NURSING SEMINAR TEHERAN, 9-19 NOVEMBER 1966
Transcript of NURSING SEMINAR TEHERAN, 9-19 NOVEMBER 1966
WORLD HEALTH ORGANIZATION -, Regional Office for the Eastern Mediterranean
REPORT ON 'IHE NURSING SEMINAR
Teheran, Iran
9 November - 19 November 1966
Ei'Il/NURS./149 EMRO 0107
FEBRUARY 1968
ENGLISH ONLY
Participants and Observers who attended the Regional Nursing Seminar held in Teheran, Iran, 9 -19 Novem ber 1966
Received in audience by H.I.M. the Empress Farah of Iran
The views expressed in this report do not necessarily reflect the official policy of the World Health Organ~zat~on.
This document has been prepared by the WHO Reg~onal Office for the Eastern Mediterranean for Governments of Member States in the Region and for those who participated in the Seminar. A lim~ted number of copies is available on request for persons officially or professionally concerned with the field of nursing.
WHO EMRO
INTRODUCTION
CHAPTER I
CHAPIER II
CHAPTER III
CHAPIER IV
CLOSING SESSION
ACKNOWLEDGEMENT
ANNEX I
ANNEX II
ANNEX III
ANNEX IV
ANNEX V
EM/NURs./l49 page i
TABLE OF CONTENTS
· ....... " " . " ... " ". . ............. " ....... , .. . THE NURSING SITUATION IN THE REGION ••••••••••
~ 1
5
SrnIMARY OF PRESENTATIONS AND GROUP DISCUSSIONS 13
1. Nursing: Its Nature and the Needs of this Region ..... """"""""" .......... " •• " •..• ,,.. 13
2. The Achievement of Understanding, Cooperation and A Desirable Working Relationshlp Between Nursing Service and Nurs~ng Education •••.•••.•.•••.•.••••.•• 17
3. The Criteria for Suitable Field Practice Areas for the Education of Nursing Students ."".,," to • • • • • • • • • • • • • • • • • • • • • • • • • 23
4. The Responsibilities of the Hospital Auxiliary and Institutional Services for Meeting the Criteria ••••.••••••••••••••• 31
5. The Role of the Nursing and Other Professional Staff in Meeting the Criteria for SUltable Practice Areas for the Education of Nursing Students ••••••••••••• 39
SUMMARY OF RECOMMENDATIONS 41
EVALUATION OF THE SEMINAR AND SUGGESTIONS FOR FUTtJRE SE1JIllJ'ARS ••••••••••••••••• "............ 43
• ••••••••••••• .s ••••••••••••••••• " •••••••••••••
• ••••••••••••• a " ••••••••••••••••••••••••••••••
AGENDA
LIST OF PARTICIPANTS, OBSERVERS AND WHO SECRETARIAT
OFFICERS OF '!HE SEMINAR
LIST OF DOCUMENTS
ORGANIZATION OF '!HE SEMINAR
47
50
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INTRODUC1'ION
E}II/NURS./l49 page 1
The second WFO Hursing SeJTIlnar ~n the Eastern Mediterranean RegiDn
\-las held in Teheran, Iran, from 9 - 19 November 1966 in cooperat~on
wi th the Goverl1!:lent of Iran. The~e were twenty-eight participants
from Afgh~stan, Cyprus, Ethiopia, lran, Iraq, Jordan, Kuwa~t, Lebanon,
Pakistan, Somalia, Sudan, Syr~an Al'ab RepubliC, Tunis~a and the U=ted
Arab Republic. In add~tion there were twelve observers from the host
country, two observers from United Nations Organizations, three observers
from other organizat~ons, and the Resource Group which consisted of the
five members of the Regional Panel of Nurses, f~ve World Health Organization
nurse educators, Mr. Khosrow Madidi, Director, Pahlavi Hospital, University
of Teheran, Dr. G. Rifka, Pubhc Health Administrator, WHO Regional Office
for the Eastern Mediterranean, M~ss Evelyn Matheson, Regional Nursing
Adviser and Miss Margaret D, McLean, WHO Special Seminar Consultant.
The central objective of the seminar was "to strengthen and improve
the learning exper~ences afforded the nurs~ng student ~n the field
practice areas."
Contributory object~ VI'S "Iere:
(i) To promote better understanding of the relationship between
nursing education and nurs~ng service;
(ii) To ach~eve ~ncreased understa.nd~ng of the necessity of full
cooperation between nurs~ng service and nursing education;
(11i) To determine factors ~n the field practice areas which
influence student le~ng.
(iv) To define the req~rements necessary fop meaningful lear=ng
in the field practice areas;
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(v) To determlne the ways in which nurse educators and nurslng
serVlce personnel can work together towards the effective
educatlon of students In the field practice areas.
The maln topics for the presentations and study group sessions were:
1. Nurslng: It's Nature and the Needs of thlS ReGlon.
2. The Relatlonshlp Between Nurslng Educatlon and NurSlng Services.
3. The Achievement of Understanding and Cooperation between Nursing
Servlce and Nursing Educatlon Personnel.
4. The Crlteria for Suitable Fleld Practice Areas for the Educatlon
of Nursing Students in relatlon to:
a. The organlzation and administration of nursing and
other instltutlDnal servlcesi
b. Personnel;
c. Physical facilities;
d. Equipment and supplies.
5. The Responslbllities of the Auxillary and Institutional Servlces
in Meetlng the Crlteria.
6. The Role of the Nurslng and other Professional Servlce Staff In
the Educatlon of Nurslng Students in the Fleld Practice Areas.
