Dual role in Nursing education and clinical services

Dr. Shailla Cannie

“Let me dedicate my life today to the care of those who come my way. Let me touch each one with a rejuvenating hand and the gentle art for which I stand. And then tonight when the day is done, let me rest in tranquility if I’ve helped just one.”
For Health for All to be achieved there must be a transformation in the approach to health and wellbeing. With a core role as a patient advocate, their scientific reasoning skills, numbers and spectrum of care across the continuum, nurses are ideally placed to lead and appraise health accommodations decision making and policy development. This year theme of International Nurses day is dedicated to A Voice to Lead—-Health for All
As one of the most trusted and revered health vocations, nursing has a pivotal role to addressing the multiple health challenges that are being faced all over the world. Nurses are the engine room of the health system and are required to respond to the health desiderata of individuals, communities and the world. In today’s health care scenario in India providing quality of inculcation and clinical training in health care is a great challenge. The collaboration between inculcation and accommodation is the vigor to provide quality care. Education and practice both provide direction to one another. Education influences best practices in clinical area and likewise demands evidence from practice influencing scholastic offering.
The Indian Nursing Council in its new resolution has introduced Dual Role of nurses to achieve optimal patient care, improve quality care and qualitative nursing education through effective utilization of qualified faculty and top of that to bridge the gap by pooling the human resources. The dual role policy will elevate the quality of services at numerous levels such as: — Promoting the utilization of humanistic approach of learning, fostering edifying and learning support of nursing from qualified faculty and staff, enhancing better orchestrating, implementation and evaluation of care, exposure to current trends and practices and to ideal role modeling, facilitating an efficacious but flexible management styles with edifying being apperceived.
In India, the healthcare system is undergoing a radical change and there are unmet health targets. The vicissitude is due to the modifications in demographics, advancement in medical technology, profit earning mentality, immigration, task shifting, edification-accommodation gap and economic recession to list a few. Subservient to medical fraternity even though long back it has been developed as vocation (WHO).Nurses facilitate co-operation from other healthcare providers e.g., medicos, paramedical staff and other ancillary staff. There are several daunting challenges faced by nurses at workplace which leave them less efficient in rendering quality care to patients, thereby hoisting an insalubrious reputation to that particular healthcare setting. Nevertheless, these challenges are disputably the primary motivators for nurses to leave their vocation, less students opting for nursing vocation, thereby contributing to staff shortage. They immigrate to other countries as remuneration and working condition are more respected in all terms.
Nurses and midwives account for proximately 50% of the ecumenical health workforce. There is a comprehensive shortage of health workers, in particular nurses and midwives, who represent more than 50% of the current shortage in health workers. The most immensely colossal needs-predicated shortages of nurses and midwives are in South East Asia and Africa. For all countries to reach Sustainable Development Goal 3 on health and wellbeing, WHO estimates that the world will require a supplemental 9 million nurses and midwives by the year 2030. Nurses play a critical role in health promotion, disease obviation and distributing primary and community care. They provide care in emergency settings and will be key to the achievement of Universal Health Coverage agenda Health for All. When we talk about shortage of nurses, the need for the dual role arises to combat the situation.
The dual role is as well supported by International Council of Nurses and World Health Organization. This step will reduce the urgent need of staff up to some extent. It is acceded that there is an exigent need to increment nurse staffing in order to achieve safe levels for patients and the population, and that nurse retention must additionally be amended. “Retention and training of in-country nurses is the key to addressing shortages,” verbally expressed Annette Kennedy, President of International Council of Nurses. Investment in the nursing education is needed in order to address the issues raised by the Human Resource globally.
The World Health Organization is developing a strategy on human resources for health. A consultation has concluded that progress towards Universal Health Coverage will require integrated, people-centered health facilities, an incentivized health workforce of nurses with dual capabilities and adequate financing from domestic and other sources. While the consequentiality of human resources in Universal Health Coverage and the Sustainable Development Goals agenda has been apperceived, the extent and impact of health workers’ with dual roles will give a dynamic turn and strength to the pooling of work force. Especially in low- and middle-income countries, the dual roles of nurses could prove to be fruitful in providing care and in education.
Dual practice of nurses plays a contributory factor in elevation of quality and standard. This will helps students in translating class room learning into clinical practice and enhances confidence and security of students due to presence of edifiers in clinical area. Besides, it keeps learners updated in theoretical/ clinical enlightenment. The added benefit helps students to learn clinical roles directly from their teachers who teach theory in the classroom. These will advances good interpersonal relationship with members of the health team who provide input into edifying students as well gives faculty the liberation to modify the cognition environment of the students in the clinical area as per the requisite. Assists in bringing advancement and transmutes in patient care area. Along with that the extension of community health practice supervised by nursing educators will develop the skills at excellent level.
This unique blend of practitioners with teaching could be applied at primary, secondary and tertiary levels of care. On the other hand, it will empower leadership roles in the nursing professionals and motivates in translating plans into actions, instrumental in building a positive and healthy work culture both as educator and practitioner. Dual role hoists the standard of patient care as well as preparing competent, empathetic nurses with professional excellence in their field.
I believe that we have learned and understood the value of academic/practice models of collaboration in health profession discipline, where inculcation and practice partner to ascertain that graduates are yare with the competencies obligatory to practice in our current and proposed health care environments. The academic and practice silos of the past are much less in evidence today. However, we still have much to learn about how to most efficaciously use partnerships to evaluate the impact of inculcation on ameliorated patient care outcomes. Such partnerships will become increasingly paramount to leverage the expertise and resources of both academic and practice settings which are needed to address the involution of patient care needs that we face in our country.
And determinately, to advance the science of nursing inculcation and evaluate the cognition outcomes associated with innovative incipient inculcation models and edifying strategies, it is essential that we predicate our practice as educators on evidence. The Dual role is well appreciated by other disciplines and accepted as a component of health team. Nurses are the powerhouse to bring change in the quality of health and promote Health for All.
(The author is Principal, Shri Mata Vaishno Devi College of Nursing)