Assignment 1

Subject: Advanced Practice of Nursing
ASSIGNMENT ON HISTORY OF
DEVELOPMENT OF NURSING
PROFESSION
INTRODUCTION:
Nursing is the unique function of the nurse, that is to assist the individual (sick or
well) in the performance of those activities contributing to health or its recovery (or to a
peaceful death) that he would perform unaided if he had the necessary strength, will or
knowledge.” - ICN
According to ANA “Nursing is the protection, and optimisation of health and

abilities, prevention of illness and injury, alleviation of suffering through the diagnosis
and treatment of human response and advocacy in the care of individuals, families,
communities and population.”
HISTORY OF DEVELOPMENT OF NURSING:

The history indicates that the principles and practices of nursing are ancient. These
ancient nursing practices are so clear, intelligent and scientific, that many of them might
fit into any of the modern textbook. Prior to the 20th century, Indian nurses were usually
young men, with women acting as midwives for assisting with childbirth. The acceptance
of nursing as a profession in India was obstructed by the low status of women, the caste
system, illiteracy and political unrest.
 300 AD Entry of women into nursing.

 1633 -Sisters of Charity founded by Louise de Marillac -established the first
educational program to be affiliated with a religious nursing order.
 1809 -Mother Elizabeth Seton introduced the Sisters of Charity into America, later
known as the Daughters of Charity.
 1836 -Deaconess Institute of Kaiserwerth, Germany, founded -institute where
Florence Nightingale received her initial education in nursing
 1860 -establishment of the Nightingale Training School for Nurses at St. Thomass
Hospital in London, England -first organized program for training nurses
 1884 -Mary Snively assumed directorship of Toronto General Hospital and began
to form the Canadian National Association of Trained Nurses -later became the
Canadian Nurses Association
 1890 -establishment of the Nurses Associated Alumni of the United States and
Canada -later became the American Nurses Association
 1901 -first university-affiliated nursing program -Army Nurse Corps established
 1911 -formed American Nurses Association
 1920 -graduate nurse-midwifery programs were established
 1926 -ANA Code of Ethics approved
 1953 -National League for Nursing in collaboration with other universities,
developed graduate nursing education.
The Unforgettable - Florence Nightingale (1820-1910):

When stating about nursing as a profession, one always gets the picture of
Florence Nightingale, the pioneer of nursing profession. She was born to English parents
on May 12, 1820 in Florence, Italy. She was entitled ' Lady of the lamp'. Her work is well
known and well recognized world wide.
She had got the opportunity of recienney good (best) education and also traveled
throughout Europe and could make good contacts which really helped her to achieve the
"mission" in her life. She came across individuals who were concerned with the reforms
of social institutions such as prisons and hospitals. In 1853, she spent three months in
Kaiserworth, Germany . In the same year she was appointed as Superintendent of
Institution for the care of sick - gentle women in London.
In 1854, during the Crimean war, when women nurses were considered to be
revolutionary, Florence Nightingale demonstrated quality nursing care along with 38
other nurses. After her extensive service at the Crimean war, efforts of Florence resulted
in the appointment of the Royal Commission on the health of the Army. As one of the
consequence, The Army Medical School was founded in 1857.
During her lifetime, her work and devotion enlightened the whole society. She was
the founder of Nightingale School for nurses, the first ever of its kind. In 1907, she was
conferred "The Order of Merit" by the King.
NURSING IN INDIA:
In 1857 the India Mutiny turned Miss Nightingales interest to the health of the
Army in India. It was for this purpose the Royal Commission was appointed in 1859. In
1868, a sanitary department was established.
In March 1888, ten qualified British nurses arrived in India to look after the
British Army in India. In 1905, during the British rule in India, missionary nurses arrived
as members of Missionary Medical Association. This was the very start of formalized
nursing service in India.
Gradually, the increasing need of adequately trained nurses led to creation of

South India Examining Board in 1911 and the North India Examining Board in 1912. It
was the mission hospital Nursing leaders who laid the foundation of systematic Nursing
education in India. However, the mid India Board of Examination was started in 1934.
But this was not regulated for registration. State-wise councils started developing from
1935 onwards. Indian Nursing Council (INC) Act was passed by the Parliament in 1947.
The Nursing Council upgraded the educational requirements which permitted only
matriculated candidates to seek admission to the schools. Now, India has State-wise
registration councils in 19 states. ( TNAI yearbook 2000-2001).
The Central Government granted an approval to the Bhore Committee's (1946)

recommendations by starting two colleges of Nursing in Delhi (1946) and Vellore (1947).
This provided university degree level courses. With the efforts of Professor S.
Radhakrishnan (the then Chairman of University Education Commission), Nursing
education in the country was integrated into the system of higher education.
Over decades, there has been an improvement in the availability of nursing

education in India.
The Indian Nursing Council was passed by our ordinance on December 31st 1947.
The council was constituted in 1949. In 1956, Miss Adrenwala was appointed as the
Nursing Advisor to Government of India. The development of Nursing in India was
greatly influenced by the Christian missionaries, World War, British rule and by the
International agencies such as W.H.O. UNICEF, Red Cross, UNSAID etc. The first
master’s degree course, a two-year postgraduate program was begun in 1960 at the
College of Nursing, Delhi.
In 1963, the School of Nursing in Trivandrum, instituted the first two years post
certificate Bachelor Degree program. The associations such as International Council of
Nurses, the nurses auxiliary of the CMA of India, T.N.A.I. Indian Nursing council and
State level Registration Council are closely connected with promotion and the upliftment
of the nursing profession.
Career opportunities:
1.Ward sister or Nursing Supervisor:
She is responsible to the nursing superintendent for the nursing care management
of a ward or unit. Takes full charge of the ward. Assigns work to nursing and non-nursing
personnel working in the ward. Responsible for safety and comfort of patients in the
ward. Provides teaching sessions if it is a teaching hospital.
2. Department supervisor/Assistant Nursing Superintendent:
She is responsible to the nursing superintendent and deputy nursing superintendent

for the nursing care and management of more than one ward or unit. Example – Surgical
department. Out-patient department.
3. Deputy nursing superintendent:
She is responsible to the nursing superintendent and assists in the nursing

administration of the hospital.
4. Nursing Superintendent:
She is responsible to the medical superintendent for safe and efficient management
of hospital nursing services.
5. Director of Nursing:
She is responsible for both nursing service and nursing educations within a
teaching hospital.
6. Community Health Nurse (CHN):
Services rendered mainly focusing Reproductive Child Health programme.
7. Teaching in nursing.
The functions and responsibilities of the teacher in nursing are planning, teaching
and supervising the learning experiences for the students. Positions in nursing education
are clinical instructor, tutor, senior tutor, lecturer, and associate professor, Reader in
nursing and Professor in nursing.
8. Industrial nurse:
Industrial nurses are providing first aid, care during illness, health educations
about industrial hazards and prevention of accidents.
9. Military Nurse.
Military Nursing service became a part of the Indian Army by which means nurses
became commissioned officers who are given rank from liutenant to major general.
10. Nursing service abroad:
Attractive salaries and promising professional opportunities, which causes a

major increase for nursing service in abroad.
11. Nursing service administrative positions:
At the state level the Deputy Director of Nursing at the state health directorate.
The highest administrative position on a national level is the Nursing Advisor to the
Govt. of India.
Scope of Nursing:
 A staff nurse provides direct patient care to one patient or a group of patients.
Assists ward management and supervision. Directly responsible to the ward
supervisor.
 Ward sister or nursing supervisor, responsible to the nursing superintendent for the
nursing care management of a ward or unit. Takes full charge of the ward. Assigns
work to nursing and non-nursing personnel working in the ward. Responsible for
safety and comfort of patients in the ward. Provides teaching sessions if it is a
teaching hospital.
 Department supervisor/assistant nursing superintendent responsible to the nursing
superintendent and deputy nursing superintendent for the nursing care and
management of more than one ward or unit for example the surgical department or
out-patient department.
 Deputy nursing superintendent responsible to the nursing superintendent and
assists in the nursing administration of the hospital.
 Nursing superintendent responsible to the medical superintendent for safe and
efficient management of hospital nursing services.
 A Director of Nursing is responsible for both nursing service and nursing
educations within a teaching hospital.
 Community health nurse (CHN) services focus on the reproductive child health
programme.
 Teaching in nursing. The functions and responsibilities of the nursing instructor
include planning, teaching and supervising the learning experiences for students.
Positions in nursing education include clinical instructor, tutor, senior tutor,
lecturer, and associate professor, Reader in nursing and professor in nursing.
 Industrial nurses provide first aid, care during illness, health education about
industrial hazards and prevention of accidents.
 The Military Nursing Service became a part of the Indian Army, and nurses
became commissioned officers who earned ranks from lieutenant to major general.
 Nursing service abroad, salaries and professional opportunities have led to
increases in nursing service abroad.
 Nursing service administrative positions. At the state level the Deputy Director of
Nursing at the state health directorate. The highest administrative position on a
national level is the Nursing Advisor to the Govt. of India.
CHARACTERISTICS OF A NURSE:
1. A caring nature:
So, what makes a good nurse? The best nurses are those that truly, and deeply,
care for the patients they work with. Being able to comfort and support people who are
ill, vulnerable, or scared, is the key to being a successful nurse.
You must take the time to make your patients feel wanted, supported, and be there as a
friend, as well as the person assigned to look after them. Also, one of the most important
nursing habits to maintain is respecting patients’ privacy. Your patients will appreciate it
immensely, as so will you, as you’ll form a bond that only exists in this wonderful career.
2. Be empathetic:
For most patients, being in the hospital is a traumatic and emotional experience.
One of the most important nursing qualities is the ability to empathize. Never think of, or
treat, your patients as a burden.
To understand how patients are feeling, you have to put ourselves in their shoes
and give them the emotional support they need.
We’ve talked to many nurses about the moments that made them proud to be a
nurse, many of which involved forming a true empathetic connection with their patients.
In many of these stories, patients would return year after year to thank their nurses. For
patients, an empathetic nurse can be nothing short of life-changing.
3. Write everything down (in detail):
Great nurses are detail-orientated and write down everything. This is important
because even a seemingly throwaway comment from a patient might hold the key to
helping them. Make notes, and most importantly, listen – really listen – to your patients.
If you don’t already have one, get yourself a quality notebook and pen that you
keep in good condition. You’ll be surprised how good stationery makes it much easier to
write things down.
4. Be organized:
Being organized is an absolute must as a nurse! Remembering when to give

patients medication is the foundation of the job, so keep track of everything and be on
time – no excuses! In fact, one of the reasons nursing candidates fail job interviews is
being late and disorganized.
5. Be emotionally stable:
This one may sound obvious or even straightforward, but we are all infallible
human beings, prone to emotions such as stress – which can sometimes affect our work.
As a nurse, however, you have a responsibility to patients to offer stability while you’re
at work.
One of the best ways to encourage emotional stability is to talk about the way you
feel. Bottling things up, instead of communicating with the people around you, will only
make things worse. As a nurse, you have a wealth of understanding people around you
every day. Talk to them and tell them how you feel. Remember that you are not alone,
and many nurses can relate to how you’re feeling.
You could also try techniques such as meditation, which are relaxing and easy to
do, without the need for expensive equipment. Exercise is also great for busting stress,
and so are the outdoors, so take a long stroll in your time off to bust those negative vibes.
6. Be adaptable:
As a nurse, every day is different. You never know what is going to happen, and if
you ever think you do, something will come along to surprise you.
As a result, nurses have to be incredibly flexible. You must be prepared for all
eventualities, and be able to act quickly when needed. This is especially true if you are a
travel nurse, as you don’t always know where and when you’re next assignment may be.
7. Have physical and mental endurance:
Being a nurse means long days that will sometimes have little or no breaks. To get
through a day, a nurse must have outstanding physical and mental endurance.
Exercise will help train your body and make it easier to get through the day, as
will brain training apps and games.
Invest in comfortable footwear. You’ll be amazed at the difference good shoes

make when you’re stood up all day. Many retailers will help you find shoes that fit your
feet properly, supporting the key areas of your foot, and body – so take the time to do
this.
Most importantly, take a break whenever you can. Tiredness has a profound effect
on the body and mind, so if you get the chance to grab a quick nap to chip away at your
sleepiness, take it.
8. Be a quick thinker (and have great judgement):

Nurses must be able to think quick on their feet and get decisions right – it could
mean life or death for your patients. You can’t always wait for information and must be
able to use your knowledge, expertise, and experience to make swift judgment calls.
There is no substitute for experience, but knowledge is the key to being able to
make good decisions. Read and learn constantly, especially if there are areas for
improvement.
9. Be hard-working:
Not only do you have to constantly keep learning as a nurse, but you also have to
be naturally hard-working. Slacking off is one of the common reasons nurses get fired.
Be passionate about what you do, and strive to be the best. Go the extra mile with
your patients, and prove to yourself that you are an inspiring person. By doing this for
yourself, you’ll find it easier to be motivated and those around you will be impressed.
10. Be a good communicator:
As a nurse, you are a member of an amazing, supportive community that will be

there whenever you need it. A problem shared is a problem halved, and when working in
the nursing profession you are never alone, so open up to the people around you and
enjoy the incredible life-long relationships you will build over the course of your career.
11. Integrity:
Standing for “respecting the dignity and moral wholeness of every person without
conditions or limitation.”
12. Authenticity:
Know yourself and know your purpose as a nurse. Instead of just showing up to
work, endeavor to develop deeper connections and establish more meaningful
connections with others, including patients and colleagues.
13. Good listening skills:
Everyone wants to be heard. Give them that opportunity. “A successful nurse, in

addition to having sound clinical skills, is compassionate, and has the ability to listen to
their clients and peers”
14. Creativity:
Be open to trying new things and coming up with creative solutions to problems.
Traveling nurses have unique opportunities to learn best practices with each new
assignment, and in turn can often provide a fresh perspective to an existing problem.
Nursing is a noble profession, filled with wonderful people, and with the support
of each other, you can go on providing great care to vulnerable patients all over the
world.
15. Coping With Stress:
The nursing field can be emotionally draining at times, which causes stress. A
combination of staffing challenges, irate patients, conflicts with colleagues and long
hours can lead to burnout. In more severe cases, it can translate to job dissatisfaction.
Stress management tools are an absolute necessity in clinical settings. At times

forces combine to create an unbearable situation for nursing staff. Communication
provides a practical solution for practitioners to cope with different types of workplace
challenges. Experts agree that stress is unavoidable in healthcare facilities but it is
manageable.
When working in an environment where communication is clear, nurses handle

their roles more confidently. They can understand the plan of care and may not
experience any stress. Additionally, staying organized has been proven to reduce stress in
the workplace. Making an effort to set priorities in a day allows practitioners to formulate
effective plans based on achievable targets.
Enlisting the help of an experienced mentor is a viable way to not only enhance
self-development but also deal with stressful situations. A mentor can give a practitioner
a chance to vent or express concerns. Keeping frustrations to oneself can deepen the
crisis. Managing stress helps avoid burnout. Nursing staff capable of managing stressful
situations and stay in control at all times have significantly better chances of advancing
into leadership positions.
CRITERIA OF NURSING PROFESSION:
1. To provide a needed service to the society.

2. To advance knowledge in its field.
3. To protect its members and make it possible to practice effectively.
Personal Qualities of a Nurse:
 Must have a Bachelor of Science degree in nursing.

 Must be physically and mentally fit.
 Must have a license to practice nursing in the country.
“A professional nurse therefore, is a person who has completed a basic nursing education
program and is licensed in his country to practice professional nursing”
Characteristics of a Profession:
 A basic profession requires an extended education of its members, as well as a

basic liberal foundation.
 A profession has a theoretical body of knowledge leading to defined skills,
abilities and norms.
 A profession provides a specific service.
 Members of a profession have autonomy in decision-making and practice.
 The profession has a code of ethics for practice.
Roles of a Professional:
1. Caregiver/ Care provider
 The traditional and most essential role

 Functions as nurturer, comforter, provider
 Mothering actions” of the nurse
 Provides direct care and promotes comfort of client
 Activities involves knowledge and sensitivity to what matters and what is
important to clients
 Show concern for client welfare and acceptance of the client as a person
2. Teacher
 Provides information and helps the client to learn or acquire new knowledge and
technical skills
 Encourages compliance with prescribed therapy.
 Promotes healthy lifestyles
 Interprets information to the client
3. Counselor:
 Helps client to recognize and cope with stressful psychologic or social problems;
to develop an improve interpersonal relationships and to promote personal growth
 Provides emotional, intellectual to and psychologic support
 Focuses on helping a client to develop new attitudes, feelings and behaviors rather
than promoting intellectual growth.
 Encourages the client to look at alternative behaviors recognize the choices and
develop a sense of control.
4. Change agent:
Initiate changes or assist clients to make modifications in themselves or in the system of

care.
5. Client advocate:
 Involves concern for and actions in behalf of the client to bring about a change.
 Promotes what is best for the client, ensuring that the client’s needs are met and
protecting the client’s right.
 Provides explanation in clients language and support clients decisions.
6. Manager:
 Makes decisions, coordinates activities of others, allocate resource

 Evaluate care and personnel
 Plans, give direction, develop staff, monitors operations, give the rewards fairly
and represents both staff and administrations as needed.
7. Researcher:
 Participates in identifying significant researchable problems

 Participates in scientific investigation and must be a consumer of research findings
 Must be aware of the research process, language of research, a sensitive to issues
related to protecting the rights of human subjects.
REFERENCES:
https://www.slideshare.net/Rv_252/history-of-nursing-in-india-amp-scope-of-nursing
https://www.slideshare.net/shonepulikkottil/history-of-nursing-15078168
https://en.wikipedia.org/wiki/Nursing_in_India
http://www.peopletree.co.in/history.htm
https://blog.soliant.com/travel-nursing/the-top-10-qualities-and-characteristics-every-nurse-should-
have/
https://www.nursechoice.com/traveler-resources/10-characteristics-of-nurses-who-are-most-
successful/
https://nursingcrib.com/nursing-notes-reviewer/nursing-as-a-profession/
TADIKELA SUBBAIAH COLLEGE OF

NURSING
Shimoga, Karnataka

ASSIGNMENT ON PERSPECTIVE
AND EDUCATIONAL
PREPARATION OF NURSING
SUBMITTED TO: SUBMITTED BY:
MRS. KEERTHI D’SOUZA MRs. RASHMI C S

ASSOCIATE PROFESSOR 1ST YEAR M.SC NURSING (OBG)
TADIKELA SUBBAIAH TADIKELA SUBBAIAH COLLEGE
COLLEGE OF NURSING OF NURSING
SHIMOGA SHIMOGA
PERCEPTIVES OF NURSING EDUCATION GLOBAL AND NATIONAL:
The demand for higher education has increased worldwide and the response has
been an impressive expansion of education offerings both within and across countries. In
recent years there has been a proliferation of educational courses that target international
clientele. This h as led to concerns about quality and consistency and also the need for
international standards of education. Internationalization in education, according to
knight “the process of integrating an international, intercultural or global dimension in
the purpose, functions and delivery of post – secondary education”. Exported education
service are delivered in various ways.
 As students travel abroad to receive their education.

