Nursing Education in India

DEVELOPMENT AND MAINTENANCE OF STANDARDS AND ACCREDITATION IN NURSING EDUCATION PROGRAMS  Role of INC, State Registration Nursing Coun il, !oar"s an" Uni#ersit$  Role of Professional asso iations an" unions INTRODUCTION Nursing education is the professional education for the preparation of Nurses to enable them to render professional nursing care to people of all ages, in all phases of health and illness in a variety of settings. Education should impart scientific and uptodate knowledge in the area of medical, social, behavioural and biological sciences. Nursing education should prepare nurses as good leaders to provide qualitative care. NURSING EDUCATION IN INDIA The Nursing Council Act came into e istence in !"#$ to constitute a council of nurses who would safeguard the quality of nursing education in the country. The mandate was to establish and maintain uniform standards of nursing education. Today, the %ndian Nursing Council is a statutory body that regulates nursing education in the country through prescription, inspection, e amination, certification and maintaining its stand for a uniform syllabus at each level of nursing education. They have also ensured easier measures for equivalence, e change and practice for nurses in any part of the country. &n the other hand, the strive for maintenance of a uniform standard and'pattern of nursing education has curbed creative development and e periments for e pansion of nursing into newer hori(ons of caring and function.

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T$%es of Nursing Progra&s ADMISSION TERMS ' CONDITION FOR SC(OOL ) COLLEGE OF NURSING

No*

Nursing Progra &s Au+iliar$ Nurse ' Mi",ife

Eligibility Criteria

Training E+a&ination Duration Nursing E amination -oard

Registration

!

!) *ass

! and !+, years

..AN/

,

General Nursing ' Mi",ifer$

!)0, Class pass with aggregate of #)1

2 and !+, years

Nursing E amination -oard

..N 3 ../

2

!* S -!asi .

!)0, Class *ass with #41 aggregate in *C-E

# years

5niversity

..N 3 ../

Regular !*S -Post !asi . !)0, 0 6N/ Distan e !)0, 6N/ 0 ,year E p. -.8c. Nursing + -.8c. 9ons. Nursing + *ost -asic -.8c. Nursing with minimum of 441 aggregate marks. one year of e perience after -asic -.8c. or *ost -asic -.8c. Nursing. ! year ;<ull time= , years ;part time= 2'4 years Additional 7ualification Additional 7ualification 2 years , years 5niversity Additional 7ualification

#

4

M* S *

, years

5niversity

Additional 7ualification

:

M* P/il

/. 8c.

5niversity

>

P/ D Post !asi S%e ialt$ Di%lo&a Courses

/. 8c.+ /. *hil

5niversity

$

..N 3 ../ one year of clinical e perience

&ne ?ear

-oard or 5niversity

Additional 7ualifications

,

M*S *  Any organi(ation under the Central 6overnment, 8tate 6overnment, @ocal body or a *rivate or *ublic Trust, /ission, Aoluntary registered under 8ociety .egistration Act or a Company registered under companyBs act wishes to open a /.8c. Nursing programme, should obtain the No &bCection+Essentiality certificate from the 8tate 6overnment.  If the institution is recognized for B.Sc. (N) programme and if one batch has passed out after found suitable by INC, then the institution ill be e!empted from N"C#Essentiality certificate for $.Sc.(N) programe from the State %o&ernment.  The %ndian Nursing council on receipt of the proposal from the %nstitution to start nursing program, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme.  After the receipt of the permission to start the nursing programme from %ndian Nursing Council, the institution shall obtain the approval from the 8tate Nursing Council and 5niversity.  %nstitution will admit the students only after taking approval of 8tate Nursing Council and 5niversity.  The %ndian Nursing Council will conduct inspection every year till the first batch completes the programme. *ermission will be given year by year till the first batch completes.  %f the institution is recogni(ed for -.8c. ;N= programme and if one batch has passed out after found suitable by %NC, then the institution will be e empted from N&C+Essentiality certificate for /.8c.;N= programe from the 8tate 6overnment.
 Su%er S%e ialit$ (os%ital0 can start /.8c.;N= programme,

however they have to get N&C+Essentiality certificate from respective 8tate 6overnment to start the /.8c. ;N= programme.
'Super Speciality (ospital are eligible to start $.Sc.(N) pro&ided they ha&e respecti&e speciality beds

U%gra"ation fro& S /ool to College
 Any DSchool of NursingD can upgrade to DCollege of NursingD

provided one batch of students have passed out after found suitable by %NC. <urther on up'gradation institution has to stop 6N/ *rograms.

2

 Do u&ents to 1e su1&itte" to INC for U%gra"ation2
o

Eecision of the management committee to upgrade school of nursing to college of nursing. Consent letter of the university to which the college needs affiliation.

o

Regulation of M*S *
•

M*S * -N.

%f parent hospital is super'specialty hospital like cardio'thoracic hospital+cancer with annual intake !) /.8c;N= in cardio thoracic+cancer
o o o

*rofessor cum coordinator ! .eader + Associate *rofessor ! @ecturer ,

The above faculty shall perform dual role.
•

M*S * -N. Annual intake of :) students in -.8c.;N= and ,4 students for /.8c. ;N= programme.
o o o o o

*rofessor'cum'*rincipal *rofessor'cum'Aice *rincipal .eader + Associate *rofessor @ecturer Tutor + Clinical %nstructor

'! '! '4 '$ ' !" ''''''''''''''' Total ' 2#

•

&ne in each specialty and all the /.8c;N= qualified teaching faculty will participate in all collegiate programmes. Tea /er Stu"ent Ratio 3 4 2 45 for M*S *-N. %rogra&&e* 6UALIFICATIONS ' E7PERIENCE OF TEAC(ERS OF COLLEGE OF NURSING

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Sr* No* 4

Post

6ualifi ation ' E+%erien e

Professor8 u&8 ' /asters Eegree in Nursing Prin i%al ' !# years e perience after /.8c. ;N= in College of Nursing . ' 2 years e perience in administration ;?ears of e perience is rela able if suitable candidate is not available= ;%f a candidate is not
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available, minimum 4 years of e perience in college of nursing, with an aggregate of !# years teaching e perience= Desira1le 2 In"e%en"ent %u1lis/e" ,or9 of /ig/ stan"ar" ) "o torate "egree ) M*P/il* : Professor8 u&8 Vi e Prin i%al ' /asters Eegree in Nursing ' !# years e perience after /.8c. ;N= in College of Nursing . ' 2 years e perience in administration ;?ears of e perience is rela able if suitable candidate is not available= ;%f a candidate is not available, minimum 4 years of e perience in college of nursing, with an aggregate of !# years teaching e perience= Desira1le 2 In"e%en"ent %u1lis/e" ,or9 of /ig/ stan"ar" ) "o torate "egree ) M*P/il* ; Rea"er ) Asso iate ' /aster Eegree in Nursing. Professor ' !) years e perience after /.8c.;N= in a College of Nursing. ;%f a candidate is not available, 4 years of e perience in College of Nursing with an aggregates of !) years teaching e perience.

