INTRODUCTION TO PHILOSPHY AND

KNOWLEDGE DEVELPOEMENT IN
NURSING

NURSING PHILOSOPHY
INTRODUCTION
In the history of mankind, civilization didnt bring
happiness to his life. In his search for
happiness, perfection and truth, he was forced
to find answers to certain vital questions related
to his existence in nature, value of life and
universe. This attempt by man to solve his
worries through seeking solutions to many
unaddressed issues led to the development of
new discipline namely philosophy.

MEANING OF PHILOSOPHY

The term philosophy is derived from or can

be traced to the Greek word Philosophia
which is made up of two words Viz, Phileo
and sophia. Phileo means love and sophia
meanswisdom. Therefore, the literal
meaning of the word philosophy is love of
wisdom. It is concerned with search for
eternal truth. For example, since times
immemorial, there have been variuos
pursuits for unfolding the mystery of
universe, birth and death, sorrow and joy.

CONT..

The ultimate truth is till to be found out. The

eternal quest for truth lends the origin of
philosophy. A love of wisdom is the essence
of any philosophic investigation. Thus
philosophy means loving wisdom or
searching for wisdom. According to Planto:
He who has a taster for every short of
knowledge and who is curious to learn and/is
never satisfied, may be justly termed as
philosopher.

Thus, Philosophy is the study of the

principles of being, of all that is god, the
world, and man himself, and also it is the
study of origin, the nature and the activities
of all that is. It is study which helps answer
all the questions by investigating the causes
and reasons for all things in the universe.

DEFINITIONS OF PHILOSOPHY

Philosophy has been defined by various scholars

from various angles.
Philosophy is the science of sciences
- Coleridge
Philosophy is the science of knowledge
- Fitche
Philosophy is the mother of all arts and the true
medecine of mind.
Cisero
Philosophy is a persisitent effort of both ordinsry and
persisitne people to make life as intelligible and
meaningful as possible.
Bramold
Philosophy is the ability to feel at ease in any society.
Aristippus

CONT
Philosophy is the tenacious attempt of
reasoning men to think through the most
fundamental issues of life, to reach reasonable
conclusions on first and last things, to suggest
worthwhile goals that can command loyalty of
individuals and groups. Carlis lamont
For example The following is an example of a
philosophy of nursing education taken from Sri
Gokulum College of nursing, Salem, Tamil
Nadu.

PHILOSOPHY

All the staff of Sri Gokulam College of

Nursing believe that the men and women
shall receive an education of the highest
grade in the art and science of nursing to
equip them for service in the relief of
suffering and the promotion of [Link]
faculty of the College believes that the
professional nurse has a unique contribution
to make in promotion of health, prevention of
illness, care and rehabilitation of the
individual, families and community

CONT
The faculty believes that Nursing Education is
a process of growth directed towards the
development of the student as a person, as a
prospective members of the nursing
profession who will uphold the dignity of the
nursing profession and strives to establish
professional autonomy in nursing education,
service and research.

Nursing education is a combination of theory and practice

applied in a realistic environment with faculty guidance.
The social, cultural, intellectual and spiritual experiences
of a liberal and professional nature contribute to the total
development of the student for democratic living and
personal [Link] faculty believes that professional
nurse contributes nursing research work towards
continuous improvement and growth of nursing and
integrates nursing profession to [Link] faculty
believes that the purpose of nursing education is to
prepare nurses who are capable of delivering quality
nursing care in a holistic approach regardless of social,
ethnic and religious or political differences.

The professional nurse fulfills her responsibility as a

member of the community and as a citizen of the
country for its growth and development.
The faculty accepts that the minimum educational
requirement as per the Indian Nursing Council and
The Tamilnadu Dr. M.G.R. Medical University are
essential pre-requisites for the diploma, Degree and
post-graduate degree programme in [Link]
faculty believes that the provision of minimum
required facilities in the hostel promotes healthy and
comfortable living. The hostel life can make an
important contribution towards the objectives of the
College.