 As education is delivered to them through distance learning.
 As educational institutions from one country provide onsite classes in another
country, often through establishing branch campuses.
Education of health professionals, specially nurses, cannot be entirely homogenous

given population health issues, such as endemic diseases, along with social, cultural and
economic differences. The standards for nursing education need to be established through
out the world to provide a guide for local services and to assure a minimum standard for
important issues such as essential qualifications for nurse educators.
EDUCATIONAL PREPARATIONS FOR NURSES:
Educational preparation for nurses means preparing the nurses at university level
and school of nursing, at hospital level and at community level.
NEED OF EDUCATIONAL PREPARATION IN NURSING:
 It is still thought by many people that nursing is only taking care of sick person.
 It is only helping the doctor in treatment of the patients. No medical service is
complete without nursing or without trained nurses.
 Nursing comprises of several responsibilities like dealing with patients of medical
illness, clients having surgeries, psychiatric or
 Nursing also involves other duties like maintaining patients, dispensing
medication, setting up the equipments of an operation theatre and many other
routine jobs.
 Growth of health industry
 The demands for nurses is also increasing making a ‘career in nursing’.
 Schools, colleges, hospitals, community health centers need trained and qualified
nurses. Criteria for selection in nursing:
 Candidates who wish to apply for nursing courses, should pass physics and
chemistry and biology as main subjects.
PATTERNS OF NURSING EDUCATION AND TRAINING PROGRAMMES IN

INDIA 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. There
are six levels of nursing education in India today. They are :
1.Multipurpose Health Worker Female training (ANM or MPHW-F)
2.Female Health Supervisor training (HV or MPHS-F)
3.General nursing and midwifery (GNM)
4.BSc. Nursing
5.MSc. nursing
6.MPhil and PhD The ANM, HV, and GNM are conducted in schools of nursing. The last
3are university level courses and the respective universities conduct examinations. Beside
there are several certificate and diploma courses in specialties.
MULTIPURPOSE HEALTH WORKER (+) TRAINING:

The training grew out of the earlier auxillary nursing and midwifery(ANM)
course. The ANM training was for 2 years. Mainly covers maternal and childcare and
family welfare. The Indian Nursing Council revised the ANMs syllabus in 1977 and
reduced the duration to 18 months. At the end of the course candidates are eligible for
working in health subcentres. There are nearly 500 schools offering this course in India at
present.
FEMALE HEALTH SUPERVISOR TRAINING:
This course was initially meant as a health visitor training course. It went to
several modifications and finally became metamorphosed into the current six months
promotional training. The female health supervisors or Multipurpose Health Assistant
(F)course is being conducted in 21 centres in the country.
GENERAL NURSING AND MIDWIFERY
The general nursing and midwifery course is conducted in 477 centers 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
4. Demonstrate skill in the problem solving methods in nursing
.5.Gain knowledge of health resources in the community and the country
6. Demonstrate skill in leadership
7. Demonstrate awareness of necessity of belonging to professional organizations.
8. Promotion of health, precaution against illness, restoration of health and rehabilitation.

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
3. Admission of students shall be once a year.4.Students should be medically fit. The

selection committee should comprise tutors, nurse administrators, and
educationalist/psychologist. The principal of the school shall be the chairperson.
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 under take 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.
BACHELOR OF NURSING COURSE
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.
Eligibility for admission
A candidate seeking admission should have:
1. Pass the 2 year of pre university exam or equivalent as recognized by concerned

university with science subjects ie Physics, biology and chemistry.
2. Students of vocational courses
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 31stDecember of the year of admission
5. Is medically fit
Objectives of study
The programme is designed :
1. To provide a balance of professional and general education
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
 A broad concept of the fundamental principles of nursing care based on sound

knowledge and satisfactory levels of skill in providing care to people of all ages in
community or institutional setting
 Understanding of the application of principles from the physical biological and
social sciences for assessing the health status
 Ability to investigate health care problems systematically
 understanding of the application of principles from the physical biological and
social sciences for assessing the health status
 ability to investigate health care problems systematically
 ability to work collaboratively with members of allied disciplines towards
attaining optimum health for all members of the society
 understanding of fundamental principles of administration and organization of
nursing service
 understanding of human behavior and appreciation of effective interpersonal
relationship with individuals families and groups
 ability to assume responsibility for continuing learning
 appreciation of professional attitudes necessary for leadership roles in nursing
appreciation of social and ethical obligations to society.
Course of study
The course of study leading to bachelor of nursing degree comprises 4academic

years
BACHELOR OF NURSING COURSE (POST CERTIFICATE) FOR QUALIFIED

NURSES
Philosophy and aims of the programme
The faculty believes that nursing is an integral part of the health care delivery
system and shire 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 life long learning process. It seeks to render appropriate behavioral
changes in students in order to facilitate their development , which assist 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
Eligibility for admission
The candidate seeking admission must:
1. Hold a certificate in general nursing.

2. Be a registered nurse
3. Have minimum of two years of experience
4. Have passed pre university exam in the arts /science/commerce or itsequivalent which
is recognized the university
5. Be medically fit
6. Have a good personal and professional record7.have working knowledge of english
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.
Objectives
The goal of the post certificate programme leading to the bachelor of nursing is the
preparation of the trained nurses as a generalist who accept responsibility for enhancing
the effectiveness of nursing care.
 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
 Investigate health care problems systematically
 Work collaboratively with members of other health disciplines
 Teach and counsel individuals , families and other groups about health and illness
 Understand human behavior and establish effective interpersonal relationships
 Teach in clinical nursing situations
 Identify underlying principles from the social and natural sciences and utilize them
in adapting to , or initiating changes in relation to those factors
 Acquire professional knowledge and attitude in adapting for leadership roles
DEGREE OF MASTER OF NURSING
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
Graduates of master of nursing programme demonstrate:
1. Increased cognitive, affective and psychomotor competencies and the ability to

utilize the potentials for effective nursing performance
2. 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.
3. Ability to practice independently as a nurse specialist
4. Ability to function effectively as nurse educators and administrators
5. Ability to interpret the health related research
6. Ability to plan and initiate change in the health care system
7. Leadership qualities for the advancement of practice of professional nursing
8. Interest in life-long learning for personal and professional learning advancement
Eligibility
The candidate seeking admission must:
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, pediatric nursing obstetric and gynecological
nursing. A registered nurse for admission to psychiatric 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
Candidate will be examined in any of the following branches—
1. Branch1-medical surgical nursing
2. Branch2-community health nursing

3. Branch 3-paediatric nursing
4. Branch4-obstetric and gynecological nursing
5.Branch5-psychiatric nursing
Four common papers are there included in the syllabus. They are:
 Advanced concepts of health and nursing

 Education and nursing education
 Bio-statistics, research methodology and nursing research
 Administration and nursing administration
MASTER OF PHILOSOPHY PROGRAMME IN NURSING
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, Rajive 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. Commitment to life-long learning
is the mark of truly professional person. In order to maintain clinical competencies and
enhance professional practice the student must stay abrupt of the new developments and
contribute to the advancement of nursing knowledge.
Objectives
The objectives of M.Phil degree course in nursing are:

 To strengthen the research foundations of nurses for encouraging research
attitudes and problem solving capacities
 To provide basic training required for research in undertaking doctoral work
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.
Part1----it consist of 3 courses, ie research methods in nursing, major aspects of

nursing, allied disciplines
Part2----after passing the part1 examination, a student shall be required to write a

dissertation. The topic and the nature of the dissertation of each candidate will be
determined by the advisory committee consist of 3members. The dissertation may include
results of original research, a fresh interpretation of existing facts, and date or a review
article of critical nature of may take.
DOCTORATE OF PHILOSOPHY IN NURSING
A candidate for admission to the course for the degree of doctor of philosophy in
the faculties of medical science must have obtained an MPhil 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 as 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.
Board of research studies (medical sciences)-Members-
 Dean and the head of the departments concerned

 Principals/ head of institutions recognized for post graduate medical studies.
 Two members nominated by the medical academic council
 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
 Should have research background
 May or may not published articles in journals
The course duration is far regular PhD course is 3 years and for part time is 4 years
REFERENCES
1. Neeraja KP. Text book of nursing education.2005.1st edn. Noida. Jaypee brothers
medical publishers( p) Ltd. Page 41 – 77.
NURSING
Shimoga, Karnataka
ASSIGNMENT ON CODE OF
ETHICS AND CODE OF
PROFESSIONAL CONDUCT

SHIMOGA SHIMOGA
CODE OF ETHICS (INS):
An international code of ethics for nurses was first adopted by the International
Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times
since, most recently with this review and revision completed in 2012.
Nursing is an art; and if it is to be made an art, it requires as exclusive a devotion,

as hard a preparation, as any painters or sculptors work; for what is the having to do with
dead canvas or cold marble, compared with having to do with the living body - the
temple of Gods spirit? It is one of the Fine Arts; I had almost said the finest of the Fine
Arts.” - Florence Nightingale
Nursing ….. Care to humanity. Universal. Working for a noble cause. Dealing
with human life. Respect for human rights, including cultural rights. Right to life.
Treating client with dignity.
Nursing is a noble profession Based on the criteria that a profession must have
 Service provided is vital to humanity and welfare of society

 Special body of knowledge
 Intellectual activity
 Accountability
 Educated in institutions
 Relatively independent: autonomy.
 Motivated by job / service
 Code of ethics: to guide decisions
 Organization (association): to encourage and support practice Kelly: - 1981
Ethics:
Greek word ethos’= The science of moral duty or ideal human character’
Ethics Philosophical ideals of right and wrong behavior. Tells us how human
beings should behave, personal standards of conduct, or attitude. It is a science of ideal
human behavior
Essence of ethics is
 Personal goodness
 Moral behaviour
 Righteous
 Justice
 Honesty
 Rules and Regulation of conduct
 Principles
 Attitude
 Values
Why nursing code of ethic:
 Help in assessing the complex situations

 Better decision making
 Enhances interaction between the health professionals and with the community
 Provide well defined policy and procedure in resolving ethical dilemma.
 Unethical practices will be minimized
 Reflect the good image of the nurses and the organization they work.
 Provide a sign of the profession’s commitment to the public
 Give a framework for the standards of conduct.
 Provide general guidelines for professional behavior.
 Helps to protect the rights of the individual, family and the community
 Provide standard curriculum.
ELEMENTS OF CODE OF ETHICS:
The ICN Code of Ethics for Nurses has four principal elements that outline the standards
of ethical conduct.
1. Nurses and people:
 The nurse’s primary professional responsibility is to people requiring nursing care.

 In providing care, the nurse promotes an environment in which the human rights,
values, customs and spiritual beliefs of the individual, family and community are
respected.
 The nurse ensures that the individual receives accurate, sufficient and timely
information in a culturally appropriate manner on which to base consent for care
and related treatment.
 The nurse holds in confidence personal information and uses judgement in sharing
this information.
 The nurse shares with society the responsibility for initiating and supporting action
to meet the health and social needs of the public, in particular those of vulnerable
populations.
 The nurse advocates for equity and social justice in resource allocation, access to
health care and other social and economic services.
 The nurse demonstrates professional values such as respectfulness,
responsiveness, compassion, trustworthiness and integrity.
2. Nurses and practice:
 The nurse carries personal responsibility and accountability for nursing practice,
and for maintaining competence by continual learning.
 The nurse maintains a standard of personal health such that the ability to provide
care is not compromised.
 The nurse uses judgement regarding individual competence when accepting and
delegating responsibility.
 The nurse at all times maintains standards of personal conduct which reflect well
on the profession and enhance its image and public confidence.
 The nurse, in providing care, ensures that use of technology and scientific
advances are compatible with the safety, dignity and rights of people.
 The nurse strives to foster and maintain a practice culture promoting ethical
behaviour and open dialogue.
3. Nurses and the profession:
 The nurse assumes the major role in determining and implementing acceptable
standards of clinical nursing practice, management, research and education.
 The nurse is active in developing a core of research-based professional knowledge
that supports evidence-based practice.
 The nurse is active in developing and sustaining a core of professional values.
 The nurse, acting through the professional organisation, participates in creating a
positive practice environment and maintaining safe, equitable social and economic
working conditions in nursing.
 The nurse practices to sustain and protect the natural environment and is aware of
its consequences on health.
 The nurse contributes to an ethical organisational environment and challenges
unethical practices and settings.
4. Nurses and co-workers:
 The nurse sustains a collaborative and respectful relationship with co-workers in

nursing and other fields.
 The nurse takes appropriate action to safeguard individuals, families and
communities when their health is endangered by a co-worker or any other person.
 The nurse takes appropriate action to support and guide co-workers to advance
ethical conduct.
CODE OF ETHICS
Nurses and Nurses and Nurses and

people practice the profession
Nurses and
co-workers
ETHICS IN INDIA:
Code Of Ethics respect rights of the individual respect privacy and confidentiality
Maintain competency to render quality care practice within framework of ethical,
legal and professional boundaires Demonstrate personal etiquettes
1. The nurse respects the uniqueness of individual in provision of care:
 Provides care of individuals without consideration of caste, creed, religion,

culture, ethnicity, gender, socio-economic and political status, personal attributes,
or any other grounds
 Individualizes the care considering the beliefs, values and cultural sensitivities
 Appreciates the place of individual in the family and community and facilitates
participation of significant others in the care.
 Develops and promotes trustful relationship with individuals
 Recognizes uniqueness of response of individuals to interventions and adapts
accordingly
2. The nurse respects the rights of individuals as partner in care and help in making
informed choices:
 Appreciates individual’s right to make decisions about their care and therefore
gives adequate and accurate information for enabling them to make informed
choices
 Respects the decisions made by individuals regarding their care
 Protects public from misinformation and misinterpretations
 Advocates special provision to protect vulnerable individuals/groups.
3. The nurse respects individual’s right to privacy, maintains confidentiality, and

shares information judiciously:
 Respects the individual’s right to privacy of their personal information

 Maintains confidentiality of privileged information except in life threatening
situations and uses discretion in sharing information.
 Takes informed consent and maintains anonymity when information is required
for quality assurance/ academic/legal reasons
 Limits the access to all personal records written and computerized to authorized
persons only.
4. Nurse maintains competence in order to render Quality Nursing Care:
 Nursing care must be provided only by registered nurse

 Nurse strives to maintain quality nursing care and upholds the standards of care
 Nurse values continuing education, initiates and utilizes all opportunities for self
development.
 Nurses values research as a means of development of nursing profession and
participates in nursing research adhering to ethical principles.
5. The nurse if obliged to practice within the framework of ethical, professional and
legal boundaries:
 Adheres to code of ethics and code of professional conduct for nurses in India
developed by Indian Nursing Council
 Familiarizes with relevant laws and practices in accordance with the law of the
state
6. Nurse is obliged to work harmoniously with members of the health team:
 Appreciates the team efforts in rendering care

 Cooperates, coordinates and collaborates with members of the health team to meet
the needs of people
7. Nurse commits to reciprocate the trust invested in nursing profession by society

Nurse:
 Demonstrates personal etiquettes in all dealings

 Demonstrates professional attributes in all dealings
Code of Professional Conduct for Nurses in India:
1. Professional Responsibility and accountability - Nurse
 Appreciates sense of self-worth and nurtures it

 Maintains standards of personal conduct reflecting credit upon the profession
 Carries out responsibilities within the framework of the professional boundaries
 Is accountable for maintaining practice standards set by Indian Nursing Council
 Is accountable for own decisions and actions
 Is compassionate
 Is responsible for continuous improvement of current practice
 Provides adequate information to individuals that allows them informed choices
 Practices healthful behaviour
2. Nursing Practice - Nurse
 Provides care in accordance with set standards of practice

 Treats all individuals and families with human dignity in providing physical,
psychological, emotional, social and spiritual aspects of care
 Respects individuals and families in the context of traditional and cultural
practices, promoting healthy practices and discouraging harmful practices
 Presents realistic picture truthfully in all situations for facilitating autonomous
decision-making by individuals and families
 Promotes participation of individuals and significant others in the care
 Ensures safe practice
 Consults, coordinates, collaborates and follows up appropriately when individuals’
care needs exceed the nurse’s competence
3. Communication and Interpersonal Relationships -Nurse
 Establishes and maintains effective interpersonal relationships with individuals,

families and communities
 Upholds the dignity of team members and maintains effective interpersonal
relationship with them
 Appreciates and nurtures professional role of team members
 Cooperates with other health professional to meet the needs of the individuals,
families and communities
4. Valuing Human Being – Nurse
 Takes appropriate action to protect individuals from harmful unethical practice

 Considers relevant facts while taking conscience decisions in the best interest of
individuals
 Encourages and supports individuals in their right to speak for themselves on
issues affecting their health and welfare
 Respects and supports choices made by individuals
5. Management - Nurse
 Ensures appropriate allocation and utilization of available resources

 Participates in supervision and education of students and other formal care
providers
 Uses judgment in relation to individual competence while accepting and
delegating responsibility
 Facilitates conductive work culture in order to achieve institutional objectives
 Communicates effectively following appropriate channels of communication
 Participates in performance appraisal
 Participates in evaluation of nursing services
 Participates in policy decisions, following the principle of equity and accessibility
of services
 Works with individuals to identify their needs and sensitizes policy makers and
funding agencies for resource allocation
6. Professional Advancement -Nurse
 Ensures the protection of the human rights while pursuing the advancement of
knowledge
 Contributes to the development of nursing practice
 Participates in determining and implementing quality care
 Takes responsibility for updating own knowledge and competencies
 Contributes to core of professional knowledge by conducting and participating in
research
REFERENCES:
1. The INC code of ethics for nurses, International Council of Nurses Revised 2012: page
no:1-4
2. Code of ethics for nurses in India

