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19 June, 2019 11:43:07 AM
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Nursing profession needs reforms

A developed health care system is impossible without a smoothly functioning nursing sector
Dr. Forqan Uddin Ahmed
Nursing profession needs reforms

The nursing profession is undoubtedly a very important part of the health care infrastructure. I will therefore highlight a few of the issues that are responsible for the low quality of inadequate nursing care of the population. The course outline for the Senior Registered Nurse developed by the Bangladesh Nursing Council in Dhaka encompasses anatomy, physiology, microbiology, social science, nutrition, nursing art, first aid, pharmacology, community nursing, family health nursing, health education, adult and child medicated and surgical nursing, psychiatric nursing, and management and supervision. Nursing ethics is not included in the syllabus. The whole period of training emphasizes for practical application of theoretical learning. The training period for senior nurses is four years. Instruction is given by sister tutors, guest lecturers, hospital nursing personnel and, occasionally, some local authority employees. Bangladesh must ensure health care to protect its human resources and fulfil a basic human need. Hence, nursing is a crucial factor in health care system. As a profession, existing condition of nursing in Bangladesh remains poor with below-average standards. They spent remaining time in unnecessary socialisation- present situation is the same. The leaders in the nursing profession should change the scenario and play a proactive role in Bangladesh's health care system.
A developed health care system is impossible without a smoothly functioning nursing sector. Plus, the profession requires qualified leadership able to empower nurses and improve their professional competence. Bangladesh’s public health challenges require a skilled health care work force to provide or improve access to quality care. Gaps in quantity and quality of nurse and midwife services and education will have an impact on attaining the health related MDGs, especially 4 and 5, by the deadline of 2015. Health care issues, such as the increased need to deal with current and future health effects of climate change, have merged to create the sense of urgency that now catalyzes work to improve nursing and midwifery. The WHO nursing and midwifery programme provides support to the Government of Bangladesh (GoB) via the Directorate of Nursing Services (DNS) and the Bangladesh Nursing Council (BNC) in order to alleviate the severe nursing and midwifery shortage, and to improve quality of education of and services provided by nurses and midwives in order to address the multiple urgent needs for a strong health care work force.

There is a severe shortage of nursing personnel in the country. Bangladesh is one of a few countries in the world that has more medical doctors than nurses: about 3 medical doctors to one nurse. Furthermore, due to the shortage of nurses and a challenging working environment (e.g. lack of nursing equipment and effective nursing management system), with few exceptions the quality of nursing care has been called into question. To address these challenges, the Government of Bangladesh (GoB) is increasing efforts to raise the image; improve the quality of services and education; and meet the shortage of nurses and midwives. The government has pledged to achieve these goals by upgrading the status of nurses and midwives, creating midwifery posts, establishing more nursing and midwifery educational institutions, increasing the seats for students, and increasing capacity development of nursing and midwifery professionals, improving the health systems that will create the positive practice environment necessary for provision of quality nursing and midwifery services. Like many countries in the world, Bangladesh is facing an acute crisis of skilled nurses. Although nurses are the essential part of health care system, there are very little initiatives to promote this noble profession. Thousands of patients are not getting proper medical care due to deficiency of skilled nurse. With proper attention and suitable programme, we can help revive the profession.
In Bangladesh, nursing is considered as a second segmental job. That is why the work value and social recognition does not encourage the brilliant boys and girls to join the profession. It creates an ill impression and contributes as one of the major causes of shortage. In order to increase the number of nurse and fulfill the actual need both government and private sector should come forward with the initiative to open more nursing institutes, colleges to attract new generation to join in nursing. There is also urgent need to uphold the significance of this noble profession. Among other barriers negative social attitudes and more restricted policies, undefined status of nurses, lack of appreciations, cultural barriers and lack of financial supports for nursing education are also the central factors behind the shortage of nurses.
Although the question of whether nursing is a profession may not be settled, nursing possesses qualities that entrust education to institutions of higher learning, has established policies for practitioners while allowing the nurse to function autonomously in practice, has a code of ethics in which to practice and has clear set of educational standards for continuing education. So, the discussion is particularly important when it is viewed from the perspective of a RN with an ADN degree who is enrolled in a RN to BSN programme, that is, the nurse is seeking to increase the current level of education under which he or she practices.
Nurses have specialized education and training validated by professional licensure in each state. We have a code of ethics and established practice standards we are bound to adhere to, a violation of which can result in our license being revoked or sanctioned. We have our own body of ongoing research that shapes and governs our practice. Nurses work autonomously without our scope of practice. We formulate and carry out our own plan of care for clients (when applicable); we apply judgment, use of critical thinking skills, and make nursing diagnosis.
Nurses use their specialized knowledge, experience, and skill set to initiate life-saving measures, improve and promote the health and well-being of the planet, and ease pain, suffering, and loss. We are all united in that common mission—regardless of where we work, our position title, or whether we are employed, unemployed, or self-employed.
The development of a culture of caring which encompasses the set of norms including altruism, excellence, caring, ethics, respect, communication, and accountability begins within the confines of nursing education. Undergraduate nursing curricula emphasize caring as a basic tenant of nursing education. The art and science of nursing involves all dimensions of patient care; a focus on the patient’s needs is paramount for the nursing student as the student develops a connection with the patient (Fahrenwald et al., 2005). A connection to the patient is part of the initiation of compassionate appropriate care. The establishment of core values in the education of a student nurse is part of the advancement of a strong caring culture in the nursing profession.
In conclusion, we can say that nurses play a very significant role for better health care in our society. Their profession can no way be ignored or neglected. Rather it has a bright and prestigious position with pride, honour and dignity. So the status of nurses

must be upgraded and virtually this sector needs to be reformed and taken care of nurses’ skill development.
The writer is a contributor to
The Independent

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Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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