Nurses play a vital role in healthcare but face many challenges in nursing education and practice. The document discusses issues like nursing shortages, disparities in rural healthcare access, and the increasing workload and complex healthcare environment exacerbated by the COVID-19 pandemic. It also outlines strategies recommended by WHO like increasing investments in nursing education, leadership training, and service delivery to address the global shortfall of nurses by 2030. The presentation highlights specific challenges faced by nurses in India such as inadequate salaries, lack of promotion criteria, workplace violence, and staffing shortages. It proposes managing these challenges through excellence, research, advocacy, career development, and collective bargaining.

1. CHALLENGES IN NURSING
EDUCATION
Presented By:
DR. INDRAWATI RAO
PRINCIPAL
GOVERNMENT COLLEGE OF NURSING, SURAT

2. • Nurses plays most vital role in delivery of primary health care within the health
care setting
• The United Nations (UN) 2030 Agenda for Sustainable Development and its 17
Sustainable Development Goals (SDGs) set clear targets for health, education,
gender equity, decent work and inclusive growth, among others.
• Central role of the nurses to achieve Universal Health Coverage
• 138 crores of population/68.24% population residing in rural and suburban area
• The global nursing workforce is 27.9 million, of which 19.3 million are
professional nurses
• WHO estimates that the world will need an additional 9 millions nurses and
midwifes by the year 2030 and India needs 4.3 million nurses by 2024 to meet
the WHO norms.
Introduction
Government College of Nursing, Surat

3. • Huge disparity among percentage of healthcare professionals in rural and
urban areas
• 138 crores of population/68.24% population residing in rural and suburban
area
• Covid -19 pandemic
• Complex Health care environment
• Disparities in access to care for vulnerable populations in urban settings
• Unequal distribution of health care services global nursing shortage, the ageing
nursing workforce, the mass traumatization of nurses, the lack of protection,
the increasing workloads and low salaries.
Government College of Nursing, Surat

4. • Themes of the Reports – Investment
Creation of positions
Leadership &
Service Delivery
• Strategic Direction for Nursing & Midwifery (SDNM 2021-2025) resolution
passed by the World Health Assembly in 28th May, 2021
• These reports estimate Global shortfalls of Nurses & Midwives – 6 Million, the
latest forecast is 13 million (after COVID)
• WHO declared 2020 as a International year of Nurse & Midwife to
commemorate 200 year of birth Anniversary of the Florence Nightingale
Government College of Nursing, Surat
Global Perspectives”

5. Overviewof Strategic Direction for Nursing & Midwifery 2021-25

6. Overviewof Strategic Direction for Nursing & Midwifery 2021-25

7. 1
3
2
Nursing
Education
Administratio
n
Nursing
Curriculum
Nursing
Research
Government College of Nursing, Surat

8. Abrupt changes in Curriculum
• Semester System
• Competency based and outcome based approach
• Transformational and relationship based education
• Self directed learning
• Credit based assessment
• Grading system
• Choice based system in elective modules
• Elective and Mandatory modules
• OSCE and OSPE based examination
Government College of Nursing, Surat

9. Government College of Nursing, Surat

10. Government College of Nursing, Surat

11. Dealing with Z generation
Government College of Nursing, Surat

12. Innovative Teaching Method
Government College of Nursing, Surat

13. Class room technology
Government College of Nursing, Surat

14. Blended learning
Government College of Nursing, Surat

15. Government College of Nursing, Surat

16. Gap between nursing theory and practice
Government College of Nursing, Surat

17. Skill gap analysis
Urgent need of skilled professionals
97.9% skill gap across various verticals of healthcare
(Public Health Foundation of India for the Ministry of Health
and Family Welfare)
Government College of Nursing, Surat