NURSING
Shimoga, Karnataka
ASSIGNMENT ON CURRENT
TRENDS AND ISSUES IN
EDUCATION

SHIMOGA SHIMOGA
CURRENT TRENDS IN NURSING EDUCATION:
INTRODUCTION:
The changes that are occurring in the social and cultural life of the society as a
result of the impact of advancements in the science based technology are broadly
described as modernisation .Since education is a multipolar process it is influenced by
the modernisation in different ways.
A profession is a dynamic integration of various faculties of knowledge. Since

nursing education is a professional education it is dynamic by its own nature and thereby
giving rise to trends . A number of issues and controversies now face educators and
communities: social issues and ethical issues.
DEFINITION:
Education is the all-round drawing out of the best in child and man body, mind
and spirit. - Mahatma Gandhi.
Nursing education is a professional education which is consciously and

systematically planned and implemented through instruction and discipline and aims the
harmonious development of the physical, intellectual, social, emotional, spiritual and
aesthetic power or abilities of the student in order to render professional nursing care to
people of all ages, in all phases of health and illness in a variety of settings in the best or
highest possible manner.
TRENDS ANS ISSUES IN NURSING EDUCATION:
A. Shift in Demographics:
It should come as no surprise to any nurse that the U.S. population is aging. In
fact, by 2020 more than 20% of the population in this country will be over the age of 65
and adults over the age of 85 are the fastest growing age group overall. As people age,
they have a greater need for healthcare. For nurses, this means not only familiarizing
themselves with the diagnoses and issues that affect older adults at a greater rate, but also
learning how best to communicate with older adults and their families about care plans,
preventative health care, and healthy aging.
B. Preventative Care:
Speaking of preventative care, it is another focal point for the future of healthcare.
Patients as well as health insurance providers and increasingly interested in engaging in
preventative measures to live a sustainably healthy life and work to prevent future issues.
For nurses, this means an increased demand for services in this area, as well as more
interfacing with other healthcare professionals, such as nutritionists, physical therapists,
and other professionals that work in careers ancillary to direct care but effective in
preventative health.
C. Consumer Education:
By now, most nurses have likely experienced the impact of increased consumer
education. Now more than ever patients are going to their appointments armed with lots
of information about the symptoms, conditions, and possible treatments. This information
can come from a variety of sources, ranging from the internet to television commercials.
While having educated healthcare consumers can certainly be helpful in many ways, the
burden also falls to nurses to be able to sort that information into valuable and specious.
D. Increased Insurance Access:
With the Affordable Care Act millions more Americans have access to health
insurance. For working nurses and those studying to enter the field, this means
tremendous continuing opportunity. It also means addressing the healthcare challenges
that may face individuals who have lived without health insurance for many years and are
finally able to bring their concerns to healthcare professionals.
E. Continued Growth in Technology:
Increased access to technology has been among the most important nursing trends
for many years running, but it continues to be an important aspect of the job. In 2015,
nurses can expect to see a continued reliance on portable and mobile technology as well
as an emphasis on telemedicine, particularly in rural and underserved areas. Nurses will
need to be comfortable with constantly changing technologies so that they can choose the
best care options for their patients, and also be able to intelligently interface with medical
technologists.
F. Health Information Privacy:
One of the ways in which technology affects patients and nurses alike is the advent
of electronic health records. Those hospitals and physician's offices that have not yet
switched to this type of medical record are surely on their way to doing so. While
electronic health records can make patient data easier to share and can improve outcomes,
it also put private information at risk for theft. This means nurses will have to stay
vigilant themselves and with staff training in 2015 to ensure that electronic patient data is
safe and secure.
G. Access to Nursing Education:
Online nursing education is certainly not new in 2015, but we can expect to see
more programs offering increased flexibility in order to provide even better access to
advanced nursing education. A continued nursing shortage, that according to the Bureau
of Labor Statistics will mean a need for more than a million new nurses by 2022, is
fueling this interest in expanded educational offerings (BLS, 2012). Online nursing
training programs will make it easier for working nurses to further their careers, taking
RNs to Nurse Practitioners without having to sacrifice their current careers.
H. Fluctuations in Retirement Age for Nurses:
In addition to new educational opportunities, the nursing shortage is likely to mean

that more nurses continue to work past the retirement age in 2015. This could mean that
older, more experienced nurses are able to take on managerial roles and also provide
hands-on training to those new to the profession. However, it may also mean that new
nurses have more trouble finding a career foothold at some institutions where nurses have
been unable or unwilling to retire.
I. A Return to Community Nursing:
The nursing profession originated in the community. Nurses (and physicians as

well) would visit patients in their homes and interact with the community at large.
However, as healthcare become more facility-focused, more nurses became tied to a
single institution and started to treat patients only in hospitals or offices. In 2015 and
beyond, some believe that there will be a shift back towards more community-based
nursing, with nurses returning to community clinics and even home-based services.
J. Collaborative Nursing:
Though we have touched on this topic earlier on, it is worth reiterating. As more
people in the U.S. have access to healthcare and advances mean more machinery,
software, and other specialty technologies that require specific training to use effectively,
nurses will increasingly collaborate with nursing colleagues as well as non-nurse
specialists on a regular basis. Further, nurses should expect to provide more collaborative
care with such specialists as dentists, social workers, mental health professionals, and
pharmacists in 2015 and beyond.
K. Continuing Nursing Education
With the changes in the health care delivery system, it has become imperative for
nurses to keep abreast of the changes. Seminars, conferences, training Programmes,
Library Searches, research, Workshops have been organized by nursing institutions to
cater to the nursing personnel. The credentialing System also favours CNE programmes.
L. Evidence based practice:

Nurses today should have a scientific bent of mind and a dynamic approach to
patient care.
These 2015 trends for nursing are certainly not the only place we can expect to see
change throughout the year, but it is a good list to consider when making choices about
your own nursing career.
New changes in our approach to health-care trickle over into how nurses are
educated. Because nursing is a public service, their training and education reflect trends
in health policy and practices. Let's take a look some current trends that Jack, a nursing
student, is being trained on as he prepares to become a nurse
REFERENCS:
1. https://www.slideshare.net/JaysGeorge/current-trends-and-issues-in-nursing-education
2. https://www.nursepractitionerschools.com/blog/nursing-trends-2015/
3. https://study.com/academy/lesson/current-trends-in-nursing-education.html

NURSING
Shimoga, Karnataka
ASSIGNMENT ON AUTONOMY
AND ACCOUNTABILITY
ASSERTIVENESS OF NURSES

SHIMOGA SHIMOGA
AUTONOMY IN NURSING:
Introduction:
Autonomy is the freedom to make discretionary and binding decisions that are
consistent within one’s scope of practice and the freedom to act on those decisions.
There are 3 purposes
1. To analyze the concept of autonomy and its relevance to nursing.
2. To identify the structural, not merely personal, attributes of autonomy.
3. To identify the unique challenges in Japan for advancing autonomy in nursing.
DEFINITION:
According to According to Lewis & Lewis & Batey (1982): It’s the freedom to
make discretionary and binding decisions consistent with ones scope of practice and
freedom to act on those decisions.
AUTONOMY FOR CLIENTS:
The a greement to respect autonomy involves the recognition that clients are “in
charge of their, own destiny in matters of health and illness”.
For e.g.- The preoperative consent.
AUTONOMY IN NURSING PRACTICE:
 Nurses attain increased autonomy through higher levels of education. In changing

healthcare system, advance practice, nurses are increasingly taking independent
roles in nurse run clinics, p collaborative practice and advance nursing practice
settings.
 Innovation by nurses, increased productivity, higher retention and greater client
satisfaction are results of autonomy
 With increase autonomy, comes greater responsibility and accountability.
BARRIERS OF NURSING AUTONOMY
 Lack of recognition and valuing of nursing knowledge and contribution to patient

care goals by physicians and other members of health care team.
 Inability to raise and resolve concerns about treatment plan.
 Interruptions to the nurse’s ability to access, coordinate resources for the patient
care.
 Relationship with nursing colleagues, physicians and managers that undermine
collaboration, confidence and shared decision making.
ENHANCING AUTONOMY IN NURSING
 Organizing medical and teaching rounds.

 Clearing, addressing and identifying expectations practiced for verbal medication
orders and cover order and unique situations in the particular units, that evoke
issues related to practice.
 Developing protocol for administration of the medications and decisions regarding
particular procedures.
 Supporting continuing education and a climate of enquiry and learning in every
day practice.
 Enhancing clinical knowledge fosters competence and clinical expertise that
strengthen autonomous decision making.
 Autonomous nursing practice depends on mutually respectful relationships with
nursing colleagues and other healthcare personals.
Autonomy can be successfully enhanced by crossing
over 4 C’s:
1. Climate
2. Competence
3. Confidence
4. Commitment
Compet
Climate
ence
Confide Commit
nce ment
ACCOUNTABILITY IN NURSING:
Introduction:
Nurse accountability is an essential component of professional nursing
practice. accountability means nurse answerable for the decision made in the professional
practice a nurse is able to make a decision and taking action immediately. accountability
is something you hold to only after a task is a don, or not and accountability cannot be
countable nurse accountability give responsibility for nurse action and ultimately being
answerable for your action nurse are take action, making a decision, and answerable for
your action. the nursing profession regulates by national and state nursing council.
Definition -
"Accountability is defined as nurse are able for her action and answerable for the
overall nursing care of her patient "
According to Sullivan and Deekan, “Accountability is being responsible for one’s
actions and accepting the consequences of one consequences of ones behavior ’s behavior
Accountability is not a vague feeling or . Accountability is not a vague feeling or an
obscure concept. It is a clear obligation which must be manifested as a structured
component of nursing practice, based on responsibility, authority and autonomy”
"Accountability is a legal province in health care which is also an moral and
ethical responsibility accountability provide responsibility for nurse to take action
and decision, judgment and nurse are answerable for her action”
Accountability means nurse answerable for her action.
HIERARCHY OF ACCOUNTABILITY:
1. Individual level
2. Institutional level
3. Professional level
4. Societal level
LINES OF ACCOUNTABILITY:
UPWARD: Accountability (looking up the line and doing what managers and
administers require)
LATERAL: Accountability (accountability as a self regulation, in which practitioners
are accountable to and ) judged by, criteria set by their peers
DOWNWARD OR PUBLIC ACCOUNTABILITY: Where staff are accountable for/to
patients.
TYPES OF NURSING ACCOUNTABILITY:
Fiscal Accountability:
This accountability is concerned with financial probity and the ability to trace and
adequately explain expenditure.
Process Accountability:
This accountability is concerned with the use of proper procedures.
Programme Accountability:
It is concerned with the activities undertaken and their quality.
Priorities Accountability:
This deals with the relevance or appropriateness of chosen activities.
REASONS FOR LACK OF ACCOUNTABILITY:
 Job description not available.

 Lack of guidelines, standards and control.
 Authority not specified.
 Overburdened staff due to shortage of staff.
 Lack of adequate training and efficient experience.
 Lack of up to date knowledge, skill and competence.
 Unwilling.
 Inadequate supervision by ward managers.
 Outdated policies, protocols & procedures.
 Lack of decision making.
Nurse accountability:
1. Infection control
2. Waste management
3. Provide good care
4. Knowledge of microorganism
5. Professional accountability
6. Workplace
1. Infection control
The first accountability of nurse what she do for control infection in workplaces
such as a hospital, clinic, community area, and training centers. the knowledge of
microbiology help to control infection in hospital or workplace because study of
microbiology provide complete knowledge of causes of infection transmission of
infection, agent of infection, the source of infection, mode of infection, entry and exit
port of infection so without the study of microbiology cannot control infection. Infection
control in hospital first accountability of nurse.
2. Waste management
The responsibility of the nurse to management hospital waste, hospital waste also
we called biomedical waste we no biomedical waste very harmful for all type of life such
as human, plant, animal. but all hospital waste not harmful, something 75% hospital
waste not create any type of infection but 25% waste are very harmful to life they waste
are liquid waste, body tissue and body part, blood ,body fluid such as urine ,
stomach(vomiting) fluid , pus. in hospital nurse are most responsible to manage
biomedical waste and send for treatment or reuse but some waste are able to reuse and
modification so nurse is responsible for waste management.
3. provide good care
Both employers and employees owe a duty of providing care to the patient and
follow the standards and protocol and provide complete care of the patient. the
responsibility of the nurse to provide care of the patient and protect self and patient
from hospital-acquired infection or infection and does not negate the responsibility of
individual employ. The nurse are able to provide good care of patient and nurse provide
any care which want by patient
4. Knowledge of microorganism
The study of microbiology provides complete knowledge about microorganism. if

nurse knows about microorganism than she can control the infection, protect from
infection and minimize the cause of infection so knowledge of microorganism really
helps to the nurse to handle the responsibility. The knowledge of microbes helps to
control infection in their working areas.
Professional accountability is associated with the nursing council, nation nursing

council, and state nursing council. nations nursing council regulate the nursing program
in country accountability of national nursing council regulate the nursing program in the
country and all state nursing council follow the program, rules, and regulation of national
nursing council
6. Workplace
The accountability of nurse changes according to the workplace because nurse

working in different places such as a hospital, community areas, and nursing training
centers. In hospital nurses responsible for control infection, cross infection, waste
management and in community areas nurse provide knowledge health education.
Nurses accountability:
 Professional
 Employes
 Society
 Individual and public
The professional accountability regulated by the national nursing council and state
nursing council we discuss above. the professional accountability of nurse give the
instruction of the all-state nursing council and they follow all rules of the national nursing
council
2. Employees and employers
In the hospital, the nurse is responsible for providing the care of the pateint, but both
employers and employees a duty of giving the care of the patient and both are
answerable.
3. Society
Every society needs of the nurses because of nurse help to providing health care to the
patient. without the medical facility, any society does not survive long time today. the
nurse is answerable for care.
4. Individual and public
Nurses accountability to providing care to individual and public but nurses need to the
permission of the higher authority of the hospital.
Important of nurses accountability
 Accountability play important important role in workplace because nurse are

working in different places.
 All care provided by nurse and nurse are answerable her action.
 All record maintenance by nurse and nurse are responsible for documentation
 Providing care to patient
 It help to control infection
 It help to regulate professional of nursing
Ways to Promote Professional Accountability in Nursing:
1. Be clear about professional role responsibilities and organizational goals
I had a wise mentor who once told me that when you are experiencing a leadership
problem – go back to the basics as a starting point. I believe this to be true about
professional accountability. Don’t assume that all professional nurses have a clear
understanding of their role or what is expected of them. You might be surprised if you
ask questions at a staff meeting about the role of an RN to see what answers emerge, but
more important what does not as part of role accountability.
2. Provide direction about how work should be accomplished
Clarity in leadership can be one of the most difficult challenges. You may think
you have been very clear about your expectations – only to learn that they were
misunderstood. Nurses need to know from their leaders how the work should be
accomplished and once is not enough.
3. Develop clear standards and metrics against which professional performance is

measured
Nurse leaders need to seek commitment from staff and set standards for role
expectations. It is often said that what is measured is what is done so be clear about how
role expectations will be measured. These expectations should not only include work
performance but also interpersonal skills.
4. Hold professionals accountable for their behavior
I believe that the single biggest issue with professional accountability is that
nurses are often not held accountable for their decisions and actions by their leaders. In
the best of all possible worlds, professional staff would come to work and meet their
performance expectations with little leadership intervention. Unfortunately, we are not
living in that world and nurse leaders do need to spend time coaching their staff. Early
intervention with performance issues is key as is providing follow up support.
5. Build a culture of accountability
Building a culture of professional accountability is key to promoting personal

accountability among staff. Staff know when “good enough” is the culture of an
organization. I have served as an expert witness for my state board of nursing in Florida.
A disturbing fact that emerges when staff are brought up for disciplinary actions for
failing to meet expected standards of care is their behavior is that unprofessional behavior
has been tolerated often for a long period of time by an employer. There needs to be
team accountability to commitments and personal relationships.
ASSERTIVENESS:
Assertiveness is a particular form of control. It is not about power. It is better
described as the art of confident, clear, honest and direct communication, while at all
times retaining respect for other people.
Assertiveness is non aggressive, non defensive and non manipulative and it does
not interfere with other people’s freedom to take an assertive stance or make appropriate
decisions.
CHARACTERISTICS OF ASSERTIVENESS:
 Self presentable
 Ability to share
 Good attitude towards work
 Fearless expression
 Straight forwardness
 Self control
ASSERTIVE COMMUNICATION:
It is a way of communicating that allows people to express themselves, direct,
honest and appropriate ways that don’t infringe on another persons right. A person
position is expressed clearly and firmly using “I” statements.
ASSERTIVE BEHAVIOR:
 Standing up for one’s right no matter what the circumstances.
 Correcting the situation when one’s rights are violated.
 Seeking respect and understanding for one Seeking respect and understanding for
one s feelings ’s feelings about particular situation.
 Interacting in a mature manner with those found to be offensive, defensive,
aggressive, hostile, blaming, attacking or otherwise unreceptive.
 Those using assertive behavior confront problems, disagreement, or personal
discomforts head on, and their intent is unmistakable to others.
 Verbal “I” statements, where individuals tell others how they feel about a
situation, circumstances, or the behaviors of others.
 Taking the risk of being misunderstood as aggressive, abrasive, or attacking.
 Being able to protect ones rights while protecting and respecting the rights of
others. |Risk taking behavior that is not ruled by fear of rejection or disapproval
but is directed by the rational belief that “I deserve to stand up for my rights”.
 Rational thinking and self affirmation of personal worth, respect and rights.
 A healthy style in which to conduct interpersonal relationship.
 Finding a win- win solution in handling problems individuals between two
individuals.
SUMMARY
• Autonomy is the state of being independent of having responsibility, authority and
accountability for one’s work and personal time.
•Accountability means being answerable for work decisions about answerable for work,
decisions about work and being professionally responsible for the standard of practice.
•Assertiveness is the ability to, “say yes or no”, when you want freedom to be yourself in
all circumstances.
CONCLUSION
A good decision is one that is in the interest of the human beings, and at the same time
preserves the integrity of all involved. As nurses move towards autonomous practice, the
professional responsibility increases and nurses become more accountable for their
clinical decision making. Today’s nurse is continuously confronted with an influx of new
theories and technologies designed to facilitate and the treatment of those who seek
restoration of health. In order for nurses to grow and develop as a profession based on
sound theoretical foundations, nurses need to examine what it means to be truly
accountable and assertive.
REFERENCES:
1. Ishikawa Journal of Nursing Vol.3(2), 2006 Frances Marcus Lewis, 1-5
2. (https://nursinglectureclass.blogspot.com/2018/01/definition-of-nurse-accountability-and.html)
3.https://www.emergingrnleader.com/professional-accountability-in-nursing/
4. http://uchsindia.com/college/images/autonomy-accountablity-assertiveness.pdf
NURSING
Shimoga, Karnataka
ASSIGNMENT ON QUALITY
ASSURANCE IN NRSING

SHIMOGA SHIMOGA
Quality Assurance
Refers to the process of achieving excellence in the service rendered to every

client
Quality Assurance
Is the defining of Nursing practice through well written Nursing standards and the
use of those standards as a basis for evaluation on improvement of client care”- Marker
(1998)
Quality control:
Refers to the activities that are used to evaluate, monitor or regulate services
rendered to the client.
Quality management:
Refers to the system of management of quality with in the institution- the design,
structure and functioning of the quality system
Quality Assessment:
Involves assessing the standards of an institution against external criteria
Quality audit:
Refers to the systematic & official examination of record, process, structure,

environment or accountto evaluate performance.
Standards:
Standards are desired & achievable levels of performance against which actual
performance in practice is compared.
Quality Improvement:
This is a process that uses clinical and technical skills to produce service. The
focus is on whole systems, not just on the performance of individual.
According to Jonas (2002), the two main Objectives are:
 To ensure the delivery of quality client care

 To demonstrate the efforts of the health care providers to provide the best possible
results
Other specific Objective of the Nursing process are
 Formulate plan of care