At the inaugural sesslon, Hls Excellency Dr. M. Shahgholi, Minister of
Publlc Health, Imperlal Iranian Mlnlstry of Public Health, His Excellency,
Dr. J. Saleh, Chancellor, University of Teheran, and Dr. A. H. Taba,
Regional Director for the Eastern Mediterranean Region of the World Health
OrganlZatlon addressed the meetlng. Hls Excellency Dr. M. Shahgholi
discussed the changes In mediclne and nurslng In the Region since the first
re~onal seminar in 1960. He emphasized that the primary purpose of
the Semlnar was to provlde an opportunlty for nurse educators and nursing
services adminlstrators to study together the improvement of the education
of nursing students as related to all of the fields in whlch these studen~
WHO EMRO
receive their practical experiences.
EM/NURS./l49 page 3
He expressed the wish that the
participants would find better ways for nurs~ng to achieve its sc~entific
objectives and its human~tar~an ends. fus Excellency Dr. J. Saleh
gave a brief history of nursing ~n Iran during the past thirty years.
He pointed out that pat~ents are benefiting from advances in medicine
but that at the same t~me they are receiving less personal care from
health personnel. He emphasized that patients st~ll need reassurance,
relief, sympathy and solace and that nurses must supply these. He went
on to say that although nurses with degrees, cl~ical nursing specialists,
qualified nurses and ass~stant nurses are needed in larger numbers,
quality must not be sacr~ficed to quantity. Dr. Taba then addressed the
assembly. After thanking the Government of Iran for welcoming the
Seminar to Iran and for their cooperatwn in the planning of the Seminar,
Dr. Taba pointed out that the agenda of the seminar was planned to
stimulate thought and discussion on the field practice areas for the
education of nursing stUdents. He expressed the hope that the recornmend-
ations of the seminar would lead to the provision of nursing best designed
to meet the needs of the peoples of the Region, in the promotion and
restoration of health and in the prevention of disease.
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CHAPTER I
THE AURS1NG SITUATION IN '!HE REGION
Six years ago, at the t~me of the first Reg~ona1 Nursing Seminar
in Lahore, West Pald::;tan, it was stated that among the weaknesses and
inadequacies impeding T~e progress of nurs~ng in this Region were the
"insufficient numbers of quahfied teaching and adm~nistrative staff;
inadequate cl~nical and f~eld facil~t~es for productive learning; lack
of underst~ng by professional workers and the publ~c about nurs~ng;
the dearth of literature ••• wr~tten by nurses for nurses; outdated 1 nurse practice acts or the abeence of an act altogether ll
•
The participants at th~s Seminar concluded that, if professional
nurses were to make a significant contribut~on to the development and
strengthe~ng of the health situation and serv~ces of this Region,
cons~stent effort on their part was essential. They envisaged that
necessary for the attainment of this contribut~on were:2
1
- the estabhshment or strengthening of nursing dHisions wi thin M~~str~es of Health;
- the establ~shment of reg~stration of nurses and legislation for nurs~ng;
- the formation of nat~onal nurses' association~with the goal of membership in the International Counc~l of Nurses;
- the organizat~on of ndt~onal nurs~ng seminars or meet~ngs;
- the constant evaluat~on, review and improvement of nursing education programmes, des~gned to provide nurs~ care and attention based on the health needs of the nation;
Jeanette A. P~tcherella and A. Dorothy Potts. Development of Nursing in the Eastern Me~terranean Region of the World Health Or anization Alexandria: EM NUBS. SEM. 21, 5 November 1960. p. 7
~orld Health Organ~zation Reg~onal Off~ce for the Eastern Mediterranean. Nursing Seminar, Lahore, Pakistan, 23 November - 3 December 1960. Final Report. Allexanc.ria: 1961, p.31
EM/NURS./149 page 6
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- the establishment of a regional programme by the World Health Organization for post-bas~c preparat~on ~n nurs~ng education;
- the establ~shment by the World Health Org~zat~on, at the reg~onal level, of refresher courses for nursing personnel w~th many years of serv~ce to the~r credit.
How well have been overcome, ~n the past s~ years, the weaknesses
and ~nadequacies impedinG the progress of nurs~ ~n this Reg~on? How
significant has been the contribution of profess~onal nurses to the
health of this Region? How many of the env~saged necessary developments
have taken place?
present time?
What is the nurs1ng s~tuation 1n the Region at the
Whereas many of the nurs~ng resources, needs and problems are similar
~ the twenty countries of the Region, there is not a s~ngle "nurs~ng
situation" but rather many "nursing situations" in a region in which
countries vary so much 1n their socio-economic development, their geography
and their human and phys~cal assets and potential.
There is great divers~ty 1n the preparat10n and act~vit1es of nurses
in this Region today.
The first graduate of the Higher Inst~tute of Nursing, University
of Alexandr~a, to rece~ve a doctoral degree, returned to the faculty of
this programme in November 1965; at the same time, plans were being
made in Dammam, Saudi Arab1a, to replace the on-the-Job tra~ning which
had been g~ven to-date by an organized educat10nal programme for aux1l~ary
nursing students.
The future nurses of Yemen are rece~v~ng an e1ghteen-month programme
of nursing studies, follow~ng a s~-month course which ass~sts them to
become adequately literate in the Arabic language; selected students
are undertaking bas~c nurS1ng stud1es lead1ng to a bachelor's deGree 1n nursing
in Iran, Iraq, the Lebanon and the United Arab Republic.