Desira1le 2 In"e%en"ent %u1lis/e" ,or9 of /ig/ stan"ar" )"o torate "egree ) M*P/il* < Le turer ' /aster Eegree in Nursing. ' 2 years teaching e perience after /.8c. ;N=

Note2 )ualifications * E!perience of Nursing +eaching faculty rela!ed till ,-., * placed under /nne!ure 0 I
External /Guest faculty may be arranged for the selected units in different subjects as required

NOTE2
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No part time nursing faculty will be counted for calculating total no. of faculty required for a college.

4

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%rrespective of number of admissions, all faculty positions ;*rofessor to @ecturer= must be filled. <or M*S *-N. %rogra&&e appropriate number of /.8c. faculty in each speciality be appointed subCect to the condition that total number of teaching faculty ceiling is maintained. All nursing teachers must possess a basic university or equivalent qualification as laid down in the schedules of the %ndian Nursing Council Act, !"#>. They shall be registered under the 8tate Nursing .egistration Act. Nursing faculty in nursing college e cept tutor+clinical instructors must possess the requisite recogni(ed postgraduate qualification in nursing subCects. 9olders of equivalent postgraduate qualifications, which may be approved by the %ndian Nursing Council from time to time, may be considered to have the requisite recogni(ed postgraduate qualification in the subCect concerned. All teachers of nursing other than *rincipal and Aice'*rincipal should spend at least # hours in the clinical area for clinical teaching and+or supervision of care every day.

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•

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ACCREDITATION IN NURSING Accreditation is a certification of the academic quality of an institution of higher learning. 8ome countries have independent+private organi(ations that oversee the educational accreditation process, while other countries accredit through a government agency. 8ome countries require accreditation and others consider it voluntary. %n either case accreditation denotes academic quality and schools that lack recogni(ed accreditation often claim accreditation from unrecogni(ed sources. 5nrecogni(ed accreditations are meaningless to the academic community. =/at is t/e o1>e ti#e of a re"itation?
 Accreditation is a voluntary, privately managed process of peer

evaluation programs.

of

post'secondary

education

institutions

and

 -eing accredited imparts to the public, potential students,

educational institutions, government agencies, lenders, and others that the institution or program meets an established standard of quality.
 %n order for students, programs, or institutions to be eligible for

federal support under the 9igher Education Act of !":4 or the
:

Nurse Education Act ;Title A%%% of the *ublic 9ealth 8ervice Act=, a program or institution must be accredited by an agency recogni(ed by the 5.8. Eepartment of Education ;E&E= and be recogni(ed in the published list of accrediting agencies. Thus, accrediting agencies play a critically important role as gatekeepers for access to federal funds.
 There are two types of accreditationF institutional ;as performed

by various regional agencies, and by the National @eague for Nursing ;N@N= for schools, such as hospital. diploma programs, not within a higher education institution=, and speciali(ed or programmatic ;such as performed by N@N and specialty nursing organi(ations for nursing schools within higher education institutions=.  All regional accrediting bodies have had, for a number of years, recognition status from the E&E. -accalaureate and graduate' degree nursing programs already meet E&E criteria due to their position within regionally accredited institutions. (o, is nursing e"u ation urrentl$ a re"ite"? A variety of organi(ations currently conduct speciali(ed accreditation of nursing education, including the National @eague for Nursing ;for all levels of nursing education, including practical, hospital diploma, as well as associate', baccalaureate', and masterBs'degree programs=, the American Association of Nurse Anesthetists ;for nurse anesthesia education=, the American College of Nurse'/idwives ;for preaccreditation and accreditation of nurse'midwifery programs=, and the American Nurses Association ;for continuing education=. %n addition, programs in institutions of higher education are reviewed by regional accrediting agencies, as well as by state agencies such as boards of education or state boards of nursing charged with approval of nursing education programs. /oreover, a variety of other nursing organi(ations have e pressed interest in creating additional accreditation review processes for oversight of graduate'level nursing education, such as nurse practitioner programs. In"ia Accreditation for universities in %ndia are required by law unless it was created through an act of *arliament. Githout accreditation %t is emphasi(ed that these fake institutions have no legal entity to call themselves as 5niversity+Aishwvidyalaya and to award HdegreeB which are not treated as valid for academic+employment purposes.I

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Accreditation for higher learning is overseen by autonomous institutions established by the 5niversity 6rants CommissionF  All %ndia Council for Technical Education ;A%CTE= including the National -oard of Accreditation ;N-A=  Eistance Education Council ;EEC=  %ndian Council for Agriculture .esearch ;%CA.=  -ar Council of %ndia ;-C%=  National Council for Teacher Education ;NCTE=  .ehabilitation Council of %ndia ;.C%=  /edical Council of %ndia ;/C%=  *harmacy Council of %ndia ;*C%=  %ndian Nursing Council ;%NC=  Eentist Council of %ndia ;EC%=  Central Council of 9omeopathy ;CC9=  Central Council of %ndian /edicine ;CC%/=  -oard of Theological Education of the 8enate of 8erampore College ;-TE88C= Go#ern&ent A%%ro#a1le Of Nursing Progra&s
 %n most states, the approval accrediting activities for nursing

programs are carried out through the state board of nursing.
 After registration laws were passed. 8tate boards of nursing