 Attend to the patient’s physical and non-physical needs
 Evaluate achievement of Nursing care
 Support delivery of Nursing care with Administrative and Managerial Services
There are two different approaches to ensure Quality
a) Quality by Inspection
b) Quality as Opportunity
APPROACH FOR QUALITY ASSURANCE:
A.GENERAL APPROACH:
 Credentialing
 Licensure
 Accreditation
 Certification
B.SPECIFIC APPROACHES:
 Peer Review
 Standard
 Nursing Audit
STANDARD-AS A DEVICE FOR QUALITY ASSURANCE:
Standard is a Quantitative or Qualitative measure against which someone or

something is judged, compared or used to service as a example The ANA Standard of
Practice Include:–
Standard 1: Data collection
Standard 2: Nursing diagnosis
Standard 3: Goals
Standard 4: Priorities & prescribed Nursing approach
Standard 5: Nursing action (health maintenance)
Standard 6: Nursing action (maximize health capabilities)
Standard 7: Evaluation (progress or lack of progress is assessed)
AUDIT AS A TOOL FOR QUALITY ASSURANCE:
ETROSPECTIVE AUDITS: This refers to an in depth assessment of quality

after the patient has been discharged and uses the patients chart as the source of data.
ONCURRENT AUDITS: It’s an evaluation method to inspect the Nursing staff’s

compliance with predetermined standards and criteria while the nurses are providing care.
MODELS FOR QUALITY ASSURANCE
A systematic model for implementation of unit based quality assurance
Basic Components of system are
 Input
 Throughout
 Output
 Feed back
QUALITY ASSURANCE PROCESS:
1) Establishment of standards or criteria
2) Identify the information relevant to criteria.
3) Determine ways to collect information
4) Collect and analyze information
5) Compare collected information with established criteria
6) Make judgment about quality

7) Provide information and if necessary take corrective action regarding findings of
appropriate sources
8) Determine ways to collect the information
FACTORS AFFECTING QUALITY OF ASSURANCE:
 Lack of resources
 Personnel problems
 Improper maintenance
 Unreasonable patient and attendants
 Absence of well informed population
 Absence of accreditation law
 Lack of incident review procedures
 Lack of goods & hospital information system
 Absence of patient satisfaction surveys
 Lack of nursing care records
 Miscellaneous factors
REFERENCES:
www.scribd.com.
NURSING
Shimoga, Karnataka
ASSIGNMENT ON COLLECTIVE
BARGAINING

SHIMOGA SHIMOGA
INTODUCTION:
The term “collective bargaining” originated in the writings of Sidney and Beatrice
Webb, the famed historian of the British labour movement, towards the end of the
nineteenth century. It was first given currency in the United States by Samuel
Gompers. Collective bargaining is a process of joint decision-making and basically
represents a democratic way of life in industry. It establishes a culture of bipartism
and joint consultation in industry and a flexible method of adjustment to economic and
technical changes in an industry. It helps in establishing industrial peace without
disrupting either the existing arrangements or the production activities.
Meaning of collective bargaining:
Collective bargaining is a process of negotiating between management and

workers represented by their representatives for determining mutually agreed terms and
conditions of work which protect the interest of both workers and the management.
According to Dale Yoder’, “Collective bargaining is essentially a process in which
employees act as a group in seeking to shape conditions and relation-ships in their
employment”.
Definition:
The Collective Bargaining is the process wherein the unions (representatives of

employees or workers), and the employer (or their representative) meet to discuss the
issues related to wage, the number of working hours, work environment and the other
terms of the employment.
Objectives:
1. To foster and maintain cordial and harmonious relations between the
employer/management and the employees.
2. To protect the interests of both the employer and the employees.
3. To keep the outside, i.e., the government interventions at bay.
4. To promote industrial democracy.
Types of collective bargaining:
There are four types of Collective Bargaining classified on the basis of their nature and
the objectives, and can be practiced depending on the different situation requirements.
Conjunctive or Distributive Bargaining:
In this form of collective bargaining, both the parties viz. The employee and the
employer try to maximize their respective gains. It is based on the principle, “my gain is
your loss, and your gain is my loss” i.e. one party wins over the other. The economic
issues such as wages, bonus, other benefits are discussed, where the employee wishes to
have an increased wage or bonus for his work done, whereas the employer wishes to
increase the workload and reduce the wages.
Co-operative or Integrative Bargaining:
Both the employee and the employer sit together and try to resolve the problems of
their common interest and reach to an amicable solution. In the case of economic crisis,
such as recession, which is beyond the control of either party, may enter into a mutual
agreement with respect to the working terms.
For example, the workers may agree for the low wages or the management may
agree to adopt the modernized methods, so as to have an increased production.
Productivity Bargaining:
This type of bargaining is done by the management, where the workers are given
the incentives or the bonus for the increased productivity. The workers get encouraged
and work very hard to reach beyond the standard level of productivity to gain the
additional benefits.
Through this form of collective bargaining, both the employer and the employee
enjoy the benefits in the form of increased production and the increased pay respectively.
Composite Bargaining:
In this type of collective bargaining, along with the demand for increased wages
the workers also express their concern over the working conditions, recruitment and
training policies, environmental issues, mergers and amalgamations with other firms,
pricing policies, etc. with the intention to safeguard their interest and protect the dilution
of their powers.
Thus, the purpose of the Collective Bargaining is to reach a mutual agreement

between the employee and the employer with respect to the employment terms and enjoy
a long term relationship with each other.
NATURE OF COLLECTIVE BARGAINING
The essential characteristic of collective bargaining is that employees do not negotiate
individually and on their own behalf, but do so collectively through representatives. It
can only exist and function in the following circumstances:
 If employees identify a commonality of purpose, organize and act in concert.

 If management is prepared to recognize their organization and accept a change in
the employment relationship which removes, or at least constraints, its ability to
deal with employees on an individual basis.
Joseph Shister has opined that collective bargaining can best be analyzed by listing its
Principal characteristics. He lists five characteristics;
(i) collective bargaining involves
group relationships;
(ii) it is both continuous and evolutionary;
(iii) it interacts with the socio-economic climate;
(iv) it is private, but at times involves government action;
(v) it varies from setting to setting.
In collective bargaining, the employer does not deal with workers directly, but he deals
with a collective authorised institution. It is an institutional mechanism for:
a) fixing up the price of labour services;
b) establishing a system of industrial jurisprudence; and
c) providing a machinery for the representation of individual and group interests.
It covers the entire range of organised relationship between union and

management, including negotiation, administration, interpretation, application and
enforcement of written agreements. It sets forth joint understandings as to policies and
procedures governing wages, rates of pay, hours of work and other conditions of
employment. It is recognised as the central institution or ‘heart’ of industrial relations in
all democratic nations.
Collective bargaining is essentially a multi-dimensional institution. It is also an

important means of extending industrial democracy to employees within the workplace.
Several conditions are necessary for its emergence and survival. These include freedom
of association for employees to organise into trade unions, which are independent both of
their employers and of the state, employer recognition, bargaining in good faith, and
mutual acceptance of the agreements entered into by employers and employees.
For Clegg, collective bargaining covers both the negotiation and the
administration of agreements. He holds that collective bargaining is the principal
influence on union behaviour. He identifies six dimensions of collective bargaining as:
extent, level, depth, union security, degree of control and scope. Further, he argues that
the dimensions of collective bargaining are themselves mainly determined by the
structures of management and of employers’ organisations.
Characteristics of Collective Bargaining:
Some of its essential characteristics may be enumerated as follows:

(a) It is a group action as opposed to individual action and is initiated through the
representatives of the workers and delegates of the manage-ment at the bargaining table.
(b) It is flexible and mobile and not fixed or static. It has flexibility and ample scope for
compromise for a mutual give and take before the final agreement.
(c) It is a two-party process. It can succeed only when the labour and man-agement want
to succeed. There must be a mutual eagerness to develop the collective bargaining
procedure, with a view to achieve harmony and progress. It can flourish only in an
atmosphere which is free from animosity and reprisal.
(d) It is a continuous process, which provides a mechanism for continuing and organized
relationships between the management and the trade unions. The heart of collective
bargaining is the process for continuing joint considerations and the adjustments of plants
and problems.
(e) The term itself is dynamic because the concept is growing, expanding, and changing.
(f) It is industrial democracy at work.
(g) It is not a competitive process but a complementary process that is each party needs
something that the other party has, namely, labour can make a greater productive effort
and management has the capacity to pay.
(h) It is an art, an advanced form of human relations. To get a proof of this one only
needs to witness the bluffing, the oratory, the dramatics, and the coyness mixed in an
inexplicable fashion, which often characterizes a bargaining session.
Importance of collective bargaining:
The need for and importance of collective bargaining is felt due to the advantages it
offers to an organisation are as follows:
1. Collective bargaining develops better understanding between the employer and
the employ-ees:
It provides a platform to the management and the employees to be at par on

negotiation table. As such, while the management gains a better and deep insight into the
problems and the aspirations of die employees, on the one hand, die employees do also
become better informed about the organisational problems and limitations, on the other.
This, in turn, develops better understanding between the two parties.
2. It promotes industrial democracy:
Both the employer and the employees who best know their problems, participate
in the negotiation process. Such participation breeds the democratic process in the
organisation.
3. It benefits the both-employer and employees:
The negotiation arrived at is acceptable to both parties—the employer and the

employees.
4. It is adjustable to the changing conditions:
A dynamic environment leads to changes in employment conditions. This requires

changes in organisational processes to match with the changed conditions. Among other
alternatives available, collective bargaining is found as a better approach to bring changes
more amicably.
5. It facilitates the speedy implementation of decisions arrived at collective

negotiation:
The direct participation of both parties—the employer and the employees—in

collective decision making process provides an in-built mechanism for speedy
implementation of decisions arrived at collective bargaining.
Theories of collective bargaining:
Walton and McKersie Theory
Walton and McKersie 4 view collective bargaining as four sub-processes –

distributive bargaining, integrative bargaining, attitudinal structuring, and intra-
organisational bargaining. Distributive bargaining applies to situations in which union
and management goals are in conflict. Integrative bargaining, on the other hand, refers to
bargaining issues that are not necessarily in conflict with those of the other party.
Attitudinal structuring is the means by which bargaining parties cultivate friendliness,
trust, respect, and cooperation. The final sub-process in Walton and Mckersie’s Theory is
intra-organisational bargaining wherein the focus is on interaction between the union and
management. These four sub-processes interact to help shape the final outcome of
collective negotiations as well as the long-term relationship between union and
management.
Bargaining Range Theory:
Bargaining range theory has its roots with the late Professor A.C. Pigou. Pigou’s
bargaining range theory explains the process by which labour and management establish
upper and lower wage limits within which a final settlement is made. The Union’s upper
limit represents the union’s ideal wage. Management will offer a wage that is well below
that acceptable to the union. From these two extremes, the union and management teams
will normally proceed through a series of proposals and counter proposals. The union will
gradually reduce its wage demands while the employer will raise its wages offer. Both
sides, however, have established limits as how far they are willing to concede, and in the
process establish a sticking point. According to this theory, the exact settlement point will
depend on the bargaining skills and strengths of the union and management negotiators.
Hicks Bargaining Model:

The Hicks bargaining model focuses on the length and costs of work stoppages.
Hicks proposed that union and management negotiators balance the costs and benefits of
a work stoppage when making concessions at the bargaining table. Each side makes
concessions to avoid a work stoppage. The central idea is that there is a functional
relation between the wage that one or the other party will accept and the length of strike
that would be necessary to establish that wage. There is a particular wage that the
employer would prefer if the union were not in the picture. He will concede more,
however, in order to avoid a strike and up to a point, his concessions will rise with the
length of strike he anticipates. A primary difference between the Hicks model and
bargaining range theory is that the Hicks model pinpoints a precise wage settlement while
the range theory does not.
The following factors or activities act as effective collective bargaining:
(1) Competitive Process:
Collective bargaining is generally becoming a competitive process, i.e., labour and

management compete each other at negotiation table. A situation arises where the
attainment of one party’s goal appears to be in conflict with the basic objectives of the
other party.
(2) Not Well-Equipped:
Both the parties—management and workers—come to the negotiation table

without doing their homework. Both the parties start negotiations without being fully
equipped with the information, which can easily be collected from company’s records. To
start with, there is often a kind of ritual, that of charges and counter charges, generally
initiated by the trade union representatives. In the absence of requisite information,
nothing concrete is achieved.
(3) Time to Protest:

The immediate objective of the workers’ representatives is always some kind of
monetary or other gains, accrue when the economy is buoyant and the employer has
capacity to pay. But in a period of recession, when demand of the product and the profits
are falling, it is very difficult for the employer to meet the demands of the workers, he
might even resort to retrenchment or even closure collective bargaining is no answer to
such a situation.
(4) Where Prices are Fixed by the Government:
In industries, where the prices of products are fixed by the Government, it

becomes very difficult for the employer to meet the demands of workers which would
inevitably lead to a rise in cost of the products produced. Whereas the supply price to the
consumers cannot be increased. It will either reduce the profits of the firm or increase the
loss. In other words, it will lead to closure of the works, which again is not in the interest
of the workers.
(5) Outside Leadership:
Most of the Indian trade unions are led by outsiders who are not the employees of
the concerned organisations. Leader’s interests are not necessarily to be identical with
that of the workers. Even when his bonafides are beyond doubt, between him and the
workers he leads, there cannot be the degree of understanding and communication as
would enable him to speak on behalf of the workers with full confidence. Briefly, in the
present situation, without strong political backing, a workers’ organisation cannot often
bargain successfully with a strong employer.
(6) Multiplicity of Trade Unions:
One great weakness of collective bargaining is the multiplicity of trade unions. In

a multiple trade union situation, even a well recognised, union with long standing, stable
and generally positive relationship with the management, adopts a militant attitude as its
deliberate strategy.
In Indian situation, inter-union rivalries are also present. Even if the unions
combine, as at times they do for the purpose of bargaining with the employer they make
conflicting demands, which actually confuse employer and the employees.
(7) Appointment of Low-Status Executive:
One of the weaknesses of collective bargaining in India is that the management

deputes a low-status executive for bargaining with the employees. Such executive has no
authority to commit anything on behalf of the management. It clearly indicates that the
management is not at all serious and the union leaders adopt other ways of settling
disputes.
(8) Statutory Provisions:
The constraints are also imposed by the regulatory and participative provisions as
contained in the Payment of Wages Act, the Minimum Wages Act, and Payment of
Bonus Act etc. Such provisions are statutory and are not negotiable.
(9) Fresh Demands at the Time of Fresh Agreement:
At the time when the old agreement is near expiry or well before that, workers
representatives come up with fresh demands. Such demands are pressed even when the
industry is running into loss or even during the period of depression. If management
accepts the demand of higher wages and other benefits, it would prefer to close down the
works.
(10) Agreements in Other Industrial Units:
A prosperous industrial unit in the same region may agree with the trade unions to
a substantial increase in wages and other benefits whereas a losing industry cannot do
that. There is always pressure on the losing industries to grant wages and benefits similar
to those granted in other (relatively prosperous) units in the same region.
Advantages of Collective Bargaining:
 Perhaps the biggest advantage of this system is that, by reaching a formal

agreement, both sides come to know exactly what to expect from each other and
are aware of the rights they have. This can decrease the number of conflicts that
happen later on. It also can make operations more efficient.
 Employees who enter collective bargaining know they have some degree of
protection from employer retaliation or being let go from the job. If the employer
were dealing with just a handful of individuals, he might be able to afford to lose
them. When he is dealing with the entire workforce, however, operations are at
risk and he no longer can easily turn a deaf ear to what his employees are saying.
 Even though employers might need to back down a little, this strategy gives them
the benefit of being able to deal with just a small number of people at a time. This
is very practical in larger companies where the employer might have dozens,
hundreds or even thousands of workers on his payroll. Working with just a few
representatives also can make the issues at hand seem more personal.
 Agreements reached through these negotiations usually cover a period of at least a
few years. People therefore have some consistency in their work environment and
policies. This typically benefits the company’s finance department because it
knows that fewer items related to the budget might change.
 On a broad scale, using this method well can result in more ethical way of doing
business. It promotes ideas such as fairness and equality, for example. These
concepts can spill over into other areas of a person’s life, inspiring better general
behavior towards others.
Disadvantages of Collective Bargaining:
 A major drawback to using this type of negotiation system is that, even though
everyone gets a say in what happens, ultimately, the majority rules, with only a
few people determining what happens too many. This means that a large number
of people, particularly in the general workforce, can be overshadowed and feel like
their opinion doesn’t really matter. In the worst case scenario, this can cause
severe division and hostility in the group.
 Secondly, it always requires at least two parties. Even though the system is
supposed to pull both parties together, during the process of trying to reach an
agreement, people can adopt us-versus-them mentality. When the negotiations are
over, this way of looking at each other can be hard to set aside, and unity in the
company can suffer.
 Collective bargaining can also be costly, both in terms of time and money.
Representatives have to discuss everything twice—once at the small representative
meetings, and again when they relay information to the larger group. Paying
outside arbitrators or other professionals quickly can run up a fairly big bill, and
when someone else is brought in, things often get slower and more complex
because even more people are involved.
 Some people point out that these techniques have a tendency to restrict the power
of employers. Employees often see this as a good thing, but from the company’s
perspective, it can make even basic processes difficult. It can make it a challenge
to deal with individual workers, for example.
 The goal of the system is always to reach a collaborative agreement, but
sometimes tensions boil over. As a result, one or both parties might feel they have
no choice but to muscle the other side into giving up. Workers might do this by
going on strike, which hurts operations and cuts into profits. Businesses might do
this by staging lockouts, which prevents members’ of the workforce from doing
their jobs and getting paid, negatively effecting income and overall quality of
living.
 Lastly, union dues are sometimes an issue. They reduce the amount of take-home
pay a person has, because they usually are deducted right from his paycheck.
When things are good in a company and people don’t feel like they’re getting
anything from paying the dues, they usually become unhappier about the rates.
 The idea of collective bargaining emerged as a result of industrial conflict and
growth of trade union movement and was first given currency in the United States
by Samuel Crompers. In India the first collective bargaining agreement was
conducted in 1920 at the instance of Mahatma Gandhi to regulate labour
management relation between a group of employers and their workers in the
textile industry in Ahmadabad
SUMMARY:
The term ‘collective bargaining’ was originally used by the Webbs, who identified and
differentiated three major categories of trade union activity—mutual insurance, collective
bargaining, and legal enactment. The content of collective bargaining may be divided into
two broad areas: substantive rules and procedural rules. The process of collective
bargaining may vary in respect of form, scope, and depth. It is concerned with regulating
both economic and managerial relationships. It is a voluntary, bipartite process; its
character is determined by the managements’ and employees’ perception of the nature of
their mutual interdependence. The bargaining structure is dynamic and varies between
different industries and organisations; however, the emphasis of collective bargaining
regulation has shifted away from multi-employer, industry-level bargaining to the
organisational level in order to respond more effectively to variations in organisational
situations and needs.
REFERENCES:
1. https://businessjargons.com/types-of-collective-bargaining.html
2. http://www.yourarticlelibrary.com/organization/collective-bargaining-importance-needs-and-
characteristics/45014
3. http://www.yourarticlelibrary.com/hrm/collective-bargaining-meaning-objectives-and-
importance/35472
4. http://www.egyankosh.ac.in/bitstream/123456789/6697/1/Unit-9.pdf
5. http://www.economicsdiscussion.net/collective-bargaining/collective-bargaining-definition-types-
features-and-importance/31375
NURSING
Shimoga, Karnataka
ASSIGNMENT ON CONTINUING
EDUCATION

SHIMOGA SHIMOGA
INTRODUCTION:
Continuing education (similar to further education in the United Kingdom and