COURSE OUTLINE
NURSING COLLEGE ADMINISTRATION
Philosophy of college of nursing
The philosophy of college of nursing is
consistent with the university and with the
goals of the government of India. The college
philosophy focuses on the nature of the
person, environment, health, the profession
of nursing and the process of education.

Faculty believe that the person is a unique

and continuously evolving being of dignity
and growth. The persons behaviour reflects
the interaction between personal and
enviromental influences. Each person has
the right in making decisions which affect
health and to accept or refuse healthcare
within the context of safety to society.

The faculty view enviroment as all

external influences affecting the life and
development of the person. The health of
individuals, families and communities is
affected by these influences.

Health is viewed as a dynamic state arising

from continuous change in the person and
enviroment. The faculty view the promotion
maintenance and restoration of health as
complex phenomena involving the joint
responsibility of the person and healthcare
providers.

Nursing is the diagnosis and actual treatment of

actual or potential health problems. Nursing involves
supportive and therapeutic interventions based on
theoritical and scientific knowledge. The goal of
nursig is to promote health throughout lifespan,
prevent illness restore and/or maintain with dignity
essential life functions altered by illness. As
healthcare professionals, nurses exert leadership to
achieve a viable system of health care delivery and
assure quality nursing care. The nurses role that of a
healthcare provides who both independently and in
collaboration with others, assesses, plans,
implements and evaluates nursing care.

Nursing is a sunthesis of art and science.

The art of nursing requires that the
practitioner apply knowledged gained from
the humanities, arts and sciences to
understand human needs. The knowledge
provides the foundation for acceptance and
appreciation of the values of the person
which may differ from those of the nurse. The
science of nursing is the contemplation,
exploration and research of the person,
enviroment and health.

Education for professional nursing practice

includes a sound theoritical knowledge base
to support experiential responsibility foe
outcomes is mutually shared by students and
faculty. The intent of the educational
programs is to the focus on the
[Link] is a life long process, with
the commitment of the learner to establish
pattern of continued inquiry.

SAMPLE OF ORGANISATION CHART OF

COLLEGE OF NURSING
INC PURPOSE AND OBJECTIVES OF Bsc
NURSING PROGRAM
OBJECTIVES
ADMISSION REQUIREMENTS
DURATION
VACATION
PHYSICAL FACILITIES IN COLLEGE OF
NURSING OVERALL REQUIREMENTS

INC PURPOSE AND OBJECTIVES OF Bsc

NURSING PROGRAM
OBJECTIVES
ADMISSION REQUIREMENTS
DURATION
VACATION
PHYSICAL FACILITIES IN COLLEGE OF
NURSING OVERALL REQUIREMENTS
CLASSROOMS
FURNISHING AND EQUIPMENT

4 CONCEPTS IN NURSING METAPARADIGM

Nurse
Client
Health
Environment

CLIENT

ENVIRONMENT

HEALTH

NURSING

NURSING AS AN ACADEMIC DISCIPLINE

Discipline

is a branch of
knowledge ordered through the
theories and methods evolving
more than one worldview of the
phenomenon of concern.
It may be the branch of
educational instructions or a
department of learning or
knowledge.

WHAT DISTINGUISHES ONE ACADEMIC

DISCIPLINE FROM ANOTHER?

Structure(amount, relationship and ratio of type

of knowledge) and tradition(content)
Language

Worldview, i.e. philosophy

Professional disciplines practical; research is

prescriptive and descriptive

Methods of knowledge development

Methods of teaching

HISTORICAL ROOTS

The discipline of nursing slowly evolved from

the traditional role of women, apprenticeship,
humanitarian aims, religious ideals, intuition,
common sense, trial and error, theories, and
research, as well as the multiple influences
of medicine, technology, politics, war,
economics and feminism.

The first nurse-theorist, Florence Nightingale

(1969), viewed nursing as having organized
concepts and social relevance distinct from
medicine. Later, Henderson (1965) described
nursing as a unique, complex service with
independent practitioners who were authorities
on nursing care.