began to emerge for the purpose of licensing nurses and protecting the public. %nspectors from the boards began making program visits for approval. Through the ANA, the Council of 8tate -oards of Nursing was created to have a common forum for those who had the responsibility to regulate the practice of nursing in each state. %n !">$, the National Council of 8tate -oards of Nursing, %nc. ;NC8-N= was formed to replace the ANA Council. NC8-N provided greater independence of the regulatory authorities from the professional organi(ation.
 Ghen a new nursing program is to be initiated, it must provide

preliminary information to the appropriate state government department while in the planning phase, often in the form of a feasibility study or a self study or both. The nursing program must be approved prior to admitting students to assure prospective students that the program will provide the
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preparation they seek. Each state also has a designated time frame to renew its approval of e isting nursing programs. This often involves a comprehensive evaluation study, done by the program+school, that is submitted to the stat.
 .epresentatives of the state approval authority then visit the

program. %n some Curisdictions, a school that has received national accreditation from the National @eague for Nursing Accreditation Commission ;N@NAC= or the Commission on Collegiate Nursing Education ;CCNE= is not required to be further reviewed for state approval=. RULES AND REGULATIONS FOR ACCREDITATION A* CONFIDENTIALIT@ OF ACCREDITATION INFORMATION All data, observations, conversations, conclusions, reports, and minutes relating to accrediting activities are C&N<%EENT%A@. Acceptance of an invitation to be a visitor constitutes a contractual agreement to safeguard the confidentiality of accrediting data. !* T@PES OF ACCREDITATION The -oard shall grant to a state nursing degree program one of the following types of accreditationF 4* Initial A re"itation a. 6ranted when the program is in compliance with all standards for a new program. *ermission is granted to admit students and the ne t review is in the final semester of the first class in conCunction with the initial national review. b. Eenied when the program does not meet all standards for a new program. The program may reapply at any time. :* Continuing A re"itation a. <ull Accreditation. All standards are met. The ne t review is in conCunction with the ne t national visit.
b. <ull Accreditation with .ecommendations. The program meets all

but one or two standards. A performance improvement plan must be submitted within three months. The program must be in compliance within one year. c. Accreditation with a statement of warning. The program does not meet three or more standards &. the performance improvement plan has not resulted in compliance with standards. A follow up focused visit is scheduled within two years.

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;* =it/"ra,al of A re"itation* %f the program is not in compliance within the time frame allowed in the 8tatement of Garning, accreditation will be withdrawn. STANDARDS FOR ACCREDITATION All state standards must be met by all programs of nursing in /ississippi in order to be fully accredited. a* A"&inistrati#e OrganiAation  An organi(ational chart depicts the relationship of the nursing unit to the parent institution,  /inimum requirements for administrators areF
o Associate degree ' /asterBs in nursing from a regionally

accredited institution and a minimum of one year of clinical e perience.
o -accalaureate and higher degree ' Eoctorate with one

graduate degree in nursing from a regionally acrcdite# institution and a minimum of one year of clinical e perience. %t is preferred that second level administrators ;i.e. Associate+Assistant Eean+Eirector= hold a Eoctorate with one graduate degree in nursing.
o All ' unencumbered current license to practice in /ississippi

&. a valid license from another Compact state ANE satisfactory criminal history background check.  The administrator, with faculty involvement, has authority and responsibility for the followingF
o *reparation and administration of the budgetJ o 8creening

and recommending candidates for faculty appointments, retention, and promotion and tenureJ and

o All administrative and leadership activities of the position.  Nursing personnel policies are not illegally discriminatory, are written, accessible, and the same as for other faculty and staff.  *osition descriptions delineate qualifications and responsibilities of nursing administration, faculty and staff. 1* E"u ational Progra&s

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 All programs must maintain national accreditation by an approved accrediting agency.  All programs must haveF
o A written statement of philosophy that reflects the beliefs of

the faculty, is reviewed and revised as needed, and reflects the mission of the parent institution. o Anticipated outcomes that are consistent with the mission of the parent institution. o A program of learning that reflects the philosophy and outcomes, is developed by the faculty and program administrator, is organi(ed so that knowledge and skills are progressively developed, and meets the requirements of the parent institution for graduation. o *rovision to grant credit for prior learning, consistent with the parent institutionBs mission and the philosophy of the unit in nursing. o A general education component that contributes to the achievement of program outcomes.
o Gritten agreements with all health care facilities that mustF

 ensure faculty responsibility for students and the selection of their learning e periences  contain termination clauses, and  be periodically reviewed and revised as necessary.  Each course must haveF o Gritten measurable obCectives. o @earning e periences and instructional methods that fulfill the obCectives.
o Evolution methods and tools that measure achievement of

classroom and clinical obCectives.  5ndergraduate student'to'faculty ratios must beF o No more than !4 to % for total enrollment. o No more than !) to ! for clinical laboratory courses. o No more than !4 to % for final semester clinical capstone courses where students work one on one with a qualified preceptor.
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Asso iate Degree  The relationship between nursing and liberal arts+general education courses is consistent with that of the parent institution with a balanced distribution of no more than :) percent of the total number of credit hours allocated to nursing courses. !a alaureate  The relationship between nursing and liberal arts+general education courses is consistent with that of the parent institution. The maCority of the course work in nursing is at the upper ;Cunior+senior= level. Gra"uate  The graduate curriculum builds on the knowledge and competencies of baccalaureate education in nursing and provides for attainment of advanced knowledge of nursing and related theories and application to advanced nursing practice. C* FACULT@ AND)OR STAFF Fa ult$  All faculty in nursing programs must have a masterBs or higher degree with a maCor in nursing, and a minimum of one year of clinical e perience as a registered nurse. E ceptions may be granted by the -oardBs Eirector of Nursing education within the following parametersF
 E ception faculty must be continuously enrolled in a graduate

degree nursing program.  The ma imum time allowed to complete the graduate program is three years.  The ma imum time allowed to complete the graduate program is three years. The maCority of faculty in graduate nursing programs must have earned doctorates in nursing or a related field from regionally accredited institutions. <aculty without a masters in nursing may teach non'nursing courses ;i.e., computer, statistics= in nursing programs where these courses are not otherwise offered at the institution. E ceptions made prior to the effective date of these standards will continue employment as e ceptions.