Ireland) is an all-encompassing term within a broad list of post-secondary learning
activities and programs. The term is used mainly in the United States and Canada.
Recognized forms of post-secondary learning activities within the domain include:

degree credit courses by non-traditional students, non-degree career training, college
remediation, workforce training, and formal personal enrichment courses (both on-
campus and online).
General continuing education is similar to adult education, at least in being

intended for adult learners, especially those beyond traditional undergraduate college or
university age.
Frequently, in the United States and Canada continuing education courses are
delivered through a division or school of continuing education of a college or university
known sometimes as the university extension or extension school. The Organisation for
Economic Co-operation and Development argued, however, that continuing education
should be "'fully integrated into institutional life rather than being often regarded as a
separate and distinctive operation employing different staff' if it is to feed into
mainstream programmes and be given the due recognition deserved by this type of
provision".
DEFINITION:
It consists of planned learning experiences beyond a basic nursing educational

program. These experiences are designed to promote the development of knowledge,
skills, and attitudes for the enhancement of nursing practice, thus improving health care
to the public.
NEED IN NURSING:
 To ensure safe & effective nursing care.
 To meet the needs of population.
 To update the knowledge of nurses & prepare them for specialization. For career
advancement. Acquire changing professional roles.
 To forsee social changes. Acquire specialized skills of personnel & meet
technological adjuncts. Bridging the shortage of specialized nurses & care.
 To make clinical specialists for direct patient care & for teaching & consultative
roles. For research aptitudes.
 To prepare nurses to see continuing education as personal, professional &
university responsibility.
 Continuing education is necessary for nurses to perform competently, and
respondpositively to advanced medical, and technological changes in this age of
rapid change, and to prevent obsolescence.
 It is needed to meet the expressed needs or interests of nurses to enable them to
provide current and ultimately safe and effective patient care.
Challenge for nurses and continuing education:
1. Nurses are the largest group in the health care system . They are the only group of
health care providers required to provide the same level of service in hospitals, seven
days per week for 365 days per year They work close to the patients and are expected to
maintain professional competence and expertise.
2. Advances in medical technology have resulted in people living longer and the need for
continuing education is evident for nurses.
3. Nurses are predominately female, and there is ongoing conflict between childbearing
and child rearing and the special needs of the nursing profession. The special needs are:
responsibility, skills demanded, stress of the work, irregularity of the hours, and
consequent intrusions on private life.
FEATURES OF CNE
PHILOSOPHY:
Philosophy - Thought of relating to basic beliefs based on values & social change.
Provides a direction for action. Nurses philosophy of life, nursing & education, belief,
etc. will influence the philosophy of continuing education. Continuing nursing education
is concerned with the development of the nurse as a person, a practitioner & a citizen to
solve the problems of communication, continuity, coordination in providing patient care.
ELEMENTS:
The philosophies of continuing nursing education recognizes:-
LEARNER:
A person, a nurse or a citizen meant for lifelong learning . To involve in nursing &
non-nursing courses. Plays different roles at every aspect of life, e.g. Adult, family
member, learner, friend Aims at self-directed learning.
TEACHER/NURSE EDUCATOR:
Accepts the concept of lifelong learning. Acts as role model. Aware of sources of
information about CNE, e.g. Self-directed individual study, in-service programmes,
formal basic courses, post-graduate academic studies. Creative teaching. Builds up
confidence in his/her students. Plays multiple roles, e.g. Guide, counsellor, motivator,
organizer, evaluator, administrative role, public relations role.
Factors affecting nurses as women:
(a) Changing patterns in employment of women
70% of female nurses reported to be married and expect to combine marriage and
a career. Temporary leave for childbearing and child rearing are expected. The
nurses’ return to work can be an easier transition if there are planned educational
activities in place,
(b) Shifts in age composition:
The proportion of the population aged 65 and over is on the increase. Many nurses
need continuing education in geriatric nursing to effectively care for these patients.
(c) Maternal and infant mortality
New knowledge and advances in technology have resulted in better means of

caring for the prematurely born and high risk infant. Nurses play a significant role in
prevention as well as in caring for those at risk. Increased knowledge regarding genetics
and new family planning methods suggest the ongoing need for continuing education for
nurses.
(d) Population Mobility
Since World War II, the migration of many people from one part of the country or
the world to another has increased. This population mobility when demonstrated in the
health care system results in a high turnover of nurses. The health Care system therefore
has been forced to provide orientation, and other forms of continuing education for
employees with a variety of education and experiential backgrounds.
BENEFITS OF CONTINUING EDUCATION:
Keeping your Nursing License
Many states require nurses to complete a certain number of continuing education

(CE) hours annually. If you fall to complete the CE hours you are at risk of losing your
nursing license. If you are unsure if you need CE credits, check to see if yours is one of
the states requiring CE for nurses.
Getting a Boost in Pay
Many employers have education as a factor in their employee evaluations. They

may require a certain amount of nursing education in order to get your standard score, but
having extra may give you a boost in the education category. This could lead to a larger
raise and help to boost to pay grade.
Keeping Your Nursing Knowledge Up to Date
Completing nursing CE credits will help you to stay current with new information.
The field of healthcare is constantly changing and the facts and values you learned in
nursing school might have changed. It is important to get refreshed on the information
you already know and learn any new information that is relevant to your nursing practice.
A nurse who has shut herself off from the possibility of learning is a nurse who
does not have her patients’ best interest at heart. Not everyone needs an MSN, but every
nurse should be constantly seeking new information and evidence-based practice to
support their nursing care. Formal nursing education through online learning is only one
of the many ways to facilitate the need to constantly grow and adapt as a nurse.
In order to provide the best care possible, it is vital that nurses are frequently
updating their knowledge. It is very important to continue your nursing education and
CEs are an excellent method of doing so. You don’t want some new nurses knowing
more than you; do you?
Nursing CE Topics Are Diverse
You may think that nursing CEs might be boring and repetitive. However, you
may be unaware that you have the freedom to choose the courses you take. Continuing
Education credits for nurses cover a range of topics that you may find relevant to your
daily practice.
The following are examples of the types of CE courses available to nurses:
regulatory, leadership, learning, communication, patient safety, occupational health and
safety, perioperative nursing, infection control, legal.
There are also courses on clinical specialties such as cardiology, emergency,

informatics, neonatal, maternal-newborn, critical care, medical-surgical, transport,
neurology, pediatrics, pharmacology, tests, vascular access, and physical assessment.
The physical assessments often have in-depth modules for each body system.
Some examples of those might be: respiratory system, digestive system, endocrine
system, excretory system, nervous system, muscular system and cardiovascular system.
Being a Reliable Source of Information
Patients and nursing colleagues will often ask your questions. It is extremely
important that you be able to provide them with accurate and reliable information. If it’s
been 10 years since you attended nursing school, how easy do you think it will be to
remember the proper levels of potassium in the bloodstream?
Regulatory requirements are updated frequently and it is important to be aware of

these changes and to know how they might impact your nursing practices. Also, often
times parts of nursing assessments are phased out and replaced over time. It is important
that you know what assessments are relevant to your patients and have not been replaced
as a standard of care.
Providing the Best Evidence-Based Nursing Care
Nursing CE courses are based on evidence-based practice. You will be learning

skills and knowledge that have been tested and proven by other nurses. This ensures that
you are able to deliver the best nursing care possible because the information you are
receiving has already been tested in practice.
Your patients depend on you to have the most accurate and up to date knowledge
to provide them with the best care possible. You might learn something that helps you to
save a life.
Being a Leader to Other Nurses
Nursing CEs can help you improve your leadership skills. You can learn better
strategies to manage your staff as well as gain skills needed to rise up the hierarchy in
healthcare.
In addition to gaining this useful information, you can also lead by example and
perhaps inspire other nurses to enhance their leadership abilities through nursing CE
credits. The more nurses who are maintaining CE hours the better!
Get Your Nursing CE Online
You need a great resource to get your nursing continuing education credits online.
You can get all your CE completed for a reasonable price at Nursing CE.com.
Expectations of the nursing profession
Under the auspices of the College of Nurses of Ontario, the primary expectation of nurses
is the provision of competent nursing care to the public. Some continuing education is
provided for nurses by the College and by the Registered Nurses’ Association of Ontario.
The term “Registered” in the title signifies to the public that the individual is qualified
and has met the minimum standards of the nursing profession.
Barriers to nurses’ continuing education
 73% of hospital nurses cited shift work as the major barrier to their continuing
education. Shift work is a necessary inconvenience for nurses because of the care
that the patients require on a 24 hour basis.
 The cost was cited by 50% of nurses as a deterrent to continuing education.
 18% of the nurses reported having to travel up to one hour by public transportation
to be able to participate in continuing educational activities
Incentives for nurses continuing education
1. 55% of nurses reported that flexible hours at work was their major incentive for
participating in continuing education.
2. Another 55% cited an increase in salary upon completion of a degree as their incentive
to participate in university programs.
3. 54% of nurses cited refundable fees upon completion of courses
NATIONAL POLICY ON CONTINUING EDUCATION (NPE)
National Literacy Mission (1988): To impart functional literacy to non-literates of

15-35 years of age group. Program of action on NPE is given by the Ministry of Human
Resource Development; Government of India .
According to NPE, Adult Education can be successfully implemented by

involving continuing education. The Janshikshan Sansthan is established for clusters of
villages with the facilities of library, reading rooms, charcha mandal, community TV set
& radio to encourage sub serving the objectives of education. However, continuing
education goes beyond post literacy therefore still it is one of the important objectives to
be achieved.
Conclusion:
Continuing education is absolutely essential for nurses to provide safe, competent

care to patients. It is also necessary to be able to respond positively to advanced medical
and technological changes in this age of rapid and constant change as well to prevent
professional obsolescence.
REFERENCES:
https://en.m.wikipedia.org/wiki/Continuing_education
Nursing Effectiveness, Utilization and Outcomes Research Unit McMaster University ▪ University of
Toronto
http://www.authorstream.com/Presentation/ipszz.irali-1881038-continuing-education-nursing/
https://thenerdynurse.com/7-benefits-of-continuing-education-for-nurses/
NURSING
Shimoga, Karnataka
ASSIGNMENT ON CAREER
OPPURTUNITIES

SHIMOGA SHIMOGA
CAREER OPPURTUNITIES:
Nursing profession might have gained momentum after the works of the most
eminent nurse, Florence Nightingale, came to light but the profession is age old and quite
possibly the most dignified. Although some believe that the work in this field is women
centric but with time more and more men have ventured into the profession.
Nursing is one of the strongest pillars that the medicine profession stands on. The
profession revolves around taking care of people which includes their physical as well as
psychological maladies. At a senior level the wok in the nursing department includes
managing particular groups of patients from pediatric ward, psychiatric ward, ICU, etc.
Apart from that the job revolves around in taking care to the medication of the patients,
maintaining patient records, administration, routine work, setting up of medical
equipment and so much more.
The career opportunities in nursing are very high not only in India but also abroad.
With more and more nursing colleges opening up each day, it is a sign of the requirement
of skilled and qualified people required for the service. Undoubtedly, the career is not for
everyone as it asks for a lot of patience and hard work.
There are many opportunities in the profession of nursing. Certification is

available in a wide variety of nursing fields, and most registered nurses are eligible to
pursue certification if they so choose. Certification can mean an increased wage and a
higher degree of professionalism, as well as recognition in the nursing community and
with the public.
Hospital Care:
Many nurses begin their nurse careers in hospital care, often working in the
hospital directly after graduating from nursing school. Most of the care provided to ill
patients in the hospital is still provided by the registered nurse. Some nurses choose to
stay in a hospital setting throughout their careers, often deciding to pursue certification as
a medical-surgical nurse.
Most of the ill patients in the hospital setting are still cared for by medical-surgical
nurses. These nurses provide care to many different types of patients with varying
illnesses, also providing care to patients that are recovering from previous surgeries.
Many rural hospitals utilize medical-surgical nurses to take care of the bulk of the
patients that are admitted. The medical-surgical nurse has specialized knowledge of many
different types of illnesses.
Medical-surgical nurses can pursue certification through the American Nurses

Credentialing Center (ANCC) or through the Academy of Medical-Surgical Nurses
(AMSN). Each certification has slightly different requirements for previous experience
and education. Both certifications require testing and a fee.
A medical-surgical nurse is also known as the Jack-of-all-Trades in the hospital

setting. She must know about a variety of illnesses and how to care for patients with
many different types of problems. Many nurses will work in this setting at some point in
their nursing careers.
Cardiac:
In the course of their nursing careers, cardiac nurses work with both ill and well
patients. They may care for patients in the hospital who have just undergone procedures
on their hearts. They may also care for patients who have suffered heart attacks or had
open-heart surgery. Other cardiac nurses work in outpatient clinics, helping to test
patients that are at risk for cardiac illness or patients that are recovering after being
hospitalized. Certification is available for the cardiac nurse, and presents an opportunity
for the cardiac nurse to become a leader in her specialty.
Cardiac nurses work in many settings across the healthcare field. They may work
in the hospital setting with patients that are critically ill, having suffered heart attacks or
heart surgery. They may also work in a clinic setting, and are often present for treadmill
testing and other cardiac testing functions that take place in the outpatient setting. These
nurses are highly skilled and trained to recognize risks and cardiac disease.
Certification is available for cardiac nurses through the American Nurses

Credentialing Center (ANCC) and requires several years of experience to qualify. Nurses
that choose to pursue certification must take and pass a rigorous test, and pay a fee for
certification and ongoing continuing education.
The cardiac nurse tends to patients who are undergoing care for their hearts. This
may be in a hospital setting or in an outpatient clinic. These nurses have a great deal of
knowledge and experience that they have gained over the course of their nursing careers.
Pediatrics:
As a part of their nursing career, pediatric nurses work with children in many
different settings. They may care for children who are hospitalized, or they may care for
well or ill children in a pediatric clinic. These nurses have specialized knowledge of
childhood diseases and pediatric medication dosing. They may pursue certification in
their field after they have obtained several years of experience.
The pediatric nurse may work with children wherever the child is located. They
may work with ill children who have been hospitalized. They also work with children
recovering from surgeries while they are in the hospital. They may also work in pediatric
clinics, helping to care for children who are both well and sick, often giving medications
and vaccinations to these children.
After several years of experience, the pediatric nurse may choose to pursue
certification through the Pediatric Nursing Certification Board (PNCB). Nurses must
have demonstrated experience and have acquired a great deal of knowledge in pediatric
nursing before being eligible for certification. Nurses must also take an examination to
demonstrate their knowledge, and also must pay a fee for certification.
Pediatric nurses care for children in many settings, both inside and outside of the
hospital. These nurses care for both well and ill children, and have specialized knowledge
of how children respond to illness.
ICU:
ICU, or Intensive Care Unit, nurses work with the most ill patients that are
hospitalized. These patients are often very near death, and ICU nurses care for them,
providing critical treatment and medication. These nurses must be very focused, and have
the ability to recognize symptoms and signs of progressing disease quickly, or it may
result in their patient’s death. These nurses often work very independently with the lives
of their patients in their hands.
After many years of experience, the ICU nurse may decide to pursue certification
in her field. This is generally done through the American Association of Critical-Care
Nurses (AACCN), and will give the ICU nurse the title CCRN. This certification requires
several years of experience in a critical-care setting, and also requires the nurse to have
attained a great deal of specialized knowledge. The testing process for the certification
can be rigorous, and nurses must also pay a fee for testing and certification, as well as
participate in continuing education.
The ICU nurse cares for the most critically ill people in all of society, and is their
best chance at recovery. Her specialized knowledge gained throughout her nurse career
can help the sickest of all patients on the path to recovery.
Psychiatric:
Psychiatric nurses work with patients suffering from mental illnesses. During their
nursing careers, they may work with hospitalized patients, or patients in recovery from
substance abuse or in outpatient clinic settings. These nurses may choose to pursue
certification after they have had some experience in their specialty, often after several
years.
Psychiatric nurses work in a wide variety of settings with people suffering from all
types of mental illnesses. These nurses may work in inpatient settings, either in hospitals
or specialized psychiatric hospitals. They may also work in inpatient or outpatient
substance-abuse recovery, often helping patients with medication. Psychiatric nurses also
sometimes work in outpatient clinics, often as case managers, helping those with mental
illnesses to find resources in the community to help them cope with their circumstances.
All of these nurses have specialized training in therapeutic communication, allowing
them to best communicate with those suffering from mental illnesses.
Psychiatric nurses may pursue certification after they have acquired some
experience. They must take and pass a certification test given by the American Nurses
Credentialing Center (ANCC), and must also pay a fee for the certification and test.
Continuing education is required of these nurses after they have become certified.
Psychiatric nurses work with many different types of mentally-ill patients over the
course of their nursing careers. They may work in an inpatient or outpatient setting to
utilize their communication skills to help their patients.
Home Health:
Home health nurses work with many different types of patients over the course of
their nursing careers. These nurses care for patients in their own homes, often after they
have been discharged from the hospital. These nurses may provide wound care,
intravenous therapy, or administer medication. Some home health nurses care for people
who are on ventilators, requiring them to have extensive knowledge of how this
machinery works. After several years of experience, the home health nurse may choose to
become certified in her specialty.
Home health nurses work with many types of patients of all ages in their own
homes. These nurses travel to the home to care for their patient, bringing their expertise
in nursing to the home bedside. These nurses often provide intravenous medication
therapy and wound care to their patients. Many nurses also provide care to critically-ill
patients that have chosen to remain at home, and may also provide care to patients bound
to ventilators.
Certification for home health nurses is provided by the American Nurses

