Trends and issues of nursing are directly related to a number of social issues. As our society becomes increasingly diverse, each trend precipitates new issues and problems. Trends result from the issues in the past, just as these issues result to another trend in the future. This is never ending process of change. Changing social norms and mores, advancing science and technology, the women movements, political and economical changes, all of them have exerted powerful influence on the practices of nursing.
Changes in society undoubtedly influence the process of professionalization. Nursing, as an occupation, is not at all detached from most recent trends and practices and this is evidently the current vital issue in the field of nursing. Johnson (1972) considers how the term professionalization can be considered in variety of ways. Firstly it may be used to refer to broad changes in occupational structure whereby professional jobs got increased numerically in relation to other occupations. Secondly it may be used in a way of implying an increase in the number of occupational associations which make constant attempt to regularize recruitment and practice in a specific occupation.
Another major issue in nursing is viewing nursing profession as only a support service whose duties are directly dictated by and auxiliary to both physician and the hospital administration. It is rarely considered as an autonomous body. Despite with its own skills and area of responsibilities, nursing has constantly suffered indescribable indignities in our society in the past.
Expanding scientific research and innovations continue to lead to newer dimensions of complex issues. These issues focus on ethics, bioethical developments, and personal choice. Expectations of personal freedom of choice raise ethical issues in certain areas like abortions, right to die, and lifestyle preferences. A number of inter related trends include the changing characteristics of the population and the political and the economic influences on health and health care. The two other trends of nursing education is the increasing shortage of qualified faculty nurse and the increasing stress related to the demands of personal and professional responsibilities.
Current Nursing Educational Trend in Nepal
When Nepal, first of all, opened its doors to the outside world in the early 1950’s, there were no professional nurses in the country. In present context patient to nurse ratio in biggest government hospitals is approximately 20:5. Nursing and midwifery personnel constitute the largest element of the health care work force in most of the countries. Nursing and midwifery education varies from one country to another country of the Region.
Professional nursing education consists of either a certificate or diploma level course of three or three and a half years of duration or a bachelor's degree in nursing of four or four and a half years. The duration of general education required for entering professional nursing and midwifery educational programmes also varies, e.g. 10 years for nurses in Bangladesh, Bhutan, Maldives, Nepal (Proficiency Certificate Level in nursing and midwifery) and Sri Lanka, 11 years in DPR Korea and 12 years in India, Indonesia, Myanmar, Nepal (Bachelor of nursing degree) and Thailand.
Post-basic or advanced levels of nursing education for obtaining a bachelor's and higher degree is
available in Bangladesh, India, Myanmar, Nepal, Sri Lanka and Thailand. Different universities of India, Indonesia, Nepal and Thailand have their own master's degree in nursing programmes.
Privatization in this sector has increased a number of private institutions and also due to global demand the number of people attracted to nursing education has increased considerably. Because of this reason, private sectors are investing their money mainly for profit motive. This significant increase in number of educational institutes has produced or number of health professionals inside the country. Since these privately invested institutions are opened only for profit motives the quality of education in such institution is considerably low. And also the number of manpower produced at present is more than the demand of health manpower in our country.
If you talk about Nepalese context, many qualified nurses have left their jobs for better opportunities and higher paying jobs in foreign countries. The trend of nurses going abroad, according to NNC, started about six years ago and the number of those going abroad has sharply increased in last two years.
Job dissatisfaction and wages (especially in government sector professional have very poor salary) have both been cited as factors contributing to the nursing exodus. When experienced nurses leave
their positions after only a few years in the profession, they are often replaced with recently graduated and inexperienced staff members. This is the revolving door syndrome, the worst possible model of workforce replacement for a profession such as nursing. Nurses in Nepal are concerned with shifting roles, standards, employment options and terms of employment, living conditions, status, and a lack of solidarity among nurses.
Nursing needs to achieve autonomy in controlling and maintaining the integrity of its professional education and united membership has to be recognized. The importance of the knowledge of nursing and contributions to health care will have to be recognized and esteemed to a greater extent by the public as well as by the government if autonomy and control over nursing practice is to be achieved.
The fact that nursing is primarily composed of women, who have been and continue to be dominated by the physicians and hospital administrators in many health care institutes that should not be overlooked. New nurses have to understand how nursing trends and issues synthesize the technical, ethical and organizational issues in the ever evolving health care arena of nursing.