Continuing Education

-: EDUCATIONAL PREPARATION :- Nursing education consists in the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to nursing students by experienced nurses and other medical professionals who have qualified or experienced for educational tasks. Most countries offer nurse education courses than can be relevant to general nursing or to specialized areas including mental health nursing, midwifery nursing , pediatric nursing and post-operative nursing. Historical Background :- During recent past decades, the moving on education has replaced the more practically focused, but often ritualistic, training structure of conventional preparation. Nursing education integrates today a broader awareness of other disciplines allied to medicine, often involving inter-professional education, and the utilization of research when making clinical and managerial decisions, orthodox (standard) training can be argued to have offered a more intense practical skills base, but emphasized the handmaiden relationship with the physician.

This is now outmoded and the impact of nursing education is to develop a confident, inquiring graduate who contributes to the care team as an equal. The educational preparation of registered nurses has been shown to be associated with patient outcomes in hospitals. Hospitals that employ larger proportions of nurses prepared at the baccalaureate and higher level have lower rates of mortality and failure to rescue. The empirical evidence shows that educational preparation of nurses makes a difference in patient outcomes.

In India there is a different type of nursing educational programme going on. There are six levels of nursing education in India today, they are : 1. Multi Purpose Health Worker Female training (ANM or MPHW-F) 2. Female Health Supervisor training (HV or MPHS-F) 3. General Nursing and Midwifery (GNM) 4. B. Sc. Nursing 5. M. Sc. Nursing 6. M. Phil and Ph. D. The ANM, HV and GNM are conducted in schools of nursing. The last 3 are university level courses and the respective universities conduct examinations.

Besides there are several certificated and diploma courses in specialties. ? Diploma Level Programme :- 1. Auxiliary Nurse Midwife (ANM) : The entrance qualification is required 10th pass and the revised curriculum designed to have 1. 5 years of vocationalized ANM programme and 6 months of general education means 2 years training programmed. 2. Lady Health Visitors (LHV) : The entrance qualification is 10th pass. The duration is 2 years. 3. General Nursing and Midwifery (GNM) course : 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 advancement 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 3 years to 3. 5 years. The basic entrance has become intermediate or class 12 instead of earlier class 10th. 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 midwife by the respective state nursing councils. ? PHILOSPHY : 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 programme 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 to 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 that 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 skills required in the nursing process in the provision of health care and nursing care of patients. ) 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. ? Eligibility for Admission : ) Age for the entrance shall be 17 years to 35 years 2) Minimum education all students should pass 12th classes or its equivalent, preferably with science subject 3) Both the science and arts are eligible 4) Students should be medically fit. The selection committee should comprise tutors, nurse administrators and Educationalist/psychologist. The principal of the school shall be chairperson. ? Course of Study : 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 ?

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 undertake general nursing course will not be given any concessions. Post certificate short term courses and diploma programmes : ? Universities Level Programme :- 1. Basic B. Sc. Nursing :- Graduate nursing education started in India in the year 1964 in CMC, Vellore and in the RAK college of nursing at Delhi university. At present several universities in India offer the course. ? Objectives of Study : The programme is designed : To provide a balanced of professional and general education ? 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 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 problem 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. Eligibility for Admission : A candidate seeking admission should have : 1. Completed 17 years of age at the time of admission or will complete this age on or before 31st December of the year of admission. 2. Minimum education all students should pass 12th science classes or its equivalent, preferably with science subjects, i. e. Physics, biology and chemistry. 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. Students should be medically fit. Course of Study : The course of study leading to bachelor of nursing degree comprises 4 academic years with six month internship. Examination is conducted at the end of each year. 2. Post Graduate Education M. Sc. Nursing :- Further the programme encourages accountability and commitment to lifelong learning which fosters improvement of quality care. ? Objectives : 1. Post Graduate or Master of Nursing programme demonstrate : ? Increased cognitive, affective and psychomotor competencies and the ability to utilize the potentials for effective nursing performance ?

