related to the demands of personal and professional responsibilities.
Current Nursing Educational Trend in Nepal
When Nepal, first of all, opened its doors to the outside world in the early 1950’s,
there were no professional nurses in the country. In present context patient to nurse

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ratio in biggest government hospitals is approximately 20:5. Nursing and midwifery
personnel constitute the largest element of the health care work force in most of the
countries. Nursing and midwifery education varies from one country to another
country of the Region.
Professional nursing education consists of either a certificate or diploma level course
of three or three and a half years of duration or a bachelor's degree in nursing of four
or four and a half years. The duration of general education required for entering
professional nursing and midwifery educational programmes also varies, e.g. 10 years
for nurses in Bangladesh, Bhutan, Maldives, Nepal (Proficiency Certificate Level in
nursing and midwifery) and Sri Lanka, 11 years in DPR Korea and 12 years in India,
Indonesia, Myanmar, Nepal (Bachelor of nursing degree) and Thailand. Post-basic or
advanced levels of nursing education for obtaining a bachelor's and higher degree is
available in Bangladesh, India, Myanmar, Nepal, Sri Lanka and Thailand. Different
universities of India, Indonesia, Nepal and Thailand have their own master's degree in
nursing programmes.
Privatization in this sector has increased a number of private institutions and also due
to global demand the number of people attracted to nursing education has increased
considerably. Because of this reason, private sectors are investing their money mainly
for profit motive. This significant increase in number of educational institutes has
produced or number of health professionals inside the country. Since these privately
invested institutions are opened only for profit motives the quality of education in
such institution is considerably low. And also the number of manpower produced at
present is more than the demand of health manpower in our country.
If you talk about Nepalese context, many qualified nurses have left their jobs for
better opportunities and higher paying jobs in foreign countries. The trend of nurses
going abroad, according to NNC, started about six years ago and the number of those
going abroad has sharply increased in last two years. Job dissatisfaction and wages
(especially in government sector professional have very poor salary) have both been
cited as factors contributing to the nursing exodus. When experienced nurses leave
their positions after only a few years in the profession, they are often replaced with
recently graduated and inexperienced staff members. This is the revolving door
syndrome, the worst possible model of workforce replacement for a profession such
as nursing. Nurses in Nepal are concerned with shifting roles, standards, employment
options and terms of employment, living conditions, status, and a lack of solidarity
among nurses.
Summary
Nursing needs to achieve autonomy in controlling and maintaining the integrity of its
professional education and united membership has to be recognized. The importance

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of the knowledge of nursing and contributions to health care will have to be
recognized and esteemed to a greater extent by the public as well as by the
government if autonomy and control over nursing practice is to be achieved. The fact
that nursing is primarily composed of women, who have been and continue to be
dominated by the physicians and hospital administrators in many health care institutes
that should not be overlooked. New nurses have to understand how nursing trends
and issues synthesize the technical, ethical and organizational issues in the ever
evolving health care arena of nursing.
References
1. Jolley, Moya, The Professionalization of Nursing: The Uncertain Path. Current
Issues in Nursing, 1989.
2. Cherry, Barbara, & Susan R. Jacobs, Contemporary Nursing....
3. Subedi. Anjali, Nurses Flock though Badly Needed Here, Kantipur, 20060-12-28.
4. WHO/Nepal, WHO Regional Office for South East Asia, 2009.
5. Oligive, L., Nursing in Nepal, Can Nurse. 1995 Jun; 91(6):25-30.
Maharajgunj Nursing Campus, Maharajgunj