In Tunisia, the graduates of the two-year basic nurs1ng educat~on
programmes are afforded a year's post-basic course which qualifies them
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to assu~e pos~tions as nurs~ng ~~strators or educators; in Iran,
plans are being made to establ~sh a two-year univers~ty-level programme
for graduates of the three-year diploma schools, which w~ll provide for
specializat~on ~n clinical nurs~ng specialities, in nursing services
admin~strat~on and ~n nursing educat~on, and will lead to the granting
of a bachelor's degree.
In certain of the Reg~onal countr~es, special and simple in-service
courses are provided to prepare otherw~se untrained workers to function
as "nurs~ng personnel II in rural heal th, tuberculos~s and communicable
eye disease programmes; in others, nurses trained to the auxiliary level
only are carrying out functions, and accepting responsibilities, which
by r~ght belong to the medical irofess~on; ~n many areas, professional
nurses are spending much of their time in messenger, clerk and reception
ist activities.
In recent years, nurses have functioned in this Region as consultants
w~th national health planning projects and as advisers ~ other top-level
nat~onal health programme activities; during this same period, nurses
have been designated and treated as health or medical auxiliaries, with
:1:) provJ.sion made for a voice in the planning and conduct of even the
nursing programmes.
In the SUdan, after more than ten years of WHO assistance, the
programme of the Khartoum Nurs~g College is under the sole administration
and direct~on of qual~fied national nurse educators, and there are but two
WHO nurses assisting with the development of the nurs~ng services of the
oountry; in Libya, the Organization is assisting with two schools of
nursing, plans to ass~st with the development of a third, and there are
at present t~rteen WHO nurses partic~pating ~n the development of these
and other health programmes, with prov~sion for the assignment of nine
additional WHO nurses.
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The divers1ty that exists in the Region today does not mean that
nurses have not bcen playing an appropriate and significant role in the
development and improvement of the health of their countr1es. Rather,
it 1S an indication of the many "faces" that nursing presents to its
public and emphasizes the many factors to be consldered in relation to
the "nursing Sl tua tlon ln tne Region".
Probably the most signlficant factors ln the contlllued progress
made by nursing in this Reglon during the past few years have been the
increaslng acceptance of lt as a career and the lncreasing recognition
of ltS importan~ role ln the health and health services of the nation.
To no little extent, the acceptance and recognition have been based on
the quality of the nursing serVlces rendered, the nursing education
programmes afforded and the courage and determination of the Region's
nursing leaders. However, to a greater extent, these have been based
on the continued emancipatlon of women throughout the Region, the con
comitant recognitlon and demand that women must play an active role in
the public life of developlng societies, and the increased support given
by Governments to nurslng.
The emphasl~ rylq~ed 0n developing and strengthening programmes for
the education and training of nurslng personnel, at the basic and post
basic levels and of the professional and auxiliary categories, has in
creased unquestionably the quantity and quality of nursing services
ava1lable in tne countr1es of thls Reg:l.On. However, in view of the
rapidly expandlng and increaslngly nore speciallzed national health
servlces,have the quant1ty and quality increased sufficiently?
It lS suggested that assessment of the nursing servlces of any of
the Region's countries does not reflect the lllterest and lmportance whioh
have been placed on nursing education and training and that there remains
much to do to provide for the quantlty, varlety and quality desired and
desirable.
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There ~s conttnu~d need ~ this Region to further expand and improve
the theoret~~al and pna~tical aspects of the nursing education programmes,
for the betterment; 01:' t''1e n 'r:,nn3; serv~ces provided.
Increased em}L.~s} s has been placed on the nurs~ng services and on
nurs~ng serv~ce', &~w·.' .3tro.tjon dUl'ing the past few years. The nurses
of Cyprus have . III ~jate0 spec' al at'tivi t~es U1 this respect and the
Government of l<u'u.i" hove requested consul tant serv~ces in assess~ng and
advising on the~~ nUl's~ng servcce pol~c~es, personnel and standards.
This emphas~s h?s also been seen in the appointment to schools of
nursing, in J.l'aQ, ';ordan, Libya, the Un~ted Arab Republic and else1fhere,
of nurse educacors qual~f~ed in nursing services admi~stration.
Further, the awareness of the Reg~onal Panel of Nurses of the pressing
need for ~mprovement in respect to the nurs~ng services led to the provi
sion of the opportunity to d~scuss, at the second Regional Nursing
Seminar, the mutual ~nterests and act~vities of nurs~ng administrators
and educators wh~ch are d~rected towards the imprOVement of the health
of the nation and of the preparation of nursing students to help meet the
health needs of t~e2r people.
When cons ... ' ... "," a v ... Ull ... " <>.l. voll to what tne par-::'~cipants at the Nurs~ng
Seminar in Lahore in 1960 envisaged as being necessary accomplishments
if profess~onal nurses were to play sign~ficant and appropriate roles ~n
the health programmes of their countries, it would appear that the nurses
of this Region have fallen far short of making this contribution. There
has been l~ttle s~gnif~cant increase ~n, or strencthen1ne of, national
nurses associat~ons-~"d nurslnc d~v~sions within Ministries.of Health.
The process of establ~Ehin6 registratjon of nurses and legislation for
nursing in the Reg~onal countries has yet to galn momentum. The World
Health Organizatlon has not established regional programmes for post-basic
preparatlon in nursing educatlon or refresher courses for nursing
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personnel with a long record of serVlce. There have not been the
number of national nursing seminars and meetlngs whlch would have
proVlded for adequate review, evaluation and improvement of both
nursing educatlon and serVlces. Required are sound and effective
proposals for better meetlng the objectlves of nursing and nurses In
thls Region in the future.