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. ? Ability to practice independently as a nurse specialist ? Ability to function effectively as nurse educators and administrators ? Ability to interpret the health related research ? Ability to plan and initiate change in the health care system ? Leadership qualities for the advancement of practice of professional nursing ?

Interest in lifelong learning for personal and professional learning advancement. ? Eligibility for Admission : 1) The candidate should be a Registered Nurse and Registered midwife or equivalent with any State Nursing Registration Council. 2) The minimum education requirements shall be the passing of : B. Sc. Nursing / Post Basic B. Sc. Nursing with minimum of 55% aggregate marks. 3) The candidate should have undergone in B. Sc. Nursing / Post Basic B. Sc. Nursing in an institution which is recognized by Indian Nursing Council. ) Minimum one year of work experience after Basic B. Sc. Nursing. 5) Minimum one year of work experience prior or after Post Basic B. Sc. Nursing. 6) The candidate shall be a registered nurse or 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 nurse. 7) Candidate shall be medically fit. 8) The candidate shall be selected on merit judged on the basis of academic performances in B. Sc. nursing, post certificate B. Sc. or nursing and selection tests. ? Course of Study : The course of study leading to master of nursing degree comprises 2 years specialty course. Examination is conducted at the end of the year. Specialties : Candidate will be examined in any of the following branches : a) Branch1 – Medical Surgical Nursing b) Branch2 – Community Health Nursing c) Branch3 – Pediatric Nursing d) Branch4 – Obstetric and Gynecological Nursing e) Branch5 – Psychiatric Nursing Four common papers are there included in the syllabus. They are : a) Education and Nursing Education ) Advance concepts of health and nursing c) Bio-statistics, research methodology and nursing research d) Administration and Nursing Administration 3. M. Phil in Nursing : In 1980 RAK college of nursing started an M. Phil programme as a regular and part time course. Since then several universities started taking students for the M. Phil course in nursing. Prominent among these are : MGR Medical University, Rajiv 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 focuses 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 lifelong 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 provided 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 part2 ? Part1 – It consist of 3 courses, i. e. 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 (thesis). The topic and the nature of the dissertation of each candidate will be determined by the advisory committee consist of 3 members. 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. 4. Ph. D. n 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 M. Phil degree of a university of have a good academic record with first or second class masters 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 a 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 ac academic council ? Three persons nominated by the medical faculty (for their special knowledge in the medical science) -: Continuing Education :- ? Introduction :- It is planned activity and directed towards meeting the learning needs available following their completion of college programme to keep the registered nurses abreast of their particular field of interest. [pic]

The continuing nursing education programme is an essential part of licensure requirement. The main thrust of the programme is to build capacities in the profession in identifying the delivery models that do not stop with advanced health care but reach out for the benefit of the whole community. It is a modern imperative, it must be future oriented geared to the facing of new situation and to the making of new responses appropriate for these situations. Continuing education for nurses allows them to hone professional competence, develop ethical principles of conduct and have the leadership qualities to adapt to changes in the society.

Continuing education seeks to address the problems of coping with exploding knowledge while developing critical thinking and interpersonal skills in the nurses. Moreover, it is also a method to predict future challenges and articulate appropriate solutions. Besides an evaluation on the training for skills, continuing education seeks to build competences in the nurses to evolve suitable strategies for clinical evaluation and treatment management in a variety of settings. This also includes credits for research into the problems of achieving the balance of optimum healthcare with lower financial implications. Definition :- “Continuing education of health workers includes the experiences after initial training which help health care personnel to maintain and improve existing and acquire new competency relevant to the performance of their responsibilities. Appropriate continuing education should reflect community needs in health and lead to planned improvements in the health of the community”. “Continuing education is all the learning activities that occurs after an individual has completed his basic education. – by Cooper. Nursing is a progressive art, in which to stand still is to go back, a woman who thinks to herself, “Now I am a full nurse, a skilled nurse, I have learnt all there is to be learnt”. Take my word for it, she does not know, what a nurse is, and never will know; she is gone back already. Progress can never end but with a nurse’s life. ” – Florence Nightingale “Continuing education refers to that education which builds on previous education” – Shannon “Continuing education in nursing consist of systematic learning experiences designed to enlarge the knowledge and skills of nurses.

