European Treaty Series - No.

59

EUROPEAN AGREEMENT ON THE INSTRUCTION AND EDUCATION OF NURSES

Strasbourg, 25.X.1967

2 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________

ThememberStatesoftheCouncilofEurope,signatoryhereto, ConsideringthattheaimoftheCouncilofEuropeistoachieveagreaterunitybetweenits membersforthepurpose,amongothers,offacilitatingtheirsocialprogressandpromoting thesocialwellbeingoftheirpopulationsbymeansofappropriateaction; Having regard to the Conventions furthering this purpose already concluded within the framework of the Council, in particular the European Social Charter, signed on 18thOctober1961, and the European Convention on Establishment, signed on 13thDecember1955; BeingconvincedthattheconclusionofaregionalAgreementontheharmonisationofthe instructionandeducationofnurseswillpromotesocialprogressandguaranteethestandard ofthenursesrequiredfortheirestablishmentintheterritoryofotherContractingPartieson anequalfootingwiththosecountries'nationals; Consideringitnecessarytolaydownminimalstandards, Haveagreedasfollows: Article1
1

EachContractingPartyshallapplyor,iftheeducationofnursesisnotunderitsdirectcontrol, recommendthecompetentauthoritytoapplytheprovisionsgoverningtheinstructionand educationofnursessetoutinAnnexItothisAgreement. ForthepurposeofthisAgreement,nursesshallbeintendedtoincludeonlygeneraltrained nurses,male orfemale.Those nurseswhose training issolely withinthe fieldofpublic health,infants'andsickchildren'snursing,obstetricsormentalhealthareexcluded. Article2 EachContractingPartyshallcommunicatetotheSecretaryGeneraloftheCouncilofEuropea listofitsauthoritiesorotherbodiesauthorisedtocertifytheaccomplishmentofanurse's instruction and education satisfying at least the standards laid down in AnnexI to this

3 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________ Agreement. Article3

1

AftertheentryintoforceofthisAgreementinaccordancewithArticle5,theCommitteeof MinistersoftheCouncilofEuropesittingwithitsmembershiplimitedtotherepresentatives oftheContractingParties,shallberesponsibleforthefurtherelaborationoftheregulations containedinAnnexItothisAgreementinaccordancewiththecurrentdevelopmentsinthis field. AnymodificationorextensionoftheregulationscontainedinAnnexIunanimouslyapproved bytheCommitteeofMinistersreferredtointheprecedingparagraphshallbecommunicated bytheSecretaryGeneraloftheCouncilofEuropetotheContractingPartiesandshallenter into force three months after the date on which the Secretary General is notified by the ContractingPartiesoftheirapprovalofthemodificationorextension. Article4

ThisAgreementshallbeopentosignaturebythememberStatesoftheCouncilofEurope, whomaybecomePartiestoiteitherby:
a b

signaturewithoutreservationinrespectofratificationoracceptance,or signaturewithreservationinrespectofratificationoracceptance,followedbyratification oracceptance.

InstrumentsofratificationoracceptanceshallbedepositedwiththeSecretaryGeneralofthe CouncilofEurope. Article5

ThisAgreementshallenterintoforcethreemonthsafterthedateonwhichthreemember StatesoftheCouncilshallhavebecomePartiestotheAgreement,inaccordancewiththe provisionsofArticle4. As regards any member States who shall subsequently sign the Agreement without reservation in respect of ratification or acceptance or who shall ratify or accept it, the Agreementshallenterintoforcethreemonthsafterthedateofsuchsignatureorafterthedate ofdepositoftheinstrumentofratificationoracceptance. Article6

AftertheentryintoforceofthisAgreement,theCommitteeofMinistersoftheCouncilof EuropemayinviteanynonmemberStatetoaccedethereto.

4 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________
2

SuchaccessionshallbeeffectedbydepositingwiththeSecretaryGeneraloftheCouncilof Europeaninstrumentofaccessionwhichshalltakeeffectthreemonthsafterthedateofits deposit. Article7

AnyContractingPartymay,atthetimeofsignatureorwhendepositingitsinstrumentof ratification, acceptance or accession, declare that it avails itself of one or more of the reservationsprovidedforinAnnexIItothisAgreement. Any Contracting Party may wholly or partly withdraw a reservation it has made in accordance with the foregoing paragraph by means of a declaration addressed to the SecretaryGeneraloftheCouncilofEurope,whichshallbecomeeffectiveasfromthedateof itsreceipt. Article8 TheannexesshallbeanintegralpartofthisAgreement.

