Nursing in India
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History indicates that the principles and practices of nursing in India are ancient. Prior to the 20th century, Indian nurses were usually young men, with women acting as midwives for assisting with childbirth. The acceptance of nursing as a profession in India is improved a lot with good quality of education and clinical exposure to students. Majority of Indian Nurses tend to move to abroad countries like Australia, Canada, USA, UK etc. as the better pay and working conditions.
Military nursing was the earliest type of modern nursing. In 1664 the East India Company started a hospital for soldiers in a house at Fort St. George, Madras. The first sisters were sent from St Thomas' Hospital, London to this military hospital.
In 1797 a Lying-in-Hospital (maternity hospital) for the poor of Madras was built with the help of subscriptions by John Underwood. In 1854 the government sanctioned a training school for midwives in Madras.
Florence Nightingale was the first woman to have great influence over nursing in India and had a close knowledge of Indian conditions, especially in the army. She was interested in the nursing service for the civilian population, though her first interest was the welfare of the army in India.
In 1865, Nightingale drew up some detailed "Suggestions on a system of nursing for hospitals in India". Graduates were sent out from the Nightingale School of Nurses at St Thomas' Hospital, England to start similar schools in India. St Stephen's Hospital, Delhi was the first one to begin training the Indian women as nurses in 1867.
In 1871, the first school of nursing was started in Government General Hospital, Madras with a six-month diploma midwives programme with four students. The first nursing school for women was started at Kanpur's Saint Catherine's Hospital by Dr Alice Marval.
Four female superintendents and four trained nurses from England were posted to Madras. Between 1890 and 1900, many schools, under either missions or government, were started in various parts of India. In the 20th century, national nursing associations were started.
In 1897, B. C. Roy worked to the standards of nursing and nurses of both sexes.
In 1908, the Trained Nurses Association of India was formed to uphold the dignity and honour of the nursing profession.
In 1918, training schools were started for health visitors and dais, at Delhi and Karachi. Two English nurses, Griffin and Graham, were appointed to give training and to supervise the nurses.
In 1926, Madras State formed the first registration council to provide basic standards in education and training. The first four-year bachelor's degree programme was established in 1946 at the college of nursing in Delhi and the Christian Medical College and Hospital (CMCH) in Vellore.
In 1947, after Indian independence, the community development programme and the expansion of hospital service created a large demand for nurses, auxiliary nurse midwives, health visitors, midwives, nursing tutors and nursing administrators.
The Indian Nursing Council was passed by ordinance on December 31, 1947. The council was constituted in 1949.
In 1956, Adrenwala was appointed as the Nursing Advisor to Government of India. The development of Nursing in India was greatly influenced by the Christian missionaries, WorldWar, British rule and by the International agencies such as the World Health Organization UNICEF, the Red Cross, UNSAID etc.
The first master’s degree course, a two-year postgraduate programme was begun in 1960 at the Rajkumari Amrit Kaur College of Nursing, Delhi. In 1963, the School of Nursing in Trivandrum, instituted the first two-year post certificate bachelor's degree programme.
Associations such as the International Council of Nurses, the nurses auxiliary of the CMA of India, T.N.A.I. Indian Nursing Council and State level Registration Council promote and support the nursing profession.
Nursing specialties and areas of practice in India
There was a time when professional nurses had very little choice of service because nursing was centred in the hospital on bedside nursing. Career opportunities are more varied now for a number of reasons. Career options include:
- A staff nurse provides direct patient care to one patient or a group of patients. Assists ward management and supervision. Directly responsible to the ward supervisor.
- Ward sister or nursing supervisor, responsible to the nursing superintendent for the nursing care management of a ward or unit. Takes full charge of the ward. Assigns work to nursing and non-nursing personnel working in the ward. Responsible for safety and comfort of patients in the ward. Provides teaching sessions if it is a teaching hospital.
- Department supervisor/assistant nursing superintendent responsible to the nursing superintendent and deputy nursing superintendent for the nursing care and management of more than one ward or unit for example the surgical department or out-patient department.
- Deputy nursing superintendent responsible to the nursing superintendent and assists in the nursing administration of the hospital.
- Nursing superintendent responsible to the medical superintendent for safe and efficient management of hospital nursing services.
- A Director of Nursing is responsible for both nursing service and nursing educations within a teaching hospital.
- Community Health Nurse (CHN) services focus on the reproductive child health programme.
- Teaching in nursing. The functions and responsibilities of the nursing instructor include planning, teaching and supervising the learning experiences for students. Positions in nursing education include clinical instructor, tutor, senior tutor, lecturer, and associate professor, Reader in nursing and professor in nursing.
- Industrial nurses provide first aid, care during illness, health education about industrial hazards and prevention of accidents.
- The Military Nursing Service became a part of the Indian Army, and nurses became commissioned officers who earned ranks from lieutenant to major general.
- Nursing service abroad, salaries and professional opportunities have led to increases in nursing service abroad.
- Nursing service administrative positions. At the state level the Deputy Director of Nursing at the state health directorate. The highest administrative position on a national level is the Nursing Advisor to the Govt. of India.
- Nursing informatics is also an area of practice for Nurses in India.
- Wilkinson, Alice (1958). A brief history of nursing in India and Pakistan. Delhi: Trained Nurses’ Association of India.