As distinct from education toward an academic degree or preparing as a beginning professional practitioner, continuing professional education activities have more specific content applicable to the individuals immediate goals, are generally of shorter duration, are sponsored by college, universities, health agencies and professional organizations and may be conducted in a variety of settings”. ? Objective of continuing education :- ? To promote the development of knowledge, skills and attitudes ? To enhance the nursing practice, thus improving health care to public.

Continuing education is a means of staff development which assist the employee to improve the performance in her present situation. For continuing education, there are a number of nursing programmes such as Diploma in cardiac care unit, Diploma in O. T. Techniques, Post Basic B. Sc. Nursing, M. Sc. Nursing etc. the certificate sources such as intensive care, pediatric care, ophthalmic care, operation theatre, premature care, kidney dialysis etc. and Diploma courses such as Teaching Public Health Administration, Psychiatric Nursing.

To develop proficiency and skills, the nurse attends orientation programmes, workshops, seminars & conferences etc. ? Features of Continuing Education :- ? Unified approach ? Relationship with other systems ? Comprehensiveness ? Accessibility for women health care workers ? Integration with the management process ? Analysis of needs as a basis for learning continuity ? Internally coordinated ? Relevance in planning ? Credibility and economic ? Appropriateness in implementation ? Need for Continuing Education :- ? To ensure safe and effective nursing care, nurses need to keep abreast with interest, knowledge and technical advancement. To meet the needs of population and should cater to the need of service ? Development of nurses will occur by preparing their knowledge and prepare them for specialization ? For career advancement ? Professional role are altered as society changes and as new knowledge and technology emerge ? If the nursing professional is to respondent effectively, to the challenge of developing wise leadership and competent practitioners, current social changes must be recognized and future ones foreseen. ? To acquire specialized skills of the personal and meet technologic adjuncts ?

Clinical specialists are needed for direct patient care and for teaching and consultative roles to help the students and staff nurses to reach higher level of competency. ? Nurses with research aptitudes and preparation are needed. ? Nurses in administrative positions need to increase their understanding of the administrative process and to design to effective methods of maximizing the contribution of individuals helps to provide nursing services to patients. ? Nursing function require high degree of skill, knowledge, competence and educational preparation ?

Needs for additional preparation for the positions area already holding or to prepare themselves for other positions ? In the world, scientific advancement, technologic innovations, social change are occurring rapidly and new patterns of health care changes in the role expectation of all health care personnel are emerging to meet these needs and demands qualified nurses are essential. ? To provide a variety of continuing nursing education opportunities of high quality to nurses in both education and service changes. ? Functions of Continuing Education :- To meet the health needs and public expectation ? Recruitment function ? Recognize gape in their knowledge ? To test ability to do final academic study ? To improve the communication between the participants, faculty, community and health sector. ? To test the participants ability to do formal academic study ? To shape or support university educational policies and practices ? To ensure the quality of education ? To grant the budget for extension of study ? To maintain academic standards ? To meet the educational requirements. ? Philosophy of Continuing Education :- Continuing Education in Nursing consists of those learning activities intended to build upon the educational and experiential bases of the professional nurse for the enhancement of practice, education, administration, research, or theory development to the end of improving the health of the public. ? It believes that participation by the nurse in continuing education activities has a positive effect on nursing care as evidenced by continuous quality improvement. ? It is committed to continuing education for nurses as one means for maintaining competency, meeting current standards of practice, and promoting excellence in nursing care. It believes that all planners and providers of continuing education for nurses should assess learning needs on an ongoing basis and systematically evaluate the effectiveness of continuing education activities. ? It recognizes its obligation to respond to request from individual practitioners of nursing, educators, and employers for updating knowledge and skills of nurses in Kentucky. ? It believes it has the responsibility to contribute to statewide planning of continuing education for nurses. ? It supports statutes and regulation which require evidence of continuing education a criterion for relic ensure of each nurse. Elements of Continuing Education :- The philosophy of continuing nursing education recognize the : 1. Learner as a person, as nurse and as a citizen. Thus continuing nursing education is seen as totality, a sound philosophy of education is recognizes all three aspects of lifelong learning. ? The teacher has to make the learner to involve in nursing and non nursing courses. It encourages provincialism among nurses, benefits by learning with persons from other walks of life. ? The learner in his life plays many different roles, for every aspects of life, there are some continuing education elements. ? It aims as self directed learning 2.