More recently, Roger's (1970) holistic

interpretations of persons have become a
critical point of departure in advancing theory by
defining nursing as an art and a science and by
providing a substantive base for theory testing.

In a landmark paper, Donaldson & Crowley

(1978) define a discipline as 'a unique
perspective, a distinct way of viewing all
phenomena, which ultimately defines the
limits and nature of its inquiry'. Since the time
of Florence Nightingale, nurse-scholars have
sought to explore, under- stand and explicate
the concepts central to the domain of
nursing: person, health, environment and
nursing.

NURSING AS AN EVOLVING DISCIPLINE

1866s
Disciplinary Paralleled
status
medicines
focus on
disease.
Emergence
of nursing
as a unique
service
with social
relevance
distinct
from
medicine

1950-1960

1970s

1980-1990

future

Theory
developmen
t begins.
Formal
separation
from
medical
focus on
disease.
Emphasis
on nursing
concept
&boundarie
s.

Theoretical
and scholarly
development
. Quest for
acceptance
as a
scientific
discipline.
Healthy lack
of
consensus.

Acceptance
into
scientific
community
as a unique
discipline.
Acceptance
of domain
concepts
and
boundaries
as a
paradigm of
nursing

Full
acceptance
as a
science.
Nurses
think
nursing.
Explicitly
defined
knowledge
on which to
base
practice.
Nursing
knowledge
for health
care

NURSING DISCIPLINE

Currently, nurse educators, scholars,

clinicians and researchers continue to
contribute to the discipline's cornerstone by
clarifying the work and role of nursing in
health care and advancing nursing
knowledge from a state of haphazard,
unverified thoughts to a discipline of
systematically organized concepts

HISTORICAL PERSPECTIVES OF
NURSING AND CONCEPTS OF
NURSING

INTRODUCTIONS
Nursing began as a desire to keep people
healthy and to provide comfort and
assurance to the sick.
Although the general goals of nursing have
remained relatively the same over the
centuries, ever-advancing science and the
changing of societys needs have deeply
influenced the practice of nursing.

STAGES OF NURSING

Nursing from Ancient times to the nineteenth

century
Early Civilization
Christianity
Middle Ages
Fifteenth to Nineteenth Century

EARLY CIVILIZATION

Egyptian physicians are believed to have

specialized in certain diseases (such as
internal diseases, fractured bones, and
wounds). They also hired women, later
known as midwives, to assist with childbirth.
These women were the first records nurses.

Greece
The Greeks believed in Apollo, the
Greek god of healing and prayed to him for
magic cures for their illness.
400 B.C., the famous Greek physician
Hippocrates believed that disease had
natural, not magical, causes.

Roman Empire
After 300 B.C., early physicians built
on the groundwork of their Egyptian and
Greek predecessors.
The Romans are best known for
advances in the health of the public

India

In ancient India, early hospitals were

staffed by male nurses who were required to
meet four qualifications: knowledge of the
manner in which drugs should be prepared
for administration, cleverness, devotedness
to the patient, and purity of mind and body.

CHRISTIANITY
With the beginning of Christianity, nursing
began to have a formal and more clearly
defined role.
Led by the belief that love and caring for
others were important, women made the first
visits to sick people, male gave nursing care
and buried the dead.
Nursing became a respected vocation.

MIDDLE AGES
More hospitals were built.
Nurses delivered custodial care and
depended on physicians for direction.
Nurse midwifery, as one of the oldest nursing
roles, flourished.
Much nursing care was provided by monks
and nuns, which was segregated by sex.

FIFTEENTH TO NINETEENTH CENTURY

The extensive population growth in cities, the
lack of hygiene and sanitation and the
increasing poverty in urban centers resulted
in serious health problem.
Society changed from one with a religious
orientation to one that emphasized warfare,
exploration, and expansion of knowledge.

Many monasteries and convents closed,

leading to a tremendous shortage of people
to care for the sick.
Women who had committed crimes were
recruited into nursing in lieu of serving
sentences.
The only acceptable nursing role was within
a religious order where services were
provided as part of Christianity charity.