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 <aculty must implement an annual professional development plan that

includes a combination of course work, continuing education presentations, or attendance at continuing education programs. The plan must have been approved by the administrative head of the program ANE must total a minimum of ten contact hours per year.  All nursing faculty ;full'time, part'time, and adCunct= must hold an unencumbered license from /ississippi &. a valid license from another Compact state ANE satisfy a criminal history background check.  Nursing faculty are responsible forF o Eevelopment, implementation and evaluation of the program of learningJ o Eevelopment of standards for the admission, progression and graduation of studentsJ o *articipation in academic advisementJ o *articipation in the activities of the total. faculty of the parent institutionJ o *articipation in professional and community activities.  *receptors shall be academically+e perientially prepared at or beyond the level for which the preceptor service is rendered and shall have a minimum of one year of e perience. D* STUDENTS  /inimal admission criteria for associate degree nursing programs are as followsF o An ACT composite score of !$ and a ,.) grade point average.
o 8tudents with less than the required ACT composite score must

have completed a minimum of !, semester hours, including Anatomy and *hysiology, with a ,.4 grade point average before being admitted. They must have made at least a grade of KCI in Anatomy and *hysiology courses.
o 8tudents who have previously earned a baccalaureate or higher

degree may enter without an ACT by completing all the course prerequisites to the nursing maCor with a grade of KCI or better and having an overall grade point average of ,.4.  /inimal admission criteria for state'supported bachelor of science nursing programs are as followsF

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o An ACT composite score of ,!. 8tudents with the required ACT composite score must also have at least a grade of KCI in each prerequisite course and a ,.) grade point average.
o 8tudents with less than the required ACT composite score must

complete all the course prerequisites to the nursing maCor with at least a grade of KCI and have an overall grade point average of 2.). o .N students and students enrolling for a second baccalaureate degree may enter without an ACT by completing all the course prerequisites to the nursing maCor with at least a grade of KCI and having an overall grade point average of ,.4.
o -accalaureate nursing programs in independent institutions may

establish admission criteria which support the goals and aims of individual independent institutions.
 Each school is permitted an allowance of !) percent of the previous

fallBs nursing program admissions for high risk students who do not meet the criteria.  *olicies in effect for students in nursing are nondiscriminatory and are consistent with those in effect for all students enrolled in the parent institutionJ policies that differ are Custified by program outcomes. E* RESOURCES, FACILITIES, AND SERVICES  <inancial support is adequate to achieve the stated outcomes for the program.  8alaries are sufficient to recruit and retain qualified nursing faculty.  *hysical facilities are adequate for the need of the program.  8ecretarial and other support services are sufficient for the needs of the program.  @earning resources and facilities are comprehensive, current and accessible to students and faculty. F* INTEGRIT@  %nformation about the program to the general public, students, employees, and others is clear, current, and accurate.  @egal limitations for licensure are printed in a current catalog.
 Complaints about the program are addressed and records are

maintained and available for review. G* EVALUATION

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 <indings from a systematic evaluation of the unit in nursing, the

program of learning, graduates, and faculty are used for the programBs development, maintenance, and revision.
 The pass rate for all first writes on the registered nurse licensure

e amination ;NC@EL .N=, regardless of where the e am was written, shall meet the following requirements.
o <irst write results for each calendar year shall be no less than "41

of that yearBs national average. Any program that has less than "41 of that yearBs national average for first writes must submit a written plan for improvement that notes changes made and+or planned by Muly ! of the following year. o The pass rate for first and second writes combined shall be no less than "41 pass for each calendar year. Each year will be calculated no later than 2 years from Eecember2! of that year and any graduate who has never taken NC@EL shall not be included in the calculation.  The pass rate for the nurse practitioner certification e am shall be !))1 of those who have taken the e am during the first year after graduation.  6raduation rates shall beF o :)1 in !4)1 of the prescribed time for the program of study for undergraduate programs. o $)1 of the prescribed program of study for graduate programs. (* C(ANGES IN E7ISTING NURSING PROGRAMS)REPORTS ;<* E"u ational %rogra&s &ust su1&it t/e follo,ing re%orts2 A tion Annual .eport Change in ownership Change in directors+deans /arkedly curriculum altering ReBuire&ent Complete annual report form Notification letter Notification letter the Eetailed description with review by Accreditation Committee Eetailed description of educational, financial, operational, management, and physical resources to offer program with'

Adding a new teaching site

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review by Accreditation Committee National accreditation status Copy of notification

Eecision made to discontinue The -oard shall be notified in writing of the program the intention of the controlling institution. %f the remaining students continue in the program, adequate faculty and educational standards shall be maintained until the last student has completed the program. This date shall be the official closing date of the nursing program. Eisposition of all studentsB permanent transcripts and final records shall be made in accordance with institutional policy. A representative of the -oard shall visit the nursing program and assist in making arrangements for proper closure and, if necessary, for the transfer of students. An institution desiring to reopen .an educational unit in nursing or a nursing program shall reapply for approval of a newly planned program.

T/e Dire tor of Nursing E"u ation ,ill su1&it a re%ort to t/e !oar" annuall$ t/at ,ill in lu"e2 a. Admission numbers . b. Enrollment and graduation numbers c. NC@EL pass rates d. Certification e am pass rates e. 6raduation rates f. 8tudent to faculty ratio g. <aculty vacancy numbers h. 6raduate enrollment by clinical maCor and practice role. i. @*N to .N enrollment C. .N to -8N enrollment

ROLE OF T(E INDIAN NURSING COUNCIL The %ndian Nursing Council is an autonomous body under the 6overnment of %ndia, /inistry of 9ealth and <amily Gelfare. %ndian Nursing Council Act, !"#> enacted by, giving statutory powers to
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maintain uniform standards and regulation of nursing education all over the Country.