The revlews presented at the Semlnar, of the nurSlng situatlon In
each of the fourteen countrles represented, showed that there have been
noteworthy accompllshments durlng the past six years but the tasks still
confrontlng the nurses of this part of the world were clearly lndicated.
A summary of the statlstics presented revealed that:
1. In all fourteen countries there appears to be a shortage of
quallfied nurses, lncluding nurse-teachers.
2. All but one country appear to have lnsufflcient funds for
nursing programmes.
3. Three countries only have leglslation for nurslng.
4. Six countries have natlonal nurses assoclations, flve of
these having membershlp In the International Council of
Nurses.
5. Flve countries have a Nursing Councilor Board which is
responsible for the admlnlstration of examlnations and the
reglstratlon of nursing personnel on completlon of baslc
studles.
6. There are nurses functlonlng at the Central level of the
Minlstries of Health of sIx of the countrles. In another
country, a senior nurse admlnistrator acts in an advisory
capaclty to the central health admlnistration, when re
quested to do so.
WHO EMFD EMjNuRs./149 page 11
7. The number of ~ategor~es of tr~ned personnel in the
fourteen countr~es varies f~om one to six. In addition,
there are untral~ec a~des or servants working within
the nurs:'L!g systeTJ :in most, if not all, of the countries.
8. Four countrlSG nave educational programmes in nursing
leading to a bachelor's degree. One country reported
plans for the establishment of a master's degree programme.
9. For th8 most part, there is provis~on for training in m1d-
wifery follOi'ling basic nur~ng studies. Post-basic educa-
tion in ward administratlon, in teaching and supervision
and in public health nursing is provided in certain
countries. Training in anaesthesiology and operating
theatre technique is provided for graduate nurses in
several countries.
It was interesting to note that one country only mentioned that the
utilization of nursing personnel and the ~nadequacy of physical facili-
ties presented problems. '!his same country was the only one to report
the need for better qualifled personnel in the nursing service department.
No mention was made in thp presentat~ons of lack of support from the
other professional, the auxiliary and the ~nstitutional services. Only
one country reported that the shortage of reference material in the mother
tongue was a problem.
The maJor objec~ves of nursing, as brought out in the presentations,
were:
1. Improvement of field practlce areas, with the goal of
improving nursing care and attention.
2. Increase of L1ursing services in rural areas.
3. Provision of staff education.
4. Improvement of the position of nursing in the country.
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CHAPI'ER II
EM/NURS./149 page 13
SUMMARY OF PRESENTATIONS AND GROUP DISCUSSIONS
1. NURSING: ITS NATURE AND THE NEEDS OF THIS REGION
Mr. A. Daly Mrs. E.I. Kamel Mrs. L.I. Kamel Ml.ss A.J. Musallam
Mrs. A.A. Osman Mrs. A. Sultan Mrs. A. Wolderufael Mrs. A. Zalat
Mrs. Glor1a Press - Moderator
The panel described the nature of nursing, highlighted the ~eeds
and problems existing 1n the Region and gave some suggestions for action.
The nature of nursing was described as a service to people in which
technical knowledge and sk1lls and sympathetic and compassionate caring
are combined and are based on an interest in and acceptance of the
individual patient and his family as they are.
The needs of the Region, based on the country reports, were for
addi tional and better qualified nursing personnel at all levels, addi
tional and more adequate physical faci11ties, adequate supplies and
equipment and finances. Common problems brought out in the panel dis-
cussion were a lack of understand1ng and cooperation between nursing
service and nursing education; a lack of a sense of respons1bility in
many persons who give nursing care; an inadequate level of general edu
cat10n of many of the nurs1ng students; the placing d! new graduates
in pos1tions in which the responS1bility 1S greater than that for which
they have been prepared; lack of understanding,of the role of nursing on
the part of physicians and other health professionals.
The panel members emphasized that while nursing must set lugh goals
of education and serV:1ce, a start must be made with what is available
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and the situatl0n must be improved realistically. For instance,
lnstead of comniserating on the shortage of nursing personnel, it must
be ensured that the personnel avallable are being used optimumly;
lnstead of complalnlng about low budgets, the budgets available must
be utl11Zed wlsely. Panel members emphaSlzed the need to plan at
all levels; for reallstlc job descriptlons; for qualified nurses to
demonstrate the role of nursing by the excellence of the nursing care
provided; to prepare new graduates, by orlentatlon prograMmes, in-service
educatlon and short courses, for the responslbilitles they must carry.
In the small dlscussion groups and in the general discussion on
thlS tOP1C, the folloWlng aspects of the topic were studled:
1. Making more effective use of existing nursing personnel.
While the need for additional and better qualifled nurse teachers,
adminlstrators and practitioners and for additional assistant nurses
is great, all particlpants emphaslzed the importance of USlng all exist-
lng nursing personnel optimumly.
the better utilization of nurses:
A number of ways were suggested for
a. Better selectl0n of students: thls should be done by
selectlng students who are lnterested in people and in
helping people, Wlth an aptitude for nurslng and Wlth
a level of general educatlon that wll1 permit them to
be successful in the educational progr~~e.
b. The conduct of a survey of eXlsting nursing personnel,
to determ1ne the numbers of fully quallfied and
auxiliary nur~es. As a result, a number of nurses
might be located who could work part-time and facts
would be known on which to base refresher and post
basic courses whlch would lncrease the competence of
nursing personnel.
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c. The preparat~on of Job descriptions, which would delineate
the nursing act~vit~es of all levels of nursing personnel.
d. The removal of non-nursing actIvities from nurs~ service.
e.
Suggestions of ways to do th~s ~ncluded the employment
of ward secretar~es and the preparat~on of enough technicians
for radiology, cli~cal laboratory and similar activit~es.