PERIOD OF NIGHTINGALE
Florence Nightingale was born in 1820 in a
wealthy family;

FIFTEENTH TO NINETEENTH CENTURY

her education included the mastery of
several ancient and modern language,
literature, philosophy, history, science,
mathematics, religion, art and music;

she was determined to become a nurse

since she believed she was called by God to
help others and to improve the well-being of
mankind;
she visited Kaiserswerth and received
nurses training at 1850 for three months;

the outbreak of the Crimean War gave

Nightingale an opportunity for achievement;
Nightingale and her nurses transformed the
military hospitals by setting up diet kitchens,
a laundry, recreation centers, and reading
rooms, and organizing classes for orderlies;

after the war, Nightingale established the

Nightingale Training School for Nursed at St.
Thomas hospital in London; the school
served as a model for other training school;
as the founder of modern nursing, Florence
Nightingale established the first nursing
philosophy based on health maintenance
and restoration.

STAGES OF NURSING

Development of modern nursing

In the early twentieth century, a movement
toward a scientific, research-based defined
body of nursing knowledge and practice was
seen;

Development of modern nursing

Nursing Education:
in 1923, the Rockefeller Foundation funded a
survey on nursing education, which
recommended that nursing schools be
independent of hospital and on a college
level;
in 1924, one of the schools of nursing was
set up at Yale University;

Development of modern nursing

Nursing practice:
by 1920s, nursing specialization was
developing;
the concept of the clinical nurse specialist
arose;
from period of Nightingale, the system of
nursing management has been improving.

CONCEPT OF NURSING
3 stages of the concept of nursing:
disease centered, patient centered and
human health centered
International Council of Nurses, in 1973,
nursing is to assist the individual, sick or well,
in the performance of those activities
contributing to health or its recovery ,
preventing disease or peaceful death.

CONCEPT OF NURSING

The American Nurses Association, in 1980,

nursing is the diagnosis and treatment of
human responses to actual or potential
health problems.

TASKS OF NURSING
Relieving pains
Maintaining health
Restoring health
Promoting health and wellness

BODY OF NURSING KNOWLEDGE

Fundamental knowledge:
physical science
fundamental medical
psychological and social science
Knowledge specific to nursing:
clinical nursing: fundamental nursing,
specialty nursing, community nursing
nursing management
nursing education

CONT
Has practitioners who are motivated by
altruism
Can be taught through a process of
professional education.
Is basically intellectual (as opposed to
physical).
Improves its techniques by the use of
scientific method.
Functions autonomously.

NURSING AS A PROFESSION
INTRODUCTION:
Nursing has a fascinating history that
parallels the history of human kind. For, as
long as there has been life, so has been a
need to seek care & comfort from illness
and injury.

CONT..

From the dawn of civilization, evidence

prevails to support the premise, that
nurturing has been essential to the
preservation of life. Survival of the human
race therefore is inextricably intertwined with
the development of nursing.

CONT

The nursing has been called the oldest of

the arts and youngest of the profession. In
looking at the historical development of
nursing as a profession, time to time sociocultural has shaped the profession of
nursing.

DEFINITION OF PROFESSION:

Profession is defined as a vocation requiring

advance training and usually involving
mental rather than manual work, as teaching,
engineering, medicine, law or theology.
--- Webster 1989.

CHARACTERISTICS OF PROFESSION:
Abraham Flexner1910 conducted study of
medical education and went on to study on
other disciplines and later, in a paper
about social work published a list of
criteria that he felt were characteristics of
all true professional work:
Is basically intellectual
Is based on body of knowledge that can
be learned

CONT
Is

practical rather than theoretical

Can be taught through a process of
professional education
Has a strong internal organization
of members
Has practioners who r motivated
by altruism

The services provided are vital to humanity

and the welfare of society.
There is a special body of knowledge which
is continually enlarged through research.
The services involve intellectual activities;
individual responsibility (accountability) is a
strong feature.