/ims and "b1ecti&es of Indian Nursing Council2  To regulate the training policies and programmes in the field of Nursing.  To bring about standardi(ation of training courses.  To prescribe minimum standards of education and training of various Nursing programmes.  To regulate these standards in all training institutions uniformly throughout the country.
 To recognise institutions + &rganisations + 5niversities imparting

/asterBs Eegree+ -achelors Eegree + *.6. Eiploma + Eiploma + Certificate Courses in the field of Nursing.
 To .ecogni(e Eegree+Eiploma+Certificate awarded by <oreign

5niversities+%nstitutions on reciprocal basis.  To promote research in Nursing.  To maintain %ndian Nurses .egister for registration of Nursing *ersonnel.  Training *rogrammes. %ndian Nursing Council is responsible for the corporate governance of Nurses and the Nursing profession. This includes the issue of discipline, the promotion of health and health care, proposing and commenting on planned legislation, as well as proactively advising, alerting and offering comment to the 6ovt. on matters affecting the Nursing profession. %ndian Nursing Council prime responsibility is to set the norms and standards for education, training, research and practice with in the ambit of the relevant legislative framework. %n this regard, the following issues are considered critical.  An ongoing review of curriculum in response to national priorities.  An ongoing review of the education system with a focus on community based education.

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 %ntegrated education with a focus on problem ' based learning to

promote critical thinking.  Competency based education.  An ongoing review of the performance of work of Nursing professionals with in the ambit of the service delivery principles.  *rotection of the rights and dignity of people. ROLE OF INC FOR NURSES
 Additional responsibilities were given to the %NC when the initial

%ndian Nursing Council Act of !"#> was amended in !"4>.  The %NC was then asked to provide for .egistration of <oreign Nurses and for the maintenance of the %ndian Nurses .egisters.  This .egister contains the names of all Nurses, /idwives, au illary nurse midwives and Hpara'nursingB workers who are enrolled on all state registers.  The %NC authori(ed 8tate Nurses .egistration Councils and E amining -oards to issue qualifying certificates. This recognition is given, however, only after those bodies have been recogni(ed by their 8tate 6overnments.  The %ndian Nursing Council has been given heavy responsibilities for Nursing *ractice and Nursing education, but it has not been able to e ert enough power to support high standards in nursing. *rivate diploma and degree programmes which have no approval of the %ndian Nursing Council ;or= state councils are growing in Number.  At the same time, many untrained and unlicensed Nursing personnel are used to staff there institutions.  There is a desperate need for Nursing practice Act which would control Nursing *ractice and education and provide soft and skilled Nursing care to the public.  ?ou may not necessarily participate in the activities of the %NC but you should know the function and authority of this body because of it unique role in the Nursing profession in %ndia. INDIAN NURSING COUNCIL ACT 8 4C<D A t O1>e ti#e2 An Act to constitute an %ndian Nursing Council. Ghere As it is e pedient to constitute an %ndian Nursing Council in order to establish a uniform standard of training for nurses, midwives and health visitorsJ ACT ?EA.F !"#>'#$.
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STATE REGISTRATION COUNCILS .egistration councils have now been established in all states. Nursing schools in the union Territories are affiliated to Nursing Councils in adCacent to state.

Fun tions !. %nspect and accredit schools of Nursing in their state ,. Conduct the e amination 2. *rescribe rules of conduct #. /aintain register of Nurses, midwives, AN/ and 9ealth visitors in the state. 4. The state registration councils are autonomous e cept they do not have power to prescribe the syllabus for courses. The procedure of registration is usually initiated by the nursing administration of y our institution you are qualified to register when you have completed the recogni(ed programme of nursing education and passed the qualifying e amination. The e amining authority will issue a diploma to you which must then be sent with copies and a property filled out application from to the register for the stat e nurses registration council in you state. This is usually done by your nursing administration who also you for the required fees. .egistration is necessary for active nursing practice either here or aboard. This is done through your state NurseBs .egistration council. %t provides you with legal protection and protect the patient from poor nursing care. %t is very important for you to be able to complete an application form for registration accurately and without omissions. %t is wise to get assistance from a senior colleague it you need it. REGISTRATION OF NURSES AND MID=IFE -LICENSING. A license is a legal document that permits a person to offer her or his skills and knowledge to the public in a particular Curisdiction, where such practice could be unlawful without a license. The purpose of Nursing license is to protect society from unskilled and in competent person who would be practice Nursing.

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.espective 8tate Nursing Council has the responsibility to issue license and to ensure maintenance of standards as laid down by %ndian Nursing Council. INSTITUTIONAL POLICIES AND REGULATION *olicy is defined as the principles and values that govern actions directed towards given ends, policy statement set forth a plan direction, or goal for action, policies may be laws, regulations or guidelines that govern behaviour in 6overnment or Agency. The rules and regulations pertaining to the rights and duties of personnel are for different positions. The rules and regulations of an office+institution ensures accountability. ROLE OF INTERNATIONAL COUNCIL FOR NURSES +he International Council of Nurses  The %nternational Council of Nurses, founded in !$"" by /rs. -edford <enwick. %t is a federation of Non N *olitical and self N 6overning National Nurses Association.  The head quarters are in 6eneva, 8wit(erland. 3urposes  To provide a means through which the National Associations can share their interests in the promotion of health and care of the sick.  6reat emphasis has been placed upon non discrimination "b1ecti&es  To promote the development of strong National Nurses Association  To assist National Nurses associations to improve the standards of Nursing and the competence of Nurse.  To assist National Nurses Association to improve the states of Nurses within their countries.  To serve as the authoritive voice for nurses and nursing internationally 4ole of International Council of Nurses  %CN is the global voice of Nursing. Among its many activities and accomplishments are the publication of the code for Nurses, the world N wide accepted definition of a Nurse and the Nurses Eilemma, a book of Ethics

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 %t also makes policy statements on health and social issues and offers a great variety of seminar and the statements aimed at maintaining and improving the status of the Nurse and the standard of Nursing around the world.
 The 6uidelines for National Nurses Associations in the %ndian

Nursing year book, !"$$ N $" is one e ample of how the council works to improve Nursing education and practice. %CN ;Council of National= .epresentation which is made up of the %CN 9onorary officers and *resident, of the National member Association O Council meets atleast every other year and once every face year at the time of %CN congress O Gork at the headquarters is carried on by a staff or clerical and e pert nursing advisor personnel 3ublications The %CN publishes the %nternational Nursing .eview on a quarterly basis. The News letter, which is published ten times a year, give new of the %CN and the National member Associations. $embership /embership in the %CN though the TNA% offices various benefit to you as an individual Nurse. A limited Number of Nursing students may have their e penses paid in order to attend the congresses as observes. Benefit Among benefits to the graduate Nurse are attendance of international congresses ;or= conferences. The %CN e change of privilege programme, professional advice ;or= assistance through %CN 9eadquarters and use of the %CN information centre.  Nurses may receive publications about development in Nursing and Nursing education around the world.