Better placewent of new graduates, The new graduate should
be placed in a staff nurse pos~tion for one year before she
becomes a head nurse, instructor or director of nursing.
If this is not poss~ble, the new graduate should be helped
to carry out the respons~bil~t~es of administration or
teaching by a good orientation and through in-service
education, after a short concentrated course in teaching
or administrat~on.
f. Salaries based on qualificat~ons and ab~l~ty, with increments
given for excellence of performance as well as length of
service.
g. Due recognition to nurses who have given long service but
who have not had the opportunity for formal advanced
preparation.
2. The effective presentat~on of nursing to other professional
health workers, the public and personnel of related social agencies.
It was believed that th~s could best be done by:
a. qualif~ed nurses demonstrating that they are a well
prepared profess~onal group, giving an excellent and
needed service to people.
b. a Division of Nursing be~ng established in Ministries of
Health.
c. a Nursing Council being established in each country.
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3. The close collaboration of nursing serv~ce and nursing educat~on,
to improve the nurs1ng care of patlents and the clinical experiences of
nursing students in field practice areas.
4. The establishment of post-basic programmes which will enable
qualified nurses to become cl~ical nursing special~sts, teachers and
administrators.
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2. THE ACHIE\TEMF",'IT' OF UNDERSTANDING, COOPERATION AND A DESIRABLE
WOruaNG RELATIONSHIP BE'IWEEN NURSING SERVICE AND NURSING
EDUCATION
There were two panel presentations on th~s topic.
1. The Relationsh~p between Education and Service ~n Nursing:
Mr. G. Avraam M~ss F. D~narband M~ss R. McEwan Mrs. K. Mowla Mrs. W.R. Shaya
Mrs. N.A. Roboobi - Moderator
2. The Ach~evement of Understanding and Cooperation between
Nursing Service and Nursing Education Personnel:
Miss B. Amiri Miss K.N.A. Jal~l Miss E. Mitchell Miss A.S. Sa'ad Miss B.M. Saad
Mrs. F. Salsal~ - Moderator
Both panel presentat~ons used role-playing to bring out the points
whiob were considered to be important in achieving understanding, cooper
ation and an effective work~ng relation~p between nurs~ng education
and nursing service.
goals:
The following were suggested to achieve the desired
1. Mutual understanding and compatib~l~ty in respect to
philosophy, object~ves, programmes, responsib~l~ties
and problems. This could be achieved by nursing
service and nursing education personnel meeting to
gether regularly to keep abreast with each other's
programmes.
2. .Cooperation in setting up nurslllg procedures and policies,
in planning the clinical experience of nursing students,
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and ~n solv~ng problems, Both the nursing students
and the nUls~~g u~~t personnel should be prepared for
the students' fiel~ p~actice befo~e lt begins. All
must understanu the purpose and content of the cl~n~cal
expe~ience ln the f:teld oractlGe area if ~t ~s to
provlde m~alllng[ul learnlr-g ~or the students.
Partlcipation III each other's programmes. Quahfled
nurses lD tne nursing serv~ce department could part~cipate
La the formal teachlng programme by demonstrating a
procedure or an aspect of nurslng care ~n wh~ch they have
SpeClal competence. In a simllar manner, the instructor
could help or support the head nurse ~n the provision of
nursing serv~ce to pat~ents.
4. Both nurs~ng education and nurs~ng serv~ce personnel should
set a bood example for the nurSlng student. They should
demonstrate deslrable attitudes towards patients, respect
for author~tYI profess~onal conduct and good nursing care.
In the small group d~scussions, the follow~ng aspects of the topic
were studied"
1. How to develop a prac~~cal plan for nurs~ng students' exPerience
in a field prdct~ce area. The steps to be kept in mind in
plannLng were cD~sidered to be:
a. To deflne what the qual~f~ed nurse needs to know and be
able to do.
b. To determ~ne the learn~ng exper~ences necessary to pro
duce this nurse.
c. To consult with the author~tles in each field practice
area on:
i. Phys~cal facil~t~es - clinical, llbrary, etc.
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ii. Transportation to the field practice area.
iii. Student health serv~ces.
iv. Student disc~pl~e and supervision.
v. Procedure and pol~cy manuals.
vi. Kinds of assignments ava~lable.
d. To prepare students for the experience through assisting
them to an understand~ng of:
~. Nursing and hospital ethics.
ii. Desirable behaviour.
~~i. Interpersonal relat~onships in nursing.
iv. Economy of t~rne. effort, material and money.
e. To plan for the evaluation of student performance, with
nurs~ng service personnel participating ~n this.
f. To provide for regular meetings of nursing education and
nursing serv~ce personnel; to identify and discuss
problems, to seek for the~r solut~on and to evaluate the
experiences afforded students.
2. How nurs~ng students and nursing serv~ce personnel can he~helped to
develop an understand~ng of comprehens~ve nursing care.
The groups def~ned comprehens~ve nurs~Db care to be that which meets
the physical and psychosocial nursing needs of patients and suggested the
following ways to help nursing students and nursing service personnel to
develop this concept:
a. The f~rst part of the curr~culurn should ~nclude study of'
normal growth and development and human behaviour and
should emphasize nurs~ng ethics. To acquire the
necessary understanding, the student should be in con
tact with people and patients early in her educational
experience.
m/NURS./149 page 20
b.
