bnc workshop group v

8/2/2019 Bnc Workshop Group V

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Sub: InSub: In depth Countrydepth Country

Assessment on Nursing &Assessment on Nursing &Midwifery in BangladeshMidwifery in Bangladesh


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10. How is the financial support to10. How is the financial support to

nursing & midwifery service?nursing & midwifery service?


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For Service GovtFor Service Govt


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For EducationFor Education


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Commentary:Commentary:

Financial support from the Directorate of the

Nursing Services is not sufficient

Inadequate govt support for nurse-midwives

higher education in the country


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11. What is the situation of turnover of nurses11. What is the situation of turnover of nurses

midwives in the health care facilities? Anymidwives in the health care facilities? Anyinformation on the reasons of resignation? Howinformation on the reasons of resignation? How

many percents a year?many percents a year?

In private sector rapid turnover due to:1. Salary differences

2. Workload

3. Other related opportunities (govt posting, job offers

abroad)

4. Personal reasons

5. Psychological Preparedness

6. Picture is similar but turnover is less than private


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BD: 12. What is the working lifespanBD: 12. What is the working lifespan

of nurses & midwivesof nurses & midwives Age limit for applying job is 18- 30 years and

working lifespan is up to 57 years

for non govt jobs usually there is no binding for

age limitations as well as for working life span

Equally applicable for all professions


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12. What is the working lifespan of12. What is the working lifespan of

nurses & midwivesnurses & midwives In the Philippine setting nursing is a 4 year

course

Midwifery is a 3 year course

Needs licensure for both courses

From 20 years of age to 65 years (retirement

period)


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BD: 13. How is the orientationBD: 13. How is the orientation

programme, monitoring system &programme, monitoring system &

coaching system for new nurses &coaching system for new nurses &

midwives?midwives? There is no regular programme or probation for

orientation & mentorship programme for newly

employed nurses & midwives.


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13. How is the orientation programme,13. How is the orientation programme,monitoring system & coaching systemmonitoring system & coaching system

for new nurses & midwives?for new nurses & midwives?

Apollo services system: (newly joined nurses for

orientation purposes)

1. One week induction period

2. 3 weeks orientation in the floor

3. 1 month orientation program

*we have in house clinical nurse trainers*


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14. How is the effectiveness of the14. How is the effectiveness of the

supervision system in clinical settings?supervision system in clinical settings?

In BD setting:

Depends on the quality of supervisors ratio of nurse

Out of 911 post for nursing supervisors all over the

country only 561 are posted

Promotion system delayed

Salary low

training less

Educational Qualification


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*As a result, their qualities are not up to the

expected level *


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In Philippine setting:

Very effective, as it requires close monitoring ofthe total delivery of care for more evaluation &

analysis. It also addresses the gap in the clinical

practice

Supervisors qualification / 4 years degree,

masters degree/leadership & management

course/doctorate degree/scholarship funds


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In Philippine setting:

Post Graduate Nursing Degrees:Masters Degree: MAN, MSN prepares

nurses for more independent role such as

Independent Nurse Practitioner, Nursinginstructor and Nursing Supervisor


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15. What is the working relationship of the15. What is the working relationship of themembers in the health care team? Are nurse &members in the health care team? Are nurse &

midwives recognized as equal partners?midwives recognized as equal partners?

In Bangladesh, overall relationship between thenurses & medical practitioner/physician is not

well recognized


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15. What is the working relationship of the15. What is the working relationship of themembers in the health care team? Are nurse &members in the health care team? Are nurse &

midwives recognized as equal partners?midwives recognized as equal partners?

In the Philippines, both should be a partner in thedelivery of care but in most instances nurses

are more advance in clinical practices which

shows increase responsibilities in the area.Doctors & nurses are equal partners.


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16. What is the relationship between nursing &16. What is the relationship between nursing &

midwifery education & service?midwifery education & service?

In Bangladesh , as there is gap in nursing

education & service in the country in terms ofscope of practices, resource availability, lack of

proper supervision & feedback, improper

utilization of nurse-midwives placement, highworkload include lack of proper monitoring &

accountability.


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16. What is the relationship between nursing &16. What is the relationship between nursing &

midwifery education & service?midwifery education & service?

In the Philippines educational system , midwifery

is incorporated in the 2nd year of their nursingcurriculum. Nursing course is more advance &

requires specific subjects areas which are

clinically based.


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17. What are issues, challenges, &17. What are issues, challenges, &

gaps in relation to service?gaps in relation to service?

Inadequate functional authority of the DNS

Insufficient nursing manpower in the DNS office

Absence of positions for nurses & midwives at

national levels

Huge vacancies against existing allocated posts

for higher position of nurse-midwives (post are

filled by either deputation or current charge)


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Since the persons position as deputation or acting

, they are reluctant to create change or take anysweeping decisions

Promotions in nursing are not timely & deserve

that resulted poor nursing leadership & strategicmanagement. Create a regulatory board,

enhancing tenureship.


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Inappropriate nurse-midwives to

population/patient ratio in all levels

Inadequate recognition of the nurses status in

the health care system


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2. Poor quality of nursing & midwifery care in

health care setting

Shortage of nurses and midwives as per

recommended staffing norms

Improper placement of nursing personnel

Inadequate number of Bachelors (minimum) and

masters (mostly absent) nurses in the clinical

settings


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gaps in relation to service?gaps in relation to service? Absent of specialized nursing discipline.

Absence of research utilization or evidence based

nursing.

Role ambiguity or role conflict of nurse

midwives in performing the responsibilities in

clinical setting

Inadequate facilities and unavailability of

patients care supporting resources including

medications, linens, equipments etc.