Practitioners are educated in institutions of

higher learning.
Practitioners are relatively independent and
control their own policies and activities
(autonomy).
Practitioners are motivated by service
(altruism) and consider their word an
important component of their lives.

There is a code of ethics to guide the

decisions and conduct of practitioners.
There is an organization (association) which
encourages and supports high standards of
practice.

TRENDS IN THE DEVELOPMENT OF NURSING

EDUCATION IN INDIA
INTRODUCTION
Nursing originated independently, existed many
centuries without contact with modern medicine.
The member of the family at home met the
nursing needs of the sick. Evolution of medicine,
surgery and public health into complicated
technical area requiring many procedures by
persons specially trained and having
understanding of scientific principles, which
brought two professions closer and together.

CONT.

On 15th august 1947 India became independent

and self govermentation . Social changes were
taking place rapidly but an alarming absence of
public health and sanitary measures continued.
The ratio of nurse to patient remained
dangerously low. The opening of nursing
schools associated with college gave nursing
profession a higher social and economic status,
than it had previously known. The formation of
many commissions and committees,
establishment of INC and tremendous work of
TNAI brought about change in nursing
education post independence.

BEGINNING OF MODERN NURSING

Since independence in 1947 many changes

have taken place and the attitude towards
nursing is still changing. More women are
being educated and many are taking up
nursing as their profession. Modern nursing
education started on the basis of Florence
Nightingales work and training plan
developed in hospital school of in London.
The main reasons upon which nightingale
established that first school were the
following :

CONT.

Nurses should be technically trained in hospitals

organized for that purpose.
Nurses should live in home fit to form their moral
character and discipline.
Florence Nightingale is credited with rounding ordinary
nursing and created the first educational system for
nurses. After hospitals came into existence in western
Europe and prior to the influence of Florence Nightingale,
hospital care was given by the such as prisoners, and
lower economic group, who were held in very low regard
by societies. More women learned to give care by doing
it. There was no organized program in educate nurses.

CONT

Nightingale stressed that nursing was not

domestic, charitable service. But a respected
occupation requiring advanced education .
She opened a school of nursing at St
Thomas hospital London in 1860 and
established the following basic principles for
the school.

The nurse should be trained in an educational institution

suggested by public funds and associated with a medical school.
The nursing school should be affiliated with a teaching hospital
but independent of it.
The curriculum should include both theory and practical
experience.
Professional nurses should be in charge of administration and
instruction and should be paid for their institution.
Students should be carefully selected and should reside in
nurses houses than form discipline and character.
Students should be required to attend lectures, take quizzes,
write papers and keep diaries. Student record should be
maintained. The demand for well trained nurses started easily in
the development of nursing education program.

MILITARY NURSING

Military nursing was the earliest type of nursing.

In 1964 the east India Company helped to start
a hospital for soldiers at fort St George, madras.
Later a civilian hospital was built and the
medical staff appointed by the east India
company, served in both hospitals. In 1797 a
lying in hospital was built and in 1854 the
government sanctioned a training school for
midwives. In 1861, through the efforts of Miss
Nightingale, reforms in military hospitals led to
reforms in civilian hospitals. Efforts were made
to provide health services for the people of
India. This laid the foundation for public health
nursing.

CIVILIAN HOSPITALS

Nursing in the military hospitals was of poor quality

carried on by male orderliness, and the menial staff. In
1871 the government general hospital, Madras, undertook
a plan to train nurses. Nurses were brought from England
to be in charge and the first six students were those who
had previously received their diploma in midwifery. Later
this plan was reversed general training was taken first,
followed by a course in midwifery. In Mumbai, among the
earliest hospitals in the Jamesedjee Jeejeebhoy group,
the first of which was opened in 1843.
Another hospital which was to play an important part in
the development of modern nursing in India was the
Pestanji Hormusji Cama hospital for women and children
which was founded in 1883 but not opened until 1886.

CONT.