Teacher/Nurse Educator : The continuing educator has to play multiple roles like : ? He has to accept the concept of learning and his responsibility to encourage nurses to recognize the value of participating in different types of educational activities. ? Guides and counselor to the learner ? Motivator and encourager of students ? Evaluator of programmes ? Producing instructional material for students ? Select and evaluate materials prepared by others. ? Administrative role (planning, budgeting, directing and evaluation) ? Public relation role to change an image of nursing and recognizing the contribution and potentials of nurses. Principles of Continuing Education :- 1. Entry gates :- The nursing profession must control entry to the profession. 2. Level of award :- The level of award on completion of nursing education programmes should be at the level of a first degree. 3. Accountability at the point of registration :- At the point of registration nurses are accountable for their own practice. 4. Knowledge development :- The creation of knowledge for the discipline of nursing and its application to the needs of society is as integral to nursing education as the communication of knowledge. . Practice experience :- Appropriate high quality practice experience delivered in partnership with practice is an essential element of nursing educational programmes with a practice component. 6. Teaching nursing :- Nursing must be taught by expert nurses who will be supported, where appropriate, by contributions from other academic and professional colleagues and users of nursing services. 7. Continuing professional development (CPD) and lifelong learning (LLL) :-All nurses must embrace and engage in the principles of continuing professional development. 8.

Support for students :- Nursing students at all levels require adequate financial and pastoral support in order to complete their courses successfully. 9. Workforce planning :- A rigorous system of workforce planning is essential in order to underpin educational commissioning. There needs to be the right number of nurses and nurse lecturers (with the right skills and knowledge base) in the right location to meet needs, including, but not limited to, the needs of the state and Nation. 10. Multi-professional education :- Professions who work together should learn together. 11.

Nursing in higher education :- Nursing must be treated equitably Alongside other disciplines in higher education ? Programme for Continuing Education :- There are some programmes for continuing educations are as follows : ? Acute Care Nurse Practitioner – ACNP ? Adult Nurse Practitioner – ANP ? Emergency Nurse Practitioner – ENP ? Family Nurse Practitioner – FNP ? Forensic Nursing ? Neonatal Nurse Practitioner – NNP ? Nurse – midwifery – NMW ? Advanced Registered Nurse Practitioner – ARNP ? Certified Nurse Practitioner – CNP ? Doctor of Nursing Practice – DNP ? Geriatric Nurse Practitioner – GNP Occupational Health Nurse Practitioner – OHNP ? Nursing Informatics ? Palliative Care ? Pediatric Nurse Practitioner – PNP ? Psychiatric Mental Health Nurse Practitioner – PMHNP ? Women’s Health Nurse Practitioner – WHNP ? Clinical Nurse Specialist ? Certified Registered Nurse Anesthetist ? Oncology Nurse Practitioner – ONP -: CAREER OPPORTUNITIES :- Nursing is the largest health care occupation and one of 10 occupations projected to have the largest numbers of new jobs annually through 2011. Opportunities should be excellent for nurses with advanced education and training.

Some states report current and projected shortages of nurses. Faster than average growth also will be driven by technological advances in patient care, which permit nurses to treat more medical problems, and an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly. As nursing positions expand beyond the traditional hospital nursing roles, nurses have increased options and flexibility. In today’s integrated health-care networks, nurses may rotate among employment settings.

Nurses work to promote health, prevent disease and help patients cope with illness. They are advocates and health educators for patients, families and communities. When providing direct patient care, they observe, assess and record patient symptoms, reactions and progress. Nurses collaborate with physicians in the performance of treatments and examinations, the administration of medications and the provision of direct patient care in convalescence and rehabilitation. Nurses work in an environment that is constantly changing to provide the best possible care for patients.