WHO EMRO
student-patient asslgnments should be long enough
to enable the student to know the patient as a
person, to know his health probl~~s, his nurS1Dg needs
and the nurslng care reqU1red.
c. Quallfied nurses should partlcipate In glving nurslng
care to patlents 1n o~e~ to demonstrate to students
comprehenslve care and effectlve nurse-patlent
relatlonsmps. The Job descriptl0n of a staff nurse
must lnclude the givlng of nurslng care to patients.
d. The non-nurslng activltles carrled out by nurses
should be re-allocated to ward secretaries and train-
ed persons in other depart~ents.
e. In-servlce educatlon should be established for all
nursing personnel.
f. There should be standardization of nursing procedures
In the school and fleld practlce area.
g. Adequate equipment and supplies should be provlded.
3. How to develop good interpersonal relationsmps between nurslng
service and nurslng education.
The followlng Means of achleving thlS were suggested:
a. Knowledge and understanding of the pmlosophies of both
serVlce and education.
b. Orientation of all personnel, both service and educatl0n.
An organizational chart could be used to explaln lines
of authority ~~d channels of communicatl0n witmn the
serVlce organization.
c. Study of work situatl0n so that people and t1me can be
better used.
d. Better teaching of students ln psychology, human
relationships and communlcatlon skills.
WHO EMRO
e.
EMjNuRs./149 page 21
The subjects ment~oned ~mmediately above should
also be included in staff educational programmes
and refresher courses for nursing service personnel.
4. How to ensure that standards and procedures in field pract~ce
areas are compatible w~th those used ~n the school.
The groups believed standard~zed procedures ~n field practioe areas
were important to student learn1ng and suggested:
a. A committee of head nurses, staff nurses and
instruotors to draw up nursing procedures.
b. The use of establ~shed nursing procedures by
all nursing service personnel.
c. That nursing students should be helped to adapt
prooedures, while maintaining scient~fic principles,
if all necessary equipment is not available.
5. The value of gu~ded experience in rural areas for nursing
students.
There was consensus that experience in a rural health agency would
be valuable for senior nursing stUdents as it would give them a better
knowledge of the heal t.h needs of the country.
6. The developMent and ~mplementat~on of in-service education
for nursing service personnel.
There should be planned in-service education for all levels of
nursing personnel. Th~s should be planned ~n the light of the learning
needs of personnel, the obJectives of the nursL~g service department and
the nurs~ needs of pat~ents. It would ~nclude orientation, on-the-job
training in skills, specif~c programmes of instruction and staff develop-
ment for all personnel. Programmes could be of two types: one
conducted on topics of interest to all personnel ~n a single category;
the second planned and carr~ed out for all nursing personnel in a single
EM/NURS./l49 page 22
WHO EMRO
unit. Although it is difficult to find t1me for staff education, the
groups stressed that the quieter periods of the day should be used and
activities could be repeated so that all day, eVening and night staff
could attend. It was emphas1zed that it is imperative to start in-service
education, however simple and limited, as it is one of the most effective
methods of helping personnel to improve their performance.
WHO EMRO EM,/NURs./149 page 23
3. THE CRITERIA !'DR SUITABLE FIELD PRACTICE AREAS FOR 'lHE EDUCATION OF
NURSING STUDENTS
Mrs. A.J. Anton lv'JI's. N.M.H. El Hagrassy Mrs. L. Kamel Mrs. G. Mirkamal1
MJ.ss E. MJ. tchell fiJI's. F. Moustafa f.lrs. N.S. Nureddin Miss A. Riahi
Miss R.D. Hill - Moderator
The panel presented seven essential criteria for field practJ.ce
areas:
1. A well organized field practice area, with a philosophy
compatible with that of the school.
Lines of authority and channels of communication should be clearly
defined and understood by all. There must be agreement upon the areas
of responsibility of nursing service and nursing education. Ideally,
the administration should be democratic, as students learn better in a
democratJ.c atmosphere.
2. An adequate number of qualified staff in both service and
nursing education.
It was agreed that there should be qualified nursing service personnel in
numb~_s~fficient so that nursing students could see GOod nursing care
being given. There should be a sufficient number of competent teachers
to supervise the nursing students in all of their field practice experiences
- on days t evenings and nights. The ratio of instructors to students would
vary depending upon the year of the programme in whJ.ch are the students.
If there are not enough teachers to guide all students having experience
at night, an instructor should deflnitely be with students durfne;
the first of such experiences. Selected, coopetent qualified nur~es
on the nursing service~staff can~participate ~ the eoparviston of
nursing students' field practice, ±f necessary.
m/NURS. /149 page 24
WHO EMRO
3. Good worLing relationships between nursing education and
nursing service personnel.
This relat1ons~p must be based on mutual understand1ng and respect.
It can be built if plann1ng for student exper1ence, problem solv~ and
evaluation of student and programme are done together and 1f all levels
of nursing service and nursing education personnel have good communacat1ons
with each other. W1thou~ good interpersonal relationships between all
concerned, no field pract1ce area can be cons1dered a good place for
student learn1ng.
4. Suff1c1ent var1ety, quantity and qua11ty of experience.
There should be various areas in wh1Ch the student may practice, to
ensure a broad education but with t1me enough in each for learn1ng to
take place. Experience must be provided 1n normal growth and develop-
ment, and 1n prevent1ve, curat1ve, rehabilitative and social health
serVices, 1n order that the student be well prepared for her role as a
nurse. Pract1ce areas should be the best available but opportunity
should be given for stUdents to apply bas1c principles 1n less than ideal
s1tuations. The ava11able pract1ce areas May not meet the cr1ter1a
but they can be usee 1n the best poss1ble way, while action is being
taken to improve theM.