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This helps the Nurse become aware of being professionally related to international organi(ations such as the united Nations and Gorld 9ealth &rganisation. ICNES ROLE IN REGULATION INCLUDES2 !. Convening regular international meetings of National Nurses Association leaders, government Chief Nurses, and national nursing regulatory authorities to address key issues in regulation. ,. /onitoring and analysing nursing regulation and regulatory forces and trends worldwide. 2. *roviding regular opportunities for interaction among individuals, groups and organisations who have an interest in or are responsible for regulating nursing. ;e.g. conferences, network and web based activities= #. *roviding national nurses associations and others with the tools ;e.g. information, guidelines, international standards, competencies and frameworks= to enable them to remain up'to'date on regulatory matters 4. *roviding nursing and other key stakeholders with advice and consultation to undertake reforms and to respond to changes having an impact on professional regulation. :. @iaising with international institutions addressing issues of regulation. >. %nfluencing+negotiating regulatory reform in the best interest of the public and the profession. $. Establishing accreditation, certification and endorsement services in selected areas. ". Collaborating with other groups and interested parties on regulatory activities and issues of common interest. !).8etting directions for the ongoing development of nursing regulation worldwide. !!.*romoting data collection in order to provide an evidence base for regulatory policies and practices. NURSING EDUCATION !OARDS 6raduate nurses may also go aboard for higher education. Eeveloped countries such as the 5nited Pingdom, the 5nited 8tates, Canada and Australia, provide opportunities for nurses from foreign
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countries to continue their nursing education. *ost certificate and post graduate courses are available as well as advanced courses in specific clinical areas such as orthopaedic or psychiatric nursing. Nursing research is studied more intensively on the level of the /asterBs or EoctorateBs Eegrees. %t is necessary to make detailed arrangements if you wish to study aboard. ?ou should be sure, first of all that your enquiries and application are sent only to approved colleges or and intuitions in the foreign country. A full transcript of you general and professional education will be needed. Even with this you may be asked to take certain courses of study in the foreign country to make up for any deficiencies in you education from their stand point. *ersonal references will be necessary. -oth your sponsoring organi(ation and the university or school to which you are going will ask for evidence of good health and your ability to study. The higher degree in nursing from abroad can be very useful to the nursing profession here. %t brings in new ideas based upon broad e perience and education as well as highly developed research. 8tudy abroad is very e pensive. %f is wise to check the .upee money e change of the country to which you wish to go. Travel, tuition and living e penses require large amounts of money which usually must be readily available as cash rather than credit payments. ROLE OF PROFESSIONAL ASSOCIATIONS AND UNIONS T(E TRAINED NURSESF ASSOCIATION OF INDIA -TNAI. %t is a national professional association of nurses.  The present name and organi(ation were established in !",, but its history of developments goes back to !")4.  The TNA% had its beginning in the Association of Nursing superintendents which was founded at @ucknow in !")4. 3urposes  5pholding the dignity and honour of the Nursing *rofession  *romoting a sense of esprit de corps among all Nurses  Enabling members to take counsel together on matters relating to their profession.

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&ther nurses gradually became members of the Association of Nursing 8uperintendents until a decision was made to establish a Trained Nurses Association in !")$. The Association was inaugurated in !")". There was organi(ations operated under the same leadership until !"!) when the Trained NursesB Association elected its own officers.  %n !",,, the two organi(ations were brought together as the trained Nurses Association of %ndia.  The organi(ation of the TNA% makes it possible for all Nurses to participate at some level.  -eginning with the local unit, which is usually made up of personnel in a specific institutions.  The level of organi(ation moves to the district. o Eistrict level o 8tate level o National level  /embers of the TNA% are usually most active on the level of the local unit. Activities and conferences, however, are planned regularly by the state branches and provide opportunities for valuable professional participation and development of the individuals member.  8ome state branches of the TNA% have full N time secretaries. Active members have an opportunity to participate on the state level also through service on the e ecutive committee of the state branch.  The interest group is one way in which the individual nurse can participate. %t centers its activities on a specific area of practice in Nursing.  This is done on a state level with groups for such areas as nursing education, Nursing administration, *ublic health and *sychiatric Nursing. The 6overning body of the TNA% is the council which is assisted by standing committees for economic welfare, Nursing .esearch and finance.

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A full time salaried secretary was first appointed in !"24. A salaried assistant secretary, who also serves as the advisor to the 8tudent NursesB Association, was appointed in !"$2. /ims  The aims of the TNA% center upon needs of the individual members and problems in the Nursing *rofession as a whole.  %t include upgrading, development and standardi(ation of Nursing education.  %t aims to improve the living and working condition for nurses in %ndia, and registration for qualified nurses /cti&ities  %t was active helping to set up basic Nursing curricula when it first organi(ed  %t has promoted the development of courses in higher education for nurses.  This includes all of the colleges of Nursing active today  The TNA% gives scholarships for Nurses who wish to go on for advanced study either here ;or= aboard. %t has also stimulated action to organi(e the 8tate Nurses and midwives .egistration councils.  %t helped to remove discrimination against male nurses and initiated much needed study and improvement of economic conditions for Nurses.  The TNA% opposes strikes unless all other means of negotiating have failed to bring about satisfactory working condition. EM!LEM OF TNAI

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$embership /embership in the TNA% is obtained by application and submission of a copy of your 8tate .egistration certificate. ?ou may transfer membership from the 8tudent Nurses Association by having a certificate e sent from the %nstitution in which you have studied within si months after completing the course.  /embership fees are required  A reduced fees is offered to those who transfer memberships directly from the 8NA.  A part of these fees is used to pay affiliation fees to the international council of Nurses.  %t is possible to apply for a life membership.  /any nursing authorities required membership in the TNA% as a condition for employment. a= The official organ of the TNA% is The Nursing Mournal of %ndia which is published monthly. The cost of this is included in the annual subscription for membership in the Association. Another impressive publication is the %ndian Nursing ?ear -ookI, which has been published N five times since !"$,. This contains important reports, discussion of trends and statistics which are available for the Nursing profession in %ndia.  %ts list of whoBs who has continued to grow with each publication. The TNA% has initially planned to make this an annual publication but found it necessary to publish it less frequently.  ?our members hip in the TNA% means your personal support in the aims and obCectives of this organi(ation. ?ou support these through your financial contributions and your participation in the activities sponsored by the organi(ation.  ?ou are encouraged to become a member of the TNA%. %f it has a large enough membership it can yield t he power it needs to bring about action which will improve the lives and careers of all professional nurses as well as healthcare to the general public. %t continues to give for a maCority membership of .egistered *rofessional Nurses.  ?ou are professional nurse, will also benefit from membership in the TNA%. %t gives you a feeling of belonging and security because of the Number of Nurses who are 5nited through the organi(ation.

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*rofessional activities give you ample opportunity to develop leadership ability and professional poise, keep abreast of changes and share and solve professional problems.  The Mournal helps you to be informed of current events in Nursing and offers N opportunities to publish articles and voice you opinions.  The TNA% can help you to apply for a career position if desired.  %t is also of help economically by providing scholarship for advanced study, railway concessions for Nursing students and staff Nurses and a @imited income for welfare aid when necessary. T(E STUDENT NURSES ASSOCIATION The student Nurses Association, organi(ed in !",). 4ole of Student Nurses /ssociation %t is associated with and under the Murisdiction of the TNA%. %n addition to providing a means of personal and professional development for the Nursing 8tudent. %t sense as a source of membership for the parent organi(ation. The Assistant secretary of the TNA% serve as advisor for the 8tudent Nurses Association. 3urposes and functions of the Student Nurses /ssociation2  To help student Nurses learn how the professional organi(ation serves to uphold the dignity and ideas of the Nursing *rofession  To promote a close rapport with other student nurses  To furnish student Nurses advice in their course in study leading upto professional qualifications.  To encourage leadership ability and help students to gain a wide knowledge of the nursing profession in all of its different branches and aspects.  To increase the student nurses social contact and general knowledge in order to help them with their total personal and professional development.  To encourage both professional and recreational meetings N games and sports  To provide a special section in The Nursing Mournal of %ndia for the benefit of the students.

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 To encourage students to complete for pri(es in the 8tudent Nurses E hibition and to attend national and regional conferences.
 To help student Nurses develop a co'operative sprit with other

student nurses which will help them in future professional relationships.  To provide a means of having a voice in what the Association stands for and does. /cti&ities 8tudent Nurses Association to that of the TNA%, the beginning level of organi(ation in the local unit established in a teaching institution. %t then more on the state and national levels as in the TNA%. $embership /embers of the local unit are led by a unit e ecutive committee which is made up of the president, 8tudent Nurses Association advisor and the remaining officers who are students. The *resident is a professional nurse members of the TNA% and some only as an advisor. The Aice *resident, who *resident at all meetings and the secretary of the unit must be students. 8tate level advisors are active members of the TNA% elected by the state branches. There is a full time secretary on the national level at the National 9ead 7uarters located in New Eelhi. This person is also member of the TNA% appointed by the TNA% council and part of the National level 8tudent Nurses Association 6eneral Committee. /embership fees in the 8tudent Nurses Association are minimal and easily met by the Nursing 8tudent. The arrangement for transfer of membership to the TNA% has made it convenient for the new professional nurse to establish a life membership in the parent organi(ation at a lower cost. This special offer for life membership is good for si months after graduation. 4ole of Student Nurses /ssociation includes i= Activities of the 8tudent Nurses Association include the 8tudent Nurses Association e hibit which has developed a high standardsF fund raising for the TNA%, fine arts and sports competition and conferences 8pecial pri(es are given for out standing achievement in specific areas of nursing education

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Nursing students are given opportunity to contribute article to the Nursing Mournal of %ndia through a regular section reserved for the 8tudent Nurses Association. Each unit received this Mournal at a reduced cost with an allowance of one Mournal for every twelve members and ma imum of si copies. 5nit activities include maintaining the dairy of unit activities, giving quarterly reports preparing articles for publication and distributing application forms for membership in the TNA% The 5nit also celebrates national and international holidays and plans other activities which promote the obCectives of the 8tudent Nurses Association. Nursing students who participate in the student Nurses Association have a valuable opportunity to begin to develop leadership abilities, social poise, competitive skills and an interest in the profession as a whole. The association and its relationship with the TNA% is also helpful to the Nursing students in many ways. *roblems in Nursing Education ;is= *roblems related to living and study conditions can be shared and solved through the united efforts of this organi(ation and the TNA%.

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COMMON =EALT( NURSES FEDERATION The TNA% is also affiliated with the common wealth nurses federation which is a Nurses Association begun by the common wealth foundations. %t is made up of Nurses associations from common wealth countries. The headquarters of the federation cue is @ondon. /ims i= To promoter sharing, better communications and close relationship between its member association. ii= %t also provide e pert professional advice scholarships for advanced study, financial assistance for professional meetings and seminars and an office through which funds can be received and disbursed for the benefit of Nursing in the countries which are represented. The common wealth Nurses federation was formally organi(ed in !">2 and operators in si regions of the world which are East, Central and 8outhern Africa, Africa west, Atlantic, Australia, for east and pacific. 8outh Asia and Europe. -eginning with ,4 member countries it is now represented in :, independent nations. T(E C(RISTIAN MEDICAL ASSOCIATION OF INDIA
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C/A% began in !")4 as a fellowship of Christian /issionary doctors to provide spiritual and professional sharing and support. %t gradually developed into a large organi(ation which include other Christian health. *rofessionals and health institutions. %ts present name was assumed in !",:. (ead5uarters 9eadquarters for the C/A% are in New Eelhi with a 8outh office in -angalore. 6unctions i= To provide spiritual support and a better understanding of the healing ministry with a focus upon the -ible. %t does this through retreats and conferences. ii= To provide professional training through formal and informal education, publication of te t books and other materials and scholarships this te t book is an e ample iii= To encourage community health work through training, advisory services and technical support. iv= To assist and support churches and health institution with study and training v= To work with other agencies in an e change of information and development and programmes it is the official agency of the National Council of Churches in %ndia. vi= To disperse health related information which will help with health education and lead towards a more healthy and Cust society. $embership /embership in the C/A% is open to Eoctors registered Nurses and AN/ + 9ealth workers J all health professionals, hospital administrators and chaplains. 8tudents in health professional courses may also become members but may not vote ;A= hold office. T(E NURSES LEAGUE OF T(E C(RISTIAN MEDICAL ASSOCIATION The Nurses league of the C/A% was founded in !"2) as the Nurses. Au iliary of the C/A%. The name was changed from Nurses Au iliary and Nurses @eague in !":4. it became affiliated to the TNA% in !"2: and promotes membership in this organi(ation.