Credentialing Center (ANCC) and requires the nurse to have experience caring for
patients in their homes. Nurses must take and pass a certification test, and must also pay a
fee for certification.
During their nurse careers, home health nurses are an important part of the
healthcare delivery system, and provide care to patients in their homes. These nurses
allow patients to be at home to receive care instead of at the hospital.
Hospice:
Hospice nurses work with patients who are near death and their families. People in
these nurse careers provide comfort and care for their patients in a very difficult time.
Nurses help families to deal with the death of their loved one, and also provide needed
medication and comfort measures to patients who are nearing death. These nurses may
pursue certification after some experience in the specialty.
Hospice nurses take care of both patients and their families, helping them to deal
with the emotional and physical aspects of an impending death. These nurses are
specialists in providing comfort and support, and proper medications to make the dying
process as comfortable as possible for both the patient and family. These nurses are
experts in communication, and also have specialized knowledge of medications that are
needed for helping patients with pain and symptom management.
Hospice nurses may pursue certification through the Hospice and Palliative Nurses
Association (HPNA). These nurses must have some experience in their specialty, and
must also pass a certification examination, as well as pay a fee for certification. Ongoing
continuing education is also required for continued certification.
Hospice nurses provide comfort and care to patients and their families through
some of the most difficult times in life. Through their nursing careers, these nurses
provide needed comfort measures, and help families and patients to deal with the
emotional issues surrounding the dying process.
Labor and Delivery:
Labor and delivery nurses help women during one of the most joyous times of life:
childbirth. Through their nursing careers, labor and delivery nurses help women to give
birth, and assist with the care of the postpartum woman and her baby. These nurses help
women become mothers, often teaching them not only how to deal with the pain of labor,
but also how to care for their new child. These nurses may pursue certification within
their specialty after they have had some extensive experience.
Labor and delivery nurses may work with women during the childbirth process,
and may also help care for ill pregnant women and for women immediately after giving
birth. Some labor and delivery nurses also help with surgical deliveries, making them
also specialists in operating-room care. All of these nurses have specialized knowledge of
the physiology of pregnancy and how to determine if things are progressing properly in
the labor process. These nurses help women give birth to healthy babies, often identifying
problems before they arise.
Nurses may certify as labor and delivery nurses through the Association of
Women’s Health, Obstetric and Neonatal Nurses (AWHONN). The testing process is
rigorous for this specialty, and several years of experience is required before being
eligible for certification.
Labor and delivery nurses help women give birth to healthy babies. Over the
course of her nurse career, the labor and delivery nurse will help women in labor and
immediately after birth to become mothers.
Dialysis:
People in dialysis nursing jobs help patients suffering from kidney failure to lead
more healthy lives. During the course of her nursing career, the dialysis nurse may help
patients both inside and outside the hospital to acquire life-saving dialysis treatment.
These nurses have specialized knowledge of the kidneys and dialysis machinery. They
may pursue certification in their field, if they choose, after they have had some
experience in the specialty.
Dialysis nurses help patients who have failing kidneys. These patients require
dialysis treatment to clean their blood in order to survive. Dialysis nurses have
knowledge of not only the kidneys, but also of dialysis equipment and how best to utilize
it. They are keenly aware of safety and the procedures for utilizing the machinery, and
are watchful for any problems that may arise. These nurses often have several years of
other experience before entering into the field of dialysis.
Dialysis nurses may pursue certification through the Nephrology Nursing

Certification Commission (NNCC), which shows their expertise in the field of dialysis.
These nurses must have experience in providing care to dialysis patients, as well as
expertise in their field. A fee for testing is required, and dialysis nurses are required to
maintain ongoing continuing education to qualify for continued certification.
Dialysis nurses assist with providing care to patients who are no longer able to
depend on their own kidney function. These nurses are able to provide life-saving care to
their patients, and have specialized knowledge of the proper care and procedures
involved in dialysis.
Emergency Room:
Emergency room nurses work with patients who have been injured, or are newly
ill and have just entered the hospital setting. Over the course of their nurse careers, these
nurses may work with trauma victims, critically-ill patients, and children and adults with
many different types of illnesses and injuries. These nurses have knowledge of many
different types of illnesses, and are trained to recognize symptoms of serious illness.
These nurses may become certified in emergency nursing after acquiring a great deal of
specialized knowledge.
Emergency nurses work with all types of patients, from the very young to the very
old and every type of patient in between. They care for patients that who suffered
traumas, either from accidents or injuries, as well as for patients who are very ill. Patients
often enter the hospital setting through the emergency department, and the emergency
room nurse must know about many different illnesses to be able to determine how critical
the illness is for the patient.
Emergency room nurses may seek certification through the Emergency Nurses
Association (ENA) after they have acquired knowledge about their field of specialty. The
test is very difficult since the nurse is required to have knowledge of many different
diseases and injuries. Certification is maintained by repeated testing and continuing
education.
The emergency room nurse will encounter many types of patients during her
nursing career. She must be able to assist with the treatment of patients with serious
illnesses and trauma, and she must recognize which patients are the most critically ill in
order to plan her care.
Neurological:
Neurological nurses work with patients who have suffered strokes or other
neurological damage. These nurses usually work in an inpatient setting, but may also
work in outpatient clinics during their nurse careers. These nurses care for stroke victims
and other patients suffering from neurological problems, and help them recover their
health. They have specialized knowledge of the brain and neurological systems. These
nurses may become certified in their specialty after they have completed several years of
employment in their field.
Neurological nurses work with people who have suffered from strokes, brain
damage, or other nerve damage. They commonly work in neurology units in the hospital
setting, caring for patients who are recovering from recent events. These nurses must
understand how the nervous system works to ensure that they can provide the best care
for their patients. They must demonstrate compassion and patience, as most patients
suffering from neurological symptoms have both physical and cognitive impairments.
Neurological nurses may decide to pursue certification through the American

Association of Neuroscience Nurses (AANA). These nurses must have experience in
neurology nursing and must have demonstrated their expertise in their field. They must
have acquired a great deal of knowledge of how to care for neurology patients to be able
to pass the testing process. A fee is also required for certification, as well as continuing
education in the specialty.
Neurological nurses work with patients who have suffered some type of nerve
damage, often stroke and trauma victims. These nurses have the specialized knowledge
needed to be able to take care of these patients and assist them to recovery.
Oncology:
Oncology nurses work with patients that have been diagnosed with cancer. During
her nurse career, the oncology nurse may provide care to cancer patients in both an
inpatient and outpatient setting. These nurses have knowledge of the physiology of many
types of cancer and specialized training in providing chemotherapeutic agents to patients.
Oncology nurses are often certified as a part of their employment, giving patients the
comfort of knowing the nurse has obtained a great deal of expertise.
Oncology nurses may care for cancer patients inside or outside of the hospital.
Hospitalized cancer patients are often critically ill, or are recovering from surgery. Most
chemotherapy is now given in the outpatient setting, and oncology nurses provide this
medication to patients. A great deal of training is required to safely administer
chemotherapy drugs, and oncology nurses often have experience in other fields before
joining this specialty.
After several years of experience, the oncology nurse may choose to pursue
certification. This is often required of oncology nurses as a part of their employment, as it
gives patients the comfort of knowing their nurse has attained a high level of expertise in
the field. Certification is provided by the Oncology Nursing
Certification Corporation (ONCC) and requires that the nurse has several years of
experience, as well as training in administering medication. A fee is required, and nurses
are also required to attend continuing education courses in oncology to maintain their
certification.
In the course of their nursing careers, oncology nurses provide care for cancer
patients. They may work either inside or outside of the hospital, often caring for patients
by administering cancer-related drugs. These highly-trained nurses provide care to many
types of patients suffering from cancer.
School:
School nurses help take care of children in the school setting. During their nursing
careers, these nurses may take care of a number of different types of children. Nurses
administer medication and help to care for ill children. They may work in school clinics,
often independently, providing care to children from preschool to college. These nurses
may pursue certification after they have attained some experience and knowledge in
school nursing jobs.
School nurses take care of children in all types of school settings. They may help
to administer medication to children who need it, or they may help to take care of
children who have complicated medical needs during the school day. They may also take
care of children who have become ill while waiting to transfer them to the care of a
parent. Some school nurses work in clinics inside schools, providing nursing care and
advice to students, usually independently. These nurses must be able to work on their
own and must have excellent clinical knowledge of many types of pediatric issues.
School nurses may decide to become certified in school nursing though the
National Board of Certification for School Nurses (NBCSN). School nurses must have a
minimum of a bachelor’s degree to qualify for certification, and must also have the
experience and knowledge needed to pass the certification examination.Nurses pay a fee
for the certification exam, and must participate in continuing education to maintain their
certification status.
School nurses take care of children during the school day in many types of school
settings. They must have a broad base of knowledge of pediatric issues and problems, and
must be able to work on their own. These nurses care for children from preschool age to
college, and must be able to identify illness and provide excellent clinical care for their
patients.
Operating Room:
Operating room nurses work with patients who are undergoing a surgical
procedure. As part of their nurse jobs, these nurses may care for patients who are
preparing for surgery, recovering from surgery, or undergoing surgery. These nurses have
specialized knowledge of the surgical patient, and must understand sterile techniques and
the surgical process. These nurses are often certified as a part of their employment.
Operating room nurses work with patients during the time of surgery. They may
work with patients before their surgeries, helping them to prepare for the surgery
physically and emotionally. Other nurses work with post-surgical patients, helping them
to recover from the trauma of surgery and from anesthesia. Other nurses work inside the
operating room, sometimes as the assistant to the doctor, and other times running the
surgery as a circulating nurse. All of these nurses have highly-specialized training in
surgical nursing, allowing them to best help their patients to prepare for and deal with the
aftermath of surgery.
Surgical nurses are often certified, usually seeking certification after several years
of employment in the field. The Association of periOperative Registered Nurses (AORN)
provides certification for several types of surgical nursing, including operating room
nurses. These certifications require a great deal of experience and preparation, and are
quite difficult. Certification provides the registered nurse with the title of CNOR, and
indicates the knowledge and expertise that the nurse has been able to attain.
Operating room nurses work in many areas of surgery in the course of their
nursing careers. They may work with surgery patients getting ready for surgery, with
patients in the operating room, or with patients recovering from the surgery itself.
SUMMARY:
Educational requirements vary by career and career level. Students interested in

these careers should use the information provided here as a basis for a career plan. The
student should also research the career further to complete a career plan. Careers
available in Nursing include: Clinical Nurse Specialist , Licensed Practical Nurse , Nurse
Anesthetist ,Nurse-Midwife , Nurse Practitioner •,Nursing Assistant •,Registered Nurse
BIBLIOGRAPHY:
https://www.successcds.net/Career/Nursing.html
https://jobs.lovetoknow.com/Career_Opportunities_for_Nurses
http://www.nursecareertips.com/nursing-career-opportunities/
https://www.slideshare.net/FIROZQURESHI/careers-opportunities-nursing
NURSING
Shimoga, Karnataka
ASSIGNMENT ON LEGAL
CONSIDERATION IN NURSING

SHIMOGA SHIMOGA
INTRODUCTION:
The role of nurses and professional nursing has expanded rapidly within the past
ten years to include expertise specialization, autonomy and accountability, both form a
legal and ethical perspective. This expansion has forced new concern among nurses and a
heightened awareness of the interaction of legal and ethical principles, labour
management and employment
Legal Aspects:
Nursing is a profession, which is practised in the society involving people. In

every society there are some common as well as statutory laws for protection of the
rights of the people. Therefore for safe Nursing practice one has to understand the law
and legal responsibilities to protect the right of her clients as well as to protect herself
from liabilities. Thus every Nurse has a personal and ethical responsibility to be aware of
State licensing laws, statutory laws, common law as well as professional code of ethics
for Nurses and changes there on occurring.
Law:
Law is a code, which regulates human conduct, capable of being enforced, and
binding to all, so as to bring order the society. It has developed over the centuries to
balance the rights of individual. However laws always respond to changes, to customs,
advancement of technology and needs of the society. Law imposes a duty on everyone to
conform to certain standards of conduct for the protection of others.
The basic law of the country is the Indian Constitution. This document provides
power, prescribes functions of the states and lays down fundamental rights for the
citizens of the country.
Purpose of law:
 To protect the rights of the individuals according to the needs of the society.
 To correct inequalities in the society.
 To punish people indulging in forbidden acts.
 To define & re- define minimum standards of behaviour in accordance to the
changes that occur in the society.
Constitutional laws:
State the fundamental rights of the citizens.

Statutory laws
Laws enacted through legislative process are called statues. They define
obligations of the citizen to act in a particular manner. Criminal laws are mostly statutory
which define forbidden acts and the punishment for commission of such acts.
Common laws
Are the decisions arising out of judicial process. Judges hearing a case or
controversy decide what law applies to the case &what law allows and condemns. In
judging the case common law decisions are considered. Judges act as finder of facts and
finder of the law.
Tort
It is the category of law involving civil wrongs against another person or

property. Tort includes negligence, assault, defamation, invasion of privacy & fraud etc.
Labour laws:
These laws lay down rights and obligations between the employer and the
employees. These laws regulate discipline, wages, leave, pension, gratuity etc. Service
laws relating to government officials differ from laws for private services. There are
different courts as civil court, criminal court, labour court, dealing the cases according to
the law involved. Supreme Court is the highest judiciary having highest power in the
country.
Professional laws in Nursing:
Like any other profession Nursing is also controlled by certain Regulatory Bodies. A
practicing Nurse must follow standards of care which originate from following sources:
State Nursing Council, which enacts Nurse Practice Acts. Professional organisations
provide guidelines for practice e.g. policystatement of Trained Nurses’ Association of
India. Employing authorities provide written policies and procedures.
National level regulatory body prescribes professional training courses to maintain
uniformity throughout the country e.g. Indian Nursing Council(INC)
1. State Nursing Council:
(It is a statutory body established by State law to fulfill the primary purpose and
protection and safeguarding of public. It enacts Nurse Practice Act, which defines who
can practice as a Nurse. A practicing Nurse must follow standards of care originating
from Nurse Practice Act. The Act serves practice of Nursing for those who have
undergone appropriate training in an institution duly inspected and recognized by the
Council or the authorized Board of Nursing Education. The State Nursing Council thus
has the power to approve and regulate training of Nurse. These Councils register all
qualified Nurses giving them the license to practice according to their specific training.
State Councils also has the power for renewal of license and its revocation.
2. Professional organizations
These organizations give guidelines for practice. Thus Trained Nurses’

Association has framed the following policy statement for practicing Nurses.
3. Written policies of the employer
Nursing has its own identity as a health profession; hence, due recognition needs
to be given to the role and contribution of Nursing personnel to health care services in the
hospital and the community. Nursing identity should be reflected in all planning pilpera,
documents, policy statements of government and government organizations with a view
to strenthen1ig development of Nursing, otherwise, this sector of the health system gets
neglected and status of the Nursing service further diminished. Nursing should not be
designated as “paramedical”, nor should its identity be lost under the term “health
workers”. Nursing is supported by auxiliaries. The term “Nursing personnel” can be used
to designate collectively, a wide variety of workers of the Nursing team, both
professionals and Nursing auxiliaries. All organisations employing Nurses should have,
standing orders, job descriptions, procedure manuals, framed by the competent
authorities to meet the need of the specific organizations. Nurses employed in an
organisatiori must be familiar with these, which should be available to her in writing.
Indian Nursing Council (INC):
It is also a statutory body established by act of Parliament in 1947. It’s function is

to maintain uniform standard of Nursing education through out the country. It prescribes
the courses along with their curriculum & ensures heir implementation through
inspection of the institutions. The INC Act1947 was amended in 1986 introducing
maintenance of Indian Nurse Register as mandatory. Thus INC has to maintain a live
register with names of registered Nurses of all the States of India. INC also prescribes the
list of authorities, who can issue the certificate, diploma or degree in- Nursingwhich are
prescribed by INC. All the State Nursing Councils, two Boards of Education under
Christian Medical Association of India, namely, Mid India Board of Nursing Education
and Board- of Nursing Education South India Branch, and Military Nursing Service have
been recognized by INC for award of diplomas and certificates in Nursing.
Negligence
Nurses are responsible for performing all procedures correctly exerting

professional judgment, also when they carryout physician’s orders. Otherwise Nurse can
be cited for negligence and malpractice. They are held responsible for their own acts
which could be acts of commission or omission. If a Nurse violates criminal statutes & if
it is proved that the act is intentional then the state will bring criminal charges against the
Nurse. If notthen civil action for negligence will be implied. Neglect of duty is
established by comparing the act with prevailing standard of care. Standard of care is
determined by establishing how another Nurse will act in a similar situation. In case of
negligence, law is applied from earlier common law decisions in similar cases as well as
from statutes. When similar situation is not available, reasoning from analogous situation
is taken into account. In case of negligence whether the Nurse or her employer will be
depends on the policy of the organization. A Nurse who acts reasonably given the
circumstances of the time of an emergency, will not be found guilty of negligence:
To sue for negligence followings must be proved:
 Nurse is legally duty bound to the patient.

 The duty performed was short of standard of care by an act• or omission.
 There, is a causal connection between the act of omission & theresulting injury,
which was forcible.
The client was actually harmed. Example: The Nurse is legally duty bound to
administer medicine in correct route and dose. She also has to be aware of possible drug
reactions. In case a Nurse fails to administer a drug in correct route, it is a case of
negligence. However there are emergency exceptions. When a bonafied emergency
exists, main question is reasonableness of the action & resource available at the time of
emergency.)
Rights of Clients:
Clients as an individual citizen have certain rights which Nurses have to be aware
of for protection of their clients, as well as safeguarding their own liabilities. These are as
follows:
Rights to a considerate & respectful care.
Right to obtain complete current information regarding his diagnosis,treatment &

prognosis from his physician.
 Right to receive relative information before giving consent to any procedure.

 Right to privacy.
 Right to refuse treatment.
 Right to receive all communication & record pertaining to care.
 Right to receive reasonable response to requests.
 Right to know the professionals by name who are treating him.
 Right to receive reasonable continuity of care.
 Right to inquire & get explanation for the incurred cost.
 Right to know the rules & regulations of the institution where .treated.
 Right to refuse to participate in research project.
Rights of Nurses:
All professionals will also have certain rights. While practicing Nurse will have
the following rights:
 Right to a just wage.

 Right to work & serve in a safe & healthy work environment.
 Right to participate in decisions related to working conditions.
 Right to have standard prescribed hours of duty as well as off.
 Right to enjoy maternity / paternity leave as per rule.
 Right to opportunities for career mobility and continued education.
 Right for additional training for working in specialized areas
 Where she is accountable for performing specialised care.
 Can refuse or protest formally a physician’s order if she believes it is harmful for
the client.
 Right to organise professionally.
 Right to political activity.
Consumers Protection Act:

The Supreme Court in November 1995 gave a judgement that patients who receive
deficient services by medical profession and hospitals are entitled to claim damages
under Consumers Protection Act 1986. The concept of the Act is that if a wrong has been
committed while giving service, the caregiver must pay for it. If it is a case of error in
judgement then it has to be proved. According to the act the consumer need not pay for
appealing to consumers court. The act also prescribes penalties for negligence. However,
the act is not applicable to government hospitals, clinics or health centres and to those
who practice there. This •is because services rendered in Government institutions are not
charged.
Medico Legal Cases:
Accidents and injuries including falls & burns:
As a Community Health Nurse she may witness cases of injury or ‘death by

violence or road accidents, she should know that these are medico-legal cases and. people
must be advised to report it to police immediately. Depending on State law Nurses are
also required to report other criminal activities as child abuse, attempted suicide,
homicide, rape, violence on women etc.
Other legal involvement:
An adult can legally give consent to donate specific organs, a Nurse may be a
witness for the same. Nurses may have to be a witness for client’s “WILL” if it meets all
the legal criteria. If legal issues are involved, Nurses may have to document all events
connected to death and treating the deceased person with dignity. She also has to obtain
permission for autopsy from nearest relative of the deceased. Incident reports must be
given in occurrence of unusual situations when. There is a possibility of legal
involvement
Medical Termination Act:
Abortions or miscarriages caused by various means, comes under Criminal Act.

