Archives

State and private sector nursing - some differences

by Malani Ranasinghe, Director, Nursing Research Foundation, Sri Lanka

This criterion would however exclude the majority of nurses in the private sector and this may be construed as discrimination because they care for the ill and injured people in Sri Lanka.

Major difference between nursing personnel in the State and private sector is the standard of the basic nursing education, which has obvious implication for SLMC registration.

It is also recognized that major differences exist in the basic nursing education of the private sector in terms of periods of training and clinical practice settings. Recently the Ministry of Tertiary Education and Vocational Training agreed to a request of the Association of Private Hospitals and Nursing Homes (APHNH) to train nurses for the private sector.

The curriculum is comparable to that of the state sector in terms of entry criteria and content.

However community health and psychiatric nursing are not included due to lack of facilities for training in these two components, and the certificate of this training will not be recognized by the SLMC. A valid registration for the private sector nursing personnel is a major challenge at the recent situation, however, a single minimum standard for nursing and a single or separate valid licence to practise nursing appears necessary for ratifying the c 149.

The recommendations of the Presidential Task Force of 1997 aided the formulation of a National Health Policy (NHP 2001-2010), which was to be implemented through a Perspective Plan for Health Development (PPHD). The need for human resource development was identified in the NHP as vital to providing quality health care. In the state sector the Nursing Minute of 1974, which was amended in 1984 is the reference document on the human resource development in the nursing service. However it does not provide guidance on administrative matters and strategies for professional advancement of the nursing service.

Due to this reason, recruitment criteria for higher posts of the nursing service are always challenged by the trade unions or by the applicants. It is also recognized that a certain degree of disillusionment exists within the nursing service at perceived delays by the Ministry of Health in solving the conflicts which arise from the nursing minute and other reasons.

The nursing minute is currently being amended to rectify these anomalies, however it is recognized that amendments do not reflect effective strategies for professional advancement of the nursing service due to various reasons that arose from administrative circulars and the lack of consensus among the nursing trade unions. The position of Deputy Director General (Nursing and Midwifery) with the separate Nursing Service Department within the Ministry of Health, which was proposed by several reports of the Health Ministry is not yet established.

This strategy is a very important step of developing policy planning leadership capacity of the nursing profession and it will be more responsive to the needs of the nursing service. A separate nursing service department with its own head on the justification and reorganized nursing minute, which leads to effective human resource development of the nursing service are prerequisite for ratification of the C 149.

Challenges

In many South East Asian region countries (Bangladesh, India, Maldives, Myanmar, Nepal and Thailand) nursing and midwifery councils have been established, with varying degrees of effectiveness in terms of public protection, strengthening of nursing and midwifery workforce management. The ratification of the Sri Lanka Nursing Council Bill (SLNC) first proposed in 1988, has stagnated due to various reasons and vested interests of diverse groups relating to the nursing profession.

The main reason for this drawback is the lack of consensus among the major trade unions regarding the member nurses to be appointed to the council. The SLNC when established is expected to be an independent regulatory body for the nursing personnel of Sri Lanka. According to the ICNC Bill, it is only related to the State sector nursing officers therefore this Bill does not reflect the mechanism to register midwives and private sector nurses. The standards of nursing practice and the code of ethics should be uniform to all nurses and midwives, irrespective of the sector. It would be worth while considering the setting up of a single council with representations from both sectors to determine these issues. Urgent steps need to be taken to establish the Sri Lanka Nursing Council with necessary amendments. However, this decision would need to be the outcome of discussions and negotiations, between the Ministry of Health, the private sector organizations, relevant trade unions and others as deemed necessary.

At present, there is no single national standard relevant to all nursing categories irrespective of training and working settings. It may be argued that graduation from a single faculty with a common degree will entitle all nurses to registration with the SLMC or proposed SLNC. The National Health Policy 1992 has proposed that the basic nursing education should be upgraded to the B.Sc. (Nursing) degree.

This recommendation has been reiterated in the national strategic plans for nursing and midwifery services (2001-2010), which was the outcome of discussions among the senior administrators, trade unions and nurses with technical assistance from WHO. It is necessary therefore to implement the National strategic plan with exploring avenues that would provide B.Sc. degree for both sector nurses and midwives. It is also revealed that infrastructure facility such as building premises (10 schools of Nursing). Qualified tutors and clinical supervisors (20 MNSc graduates and more than 300 graduate Nurses) are available for implementing the B.Sc. degree program nurses.

Despite the efforts of the Ministry of Health it is evident that major problems exist regarding the quantity and quality of nursing services and personnel. This situation directly influences the health of the people. The national strategic plan for nursing and midwifery development 2001 - 2010 has proposed strategies to overcome these many deficiencies.

This draft plan emphasizes issues in six key areas (i) quantity of nurses (ii) quality of nurses (iii) client satisfaction (iv) job satisfaction (v) career development (vi) policy development. Establishment of the DDG (Nursing and Midwifery) position and the Nursing Service Department the, Nursing Advisory Committee within the Ministry of Health, and the Nursing Council and revising the Nursing Minute according to current needs of the service are the major consideration of the National Strategic Plan.

It is therefore very important that urgent steps be taken to implement this plan within the available resources for effective ratification of the convention 149. There is evidence of substantial participation of nursing personnel in the planning nursing service, however, their skills and competencies in leadership qualities need to be improved to contribute more meaningfully.

www.crescat.com

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries

Produced by Lake House
Copyright © 2003 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager