God’s own country is no longer the leading supplier of nurses. Lesser states such as Karnataka, Andhra Pradesh, Punjab, Madhya Pradesh, Rajasthan and Maharashtra have leaped ahead, radically redefining healthcare across the nation.

While Kerala, which in popular perception has been known to produce the largest number of nursing graduates, has seen a moderate year-on-year growth, Karnataka and AP have added half-a-thousand seats in a bid to expand nursing education. The expansion of hospitals fuelled the trend and Kerala’s neighbors fervently responded to that call.

From 2003/04 to 2010, nursing schools in Karnataka and Andhra Pradesh multiplied at a feverish pace, churning out nurses in ever-increasing numbers, varying in ability, passion and preparation. To boost the count of graduates, state governments took a lenient view towards nursing education, allowing several private players to set up schools (for diploma courses) and colleges.

Young ladies who used to travel, albeit in small numbers, from Punjab, Rajasthan and Maharashtra, to Kerala also saw schools coming up within their neighbourhood. “Moreover, from across the country, students knew that there was easy entry into nursing colleges in Karnataka where there was no entrance exam. Also, there are colleges which run non-attendance programmes,” said Latha R, registrar of the Kerala Nursing Council.

Sources explain that the glut in nursing institutes has forced some to offer external courses, which do not require candidates to attend college; they merely need to pay fees and finally take an exam for graduating as a nurse.

That kind of ‘liberal’ education probably brought down the quality of nurses in Indian hospitals and those exported abroad. “Recently, heads from UK’s Nursing and Midwifery Council visited India to find out why the quality of nurses had degraded and they realized that the education and training offered in many states was rather poor,” added Latha R.

“There are so many one room nursing schools. Yet, the Indian Nursing Council (INC) gives them permission to run. The proliferation has led to a massive deterioration in nurses training from Karnataka,” said a principal of a deemed medical university in Navi Mumbai.

But Karnataka too probably has woken up to that. In 2005, a government committee recommended closing down of many of the 800 colleges, many of which were not physically standing. These colleges were on paper and ran external programmes. Now a campaign for improving the quality and range of teaching has forced the nursing council to trim student intake despite permission from the INC.

BN Muninarayanappa, registrar of the Karnataka Nursing Council said the “golden era” of nursing in his state is over. “More than 50% nursing institutes have closed down after 2010. Earlier there was an exodus of students from the north east, Rajasthan, Delhi, Haryana, Gujarat and UP. Now there are not as many students coming as nursing institutes have come up in good numbers everywhere in the country,” he said.

The drive to improve quality, Muninarayanappa said, has picked pace. “Now we do not permit colleges to admit students based on the INC sanctioned strength. Even the graduation rate has fallen and our results are about 15% on an average.”

State nursing councils and college heads across the country criticized the apex body — INC — for diluting the quality of nursing education. “Caring for patients long after doctors have made their daily rounds, nurses see hospitals at their very best and their absolute worst moments. In short, nurses are the foot soldiers and their training has to absolutely controlled,” said a principal.

Date: April 12th, 2014

Source: TOI