Therefore in 1971 Medical Termination Act was passed by the Parliament to provide
some exception in provision of the penal code act.
According to this act abortion can be done only in case of pregnancy, not
exceeding 12 weeks & is carried out at a licensed clinic or hospital by a licensed medical
practitioner. Beyond 12 weeks of gestation, abortion can be done only with consent of
two licensed doctors agreeing that continuation of the gestation is threatening to the life
of the pregnant women. Community Health Nurse has to be aware of this act so that act
she can prevent illegal abortions in the community, and guide pregnant mothers to a
licensed clinic or hospital when necessity arises.
Standing Order:
Community Health Nurse who works independently in a community, is unlike the

Nurse working in a hospital setting. For sometimes, in an emergency, she may have to
perform certain activities, which she normally does not perform without the doctor’s
order. Therefore, to shoulder such responsibilities at the time of emergency, there is need
,for standing orders or instructions, by .the authority, which will provide legal protection
to the Nurse in case of any controversy. Each organisation has it’s own standing orders
usually prepared jointly by the authority & the Nurse. It is expected that the Nurses use
the. standing orders only at the time of emergency. If there is any doubt, the standing
orders should not be carried out. After carrying out the standing orders, it should be
recorded immediately with signature,, date, time & to be brought to the notice of the
Medical Officer or her supervisor as early as possible.
Examples: Injection Methyl Ergometrine, 0.2 mg IM may be a standing order for

the ANMs, to be ‘given when the placenta has not separated within.5-i0 minutes of
delivery of-the baby or-excessive., bleeding starts with or without expulsion of placenta.
In case of eclampsia, there could be a standing order for ANMs to give in-between fits,
diazepam 10 mg orally & nephadipin 10 mg crushing& giving under the tongue. ANMs
have standing orders for administering CO-trimoxazole tabletto children in specific
doses, in case of ARI. There is a standing order for ANMs/FHWs for administration of
antimalarial drugs.
Points to be remembered:
 Be sure of standing orders given in writing.

 If there is any doubt refrain from carrying out standing orders, till it is clarified.
 Record immediately with signature, date and time.
 Do not leave your client, keep a watch for some time.
 Give necessary instructions to a responsible family member before leaving your
client.
 Report to your supervisor or medical officer as early as possible for information &
support.
Records & Reports:
These are very important documents to provide support to a / PFIN for the services
she is giving. These will be permanent documents to show the supervision performed,
meeting held, visit done, and various other activities performed.
 Records and reports help to:

 Review the work done.
 Follow the progress.
 Plan services for the future.
 Helps in communication between the workers.
 Serve as a tool for evaluation of services.
 Provides data for research.
Reports & records, to be maintained, is always spelt out by the. authority. It may
differ in different organisations.
Records to be maintained by PHN
 Diary for all daily activities.

 Tour diary.
 Records of any specific activities which may be demanded for e.g.IUCD insertion,
immunisation given etc.
 Home visits
Reports to be prepared by PHN
 Advance report of weekly or monthly programmes planned.

 Advance tour programme.
 Monthly report of performances of ANMs on FHS under her supervision.
 Evaluation report of each worker under her supervision.
 Annual report of all activities performed by herself & by her subordinates.
 Any specific report demanded by the authority,
 Special points to be remembered:
 Writing must be eligible.
 Neatness and tidiness is essential.
 Never over write.
 Whenever scratching out any writing, initial it.
 Write short sentences.
 Write only the essentials, avoiding redundancy.
 Write to the point.
 Sign at the end of reports and records with dates.
 Remember that records and reports are also legal documents, hence to be kept
properly in safe custody.
Points to be remembered for maintaining records and reports:
 Have to be accurate & complete.

 Documented at the time of actual occurrence.
 Clear & eligible.
 Written concisely without eliminating important points
 Easily available.
 Authenticated with signature and date.
Professional Responsibilities of a Nurse:
They are responsible for confirming that informed consent has been obtained from
the patient or his guardian before any surgery or other. medical procedure is performed.
However, in emergency situation it is exempted if it is impossible to get to obtain such
consent from the client or his authorised person.
Nurses are obliged to follow physicians orders unless they believe that the orders
are wrong arid could cause harm to the client. Here Nurse has to make formal report
explaining her refusal to carry out the order.
Nurses should speak and act carefully to her client to avoid apprehensions,
otherwise it can be considered as an assault and thus become a punishable act.
Before carrying out any physical procedures Nurse has to obtain informed consent from
her client. Otherwise it will be unlawful, meaning will ful touching of other’s body.
Nurses require additional training and ongoing in-service education for practising
in specialised areas e.g. neurology, critical care, intensive cardiac care, care carrier etc. as
they are legally accountable for carrying out the specialized duties and related to
advanced technologies.
Nurse patient ratio has been standardised centrally as well as State— wise. It has
already been prescribed by INC as well as by TNAI. If a Nurse has been forced to care
for patients more than what is reasonable, she has. The right to bring it to the notice of the
Nursing administration.
A registered practsing Nurse can never refuse from her service when she is called
at the time of emergency by responsible authorities
LEGAL RESPONSIBILITIES OF NURSE:
Responsibility of Appointing and Assigning
Nursing administrators are expected to be aware of appointment and assignment A

Manager who departs from agency’s hiring policies can beheld negligent if she or her
appoints an employee, without appropriate screening and that employee later injures a
patient. The nurse administrator shave responsibility for staffing and supervising nursing
units to ensure safe, effective patient care) Therefore they have the authority to
temporarily reassign a nursing employee from one unit to another to compensate for
emergency staff shortages. In shifting an employee to compensate for personnel
shortage, a supervisor or manager must take into consideration the nurse’s capability to
discharge duties of the temporary position. In floating nurses to an intensive care unit to
compensate for understaffing, the manager should reassign only those nurses whose
education and experience have prepared them to perform all of the nursing functions
common to anintensive care unit.
Each nurse has legal responsibility to make full disclosure of her or his
background knowledge and skills and notify the nurse manager when given an
assignment for which she or he is not qualified. The manager is also obliged to adjust the
amount and type of supervision to fit and employees level of maturity and experience.
Less experienced or less skilled employees need more professional support and advice
from the manager.
Responsibility in Quality Control:
The nursing administrator and the authority of the agency at all level shave a legal
obligation to ensure nursing quality. A nurse manager’s legal responsibility for quality
control of nursing service imposes a duty to observe, report and correct the incompetence
of any patient care provider. Usually the head nurse or ward in charge is responsible for
quality of patient care given by all personnel including medical on the nursing unit,
whether or not these individuals have direct reporting responsibility to the head nurse.
Responsibility for Equipment:
To protect patients and employees from injury, a nurse manager must ensure that
all patient care equipments are fully functional and that defective equipment is promptly
repaired or replaced; He/she must ensure that nursing personnel know how to operate
sophisticated equipment, so that he/she is expected to provide instructions in proper care
and storage of patient care equipment, even then, there is a service contract providing for
maintenance by an outside contractor. Nurse also have duty to refuse to use equipment
known to be faulty or that was not designed for use in the situation where it was ordered.
Responsibility for Observation and Reporting:
Nursing personnel have more frequent and prolonged patient contact than other
care-giver. Nurses are trained to detect significant symptoms and reactions. Consequently
nurses have a legal duty to observe patients frequently and report findings that have
diagnostic or treatment value for the patient’s physician and other members of the
patient’s treatment team. The nurse is expected to observe a patient more closely when
his or her condition implies increased health risk. Infants, children, aged, disoriented
psychiatric and critically ill patients require more frequent observation than other
patients with no evidence of impending respiratory or cardiac emergency. The nurse has a
duty to record and report observations of a patient’s condition promptly, so that the
physician can base treatment, decisions on up-to-date information about the patient’s
health needs. When the patients condition deteriorates to the point that immediate action
is needed to save life or limb, the nurse must report observations of the patient’s
worsening conditions to the concerned doctor in person or any means. The nurse has
aduty to report improper medical care through appropriate channels in order to protect
patients from Doctor’s negligence.
Responsibility to Protect Public:
The nurse has a legal duty to protect the public from injury by dangerous patients.
Each nurse manager or administrator should ensure that the agency in which she or he is
employed has a policy describing the procedure to be followed when a patient with
violent tendencies or who threatens violence to others is discharged or escapes from the
health care agency. The manager must ensure that nursing personnel follow the
procedures to alert community members to the presence of a potentially dangerous
patient in their midst.
Responsibility for Record Keeping and Reporting:
Nurses have legal responsibility for accurately reporting and recording patients
conditions, treatments and responses to care. The medical record is a written or
computerised account of a patient’s illness and treatment that includes information
submitted by all members of the patients health care team: The medical record is an
information source document that should be used to plan care, evaluate care, allocate
costs, educate personnel, research care measure, and substantiate legal claim.
Patients medical record is essential to proper care, and it is the property of the
Health care agency. However, patient has a property right to information contained in the
report; the patient has right to inspect and copy the record after being discharged.
However, It is not advisable to allow a patient to review his or her medical record without
medical supervision and explanation, because patient is likely to misunderstand certain
record notations.
Failure to record significant patient information in the medical record makes a

nurse guilty of negligence when the patient is injured because of physicians/surgeons
ignorance of significant information almost medical history, signs and symptoms. The
medical record must be accurate to provide a sound basis for care planning. Therefore,
errors in nurses charting must be corrected promptly in a manner that leaves no doubt
about the facts.
Every health care agency should have a policy and protocol that direct that an
erroneous chart entry be crossed through, labelled or erroneous, signed by the employee
who correct the error and retained in the patients record. Correct information should then
be documented to replace there roneous data. Pages of the record that contain erroneous
and correct edentries should never be destroyed. Nurses who conspire with Doctors and
others to falsify patient record for purposes of concealing a criminal violation may be
found criminally liable
All health personnel require to report certain incidences to concerned authorities

such as child abuse, ophthalmia neonatarum - infant phenylketonuria, communicable
diseases births out of wedlock, gunshot wounds, suicide, rape and use of un prescribed
narcotics reporting information about criminal acts obtained during patient care, the
Nurse must reveal such information only to the police, because it is considered a
privileged communication.
Responsibility for Death and Dying:
There are many issues surround the events of death. Death occurs when there is an
absence of brain function, despite functions of other body organs. However, Nurses must
be aware c legal definition of death because they must document all events that, when the
patient is in their care. Sometime there will be issues of enthanasia, either active or
passive. Activeenthanasia is defined as intentional homicide, e.g. intentionally
administering a lethal dose of morphine to a patient to cause death. An example of
passive enthanasia includes, removing breathing support or withholding blood transfusion
from a terminally ill patient with irreversible brain damage, may raises legal questions. In
addition, documenting all events surrounding death, Nurses have other specific legal
duties which include, treat a deceased person with dignity (wrongful handling is a ground
for a lawsuit) and obtaining consent for an autopsy from the decedent (before death) or a
close family member (after death). A competent adult can legally give consent to denote
specific organs and nurses may serve as an witness to this decision.
CONCLUSION
A general overview of the legal aspects of nursing has been presented. The legal
definition of the standard of care for nurses is defined as that of what a reasonable and
prudent nurse would do when caring for a same or similar patient in the same or similar
circumstances. The reason for having such a general definition is to allow for changes in
the manner in which nursing is practiced. Guidelines and hospital policies and procedures
are more specific but may change from year to year. As a result, the nursing care
provided to a same or similar patient under the same or similar circumstance in one year
is likely to be different from care in previous or later years. For specific legal issues or
questions, nurses are encouraged to seek guidance from their facility's legal or risk
management departments whose personnel are versed in local laws and regulatory
requirements.
BIBLIOGRAPHY
1. B.T. Basavanthappa (2002) “Nursing Administration”, New Delhi J.P.Brothers.
2.Anitha W. Finkelman (2009) “Leadership and management in Nursing”, First ed,

Pearson, India.
3. Ann Marriner – Tomey (1992) “Guide to Nursing Management”, 4th Edition, Mosby.
4.Ruth M. Tappen (2001) “Nursing Leadership and ManagementConcepts and pratice, 4
thEd., Davis,.
5.Bessie L. Marquis (2009) “Leadership roles and management functionin Nursing”, 6th
Ed, Wolters Kluwer.6.Indian Nursing Council, “Teaching Material for Quality

AssuranceModel” – 2006.
7. https://www.nursingcenter.com/upload/static/403753/ch03.html
NURSING
Shimoga, Karnataka
ASSIGNMENT ON ROLE OF
REGULATORY BODIES

SHIMOGA SHIMOGA
INTRODUCTION:
Regulatory agencies/bodies are institutions created by governments to provide

certification, registration, licensing or regulatory affairs thereto ensuring the protection of
public interest and other similar components of control. They make rules, implement
them and prosecute the violators by performing quasi-legislative, administrative and
quasi-judicial functions. They are, therefore, called the fourth branch of the modern
government. Being multi-member bodies, they are independent of the executive’s
influence. They are also described as ‘headless’ as they owe no subordination to
executive. However, their actions are subject to judicial review and can be declared void.
In Pakistan, they are called Independent Regulatory Bodies (IRBs). They have been
established to undertake public regulation and control of the private economic activities
and private property with the aim of protecting and promoting social interest.
DEFINITION:
“Regulatory body is public authority or government agency responsible for

exercising autonomous authority over some areas of human activity over some areas of
human activity in a regulatory or supervising capacity”
OR
“Regulatory body is the formal organization designated by a statue or an

authorized government agency to implement the regulatory forms and process whereby
orders, consistency and control are brought to the profession and its practice”
ROLE OF REGULATORY BODIES:
 To ensure public’s light quality health care services

 To support and assist professional members
 Set and enforce standards of nursing practice
 Monitor and enforce standards of nursing education
 Set the requirement for registration for nursing professional
MAJOR TYPES OF REGULATORY BODIES:
 International council for Nurses

 Indian Nursing Council
 State Nursing Council
 Trained Nurses association of India
 Student Nursing association
 National League for Nursing
International Council for Nurses:
CN was founded in 1899 with Great Britain, the United States, and Germany as
charter members. ICN is governed by a Council of National Representatives (CNR). The
CNR is the governing body of the ICN and sets policy, admits members, selects a board
of directors, and sets dues. As of 2013, there were 135 National Representatives (one for
each member organization). National Representatives are selected by each member
association. The CNR meets every two years.
Between meetings of the CNR, ICN is governed by a 16-member board of

directors. Members of the board include ICN president and 13 directors elected on the
basis of proportional representation from ICN's seven geographic areas. Directors are
term-limited to two consecutive four-year terms of office. The board meets at least once a
year, although it usually meets three to four times a year.
ICN has four officers. They include a president and three vice presidents. The
officers function as an executive committee for the board, and as the board's budget and
finance committee. The president is elected by the CNR. The president serves a four-year
term of office, and is limited to one term in office. The vice presidents are elected from
among the board members. The highest vote-getter is the First Vice President, the
second-highest vote-getter the Second Vice President and the third-highest vote-getter the
Third Vice President.
Day-to-day operations of ICN are overseen by a chief executive officer (CEO)

who works in close collaboration with the ICN President.
Purposes:
 To provide a means through which the National Associations can share their
interests in the promotion of health and care of the sick.
 Great emphasis has been placed upon non discrimination
Objectives:
1. To promote the development of strong National Nurses Association

2. To assist National Nurses associations to improve the standards of Nursing and the
competence of Nurse.
3. To assist National Nurses Association to improve the states of Nurses within their
countries.
4. To serve as the authoritive voice for nurses and nursinginternationally
Role of International Council of Nurses:
 ICN is the global voice of Nursing. Among its many activities and
accomplishments are the publication of the code for Nurses, the world – wide
accepted definition of a Nurse and the Nurses Dilemma, a book of Ethics
 It also makes policy statements on health and social issues and offers a great
variety of seminar and the statements aimed at maintaining and improving the
status of the Nurse and the standard of Nursing around the world.
 The Guidelines for National Nurses Associations in the Indian Nursing year book,
1988 – 89 is one example of how the council works to improve Nursing education
and practice.
ICN (Council of National) Representation which is made up of the ICN Honorary

officers and President, of the National member Association
Council meets at least every other year and once every face year at the time of ICN
congress
Work at the headquarters is carried on by a staff or clerical and expert nursing advisor
personnel
Publications
The ICN publishes the International Nursing Review on a quarterly basis.

The Newsletter, which is published ten times a year, give new of the ICN and the
National member Associations.
Membership:
Membership in the ICN though the TNAI offices various benefit to you as an
individual Nurse. A limited Number of Nursing students may have their expenses paid in
order to attend the congresses as observes.
Benefit:
Among benefits to the graduate Nurse are attendance of international congresses

(or) conferences.
The ICN exchange of privilege programme, professional advice (or) assistance

through ICN Headquarters and use of the ICN information centre.
Nurses may receive publications about development in Nursing and Nursing

education around the world.
This helps the Nurse become aware of being professionally related to international
organizations such as the united Nations and World Health Organisation.
ICN’S ROLE IN REGULATION INCLUDES:
1. Convening regular international meetings of National Nurses Association leaders,

government Chief Nurses, and national nursing regulatory authorities to address key
issues in regulation.
2. Monitoring and analyzing nursing regulation and regulatory forces and trends
worldwide.
3. Providing regular opportunities for interaction among individuals, groups and

organizations who have an interest in or are responsible for regulating nursing. (e.g.
conferences, network and web based activities)
4. Providing national nurses associations and others with the tools(e.g. information,
guidelines, international standards, competencies and frameworks) to enable them to
remain up-to-date on regulatory matters
5. Providing nursing and other key stakeholders with advice and consultation to
undertake reforms and to respond to changes having an impact on professional
regulation.
6. Liaising with international institutions addressing issues of regulation.
7. Influencing/negotiating regulatory reform in the best interest of the public and the
profession.
8. Establishing accreditation, certification and endorsement services in selected areas.
9. Collaborating with other groups and interested parties on regulatory activities and
issues of common interest.
10. Setting directions for the ongoing development of nursing regulation worldwide.
11. Promoting data collection in order to provide an evidence base for regulatory policies
and practices.
INDIAN NURSING COUNCIL:
The Indian Nursing Council is a national regulatory body for nurses and nurse
education in India. It is an autonomous body under the Government of India, Ministry of
Health & Family Welfare, constituted by the Central Government under section 3(1) of
the Indian Nursing Council Act, 1947 of Indian parliament. Since 1947 Indian Nursing
Council Act has undergone minimal amendments. This resulted in several anomalies that
have impacted the morale of Registered Nurses in India especially those practicing in the
private sector. The last amendment of the act was in the year 2006. According to the
original act the function of the council is to provide uniformity in nursing education.
ROLE OF THE INDIAN NURSING COUNCIL
The Indian Nursing Council is an autonomous body under the Government of India,
Ministry of Health and Family Welfare. Indian Nursing Council Act, 1947 enacted by,
giving statutory powers to maintain uniform standards and regulation of nursing
education all over the Country
Aims and Objectives of Indian Nursing Council:
 To regulate the training policies and programs in the field of Nursing.

 To bring about standardization of training courses.
 To prescribe minimum standards of education and training of various Nursing
programs.
 To regulate these standards in all training institutions uniformly throughout the
country.
 To recognize institutions / Organizations / Universities imparting Master’s
Degree/ Bachelor’s Degree / P.G. Diploma / Diploma /Certificate Courses in the
field of Nursing.
 To Recognize Degree/Diploma/Certificate awarded by Foreign
Universities/Institutions on reciprocal basis.
 To promote research in Nursing.
 To maintain Indian Nurses Register for registration of Nursing Personnel.
 Training Programmes.
Indian Nursing Council is responsible for the corporate governance of Nurses and
the Nursing profession. This includes the issue of discipline, the promotion of health and
health care, proposing and commenting on planned legislation, as well as proactively
advising, alerting and offering comment to the Govt. on matters affecting the Nursing
profession.
Indian Nursing Council prime responsibility is to set the norms and standards for
education, training, research and practice with in the ambit of the relevant legislative
framework. In this regard, the following issues are considered critical.
 An ongoing review of curriculum in response to national priorities.