Provisions for the nursing care of patients in these early

hospitals were very limited. In the JJGroup nursing was
done by medical students and menials until 1878 when
the government invited the sisters of the community of all
saints to come from England and taken over the work of
nursing. Their work was appreciated and the need for
training nurses was felt. At this time it was difficult to get
nurses. There were only a few Anglo- Indian and Indian
Christian girls working in missions hospitals. The sisters
of all saints took the first steps to establish a training
school for nurses in this hospital. In 1891, Bai Kashibai
Ganpat , was the first Indian nurse to come for training.
Training was at first 2 years but became three years when
the Bombay Presidency Nursing Association was
established in 1909.

MISSION HOSPITALS

Mission hospitals were the first to begin the

training of Indian as nurses, very gradually
overcoming the prejudices of parents against
sending their girls for a training which was
felt to be beneath the dignity of decent
educated girls. Religion prevented Hindu and
Muslim girls from joining at all and so only
Christian girls could be trained at first. But for
many years even they felt nursing was an
inferior profession.

In the beginning there was no uniformity of course or

educational requirements. About 1907 1910 the
north India united board of examiners for mission
hospitals was organized and set up rules for
admissions and standard of training and conducted a
public examination . On 24th may 1909 the Indian
medical mission association granted the nursing
diploma after examining student by central board for
nurses training schools in south India. A few years
later in mid India and the south India boards of nurse
examiners were similarly set up. These are
examining boards of the nurses. League of the
Christian medical association of India. The name of
the south India Board was changed to The board of
nursing education Nurses league of Christian
medical association on India, south India Branch in
1975.

THE DUFFERIN FUND

Until the late 19th century there were no women

doctors and therefore no care for women except in
mission hospitals. The fact was brought to the
attention of Queen Victoria. At this time lady Dufferin
was coming out to India and asked her to take a
special interest in this problem. Lady Dufferin wrote to
her friends and influential people to get financial aid.
Thus, in 1885 lady Dufferin was responsible for
starting the national association for supplying
medical aid by women of India . This is commonly
called the dufferin fund and continues to provide
medical education for women, to train nurses and
midwives for hospitals and private work and to
improve medical facilities for women.

Between 1890 and 1900 many schools, under either

missions or government, were started in various parts
of India. There was a need for systematic training for
nurses like thst given in the Nightingale school, in
England. Thus it was that in 1886, money from the
dufferin and was made available for this purpose.
Miss Atkinson a Nightingale nurse was brought out
from England to Mumbai to set up and be the
superintendent of the first modern training school for
nurses in India. The school was established in the
cama hospital for women and children in 1891. It
begins with a one year course but by 1905 it had
been extended to three years.

TEXTBOOKS

One of the handicaps in the development of nursing

schools was the lack of textbooks. In other countries
books had been written by doctors and nurses. Some of
these were translated into the vernacular for the early
schools. Many English and American textbooks are being
used in the schools today. There is a great need for
textbooks which have been written by Indian nurses. A
beginning has been made in this work and the first
textbook for nurses in India, was put forth by the south
India examining board of the nurses league of the
Christian medical association of India in 1941. The
nurses, league has also directed the publishing of a
textbook for auxiliary nurse midwives first printed in 1967.

CONT.

This book was completely revised and published in 2

volumes in 1985 as a textbook for the health worker
(ANM) to meet the needs of the health worker. Several
manuals related to the basic sciences and nursing have
been published by other professional nursing bodies.
Although progress has been made in the publication of
textbooks by the nurses of India, there remains a wide
area of subjects which have not been touched upon and
the general need for more and more varied textbooks
continues. The author of this text also written titled
community health nursing. Nursing administrations,
Nursing research, Fundamental of nursing, nursing
educations and medical surgical nursing published
through M/S Jaypee Brothers medical publishers New
Delhi.

NURSING EDUCATION

Nursing education in India began with very brief

periods of training as mentioned in the first part.
Orderliness and midwives were often chosen for this
and were given a period of two to 6 months of closely
supervised practical experience in general nursing,
then called sick nursing. This was training in the
hospital and certificates were given after completion
of training.
The basic program for combined general nursing and
midwifery developed rapidly after 1871. The need for
theory as well as practical experience was felt. The
training for general nursing was extended to two
years and then three years before the student went
on for midwifery training.