5. Accessib1:1ty of f1eld practice areas.
Considerable emphasis 1s placed by many scnools on the field prac-
t1ce areas be1ng 1U close proxim1ty to the school. It was agreed that
the maJor field practice experiences must be afforded in areas close to
the school but that spec1al experiencns such as obstetric, paediatriC,
psych1atr1c and publ1c health nurs1ng could be provided farther away,
if transportation 1S re11able and/or supervfsed liv1ng accommodation
available .. If all the essent.l.t,l f1eld practice areas are not
WHO EJI1PD EMjNuRs./149 page 25
available then a school should not contlnue its programme or the curriculum
should be approprlately modified.
6. Adequate supplies, eqU1pment and physlcal facillties.
Sufficlent supplles and equipment should be available for the nurslng
students to give good nursing care and to enable them to observe nursing
service personnel doing so. The supplies and equipment provided for
nursing students should not be atYPlcal for the institution or tbe country.
A library and conference room are deslrable but, if non-exlstent, some
reference material should be provlded and some place found where nurs~g
students can have nurslng care conferences.
7. Standardized nursing procedures.
The nursing procedures used in the field practice area should be
the same as those taught in the school. The procedures should be drawn
up by a committee of nursing serVlce and nursing education personnel
and will need periodic revision. The procedures should be written in
the mother tongue and easily accesslble to all persons giving nurslng
care.
The small study groups discussed the following aspects of the
topic;
1. An adequate number of quallfled staff in both nursing service
and nursing educatlon.
The groups agreed thnt lt was difficult to decide how many nurslng
service personnel were sufficient. It was believed that a qualified
nurse should be in charge of the fleld practice areas and that stUdies
should be undertaken in each country or acency to deelde on the
number of nurSlng personnel of each category required to give good nurs-
ing care to patlents. It was recognized that the number in each
category would vary according to patients' nursing needs. The nursing
EM/NURS./149 page 26
WHO EMRO
students should be under the supervision of a qualified instructor at
all times. To meet thls goal in-service educat10n must be established.
2. How to afford experience for students in the areas of normal
growth and deve10pnent and mental health nursing.
a. Practice areas related to normal growth and developments
It was suggested that nurs1ng students could acquire an understand
ing of normal growth and development early 1n the educat10nal programme
by having guided experience in home V1S1ting, maternal and child health
centres, paediatric out-patient c11nics and wards, orphanages, nursery
schools, kindergartens and pr1mary schools. Students should not only
observe but also part1c1pate 1n the services provided for the children.
b. Mental Health Nursing:
The stUdent should be introduced to the principles and pract1ces
of mental health nursing early in her experience. The teaching of
mental health nursing should start with normal behav10ur and should be
lntegrated in all clinical nursing courses. Specif1c experiences in
psychiatr1c nurS1ng should be afforded later 1n the educational programme.
If it 1S not possible to provide such an experlence a short course on
mental illnesses and on the care of the mentally ill patients should be
included.
3. The preparat10n of a nurslng procedure book.
The s~eps in setting up a nurSlng procedure book were outl1ned as
follows:
a. Invest1gate the service area 1n relation to needs,
eqUlpment and poss1ble but safe standards of prac-
tice.
b. Form a jOlnt committee of nursing serV1ce and nurs
ing educat1on.
WHO EMRO EMjNuRs./l49 page Z7
Suggested members were: DirecGor of Nursing Service3
D~rector of Nurs~ng Education, Clinical Instructor,
Supervisor, Head Nurse, Staff Nurse.
c. Con5ul~ w1th the hospital admi~strator and medical
perso~El. as required.
d. Plan for a procedure book wb2ch would have:
all procedures, ~n alphabetical or subject order
- a standardized procedure outline:
- object~ves
- equipment necessary
- points of emphasis
- steps ~n the procedure
- after care of the patient
- after care of equipment
- recording
- loose leaf pages so that ~ndividual procedures
can be revised as necessary
- procedures written in the mother tongue and in
the language of instruction.
4. How to obta~ adequate physical facilities, supplies and
equipment.
The groups d~scussed the subJect in relation to quality, quant~ty
procurement and distr~bution and concluded that:
a. A survey of needs and resources is necessary and
based on the results of this survey, standards for
qual~ty, quantity and type of equipment and supplies
shoUld be set up.
b. Nursing should be represented on the appropriate
committees and must be able to advise on, predict
EN/NURS./l49 page 28
WHO EMRO
and Justl.fy requirements for fac~li t~es, suppl~es
and eq~pment.
c. Nurs~ng must be able to accept new ideas and be
w~lling to relinquish trad~ t~onal " jobs" and
responsibilit~es that are of a non-nursing nature.
d. A central supply room for ster~le and non-ster~le
equ~pment and suppl~es should be set up, staffed by
tra~ned, non-nurs~ng personnel who would deliver
supplies to the nursing areas and p~ck up so~led,
used supplies. If a s~ngle central supply room is
not poss~ble then a small area for storing and pre
paring supplies can be set up in each nurs~ng unit,
with a non-nurse in charge.
e. It is important to have trained hosp~tal adm~n1stra
tors with a philosophy that enables all departments
to plan the best for the patients' well-being.
f. There is a need to evaluate the cost of maintenanoe,
repa1r and renovation of old buildings and compare
th~s w~th the cost of constructing new, more func
tionally des~gned bu~l~ngs.
g. Nurs~ng administrators should be able to understand
b~ld~ng plans and ~tell~gently present and Just~fy
the needs of nursing. Although new well-designed
bu~ld~ngs w~th adequate supplies and equ~pment do not
automatically produce better patient care, they do
help good doctors and nurses to do a better job.
5. How to attain suffic~ent var~ety, quality and quant~ty of public
health nursing experience.