 An ongoing review of the education system with a focus on community based
education.
 Integrated education with a focus on problem - based learning to promote critical
thinking.
 Competency based education.
 An ongoing review of the performance of work of Nursing professionals with in
the ambit of the service delivery principles.
 Protection of the rights and dignity of people.
ROLE OF INC FOR NURSES:
1. Additional responsibilities were given to the INC when the initial Indian Nursing
Council Act of 1947 was amended in 1957.
2. The INC was then asked to provide for Registration of Foreign Nurses and for the
maintenance of the Indian Nurses Registers.
3. This Register contains the names of all Nurses, Midwives, auxillary nurse
midwives and ‘para-nursing’ workers who are enrolled on all state registers.
4. The INC authorized State Nurses Registration Councils and Examining Boards to
issue qualifying certificates. This recognition is given, however, only after those
bodies have been recognized by their State Governments.
5. The Indian Nursing Council has been given heavy responsibilities for Nursing
Practice and Nursing education, but it has not been able to exert enough power to
support high standards in nursing. Private diploma and degree programmes which
have no approval of the Indian Nursing Council (or) state councils are growing in
Number.
6. At the same time, many untrained and unlicensed Nursing personnel are used to
staff there institutions.
7. There is a desperate need for Nursing practice Act which would control Nursing
Practice and education and provide soft and skilled Nursing care to the public.
8. You may not necessarily participate in the activities of the INC but you should
know the function and authority of this body because of it unique role in the
Nursing profession in India.
ORGANIZATION STUCTURE INC:
President
Vice-President
Secretary
Joint – Secretary
Depty – Secretary
Assistance – Secretary
Office Staff
Total number of regular employees - 21 (including 1 deputationist ie. Secretary)

Total number of Contractual employees – 49
Grand Total – 70
STATE NURSING COUNCIL:
Registration councils have now been established in all states. Nursing schools in
the union Territories are affiliated to Nursing Councils in adjacent to state.
Functions:
1. Inspect and accredit schools of Nursing in their state
2. Conduct the examination
3. Prescribe rules of conduct
4. Maintain register of Nurses, midwives, ANM and Health visitors in the state.
5. The state registration councils are autonomous except they do not have power to
prescribe the syllabus for courses.
The procedure of registration is usually initiated by the nursing administration of y

our institution you are qualified to register when you have completed the recognized
programme of nursing education and passed the qualifying examination.
The examining authority will issue a diploma to you which must then be sent with
copies and a property filled out application from to the register for the stat e nurses
registration council in you state. This is usually done by your nursing administration who
also you for the required fees.
Registration is necessary for active nursing practice either here or aboard. This is
done through your state Nurse’s Registration council. It provides you with legal
protection and protect the patient from poor nursing care. It is very important for you to
be able to complete an application form for registration accurately and without omissions.
It is wise to get assistance from a senior colleague it you need it.
REGISTRATION OF NURSES AND MIDWIFE (LICENSING):
A license is a legal document that permits a person to offer her or his skills and
knowledge to the public in a particular jurisdiction, where such practice could be
unlawful without a license. The purpose of Nursing license is to protect society from
unskilled and in competent person who would be practice Nursing.
Respective State Nursing Council has the responsibility to issue license and to
ensure maintenance of standards as laid down by Indian Nursing Council.
INSTITUTIONAL POLICIES AND REGULATION:
Policy is defined as the principles and values that govern actions directed towards
given ends, policy statement set forth a plan direction, or goal for action, policies may be
laws, regulations or guidelines that govern behaviour in Government or Agency.
The rules and regulations pertaining to the rights and duties of personnel are for
different positions. The rules and regulations of an office/institution ensures
accountability.
ROLE OF PROFESSIONAL ASSOCIATIONS AND UNIONSTHE TRAINED

NURSES' ASSOCIATION OF INDIA (TNAI):
It is a national professional association of nurses.
 The present name and organization were established in 1922 but its history of
developments goes back to 1905.
 The TNAI had its beginning in the Association of Nursing superintendents which
was founded at Lucknow in 1905.
Purposes:
 Upholding the dignity and honour of the Nursing Profession
 Promoting a sense of esprit de corps among all Nurses
 Enabling members to take counsel together on matters relating to their profession.
Other nurses gradually became members of the Association of Nursing

Superintendents until a decision was made to establish a Trained Nurses Association in
1908.The Association was inaugurated in 1909.There was organizations operated under
the same leadership until1910 when the Trained Nurses’ Association elected its own
officers.
 In 1922, the two organizations were brought together as the trained Nurses
Association of India.
 The organization of the TNAI makes it possible for all Nurses to participate at
some level.
 Beginning with the local unit, which is usually made up of personnel in a specific
institutions.
 The level of organization moves to the district.
 District level
 State level
 National level
 Members of the TNAI are usually most active on the level of the local unit.
Activities and conferences, however, are planned regularly by the state
branches and provide opportunities for valuable professional participation and
development of the individuals member.
 Some state branches of the TNAI have full – time secretaries. Active members
have an opportunity to participate on the state level also through service on the
executive committee of the state branch.
 The interest group is one way in which the individual nurse can participate. It
centers its activities on a specific area of practice in Nursing.
 This is done on a state level with groups for such areas as nursing education,
Nursing administration, Public health and Psychiatric Nursing .
The Governing body of the TNAI is the council which is assisted by standing
committees for economic welfare, Nursing Research and finance.
A full time salaried secretary was first appointed in 1935. A salaried assistant
secretary, who also serves as the advisor to the Student Nurses’ Association, was
appointed in 1983.
Aims:
 The aims of the TNAI center upon needs of the individual members and problems
in the Nursing Profession as a whole.
 It include upgrading, development and standardization of Nursing education.
 It aims to improve the living and working condition for nurses in India, and
registration for qualified nurses
Activities:
 It was active helping to set up basic Nursing curricula when it first organized
 It has promoted the development of courses in higher education for nurses.
 This includes all of the colleges of Nursing active today
 The TNAI gives scholarships for Nurses who wish to go on for advanced study
either here (or) aboard. It has also stimulated action to organize the State Nurses
and midwives Registration councils.
 It helped to remove discrimination against male nurses and initiated much needed
study and improvement of economic conditions for Nurses.
 The TNAI opposes strikes unless all other means of negotiating have failed to
bring about satisfactory working condition.
Membership:
Membership in the TNAI is obtained by application and submission of a copy of

your State Registration certificate. You may transfer membership from the Student
Nurses Association by having a certificate e sent from the Institution in which you have
studied within six months after completing the course.
 Membership fees are required

 A reduced fees is offered to those who transfer memberships directly from the
SNA.
 A part of these fees is used to pay affiliation fees to the international council of
Nurses.
 It is possible to apply for a life membership.
 Many nursing authorities required membership in the TNAI as a condition for
employment.
The official organ of the TNAI is The Nursing Journal of India which is published
monthly. The cost of this is included in the annual subscription for membership in the
Association. Another impressive publication is the Indian Nursing Year Book”, which
has been published – five times since 1982.
This contains important reports, discussion of trends and statistics which are
available for the Nursing profession in India.
 Its list of who’s who has continued to grow with each publication. The TNAI has
initially planned to make this an annual publication but found it necessary to
publish it less frequently.
 Your members hip in the TNAI means your personal support in the aims and
objectives of this organization. You support these through your financial
contributions and your participation in the activities sponsored by the
organization.
 You are encouraged to become a member of the TNAI. If it has a large enough
membership it can yield the power it needs to bring about action which will
improve the lives and careers of all professional nurses as well as healthcare to the
general public. It continues to give for a majority membership of Registered
Professional Nurses.
 You are professional nurse, will also benefit from membership in the TNAI. It
gives you a feeling of belonging and security because of the Number of Nurses
who are United through the organization.
Professional activities give you ample opportunity to develop leadership ability and
professional poise, keep abreast of changes and share and solve professional problems.
 The Journal helps you to be informed of current events in Nursing and offers –
opportunities to publish articles and voice you opinions.
 The TNAI can help you to apply for a career position if desired.
 It is also of help economically by providing scholarship for advanced study,
railway concessions for Nursing students and staff Nurses and a Limited income
for welfare aid when necessary.
THE STUDENT NURSES ASSOCIATION:
The student Nurses Association, organized in 1920.
Role of Student Nurses Association:
It is associated with and under the Jurisdiction of the TNAI. In addition to

providing a means of personal and professional development for the Nursing Student. It
sense as a source of membership for the parent organization. The Assistant secretary of
the TNAI serve as advisor for the Student Nurses Association.
Purposes and functions of the Student Nurses Association:

 To help student Nurses learn how the professional organization serves to uphold
the dignity and ideas of the Nursing Profession
 To promote a close rapport with other student nurses
 To furnish student Nurses advice in their course in study leading up to
professional qualifications.
 To encourage leadership ability and help students to gain a wide knowledge of the
nursing profession in all of its different branches and aspects.
 To increase the student nurses social contact and general knowledge in order to
help them with their total personal and professional development.
 To encourage both professional and recreational meetings – games and sports
 To provide a special section in The Nursing Journal of India for the benefit of the
students.
 To encourage students to complete for prizes in the Student Nurses Exhibition and
to attend national and regional conferences.
 To help student Nurses develop a co-operative sprit with other student nurses
which will help them in future professional relationships.
 To provide a means of having a voice in what the Association stands for and does.
Activities:
Student Nurses Association to that of the TNAI, the beginning level of

organization in the local unit established in a teaching institution.
It then more on the state and national levels as in the TNAI.
Membership:
Members of the local unit are led by a unit executive committee which is made up of the
president, Student Nurses Association advisor and the remaining officers who are
students. The President is a professional nurse members of the TNAI and some only as an
advisor. The Vice President, who President at all meetings and the secretary of the unit
must be students.
State level advisors are active members of the TNAI elected by the state branches. There
is a full time secretary on the national level at the National Head Quarters located in New
Delhi. This person is also member of the TNAI appointed by the TNAI council and part
of the National level Student Nurses Association General Committee.
Membership fees in the Student Nurses Association are minima land easily met by
the Nursing Student. The arrangement for transfer of membership to the TNAI has made
it convenient for the new professional nurse to establish a life membership in the parent
organization at a lower cost. This special offer for life membership is good for six months
after graduation.
Role of Student Nurses Association includes:
i) Activities of the Student Nurses Association include the Student Nurses Association
exhibit which has developed a high standards: fund raising for the TNAI, fine arts and
sports competition and conferences
ii) Special prizes are given for out standing achievement in specific areas of nursing
education
iii) Nursing students are given opportunity to contribute article to the Nursing Journal of
India through a regular section reserved for the Student Nurses Association.
iv) Each unit received this Journal at a reduced cost with an allowance of one Journal for
every twelve members and maximum of six copies.
v) Unit activities include maintaining the dairy of unit activities, giving quarterly reports
preparing articles for publication and distributing application forms for membership in
the TNAI
vi) The Unit also celebrates national and international holidays and plans other activities
which promote the objectives of the Student Nurses Association.
vii) Nursing students who participate in the student Nurses Association have a valuable
opportunity to begin to develop leadership abilities, social poise, competitive skills and
an interest in the profession as a whole. The association and its relationship with the
TNAI is also helpful to the Nursing students in many ways. Problems in Nursing
Education Problems related to living and study conditions can be shared and solved
through the united efforts of this organization and the TNAI.
National League for Nursing:
As a nurse educator, it is my responsibility to include specific and important standards

into my practice that are outlined by the NLN. The development of these standards and
incorporation into nursing education ensures quality and accountability of the educator
and demonstrates how these standards can improve outcomes for the student. Listed are
the standards, and how I will embody these standards into my role as a nurse educator.
1. Facilitate Learning:
The recognition that not all students are alike or come from similar backgrounds is
essential. Each individual is unique and has equally diverse learning needs. It is the
responsibility of the nurse educator to create not only a curriculum, but an atmosphere
where learning is encouraged, and learning style is embraced. This may include a variety
of learning opportunities and methods; clear criteria and expectations explained; and
availability of the nurse educator for further questions or exploration into other
methodologies.
2.Facilitate Learner Development and Socialization:
It is essential that the nurse educator be cognizant of the progress that each student
is making, especially toward their own perceived educational, personal, and professional
goals. As this varies between student to student, the educator must be aware of the
different learning styles and assist the student in recognizing these styles to facilitate
understanding of the content and context of the material being presented. The educator
must be a role model of nursing excellence, developing critical thinking skills and
communicate accurately and in a positive manner.
3. Use Assessment and Evaluation Strategies:
Learning and the assessment of such learning is a continuous and revolving

process. The nurse educator must engage the student in this process as much as possible
by providing timely feedback and embracing feedback from the students. I consider the
role of nurse educator as one in which learning is also continual, therefore all parties need
to be involved in the process of evaluation strategies. A well-rounded nurse educator will
assist with data gathering and utilize that data to improve teaching and learning
outcomes.
4. Participate in curriculum Design and Evaluation of Program:
The nurse educator must be continually learning new health care trends, have a
commitment to the community, be able to assess and promote current best practices, and
participate in the development of a curriculum that reflects role. Included in this, as
mentioned above, is the continual willingness to assess and evaluate what is being taught
and how it is being taught. As nursing programs and their students interact with the
community and health care facilities, building solid and trusting relationships with these
associations are as necessary and the relationship-building with the students.
5. Function as a Change Agent:
Continual change is difficult for many, but especially within the confines of one’s
work, education, and livelihood. Currently, healthcare is one area that is experiencing a
great deal of changes, many of which are not fully understood. It is therefore a major
responsibility of the nurse educator to keep students informed of changes, and more
importantly, model a behavior of change as a positive component in health care today. By
being a positive role model, change becomes less scary and allows students to explore
ideas of process improvement and develop the tools that will allow them to become a
change agent as well.
6. Pursue Continuous Quality Improvement in the Nurse Educator Role:
The NLN lists that a commitment to life-long learning is an important aspect in a

quality nurse educator. I believe my commitment to this is obvious: I have just recently
turned 60 years old and I am just beginning my Master’s Program. It is a challenge for
each nurse educator to make this commitment to continuous learning; be willing to
explore societal changes; and then be willing to change strategies according to current
data and trends. Safety and quality for our patients should always be at the forefront of
our nursing practice, and seeking out and adapting to current standards is an important
approach in this pursuit.
CONCLUSION:
The development and maintenance of a standard and accreditation in nursing

education programs, role of INC, State Registration Nursing Councils, Boards and
University, Role of Professional Associations and Unions participation of professional
organization is of profit to you and to profession. The profession provides a means
through which united efforts can be made to elevate standards of Nursing education and
practice
BIBLIOGRAPHY:
1. B. Sankaranarayanan B. Sindu, 2008, Learning and teaching nursing 2nd Edition,

Brainfil Publishing Company P.No.52.
2.Teaching material for Quality Assurance model – Nursing IEdition 2006. Published by
Indian Nursing Council P.No.88.
3.Curriculum Developed in Nursing Education I Edition 2005Jones and Barlett

Publishers P.No.53.
4.K.P.Neeraja, Text Book of Nursing Education, I Edition 2006.Jaypee Brothers

Company P.No.48 – 74.
5. Professional Adjustment and Ethics for Nurses in India Ann. J.Zwener, B.A., R.N.,
M.Sc 6thEdition 1995. B.I. PublicationsPvt. Ltd., 234 – 255.
6.https://en.wikipedia.org/wiki/International_Council_of_Nurses
7. https://www.indiannursingcouncil.org/about-indian-nursing-council.asp?show=about-struc
8. https://www.scribd.com/doc/221595190/national-league-for-nursing

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Subject: Advanced Practice of Nursing

According to ANA “Nursing is the protection, and optimisation of health and

HISTORY OF DEVELOPMENT OF NURSING:

 300 AD Entry of women into nursing.

The Unforgettable - Florence Nightingale (1820-1910):

Gradually, the increasing need of adequately trained nurses led to creation of

The Central Government granted an approval to the Bhore Committee's (1946)

Over decades, there has been an improvement in the availability of nursing

1.Ward sister or Nursing Supervisor:

2. Department supervisor/Assistant Nursing Superintendent:

She is responsible to the nursing superintendent and deputy nursing superintendent

3. Deputy nursing superintendent:

She is responsible to the nursing superintendent and assists in the nursing

6. Community Health Nurse (CHN):

Services rendered mainly focusing Reproductive Child Health programme.

10. Nursing service abroad:

Attractive salaries and promising professional opportunities, which causes a

11. Nursing service administrative positions:

3. Write everything down (in detail):

Being organized is an absolute must as a nurse! Remembering when to give

7. Have physical and mental endurance:

Invest in comfortable footwear. You’ll be amazed at the difference good shoes

8. Be a quick thinker (and have great judgement):

10. Be a good communicator:

As a nurse, you are a member of an amazing, supportive community that will be

13. Good listening skills:

Everyone wants to be heard. Give them that opportunity. “A successful nurse, in

15. Coping With Stress:

Stress management tools are an absolute necessity in clinical settings. At times

When working in an environment where communication is clear, nurses handle

CRITERIA OF NURSING PROFESSION:

1. To provide a needed service to the society.

Personal Qualities of a Nurse:

 Must have a Bachelor of Science degree in nursing.

 A basic profession requires an extended education of its members, as well as a

1. Caregiver/ Care provider

 The traditional and most essential role

Initiate changes or assist clients to make modifications in themselves or in the system of

 Makes decisions, coordinates activities of others, allocate resource

 Participates in identifying significant researchable problems

TADIKELA SUBBAIAH COLLEGE OF

Subject: Advanced Practice of Nursing

SUBMITTED TO: SUBMITTED BY:

MRS. KEERTHI D’SOUZA MRs. RASHMI C S

PERCEPTIVES OF NURSING EDUCATION GLOBAL AND NATIONAL:

 As students travel abroad to receive their education.

Education of health professionals, specially nurses, cannot be entirely homogenous

EDUCATIONAL PREPARATIONS FOR NURSES:

NEED OF EDUCATIONAL PREPARATION IN NURSING:

PATTERNS OF NURSING EDUCATION AND TRAINING PROGRAMMES IN

Nursing Council Act came to existence in 1948 to constitute a council of nurses

1.Multipurpose Health Worker Female training (ANM or MPHW-F)

2.Female Health Supervisor training (HV or MPHS-F)

3.General nursing and midwifery (GNM)

MULTIPURPOSE HEALTH WORKER (+) TRAINING:

FEMALE HEALTH SUPERVISOR TRAINING:

GENERAL NURSING AND MIDWIFERY

4. Demonstrate skill in the problem solving methods in nursing

.5.Gain knowledge of health resources in the community and the country

6. Demonstrate skill in leadership

7. Demonstrate awareness of necessity of belonging to professional organizations.

8. Promotion of health, precaution against illness, restoration of health and rehabilitation.

3. Admission of students shall be once a year.4.Students should be medically fit. The