5 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________ Article9

1

AnyContractingPartymayatthetimeofsignatureorwhendepositingitsinstrumentof ratification, acceptance or accession, specify the territory or territories to which this Agreementshallapply. Any Contracting Party may, when depositing its instrument of ratification, acceptance or accessionoratanylaterdatebydeclarationaddressedtotheSecretaryGeneraloftheCouncil of Europe, extend this agreement to any other territory or territories specified in the declarationandforwhoseinternationalrelationsitisresponsibleoronwhosebehalfitis authorisedtogiveundertakings. Any declaration made in pursuance of the preceding paragraph may, in respect of any territorymentionedinsuchdeclaration,bewithdrawnaccordingtotheprocedurelaiddown inArticle10ofthisAgreement. Article10

1 2

ThisAgreementshallremaininforceindefinitely. AnyContractingPartymay,insofarasitisconcerned,denouncethisAgreementbymeansof anotificationaddressedtotheSecretaryGeneraloftheCouncilofEurope. Such denunciation shall take effect six months after the date of receipt by the Secretary Generalofsuchnotification. Article11 TheSecretaryGeneraloftheCouncilofEuropeshallnotifythememberStatesoftheCouncil andanyStatewhichhasaccededtothisAgreementof:
a b c d e f g

anysignaturewithoutreservationinrespectofratificationoracceptance; anysignaturewithreservationinrespectofratificationoracceptance; thedepositofanyinstrumentofratification,acceptanceoraccession; anydateofentryintoforceofthemodificationsorextensionsreferredtoinArticle3.2; anydateofentryintoforceofthisAgreementinaccordancewithArticle5; anycommunicationreceivedinpursuanceoftheprovisionsofArticle2; anynotificationreceivedinpursuanceoftheprovisionsofArticle7;

6 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________
h i

anydeclarationreceivedinpursuanceoftheprovisionsofArticle9; anynotificationreceivedinpursuanceoftheprovisionsofArticle10andthedateon whichdenunciationtakeseffect.

7 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________ In witness whereof the undersigned, being duly authorised thereto, have signed this Agreement. DoneatStrasbourg,this25thdayofOctober1967,inEnglishandFrench,bothtextsbeing equallyauthoritative,inasinglecopywhichshallremaindepositedinthearchivesofthe CouncilofEurope.TheSecretaryGeneraloftheCouncilofEuropeshalltransmitcertified copiestoeachofthesignatoryandaccedingStates.

8 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________

ANNEXI Minimalstandardsfortheinstructionandeducationofnurses

ChapterIDefinitionofthefunctionsofgeneraltrainednurses
1

Thegeneraltrainednurseexercisesinconformitywiththenationallegislationthefollowing essentialfunctions:
a

giving skilled nursing care to persons as required in accordance with the physical, emotional and spiritual needs of the patient, whether that care is given in health institutions,homes,schools,placesofwork; observing physical and emotional situations and conditions which have significant bearingonhealthandcommunicatingthoseobservationstoothermembersofthehealth team; training and giving guidance to auxiliary personnel who are required to fulfil the nursingserviceneedsofallhealthagencies.

Thisalsoinvolvesanevaluationofthenursingneedsofaparticularpatientandassigning personnelinaccordancewiththeneedsofthatpatientataparticulartime.

ChapterIIEducationalstandardrequiredofcandidatesforadmissiontoschoolsofnursing Candidatesforadmissiontoschoolsofnursingshallnormallyhavereachedaculturaland intellectualstandardequivalenttoatleastthatofthe10thyearofgeneraleducation.They shallthereforeeitherpossessarecognisedschoolcertificatesignifyingthecompletionofsuch generaleducation,ormusthavepassedanofficialentrance examinationofanequivalent standard. ChapterIIIDurationandcontentoftheeducationalprogramme Nursesshallhaveaminimumof4600hoursbasicnursingeducation.Atleasthalfthetotal timeshallbedevotedtoclinicalinstruction(practicalexperience)(seeBbelow).However,the numberofhoursoftheoreticalandformalinstruction(seeAbelow)shallnotbelessthanone thirdofthetotaleducationalprogramme. ATheoreticalandformalinstruction Instructionshallincludeallaspectsofnursing,aswellasthepreventionofsickness,health