18. Enhancement of Faculty Development program

19. Technological Advancements and digital Health

20. AI – IN NURSING CARE
• Artificial intelligence (AI) comprises many healthcare technologies
transforming nurses’ roles and enhancing patient care.
• In healthcare, AI typically refers to the ability of computers to
independently convert data into knowledge to guide decisions or
autonomous actions.
• However, precisely defining AI can be challenging because of its breadth of
applications, including risk prediction algorithms, robots, and speech
recognition—all of which augment nursing practice and are on a fast track
to changing healthcare as a whole.
• Nursing AI tools include clinical decision support, mobile health and sensor-
based technologies, and voice assistants and robotics.
AI in Nursing Care

21. AUGMENTED REALITY (AR) AND VIRTUAL REALITY (VR)

22. INTEROPERABILITY

23. TELENURSING
Telenursing is the delivery, management and coordination of care and services
provided via tele communication and information technology within the domain of
nursing.”

25. Evidence Based Practice
The American Nurses Association (ANA) predicts that by
2020, 90% of all nursing practice will be based on EBP
research findings.

26. INCOPERATING EVIDENCE BASED PRACTICE IN NURSING

27. Multi-Generational Workforce
Nursing leaders are faced with four distinct generations of
nurses which each offer their own set of values, work
ethics, and communications style..
Address generational differences as a whole in order to
nurture an environment of open and respected dialogue
concerning expectations as well as what factors both
attract and promote retention of these nurses

30. Challenges in hospital settings
• Disparity in salaries – There is disparity in salaries at
state and centre level, rural and urban level, and private
and government sector. The decision for minimum
wages for nurses is still pending. Appointing nurses for
contractual period by the govt and private hospitals is
another thing which puts the nurse at unease and
produces uncertainty in her mind about her growth,
hence she cannot work with her full potential to deliver
quality care.

31. Challenges in hospital settings
⚫ Criteria of Promotion: There is no certain laid out criteria for
promotion in government as well as private sector. Sometimes
even talented nurses don’t get their due promotion and
incentives due to some internal politics and corruption.
Unfortunately nurses keep low hope of promotion in clinical or
teaching setting and flee to greener pastures.
⚫ Lack of performance based incentives

32. Challenges in hospital settings
Violence in the workplace
⚫ Nurses are subjected to violence at workplace by caregivers,
relatives and other healthcare employees.
• Incidences of bullying, harassment and abuse are increasing
day by day.
• Employers, victims, nursing leaders and the political system
need to work on united approaches to layout plan for such
circumstances.
⚫ The mean age and work experience of the nurses were 33.5
± 7.5 and 10.85 ± 10.1 years, respectively. The highest
prevalence of verbal, physical, sexist, and racist violence was
from:

33. Challenges in hospital settings
Nurses migration.....increased staff turn over
• Caste based reservation system
• Poor pay and facilities, No respect or social status
•Increased workload, Lack of Recognition
•Occupational Stress and unfavourable working environment
(bullying)
• Ineffective academic and professional growth
• availability of various incentives, job dissatisfaction, social or
political unrest and less social welfare

34. Lack of Synchronicity in Team work
*Language barriers
*Distractions
*Physical proximity
*Difference in Personalities
*Workload
*Varying communication styles
*Conflict
*Lack of verification of information
*Shift change

36. Working Conditions
*Inadequate staffing
*The nurse-patient ratios are usually not met at the
hospitals.
*Long shifts without breaks.
*Too much documentation
*Nurses are prone to experience burnout and fatigue
*Nurses face ethical dilemmas with restricted
resources
*Decline in quality care to patients

37. Shortage Of Staff
Retiring Nurses
Covid-19 effect
Scarcity of Nursing Educators
Many Nurses Leaving the Field
Growing Population
Migration of Nurses

40. Workplace Violence Against Iranian Nurses: A Systematic Review
and Meta-Analysis Azami M. Moslemirad M. YektaKooshali MH,
Rahmati S, Soleymani A, Bigdeli Shamloo MB, Esmaeilpour-
Bandboni M, Khataee M, Khorshidi A, Otaghi
Workplace Violence
Nurses are subjected to violence at workplace by
caregivers, relatives and other healthcare
employees.
Incidences of bullying, harassment and abuse are
increasing day by day.
The mean age and work experience of the nurses
were 33.5 7.5 and 10.85 ± 10.1 years, respectively.