The present basic program for nursing

education throughout India consists of a 3
year program in general nursing and six to
seven months in midwifery. Uniformity of
training is maintained by recognition of
schools which meet the standards and
requirements given by the Indian nursing
council. The basic certificate program now
includes all areas of nursing as well as
integrated community health nursing.

Post certificate courses were first offered in nursing

administration, supervision and teaching. These
originated at the college of nursing, New Delhi, the
college of nursing, CMC hospital, Vellore and the
government general hospital, Chennai. The first four
year basic bachelor degree programs were
established in 1946 at the college of nursing in New
Delhi and Vellore. This program is now offered at a
number of other colleges. In 1963 the school of
nursing in Trivandrum instituted the first two year post
certificate bachelor degree program. Other schools
have begun this program since that time.

The first masters degree course, a two year

postgraduate program, was begun in 1960 at
the college of nursing in New Delhi.

AUXILLIARY NURSING

The use auxiliary nursing personnel to ease the

shortage of professional nurses had been
common in some countries when it was first put
into practice in India. A two year program for the
auxiliary nurse midwife was first established in
1951 at St Marys hospital, Tarn Taran in Punjab
state. By 1962, there were 263 courses being
offered in India. The auxiliary nurse midwife is
prepared to practice elementary nursing and full
midwifery. She functions primarily in the
community rather than the hospital.

CONT.

The practice of the auxiliary nurse midwife

has helped, to improve the amount of care
given to the patient as well as the health
teaching given to the public. In 1977 the
ANM course was completely revised by the
Indian nursing council and expanded to
include sociology, health education and
communication skills and subjects necessary
to equip the multipurpose health worker/ANM
to serve effectively as a primary health care
worker in the community.

DEVELOPMENT OF NURSING EDUCATION IN

INDIA (POST INDEPENDENCE)
Trained association of India
TNAI helps the initiation of university level education
in India. Recommendations of the Bhore Committee
were implemented within year
Passing of the INC ACT
Deputation of Indian nurses abroad for post basic
education.
The TNAI made significant achievements in the
field of nursing education. It creates awareness
among nurses through nursing journals of India and
organizing continuing education programmes. TNAI
also offers scholarships to deserving candidates to
take up studies within the country and abroad.

ESTABLISHMENT OF INDIAN NURSING COUNCIL

The INC was constituted to establish a uniform standard

of education for nurses, midwives, health visitors and
auxiliary nurse midwives. The INC act was passed
following an ordinance on December 31st 1947. The
council was constituted in 1949.
MAIN PURPOSE OF THE COUNCIL
To set standards and to regulate the nursing education of
all types in the country.
To prescribe and specify minimum requirement for
qualifying for a particular course in nursing.
Advisory role in the state nursing council.
To collaborate with state nursing councils, schools and
colleges of nursing and examination board.

STATE REGISTRATION COUNCIL

Functions :
Inspect and accredit schools of nursing in their
state.
Conduct the examinations
Prescribe rules of conduct
Maintain registers of nurses , midwives, ANM
and health visitors in the state.
The state registration council are autonomous
except they do not have power to prescribe the
syllabus for courses.

RECOMMNEDATIONS OF VARIOUS COMMITTEES

PERTAINING TO NURSING EDUCATION

.
The recommendations given by committees and
commission provided guidelines for improvement and
growth of nursing education.
Health survey and development committee (Bhore
committee) 1946
Establishment of nursing college and creation of an all
India nursing council
Shetty committee 1954
Improvement in conditions of training for nurses
Minimum requirement for admission to be in accordance
with regulation of the INC.

CONT..

Health survey and planning committee ( Mudaliar

committee) 1959-61
Three grades of nurses viz , the basic nurses(
4years) auxiliary nurse midwife (2yrs) and nurses
with a degree qualification.
For GNM minimum entrance qualification
matriculation
For degree course passed higher secondary or pre
university
Medium of instruction preferably English in general
nursing.
Degree course should be taught only in English.

