The recent protest by nursing students in government medical colleges throws up an issue that has been simmering for sometime.
The government's decision to recruit students from private nursing colleges in government hospitals has caused considerable discontent among nursing students in government colleges who think they are better qualified with hands-on experience.
Practical knowledge
The nursing students in government medical colleges have been working in hospitals attached to the medical colleges as part of their training programme. “We have practical knowledge by virtue of having trained on patients, whereas private college nurses depend on the knowledge they acquire in a classroom,” said a recently qualified nurse.
Theory classes provide the knowledge that nurses need for taking competitive examinations to qualify for a job abroad. But learning by practice is infinitely beneficial when one is exposed to real-time situations, say experts.
Good training
“While private hospitals are doctor-driven, a well-trained nurse can easily handle simple cases such as poisoning,” says T. Leelavathi, secretary, Tamil Nadu Nursing Association. For instance in a primary healthcare centre, the nurse can easily manage a patient, and handle a variety of situations, she adds.
“Studying theory and memorising is not enough. Practical knowledge is needed for nursing care. Knowledge of a patient's anatomy and physiology is important for a medical student, but for a nursing student care is about nursing to improve the patient's health,” says Ms. Leelavathi.
Humane care
Nursing students in Tamil Nadu learn the nuances of providing psychological and physiological care.
“Nursing education is care-model driven. The [nursing] students are taught to forget their family background. When they counsel patients and empathise with them, half the battle is won.” In private hospitals the focus is more on equipment, which can only provide treatment and not cure, she asserts.
Licence
As a provider of geriatric nurses, K. Vasudevan has seen nurses who are not trained to administer first aid.
“Nursing care for an immobile patient could be around Rs. 30,000. In a hospital a day in intensive care unit could cost at least Rs. 8,000 but with a properly trained nurse an ICU could be created at home for as little as Rs.1,500.”
“Like doctors, nurses must be licensed to practise as they are handling human life,” says G. Josephine, registrar of Nursing Council. In government hospitals the students undergo supervised learning.
The Indian Nursing Council mandates that a student of diploma in nursing, whether in private or government college, must undergo 1,695 hours of theory and practice each year for three years to qualify.
The curriculum specifies that they spend two thirds of their time in practical training and theory is taught for the rest of the hours.
More nurses needed
“Consider the scene: the population of the State is seven crore. According to the World Health Organisation, a developing country should have two beds for every 1,000 persons. We have 1.10 lakh beds and about four crore people seek treatment at government hospitals. Naturally the students who train in government hospitals are much better qualified,” Dr. Josephine points out.
On the perception that private nursing college students are better in theory, she says:
“The students who come to government nursing colleges are meritorious students. Besides nursing teachers have worked as nurses for 48 hours and each teacher has around 20 years of service. A teacher is in-charge of 10 students as they learn about care-giving in hospitals. Even theory-based questions are about application. The students' clinical exposure and experienced teachers will stand them in good stead.”