9 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________ education,rehabilitation,drugactionandadministrationofdrugsandproblemsofnutrition anddietetics,andalsofirstaid,resuscitationandthetheoryofbloodtransfusion. Theoryandpracticeshallbecoordinatedandintegratedthroughouttheprogramme. Thesubjectstobeincludedinthecurriculummaybegroupedundertwoheadings:

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1

Nursing Professionalorientationandethics Generalprinciplesofhealthandnursing Principlesofnursingcareinrelationto: generalmedicineandmedicalspecialities generalsurgeryandsurgicalspecialities careofchildrenandpediatrics maternitycare mentalhealthandpsychiatry careoftheagedandgeriatrics.

Fundamentalsciences Anatomyandphysiology Generalpathology Bacteriology,virology,parasitology Biophysicsandbiochemistry Hygiene: preventivemedicine healtheducation. Socialsciences: sociology psychology principlesofadministration principlesofteaching socialandhealthlegislation legalaspectsofnursing.

BClinicalinstruction(practicalexperience) Practicalexperienceshallcoverallaspectsofthenurse'srole,includingthepreventionof sickness,healtheducation,firstaid,resuscitationandbloodtransfusion. Itshallinclude: Generalmedicineandmedicalspecialities Generalsurgeryandsurgicalspecialities Careofchildrenandpediatrics Maternitycare Mentalhealthandpsychiatry(inaspecialisedserviceifpossible) Careoftheagedandgeriatrics.

Thefollowingfactorsshallbetakenintoaccountinchoosingsuchfields:

11 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________
1

Theexperiencegainedshallbeofeducationalvalue.Itisthereforenecessarytohave: sufficienttrainedstafftoensurethatthenursingcareissatisfactory; adequateandsatisfactoryphysicalfacilities,equipmentandsuppliesforthenursingcare ofpatients.

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2

In all departments or units to which student nurses are assigned during the practical experiencethereshallbeatalltimesatleastonequalifiednursetoprovidesupervision,and sufficientadditionalstafftoensurethatthestudentdoesnotundertaketaskswhichhaveno nursingeducationalvalue. Qualifiednursesindepartmentsorunitsapprovedasfieldsofpracticalexperienceshallassist inthesupervisionandinstructionofthestudentsforwhomthetutorialstaffisresponsible.

ChapterIVRequirementsfortheorganisationoftheschoolofnursing Inorderthattheproposedschemesofnursingeducationmaybeadequatelycarriedoutthe organisationandoperationoftheschoolhastomeetthefollowingrequirements: AAdministrationoftheschoolofnursing Theadministrationoftheschoolshallbeplacedunderthedirectionofamedicalpractitioner oranursewhoiscompetentinteachingandadministration. BTeachingstaff Theinstructionshallbegivenbyqualifiedteachers:doctors,nursesandspecialistsinvarious disciplines.Eachschoolshouldhaveonitsstaffatleastonequalifiednursewhohasreceived trainingofatleastoneyear'sdurationwhichqualifiedherintheteachingofnursing. CSchoolfinances Thesumofmoneyavailabletomeetexpendituredirectlyattributabletonursetraining,e.g. salariesoftutorsandcostofteachingequipment,shouldbeclearlyidentifiable. ChapterVEvidenceofcompletionoftheeducationprogramme A Aschoolrecordshallbekeptforeachstudent,theauthenticityofwhichwouldbeguaranteed bythecompetentauthoritystating: detailsofcoursesattended testandexaminationresults anappreciationofthepersonalandprofessionalaptitudesrevealedbythestudentinthe courseofthestudies.

B Thefinalexaminationshallcomprisewritten,practicalandoraltests,anditssuccessfulresult shouldbecertificated.

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ANNEXII

AnyContractingPartymaydeclarethatitreservestheright:
1

toderogatefromtheprovisionsofChapterIIofAnnexIbyprovidingthatcandidatesmay have reached a cultural and intellectual standard equivalent to eight years of general education; toderogatefromtheprovisionsofChapterIIofAnnexIbyprovidingthatcandidatesneed notpossessarecognisedschoolcertificate; toderogatefromtheprovisionsofChapterIIIofAnnexIbyprovidinganumberofhoursof theoreticalandformalinstructionotherthanthatreferredtointhatchapter; toderogatefromtheprovisionsofChapterIIIofAnnexI: i byretainingasoptionalsubjectsinthecurriculumandinpracticaltraining,maternity care,mentalhealthandpsychiatryandcareoftheagedandgeriatrics,or byprovidingthatclinicalinstructionshallnotcovermentalhealthandpsychiatry.

ii

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RECOMMENDATIONS

Minimumagerequiredforadmissiontoschoolsofnursing Nohardandfastminimumageforadmissiontoaschoolofnursingshouldbelaiddown.In countrieswheregeneraleducationisincludedintheprogramme,theageofentrymaybe considerablylowerthanwhensuchgeneraleducationisregardedasaprerequisite.Maturity alsodependsonsocialandclimaticconditions. In general, students should not come in contact with patients and with the hospital atmosphereuntilanagevaryingfrom17to19accordingtothecountry.

II

Educational standard required of candidates for admission to schools of nursing (cf.Agreement,AnnexI,ChapterII) Thedurationof10yearsofgeneraleducationisnotobligatoryiftheeducationalstandard reachedafterashorterdurationhasanequivalentculturalandintellectuallevel.

III

Durationandcontentofeducationalprogramme(cf.Agreement,AnnexI,ChapterIII,first paragraph) Ifthetotalnumberofhoursofeducationaremorethan4,600theproportionsindicatedneed onlyberespectedinrelationtotheminimumnumberofhours.

IV

Practicalexperience(cf.Agreement,AnnexI,ChapterIII,B)
a

Fields of practical experience should be proposed by the director of the school and approvedbythecompetentauthorityofeachcountry. Practicalexperienceshouldbeorganisedbythedirectoroftheschoolandplacedunder thesupervisionofthetutorialstaffoftheschool. TheprovisionNo.2,whichrequirestheexistenceofsufficientadditionalstafftoensure thatthestudentdoesnotundertaketaskswhichhavenonursingeducationalvalue,has thepurposeofguaranteeingthatthenursingstudentsarenotgivenworkwhichdoesnot enterintotheirfieldofeducationandwhichshouldbecarriedoutbyotherpersonnel. AsfaraspossiblethenursesmentionedunderNo.3shouldhavereceivededucationin teachingnursingandadministration. Thefollowingfactorsshouldalsobetakenintoconsideration:

15 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________ numberofpatientsinthedepartmentorunit, varietyofclinicalconditionspresentedbythepatients, efficiencyofadministrationofthedepartmentorunit, existence of programmes of inservice education for the nursing staff of the departmentorunit, themaximumdesirablenumberofstudentsinthedepartmentorunit, theteachingmethodsemployed.

16 ETS59InstructionofNurses,25.X.1967 ___________________________________________________________________________________________
V

Requirements for the organisation of the school of nursing (cf. Agreement, AnnexI, ChapterIV)
a

Administrationoftheschoolofnursing Administrationoftheschoolofnursingshouldnormallyhavethesupportandadviceof a body composed of nurses trained to give instruction and representatives of other disciplinessuchasmedicine,generaleducation,administrationandthesocialsciences.

Teachingstaff Thereshouldbetutorsresponsiblefortheapplicationofthecoordinationoftheoretical and practical instruction. Tutors should be nurses prepared to give theoretical and practicalinstructionandsupervisepracticalexperience.Theyshouldcontributetothe students'educationandprofessionaltraining.Thenumberoftutorsshouldberelatedto the number of students in order to ensure proper instruction and supervision. A proportionof15studentstoeachtutorisproposed.

Facilitiesfortheschoolofnursing Adequate space should be available for the number of students in the school. The followingteachingfacilitiesshouldbeprovided:classanddemonstrationrooms,small roomsforgroupwork,libraryandlaboratory.Individualofficespaceshouldbeavailable accordingtothenumberoffulltimeadministrativeandteachingstaff.

TeachingequipmentAdequateequipmenttoenablemodernmethodsofteachingtobe used extensively should be provided. Particular emphasis should be placed on the availabilityofaudiovisualaids.

VI A

DocumentstobeproducedbythenurseA. certificate(diplomaorotherdocument)authenticatedbythegovernmentofthecountryof issueorbythedesignatedauthorityinthatcountry. Anextractoftheschoolrecord Thisextractshouldcomprise: thenurse'scivilstatus, coursesattended, resultsobtained.

Evidenceoflinguisticability