Mukherjee committee, 1966

Training of nurses and ANMS required for
family planning
Kartar singh committee 1972-73
Multipurpose health worker scheme
Change in designation of ANMS and LHV
Setting up of training division at the ministry
of health and family welfare

Sarojini Varadappan committee, 1990 ( a high

power committee on nursing and nursing
profession)
Two levels of nursing personnel
Post basic Bsc nursing degree to continue
Master in nursing programme to be increased and
strengthening
Doctorate in nursing programme to be started in
selected university.
Continuing education and staff development for
nurses.

CONT.
Working groups on nursing education and
manpower, 1991
By 2020 the GNM programme to be phased out
Curriculum of Bsc nursing to be modified
Staffing norm should be as per INC
There should be deliberate plan for preparation
of teachers Msc/Mphil and Phd degrees.
Improvement in functioning of INC
Importance of continuing education for nurses.

DEVELOPMENT OF NURSING EDUCATION

1. Training of dais( birth attendant)
The dais training continued post independence.
The goal was to train one dai in each village and
ultimate goal was to train all the practicing dais
in the country. Duration of training was 30 days.
No age limits was prescribed, training include
theory and practice, more emphasis on field
practice. This training was done at sub centre
and equipments provided by UNICEF.

2. Auxiliary nurse midwife

In 1950 Indian nursing council came out with some
important decisions relating to future patterns of nursing
training in India. One of the important decisions was that
there should be only two standard of training nursing and
midwifery, subsequently the curriculum for these courses
were prescribed.
The first course was started at St Marys hospital Punjab,
1951. The entrance qualification was up to 7/8 years of
schooling. The period of training was 2 years which
include a 9 month of midwifery and 3 months of
community experience.
.

CONT.
In 1977, as a result of the decision to prepare
multipurpose health worker and
vocationalization of higher secondary education,
curriculum was revised and designed to have
1.5 years of vocationalized ANM programme
and six months of general education. The
entrance qualification was raised from 7th
passed to matriculation passed.
Under multipurpose scheme promotional
avenue was opened to senior ANMs for
undergoing six months promotional training for
which course was prescribed by INC

3. Lady health visitor course

Training of LHV course continued post
independence. The syllabus prepared and
prescribed by INC in 1951. The entrance
qualification was matriculation. The duration
was two and a half years which subsequently
reduced to 2 years.

4. General nursing and midwifery course

GNM course existed since early years of century. In 1951,
syllabus was prescribed by INC. In 1954 a special
provision was made for male nurse. In 1954 public health
nurse was integrated into basic nursing course.
First revision of the course was done in 1963. In 1964-65
psychiatric nurse included in curriculum. The duration of
course was reduced from 4 years to 3.5 years. Second
revision was done 1982. The duration of the course
reduced to 3 years. The midwifery training of one year
duration was gradually reduced to 9 months and then 6
months, finally 3 year integrated programme of GNM was
prescribed in 1982.

5. Post-basic / Post certificate short term courses

and diploma programmes
During 1948-50 four nurses were sent to the U.K by
govt of India for mental health nursing diploma.
During 1954 manzil medical health centre, lucknow
gave psychiatric nursing orientation course of 4-6
weeks duration. In 1951 a one year course in public
health was started at college of nursing Delhi. Govt of
India felt urgent need for psychiatric nurses during
1953-54 this resulted in first organized course at All
India institute of mental health nursing. Delhi.

6. Ph.D in nursing
Indian nurses were sent abroad for PhD
programme earlier. From 1992 PhD in
nursing is also available in India. MAHI is
one of the universities having PhD
programme.

CURRENT EDUCATIONAL PATTERNS IN NURSING

Non university programme

Basic ANM-GNM
Advanced post certificate diploma
University programme
Basic Bsc (N)
Post Basic Bsc(N) IGNOU
Advance [Link] (Nursing)
[Link]
Ph.D
Trends in nursing education changes from basic
general nursing service to doctorate education in
nursing.