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gaps in relation to service?gaps in relation to service? Absent of quality assurances mechanisms in the

hospitals setting

Gap between the theory-practice due to the

shortage of qualified nurse educators, absent of

clinical nurse teacher and lack of coordination

between education and services. Poor supervision and management in nursing due

to :


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gaps in relation to service?gaps in relation to service?= shortage of supervisors

= Promotion based on service experience , not the

education

= Inadequate preparation of nurse managers

= Lack of in-service education and administrative

training for nurse supervisors and superintendent

as well

I


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gaps in relation to service?gaps in relation to service? Lack of accountability for assigning

responsibilities.

3. Lack of Job satisfaction of nurse-midwives due

to:

Low salary structure

Involvement of nurse-midwives with non-nursing

tasks.


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gaps in relation to service?gaps in relation to service? Unfavourable working environment and lack of

job security

Poor organizational climate

Delayed promotion and lack of career mobility

Lack of welfare plan for nurses and absence of

incentives for overworks

Inadequate accommodation or vehicle facilities.


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gaps in relation to service?gaps in relation to service?4. Issues related to higher education of nurse-midwives

due to

No opportunity for MSc. & PhD. In nursing in thecountry

Limited scope for direct and post basic bachelor

education for nursing

No posting or promotion for higher educated nurses that

resulted lack of interest for self development as well as

professional development.


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gaps in relation to service?gaps in relation to service? In adequate support for higher education in

nursing.


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BD: 17. What are issues, challenges, &BD: 17. What are issues, challenges, &


Knowledge, skills, & attitude

Dedication & commitment

Technical knowledge on upgraded medical

facilities

Poor acceptance of the community towards the

nursing course (cultural acceptance)


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BD: 18. Any measures that are being implemented toBD: 18. Any measures that are being implemented toimprove the situation or what else should be done?improve the situation or what else should be done?

A. The measures that are being implemented to

improve the situations:

Revised and updated diploma & BSc. Nursing

curriculum


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BD: 18. Any measures that are being implemented toBD: 18. Any measures that are being implemented to

improve the situation or what else should be done?improve the situation or what else should be done?

Increases the number of nursing institutes, basic & post

basic nursing colleges and increases the number of

student admission (nearly doubled) Specialized courses for various discipline in nursing

(critical care, oncology nursing, emergency & trauma

nursing, geriatric nursing etc)

Create additional post like quality nurse manager,

infection control , ratio 1 nurse to 100 patients, nurse

clinician, nurse anaesthetist, IV therapist nurse,

rehabilitation nurse, nurse educator


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To respond the MDGs 4 & 5 , 6 month midwifery

course has been started & 3 years midwifery curriculum

approved (not started yet)


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3000 post has created for midwife to place them

at community hospitals level.

Approximately employed of 1747 new nurses in

different hospitals

26 nurses sent for Masters in Nursing from

Thailand and one for PhD in 2008 and 10 nursesfor Masters in 2011.


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Capacity building training for nursing research &

evidence based nursing by the support of WHO

Upgraded all diploma nurses from grade from 8th

to 10th (Third class to 2nd class)

Teachers development training occassionally

supported by WHO


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18. Any measures that are being implemented to18. Any measures that are being implemented to


B. The additional activities or initiatives to address

the existing situation in order to improve the

following measures should be done:

Change the current recruitment policy-the policy

for higher position should be based on education

and expertise. Creation for new post in all sectors of nursing

services including administration , education and

services


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Create facility for higher education in nursing

within the country (Masters in nursing & PhD in

nursing gradually)

Expand the scope for specialized nursing

education

Strengthening the nursing research & evidencebased nursing


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Provide accommodation facilities for nurses in

all levels and develop Day Care Centre for

nurses children. Since, 90% nurses are female.

Build up quality development policy & the

mechanism for continuous quality improvement

(CQI) Develop strategic plan for improvement in all

nursing fields.


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Provide ethical training for nurses focusing on

behaviour change

Create the post for head nurse/ charge nurse and

promote as qualification in education and

expertise.


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18. Any measures that are being implemented18. Any measures that are being implemented

to improve the situation or what else should beto improve the situation or what else should bedone?done?

Modify & enhance the nursing curriculum

Some modifications in the content to thecurriculum in relation to behavioural science and

communications need to be incorporated

In order to meet international standards inteaching and professional skills, some of the

most important behavioural skills would include:


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In the Philippine setting:In the Philippine setting:

Bangladesh could follow the model of some of

the nurse exporting countries like the Philippines

where nursing schools have teamed up withnorthern partners to create, develop, promote and

seek US based hospital and nursing home

partners who wish to alleviate their nursingshortages.


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In the Philippine setting:In the Philippine setting:

The partnerships have created strategic alliances

with the nursing schools and hospital system and

other health care providers.


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Suggestions/Measures:Suggestions/Measures:

Government of Bangladesh could come up with a

special project to establish at least one

international standard nursing college withtechnical assistance from development partners,

with the standard of intake at par with western

nursing institutes. *DG nursing & midwifery

*independent university of nursing & faculty


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Furthermore private universities should be

encouraged to set up international standard

nursing institutes to primarily target theinternational labour market

-should focus more on the skills development


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Laboratory equipment (skills laboratory) should

be designed to international standards eg:

dummies (resusci ann, Mrs. Chase,resus for adult& pedia), crash cart, OT surgical instruments


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Thank You!Thank You!

Quote of the day : What I do todayQuote of the day : What I do today

is important because I amis important because I am

exchanging a day of my life into it.

exchanging a day of my life into it.

bnc workshop group v

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