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by P.K a r t h i k e y a p r a s a t h
• Nursing is the oldest of arts and the youngest of professions. • Fundamental responsibility of the nurse is four fold: 1. To promote health, 2. To prevent illness, 3. To restore health and 4. To alleviate suffering.
Modern nursing involves :
1. 2. 3. 4. 5. Bhore committee (1946) Shetty Committee (1966), Kartarsingh committee (1973). Bajaj Committee (1986) and High power committee on nursing and nursing profession (1989)
• To innovate means to introduce something new, to be creative. An administrator must be innovative, an agent of change. If there is no change the organization/institution /country stagnates and goes down.
1. Nursing services:
1. 2. 3. 4. 5. 6. 7. 8. 9. Poor working conditions: Recruitment Job description Lengthy hours of duty and split duty Less salary, Allowances and other Incentives Less Promotional opportunities Harassment of Nurses by others Improper supplies Improper supplies
1.Poor working conditions:
• To improper job descriptions, long hours of work and spilt duty. Less pay and allowances as compare to other equal cadre in government services. Less promotional opportunities, no special incentives, occupation risk. Harassment of nursing personnel by some office staff and medical personal and annoyance of group, ect.
I. Nursing Services Contd….
• Recruitment of trained nurses should be made by selecting candidates who are settled and trained in their respective states. • For which earlier procedure for recruitment of staff nurses by the state Directorate of Health services was good. It is always better to withdraw the selection of nurses by the public services commissions immediately as it was badly experienced by the locally
3. Job description
I.Nursing Services Contd….
• Previously the job descriptions of nurses were made by the nonnursing persons. so it will not suit the present working pattern of nurses. The clear cut job descriptions of nurses of all categories need to be drafted and enforced in to practice.
4. Lengthy hours of duty and split duty:
In most of the states and union territories the duty schedule is “on duty”, “off duty” and night duty.
• 7.30a.m to 1.00p.m • 1.00p.m to 4.00p.m • 4.00p.m to 8.00p.m
• 5 1/2 hours duty • rest • 4 hours duty
• 9 1/2 hours duty • Total
• 7.30a.m to 12.00 noon • 12.00 noon to 1.00p.m • 1.00p.m to 4.00p.m • Total • • • • 4 1/2 hours duty Break 4 hours duty 8 1/2 hours duty
12 hours duty *Night Duty:
5. Less salary, Allowances and other Incentives:
• The pay scale of staff nurses has been recommended by the TukolPay Commission and implemented by the Karnataka Government. The Government to implement the pay scales of nurses of all categories. • And also there is disparity in uniform allowance, washing allowance, risk allowance and compensatory allowance. It has been suggested to IV pay commission. ie., uniform and washing allowance and additional increment for nurses possessing
6. Less Promotional opportunities:
• These rules should be made flexible according to needs and as soon as vacancy arised, immediately it should be filled. In cases of stagnation, selection grade and running scale may be given. • And also should take steps to increase promotional avenues for nurses to increase efficiency and also to prevent ‘brain drain’.
7. Harassment of Nurses by others:
• There are some instances occurred in various circumstances in different places, harassment of nurses by clerical staff, while taking their salaries and claiming other arrears, leave of their own credit and sometimes by the administrators of the institution. • Legal security and protection also should be provided to nurses in the form of acts, eg ‘nurse’s protection act’ on the lines of ‘civil rights protection
8. Improper supplies
• In most of the hospital and other health institutions, no standard has been followed in supply of drugs, equipment and linen etc.
2. Nursing education:
1. No independent building for schools, 2. No independent principal for school, 3. Inadequate hostel facilities for students, 4. Acute shortage of qualified teachers in nursing, 5. Underutilization of clinical facilities
No UGS status for college teachers in nursing
9. Less stipend for nursing students. 10. Less supply of AV Aids. 11. Less promotional opportunity for teachers of both schools and colleges. 12. No separate budget for schools. 13. Msc Nursing course not started in the some government college.