41. Professional Councils:
• Must restrict themselves to the role of Professional Standard
Setting Bodies (curriculum framework, against which
educational institutions will prepare their own curricula)
• Separate Nursing and Midwifery Councils
Separate Directorate
Education:
• Must be left to the Universities and Colleges.
• Responsibilities of governance, regulation, accreditation, and
funding.
• Must be aligned with general education -NAAC ..

42. From Silos to Synergy…

43. Challenges faced by Nurses at workplace

44. Managing challenges
• Personal and professional excellence
• honesty
• hardwork
• teamwork
• Professional ethics
• Good communication
• KASH

45. Managing Challenges
• Well groomed personality- Building a positive image in
the society by appropriately communicating with patients,
caregivers and colleagues, improved dressing sense, and
being skilled in the competencies.
Continuing Research- Sharing of evidence and best
practice by getting involved in research activities with full
enthusiasm and motivation. Regularly participating in
conferences, workshops to update her knowledge and
sharing the knowledge with peers.

46. Managing challenges
•Partnering with media
• Nursing needs to be advertised positively in media.
•It is not merely hand-holding and emotional experiences with
patients but also involves knowledge-based care that requires
high levels of competency.
• Most of the non nursing people/disciplines are not even aware
that Nursing is a full time programme with well defined curriculum
and council, Ph.D. In Nursing is also available

47. Managing challenges
Career advancement
• Opportunities for Career advancement and personal
development should be offered under Continuing Nursing
education programs for better clinical skills, promotion, and
competency based recognition.
• Employment process of Nurses in India should include an
exit interview to explore what went wrong during their tenure
and why nurses are leaving or repeatedly changing their
jobs.

48. Managing challenges
Collective Bargaining between employers and nursing personnel to
regulate salaries, working environment, benefits, and other compensation
needs to be practised. For that each and every nurse should be a
member of a reputed association like TNAI so that negotiations can be
done.
*The nurses voice has yet not been heard due to the historical role of
nurse as handmaiden (not an independent role), limited role in decision
making; largely physicians have all the say in decision making related to
patient care. Nurses should be very clear with their role, have confidence
and should not be insecure and should not have any sense of inferiority
while carrying out their duties.

49. Managing challenges
Strong Nurses Network
• In these times of social media, nurses should develop strong
network to connect with each from all corners of country, to
speak unanimously for their rights, to spread awareness
about their rights, needs and demands for growth of the
profession.

50. Managing challenges
Policy making- Advocacy, Lobbying
• Lobbying is the act of attempting to influence decisions
made by officials in the government, most often legislators
or members of regulatory agencies.
• Lobbying is done by many different types of people and
organized groups, including individuals in the private
sector, corporations, fellow legislators or government
officials, or advocacy groups (interest groups).
• Nurses must build new partnerships with other clinicians,
business owners, philanthropists and elected officials.

51. Developing leadership qualities
*Mentoring and nurturing novice nurses
Senior Nursing professionals’ willingness to guide and
support creates a loving and non-judgmental
environment facilitating nurses to learn and grow.
*Mentorship is indeed a great way to support nursing
profession growth and promote its glory. LLead by
example

52. Challenges in Nursing Research
*Researcher competencies
*Culture prioritize more on clinical practice
*Ethical issues
*Evidence based practice
*Financial constraints
*Lack of guidance, support & resources
*Ambiguity in relation to research role expectations
*Patient care outcomes

53. • Summary
• Maintaining moral and ethical standards
• Being honest and hardworking
• Collaboration
• Participating in policy making decisions
• Being updated
• Good communication skills
• Partnering with media

55. Take home message
Innovation and pedagogy
Happy Nurse Educators.. Students…
Critical thinkers
Quality care
Cost effectiveness
Addresses complex health care needs