Nurse education: in need of radical change for PHC?
Hammond, M.; Mazibuko, R.
Tropical Doctor 21(1): 5-8
1991
ISSN/ISBN: 0049-4755 PMID: 1998230 DOI: 10.1177/004947559102100104Document Number: 314663
Inappropriate models of nursing and nursing education based on the western medical model and medical education impede the development of adequate national health service and primary health services. Nurses are an untapped resource for primary health care (PHC) along with non-nurse PHC workers. They have the potential to change the nature, quality and quantity of PHC services to a much greater extent then investment in reform of medical education. Nursing's large numbers, position as health care providers, and their power in the community, district, and national explaining why radical nurse's education changes can have the greatest impact. The nursing education experience is the basis for the theoretical discussion of what developing countries need from the nurse. Questions of concern are what is the reality for most nurses in the 3rd World and how can nursing education be changed to prepare nurses to meet community needs. Nurses can provide clinical skills accessible to the community and respectful approaches and attitudes toward the impoverished. Nurses currently are geographically, socially, and psychologically removed from the community in need. Those working in rural PHC are ill-equipped by training and adjust poorly to conditions that don't meet ideal settings. However, in spite of the limitations of PHC training, these nurses may still be desired as the chosen provider over non-PHC trained personnel. Nursing education can be changed by changing content and process. The content must encompass an understanding of the social, economic, and political issues affecting health and health services, their clients, and themselves. Detailed situation and community needs must be incorporated into all curricula. Specialties need to be identified and a determination made about the suitability and number needed of comprehensively trained professional nurses with a hospital orientation. The author recommends limiting hospital nursing. Colonization has brought with it many disadvantages for health care. Authoritarian education which produced passive, subservient and uncritical nurses is not appropriate. An adult education approach with a new guard of educators equipped to train active PHC workers, educational policies which support educational innovation, and practical hands-on-learning is needed. The changes are necessary to produce confident, supportive community oriented nurses.