• Just like medical, engineering and dental education, the nursing education is also in the hands of private bodies and encouraging commercialization of education.
1. Non-involvement of nursing administrators in planning and decision making in the governmental hospital administration. 3. No specific power has been assigned to nursing superintendents but he /she has been made in charge of all inventories and linen of hospital. 5. Nursing superintendent will have no authorities to sanction leave to their subordinates. 7. Lack of knowledge in management of hospital among medical/nursing administrators. 9. Administrator, always dependent on the advice of clerical
6. 7. 8. 9.
Prevalence of role ambiguity, among administration administrators. Unnecessary interference of non nursing personnel (Medical/clerical) in nursing administration. No written nursing policies and manuals. No proper job description for various nursing cadres. includes orientation, in-services education, continuing education etc.
10. No organized staff development programs me which
11.No special incentive like, Rajyotsava Award, Republic day awards, teachers awards, as government itself honors with these awards other government servants like teachers, police persons etc. 12.Inefficiency of nursing councils of state and union to maintain standards in nursing. 13.No efforts at higher level for implementation of separate directorate of nursing sanctioned by the Karnataka government.
Present Designation A. Medical wing: • Staff Nurse • Senior staff Nurse • Nursing Superintendent Grade II • Nursing Superintendent Grade I • Sr. Nursing Superintendent Grade Suggested Designation • Staff Nurse • Assistant Nursing Officer • Deputy Nursing Officer • Nursing Officers • Chief Nursing Officer(To be created)
Present Designation B. Public Health Wing • ANM/Jr.HAF • LHV/Sr.HAF • Asst. Nursing Superintendent (PH) • Nursing Superintendent (PH) • District Nursing Supervisor (PH) Suggested Designation • Primary Health Nursing • Community Health Nursing • Asst. Nursing officer (Community Health) • Deputy Nursing Officer (CH)
SOLVING NURSING PROBLEMS
• Identifies opportunities for improvement or overcoming major problems. • Has a readiness to accept change. • Creates and sustains the change effort. • Evaluates, reviews and modifies activities appropriately for effective change and
I. Working Problems occurring in the field or setting b) Mistakes in the nature of omitting or forgetting the important works that should be done. c) Failure to produce works according to job specialization. d) Carelessness in workmanship-poor work e) Wastage of manpower, money and material because of lack of knowledge. f) Grouping Problems
II. Problems related to policies procedures b) The issues of inadequate records and appreciation c) Carelessness in the care and maintenance of institutional and patients property d) Lack of knowledge regarding the procedure and policies.
III. Problems involving attitude and appreciation b) Conservative attitude towards the acceptance of new and progressive ideas. c) Lack or team spirit d) Lack of cooperation among the health professional
IV. Disciplinary problems b) Leaving the patients who require constant attention. c) Taking off duty without prior notification. d) Abuse of sick leave privileges e) Negligence of Duty f) Lack of interest g) Quarrelsome.
V. Nursing services Vs Nursing education problem
a) Lack of knowledge and unwillingness to make assignments, which provides teaching opportunities. b) Failure on the part of staff nurses and head nurses to realize their role and responsibility in terms of supervision and follow up. c) Inadequate orientations programme with subsequent dissatisfaction with rotation, promotion and salary requirement. d) Failure to provide in-service education
VI. Intangible and unpredictable problems of personal b) Illness, death and accidents to members in the family causing emotional, social and economic pressures apart from work. c) Personal health problems.
Ways to resolve problems:
1. Noting creative abilities of those persons who develop new methods and techniques. 2. Providing time and opportunity for people to do creative work. 3. Recognizing those who are experts in clinical practice, teaching research and management. 4. Encouraging risk taking and
Nurse manages can plan to nourish creativity in nursing personnel by:
• Innovative means to introduce something new on the creative various problems are occurring in nursing profession, so it is the duty of an administrator. To be innovative, an agent of change.
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