Wednesday, July 20, 2005

Nursing a healthy choice

Lucrative options beckon nurses not only to countries like the USA, Ireland, West Asia and Australia, but also to the rising number of corporate-run hospitals in India, writes Usha Albuquerque

MEDICAL care is of no value without timely and efficient nursing care. Nursing services are the most important services in the hospital, whether in a general ward or an operation theatre. Nurses are the working arms of the doctors, constantly carrying out a range of duties related to the care of those who are sick, or for the better health of those who are well. The profession requires service, with dedication, love and tender care of the physically incapacitated, sick, injured, convalescing mothers, new-borns, the aged and sometimes, mentally deranged or sick people.

Nursing is not a second-choice career for people unable to get into medical schools. The two professions are complementary and suit people with very different aims and personalities. A vital difference is that a doctor’s contact with the patient is fleeting, while the hospital nurse must establish and keep up a relationship with the patient.

Nursing covers a range of jobs which vary widely in terms of levels of functions, responsibility, professional qualifications required and work environment. There is, therefore, scope for people with widely different aims, interests and abilities. While most nurses work in hospitals, taking care of sick people and helping them recover, they also handle other duties. Visiting nurses go to the homes of the sick. Some nurses assist in offices of doctors and dentists. Others work in clinics, schools, factories, in the armed forces, and on ships. Some nurses, for example, concentrate entirely on bedside nursing, or operating theatre work: others manage whole hospital groups.

With the increase in the number of old persons needing both medical and physical care, geriatric nursing, particularly in the West, is in great demand. Another specialised field is psychiatric nursing. The psychiatric nurse is trained to handle patients who are suffering from mental and emotional disorders. Some nurses enter paediatric nursing and are concerned with the care of sick babies and children.

Other specialised fields may be nursing administration and nursing education, orthopaedic nursing, public health nursing etc.

Work profile

It is quite difficult to define the work of a nurse. It involves establishing relationships with patients and also doing basic bedside nursing chores. Nurses have to record temperature, administer medicines, assist the patient in personal care and so on. Nurses everywhere mainly perform routine chores. Most importantly, they provide emotional support as well as physical care to the suffering.

Nurses working in hospitals require extensive knowledge for carrying out a variety of highly complex and responsible tasks. These include administrating a vast array of drugs in the right dosages and understanding what side-effects to watch out for; keeping records on patients and knowing at all times what changes, if any, have occurred in their patients’ condition.

Patient care comprises assessing, discussing and planning for individual patient needs, putting them into operation and then monitoring and, if necessary, changing it.

Nurses work in teams, with doctors, psychologists, occupational therapists and other specialists.

Nurses also perform the role of midwives, looking after mother and child during pregnancy, and until about four weeks after the birth of the child. Particularly in rural or semi-urban communities where there are no doctors, midwives and auxiliary nurses provide anti-natal and post-natal advice, support and instruction, and only call a doctor in case of any emergencies.

Course clues

Formal training in nursing is essential. There are courses at different levels for nursing.

The Auxiliary Nursing and Midwifery (ANM)/ Multi-purpose Health Worker programme is a 18-month to 2-year diploma programme with a minimum qualification requirement of Class X.

The General Nursing and Midwifery (GNM) programme of 3 years’ duration after plus two or its equivalent with science, and most often through an entrance test in English and general science.

B.Sc Nursing is a four-year course, the eligibility for which is plus two with science. Candidates with this qualification have to take a qualifying exam.

Certificate courses in General Nursing (GN) and General Nursing and Midwifery (GNM) of one year/18 months’ duration are also available after Class X. Those who have completed plus two and have 3-5 years’ work experience after the GN or GNM can join the 3-year B.Sc programme in the second year.

M.Sc Nursing is a 2-year course after graduation.

Further specialisations in operating theatre nursing, cardiac care, surgical nursing and other specialisations can be taken up as part of a Master’s degree or a post-diploma course.

Skill set

In addition to academic qualifications and specialised training, nurses need to have basic common sense and good health, a practical bent of mind, sympathy for the sick and the old without sentimentality, patience, a sense of humour and powers of observation. You must also have an interest in medicine, and the new advances, be prepared to take the initiative when necessary, have organisational ability and the ability to take responsibility. Male nurses may be called upon to handle the more physically demanding activities such as lifting patients on and off the stretcher, helping incapacitated patients, or in movement of heavy medical equipment, and so require good physical strength and stamina too.

Placement prospects

All qualified nurses have to get themselves registered. They can be employed wherever nursing services are rendered e.g hospitals, nursing homes, medical treatment rooms, clinics, industries, factories, public health organisations and so on.

Private and public institutions for individual nursing of the aged, the disabled, as well as creches and orphanages also employ nursing staff to provide specialised care.

Psychiatric nurses may be employed in a mental hospital, a ward of a general hospital or in a sanatorium.

Nurses with a postgraduate qualification can teach in training schools.

Those qualifying through the Armed Forces Medical College are taken into the Armed Forces Nursing Services.

Avenues abroad

The demand for qualified nurses is increasing both in the rural and urban areas. As corporate organisations move into the area of healthcare, setting up new multi-speciality hospitals, the demand for nurses will continue to grow. There is also a growing demand for nurses, both male and female in countries abroad where the numbers of single, elderly, and incapacitated patients is increasing. As the training provided in India is considered on a par with international standards, there are plenty of employment avenues for nurses in the Far East, West Asia, Australia and the United States of America.

With appropriate training and motivation, those with the spirit of Florence Nightingale can look forward to a bright and prosperous future.

Training talk

There are around 850 schools and 170 colleges of nursing in India, offering diploma, graduate, and postgraduate courses. Admission is on the basis of an all-India admission test available in some institutions, including:

  • All-India Institute Medical Sciences, New Delhi

  • Jamia Hamdard College of Nursing, New Delhi

  • Rajkumari Amrit Kaur College of Nursing, New Delhi

  • College of Nursing, Ludhiana

  • College of Nursing, PGIMER, Chandigarh

  • Armed Forces Medical College, Pune

  • College of Nursing, SMS Medical College, Jaipur

Specialised training is also available in several institutions like Central Institute of Psychiatry, Ranchi; AIIMS, New Delhi; and National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, for Psychiatric Nursing.

The All-India Institute Of Physical Medicine and Rehabilitation, Mumbai, conducts a one-year postgraduate course in rehabilitation techniques for nurses having 3 years’ experience.

— The writer is a noted career expert