Present nursing dilemmas in Nepal

Currently, there are two clear groups: BSc and BN graduates. And since it’s BN that has been accepted all these years, BSc graduates are normally pushed aside when it comes to employment opportunities.

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When Sabina Khatri, 23, returned to Nepal after completing her Bachelors of Science (BSc) in Nursing from India, she was unable to find an appropriate job at any recognized hospital. Whenever she approached any hospital, she was denied employment on the basis of her lack of experience in the field. Competing for the same position with graduates of Bachelors in Nursing (BN) who have many years of clinical knowledge, Khatri’s chances of finding a proper job seemed almost impossible.

“I didn’t know about the preferences of BN over BSc when I decided to study nursing. When I came back, I was frustrated to find out that though hospitals had vacant positions, they wanted to give them to people who have the BN background,” says Khatri.

Khatri represents the frustration of many like her who have taken to BSc Nursing courses instead of the regular BN courses. Before the introduction of BSc Nursing courses in 1996 by the BP Koirala Institute of Health Sciences, BN was the only way of becoming certified nurses. But unlike in other Bachelors degree courses, a person is required to complete their PCL level in Nursing, or in popular terms, must have completed the degree of Staff Nurse and worked for two more years to be eligible for the BN course.

The BSc Nursing degree, however, does not require the applicants to have any prior experience in the field. They don’t even have to have completed PCL Nursing; instead, they should have completed their Intermediate in Science.

“BN graduates are certainly more exposed to the practical field than graduates of BSc Nursing like us. And sometimes, even the senior nurses only have the background of PCL-level Nursing. So when we go to the field, no matter what knowledge we have about health sciences, their practical knowledge overshadows us,” says Pramita Shrestha, 26, who had completed her BSc three years back from Purvanchal University.

Though BSc Nursing courses were available in Nepal since 1996, its prominence only rose in the mid-2000s when other academic institutions associated with Institute of Medicine (IOM), Kathmandu University and Purvanchal University also started to offer such courses.

But with regard to the preference of candidates from BN courses in hospitals, why was BSc Nursing courses introduced in the first place?
“When it was first introduced, I had the same doubts about the BSc graduates. Like everyone else, I was also skeptic if they would be able to perform as good as their BN counterparts. But now, having worked with some of the BSc graduates, all my doubts have been cleared,” says Sanu Tuladhar, Principal of Kathmandu Model Hospital School of Nursing (KAMHSON) which currently offers PCL and BN courses only but will be introducing BSc Nursing courses also, probably from this year.

Tuladhar adds that it is natural for people to oppose the change during its initial phase but she also blames the abrupt introduction of such courses without proper planning in establishing the graduates in the competitive work field like nursing.

“Currently, there are two clear groups: BSc and BN graduates. And since it’s BN that has been accepted all these years, BSc graduates are normally pushed aside when it comes to employment opportunities,” she says.

Shrestha, who has resorted to teaching after having difficulty in working in many different hospitals, says that BSc graduates may also have been discriminated against as they also pose as threats to many senior nurses who have only completed their PCL level. “It’s obvious that when new more knowledgeable batches of nurses arrive, the old ones will have insecurity regarding their career,” she says.

Tara Pokharel, Campus Chief at Maharajgunj Nursing Campus, also believes that the prejudices against BSc Nursing aren’t because of their capabilities but due to the attitudes of fellow professionals and the authorities concerned.

“BSc graduates, with their elaborate knowledge of health sciences, can form more efficient teams in the field. They may be a little short on practical experience at first but they can catch up to that level within a few months,” she says.

There’s no doubt that BN graduates have sound practical knowledge, as a large part of their academia is based on their practical experiences. It’s natural for any individual or organization to trust those who have already worked in the field than those who have just stepped into it. However,, academic institutions opine that BSc courses are more reliable in terms of detailed understanding of health sciences and its relevance with international standards.

Though Shrestha is distraught over the less employment opportunities provided by her academic background, she says that she may have higher chances of acquiring employment in foreign hospitals or even scoring scholarships in foreign countries for higher studies.

“BN course graduates need some years to be qualified for studies abroad even though they may have years of experience,” she says.To address the very issue, nursing campuses have increased the academic year duration for BN students from two years to three years. “We developed a new curriculum and started the new course since last year,” says Tuladhar.

The Maharajgunj Nursing Campus is also working to increasing the duration to bring BN courses closer to international standards.“The curriculum has also been improvised to accommodate more science-related knowledge that could help the graduates to have a clear reasoning of their work while working in a team. We’ve tried to include parts of elaborate courses that are taught to BSc Nursing students,” says Pokharel.

With equal measures of pros and cons on both courses, both are good in their own respective areas. Though the government has categorized graduates of both courses at the same level, BSc graduates still complain of being looked down upon for having fewer years of experience.

The BSc Nursing courses are going to thrive in another 4-5 years. They are not less capable than BN graduates in any sense; they just need a little space to work on their clinical abilities and a change in people’s attitude,” adds Pokharel.

Many students who take BSc Nursing courses come to know about the preference of different degrees only after they have ventured into it. Even though the curriculum is said to be more advanced by academic institutions and they are expected to have a rational reasoning in addition to clinical knowledge, their chances of employment look slimmer in comparison to the BN graduates. Therefore, it is a high time that concerned authorities review both the courses, and design them so that they evenly fit with the requirements of the employing institutions as well as in accordance to the international standards.

source: Manandhar, Asmita (2013),"Present nursing dilemmas in Nepal",republica,5 July 2013
photo courtesy:Keshab Thoker/republica

2013-07-09 | EducateNepal


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