Nurses are continuously learning about the latest technology as well as considering the evidence that their nursing practice is based upon. Many school of health sciences provides exceptional clinical training experiences through many affiliated nursing education programmes. Facilities or areas in which nurses typically are employed include : ? Hospitals ? Clinics or offices ? Nursing Homes ? Home-health ? Public health ? Occupational health or Industrial Nurse ? Leadership positions ? Teaching positions at hospitals, colleges and Universities For nurses, a wide range of career opportunities are available as discussed under. For ANM :- ? Works as multipurpose health worker male and female at sub centers. ? With experience & training can be promoted to lady health visitors ? For career development, can do diploma in general nursing and midwife of 3. 5 years course. ANM’s are relaxed for six month during 3rd year of GNM course. ? For GNM :- General nurse and midwife can work. ? As a Staff nurse/sister grade II in the hospital. ? In various health programmes ? Can go abroad after clearing certain exams as per requirement of country. ? She can do Post Basic B. Sc. Nursing of 2 years and can become a graduate nurse. She can do certain certificate courses of duration ranging from 3 to 6 months such as certificate course of obstetric nursing or kidney dialysis. ? She can do diploma of 9 to 12 months of public health administration. ? She is promoted with her experience as sister grade I/ANS/DNS ? For B. Sc. Nursing/Post Basic B. Sc. Nursing :- ? Nurse can work : ? In hospitals : As a staff nurse to give care to patients. She is promoted as a sister grade I, ANS, DNS & Nursing Superintendent with experience. ? In Community : As a public health nurse to prevent, maintain, treat & rehabilitate the people as per their needs.

Participates in various health programmes. She can work as an industrial nurse, school health nurse etc. ? She can compete various international exams and can to abroad to work as a nurse. ? She can conduct researches. ? She can work as a clinical instructor in schools and colleges to teach nursing programmes such as ANM & GNM. ? To develop her career she can do masters of nursing. ? She can do certificate courses of nursing to become specialized in particular field. ? For M. Sc. Nursing :- ? M. Sc. nurse with experience can work : As a lecturer (if have 3 years experience of teaching) in college of nursing to teach various programmer of nursing. If have more experience, according an work as a reader, associate professor, professor, vice principal & principal of college of nursing. ? As a clinical nurse in hospital and with experience can work as a sister grade I/ANS/DNS/NS/CNO. Once promoted, she does administrative along with clinical work. ? She can work as a Public Health Nurse, District Health Nurse and directorate of nursing and also at State Nursing Council as a registrar and Indian Nursing Council as a president, vice president etc. ith experience. ? She can do further her M. Phil or Ph. D. in nursing. ? She can enhance herself as well as of other’s knowledge by organizing workshops, seminars etc. ? She can act as a counselor. According to specialization in M. Sc. Nursing, she can be at various higher level posts in hospitals & community. Bibliography 1) Annamma, K. V. (1989). ‘A New Text book for Nurses in India’. Madras, B. I. Publications. 2) Honda, U. and Gulani, K. K. (1995). ‘Community Health Nursing’, New Delhi, Ignou Publications. 3) Hurndr, R. and Letiman, B. 1983). ‘Nursing Education in India’, New Delhi. 4) Neeraja K. P. (2003), ‘Text Book of Nursing Education’, New Delhi: Jaypee Brothers. 5) Sandaranarayanan, B. and Sindhu, B. (2003), ‘Learning and Teaching Nursing’, Calicut, Brainfill. 6) TNAI (2000). ‘History and trends in Nursing in India’, New Delhi. 7) TNAI (1995). ‘Indian Nursing Year Book’, 1993-95, New Delhi – TNAI. 8) TNAI (2002), ‘Indian Nursing Year Book’, 2000, New Delhi – TNAI. 9) Wilkinson, A. (1965). ‘History of Nursing in India and Pakistan’. New Delhi, TNAI.