Nursing Education and Training: The Status in the Punjab Public Sector Health Services

Abstract

Punjab produces nurses holding diploma in general nursing, while globally this qualification is increasingly been replaced with baccalaureate and master in nursing. As a consequence, whereas the quality of healthcare is on the lower ebb, nurses holding diploma qualification can hardly compete in the international job market and only a few of them can join post graduate education.
Objectives: (i) To define a conceptual framework for nurses' education and training; (ii) To review the nurses' education and training in Punjab, Pakistan; and (iii) to propose measures for improving the situation with the purpose to improve quality in health care delivery.
Methods: this is a cross sectional study that used mix methods. All 42 public sector schools of nursing in Punjab were included. A structured questionnaire was used to collect primary data about the status of the nursing education and training. In addition to infrastructure, issues related to pre-education, education and
training, and post-education nurse practice were studied. In-depth interviews were held with stakeholders and observation was used to collect qualitative data. Since a priori framework was used in designing the study, it also guided the analysis and presentation of findings.
Results: image of nursing has improved and while entry qualification remains matric with science, increasingly candidates with FSc. are applying. Governance is an issue across all schools, which lack student affairs department. Education services are more akin to skills without much theory building. 42% teaching positions were vacant, while there are no post for non-nursing subjects teachers. They are hired and paid by the students. Over 60% of school budget goes for stipend and was considered by many teachers a factor responsible for deteriorating nursing education. There is no research culture, and while skill labs and libraries are there, those are used infrequently and ineffectively. Maintenance of building with few exceptions is poor and while there is transport, but to use students pay for fuel.
Conclusion: radical measures are required for improving nursing education and training system. Pakistan Nursing Council has already set 2018 for schools to take last batch of diploma in nursing. Instead it has recommended upgrading schools to colleges and introducing baccalaureate of science in nursing. The
availability of faculty will remain a challenge and while postgraduate nursing institutes to produce masters in nursing should be established, foreign faculty will be required to immediately fill up the gap.