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The Nurses league of the C/A% was originally organi(ed to meet the needs felt by Christian Nurses to share common problems related to training and registration of Nurses. "b1ecti&es  *romote co'operation and encouragement among Christian Nurses  *romote efficiency in Nursing education and service  Encourage the highest quality of candidate to choose Nursing as a vocation  8ecure the highest standard possible in Christian Nursing education through the Christian 8chools of Nursing  And consider the special work and problems of Christian Nurses wherever employed especially in isolated areas The Nurses @eague has a full time secretary, until !"$: it published the Christian Nurse bi monthly but now limits regular publications to a column in the C/A% newsletter. /embership fees are required and a life membership is available. Nursing students may become associate member of the league membership in the NursesB @eague may be requirement for certain Nursing positions under control of Christian employing authorities. /cti&ities %t include National and area conference and retreats for its members,  Eevelopment of @eadership abilities is encouraged by participation in these meetings where professional papers and e hibits of high quality are given.  Each meeting also allows for sharing of problems common to the Christian Nurse.  The Nurses league has two e amining boards which are recogni(ed by the %ndian Nursing council. &ne is the /id'%ndia -oard of e aminers and the other is the -oard of Nursing Education in 8outh %ndia. These bodies direct e aminations in general nursing and midwifery and diplomas granted by them are accepted for .egistration with the states in those areas. Another maCor contribution of there boards has been continues to be the overseeing of the preparation of te t books and manuals for Nursing education in %ndia.

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 They have published at least nine te t books, written in both the English and 9indi languages for Nursing Education. T(E INTERNATIONAL RED CROSS The %ndian .ed Cross society, discussed on pages !,$ N !,", is related to other .ed Cross organi(ations around the world through international organi(ations. The first to be established was the %nternational Committee of the .ed Cross also called the %C.C. %t follows the directions of the 6eneva conventions in an effort to protect victims of armed conflict. %ts head quarters are in 6eneva, 8wit(erland. ROLE OF INTERNATIONAL RED CROSS  %C.C delegates visit and inspect prisons of war camps  They arrange for delivery of mail and food package to the prisoners  They also offer emergency relief by providing food and medical supplies  A very valuable service is that of a central tracing agency which helps to locate prisons of war and missing persons long after a conflict is over.
 8ome countries prefer to call this same national organi(ation the

.ed Crescent. The international league of .ed Cross and .ed Crescent 8ocieties was formed in !"!" after Gorld Gar %.  %t works closely with national society during times of natural disasters  %t provides e perts and seminars to help these societies improve their administration and services.  The only national society which is not affiliated with the league is that is %srael the /agen Eavid Adam.
 A super global body made up of the above league and national

societies is the international conference of the .ed Cross which is also based in 6eneva.
 This body meets only once in four years, it supports unity in the

work of all these organi(ations and promotes government support of the .ed Cross activities. UNITED NATIONAL INTERNATIONAL C(ILDREN EMERGENC@ FUND

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5N%CE< is an agency of the 5nited Nations. %t was founded in !"#: for the purpose of helping mothers and children in countries affected by Gorld Gar %%. %t now offers services in all undeveloped countries. %t is financial by voluntary contributions only either from individuals ;or= 6overnment. ROLE OF UNICEF Contributions of 5N%CE< in %ndia have provided teaching equipment for Nursing education, te tbooks and visual aids for schools of nursing, and training for personnel to help with the health of mothers and children. T(E =ORLD (EALT( ORGANIGATION The world health organi(ation, commonly called the G9&, is also a speciali(ed agency of the 5nited Nations. %t was organi(ed in !"#$. 3urpose 9elping to achieve the highest possible level of health of all people more than one hundred countries are members of G9& and help to finance its broad health activities around the world. ROLE OF =(O The G9& has been active in Nursing education and practice in a number of ways here in %ndia. %t has offered guidance in setting up programmes of Nursing education and has promoted training for au iliary nursing personal. The G9& promotes public health in many ways around the world. %t is currently well known for its declaration of making towards. K9ealth for all by ,))) A.*.I. This declaration has given a tremendous push to developing primary health care and recogni(ing the very essential role of Nursing in the health care system. CONCLUSION 8o far we have discussed about the development and maintenance of a standard and accreditation in nursing education programs, role of %NC, 8tate .egistration Nursing Councils, -oards and 5niversity, .ole of *rofessional Associations and 5nions participation of professional organi(ation is of profit to you and to profession. The profession provides a means through which united efforts can be made to elevate standards of Nursing education and practice. !I!LIOGRAP(@

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!. -. 8ankaranarayanan -. 8indu, ,))$, @earning and teaching

nursing ,nd Edition, -rainfil *ublishing Company *.No.4,. ,. Teaching material for 7uality Assurance model N Nursing % Edition ,)):. *ublished by %ndian Nursing Council *.No.$$. 2. Curriculum Eeveloped in Nursing Education % Edition ,))4 Mones and -arlett *ublishers *.No.42. #. P.*.NeeraCa, Te t -ook of Nursing Education, % Edition ,)):. Maypee -rothers Company *.No.#$ N >#.
4. *rofessional AdCustment and Ethics for Nurses in %ndia Ann. M.

Qwener, -.A., ..N., /.8c :th Edition !""4. -.%. *ublications *vt. @td., ,2# N ,44.
:. Net 8ource.

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