The groups considered the organizat~on of ~nstruct~on and field prac~
tice in public health nursing. Students need to acquire: pos~t~ve health
WHO EMRO a.1/NURS. /149 page 29
attitudes, knowledge of health programmes, a knowledge of and skill in
using community resources, skill in teaching heal til and a knowledge of
how to participate l.n planru.ng, deVeloping, improving and evaluating
health programmes.
The above could be acquired by the students ~f there is emphasis
throughout the curr~culum on the promotion and maintenance of health,
prevention of disease and accidents, rehabilitation and public health
nursing; if students have GUided experience in cJ.lnic, home vis~t1ng,
school health, well-baby, industrial and mental health progranmesj by
using the services of all health and other social agencies.
WHO :WID EM/NURS./l49 page 31
4. THE RESPONSIBILIT'! OF THE HOSPITAL AUXILIARY AND INSTITUTIONAL
SERVICES FOR MEETING THE CRITERIA FOR SUITABLE FIELD PRACTICE
AREAS:
Mrs. M. Demissie M~ss A. Goevderelian Miss F. Hargett Miss A. Nasab M~ss M.B. PoorkaJ Miss B. Saad
Miss M.D. McLean - Moderator
The panel believed that the responsib~l~ty of the Hospital Auxiliary
and Institut~onal Serv~ces for meet~ng the criteria for s~table field
pract~ce areas could be fulfilled most effectively by these services
supporting the professional care serv~ces, includ~g nursing.
Many examples of the poor ut~lization of nurses were given. Head
nurses spend a great deal of t~me on non-nursing act~vities suoh as
writ~ng requ~sit~ons for food, X-ray, laboratory, drugs and other suppl~es;
filling in ~dentifying ~nformation on patients' charts;
telephones; looking for doctors; directing visitors;
answering
acting as
messengensand s~pervis~nb and direct~ng housekeeping and dietary staff.
Qual~f~ed nurses spend time in looking for, collecting and preparing
supplies and equ~pment to g~ve nursing care; ~n cle~ng up eq~pment
after use; ~n serv~ng meals and nour~shments; in cleaning beds and
bedside tables when pat~ents are disc~'ged and mak~ up the clean bed;
in making out d~et l~sts, charting temperature, pulse and resp~ration,
counting soiled l~nen and acting as messengers. Ass~stant nursing
personnel are also poorly util~zed as in many places they carry out many
housekeeping, dietary, messenger and supply functions. In several
places qualified nurses work as laboratory and X-ray technicians. Thus,
the time available to nursing personnel for g~ving and supervising nurs
ing care is decreased by the necessity of carrying out many non-nursing
EMjNTJRS.jl49 page )2
actJ. vi t~es.
WHO EMRO
A descr~ption of the relationship of hospital services was given -
see chart on page )C(. The patl.ent is the centr~ of hospital actJ.vity.
Around the pat~ent are the profess~onal care services (A) and supporting
these are the hosp~tal auxil~ary services (B), wh~ch ex~st because the
~nstitut~on is a hospital, and the Inst~tutional Serv~ces (C) which
exist in any ~nst~tution where a grou~ of people are housed and fed.
The hospital auxil~ary and ~nst~tut~onal serv~ces should carry out their
responsibilit~es fully so that the profess~onal personnel can spend all
of the~r time on patient care. For example:
a. The Admitting Department should ~dent~fy the patient and
send his f~le ready for use, including routine requ~sit~ons,
to the nurs~ng = t.
b. Housekeeping should carry out all housekeeping activities
including clean up of discharge units and making up of
clean beds.
c. Supply departments (l~nen, central stores, ster~le supplies)
should provide supplies at the time needed in the place
needed and ~n the most usable form, on a quota basis, and
should p~ck up, decontaminate and re-process all used
suppl~es and eq~pment.
d. X-ray and the cl~n~cal laboratory work should be done by
appropr~ately tra~ned techn~cians.
e. The d~etary department should prov~de meals and nourish
ment at the pat~ent's beds~de.
f. The pha~acy should supply all medications, ~ncluding
narcot~cs and dangerous drugs, to the nursing units on
a quota system.
WHO EMRO EM/NURS./149 page 33
g. All recept~onis" and cler~cal activ~t1es should be
carried out by a ward secretary.
It was suggested that hosp~ta1 plann~ng co~ttees give consideration
to placing the follow~ng un1ts contiguous in the physical plant: receiv-
ing, central stores, laundry, central decontamination, central packaging
and ster~lizing and processed stores. ~s would allow for the function-
al operation of a completely centralized supply service. Pharmacy could
also be contiguous to the supply area. Then, sterile supplies and
equipment, housekeeping suppl~es, clean linen and stock drugs could be
delivered by the personnel of the centralized supply area and all used
supplies could be p~cked up by them. In commenting on the presenta-
tion, a hospital ad~nistrator stated his belief that low budget and
shortage of trained personnel is not as great an obstacle as the attitudes
of nurses who do not want to g~ve up non-nursing activities. He pointed
out that hospital administration expects nurses to decide on what is
nursing and what is non-nurs:mg and to make their decisions known.
The panel and the small group d~scussion members recognized 'that it
might not be poss~ble to set up a completely centralized supply system
and to remove all non-nursing act~vities from the Nursing Service
Department at once. However many excellent suggest~ons of steps to be
taken toward this object~ve were given:
a. To help the authorities and nursing persaneel to become aware
of the wastage of nurs~ng care time:
~. Outl~ne nursing act~vities.
ii. Conduct work stu~es on the activit~es of nurs~
personnel to cbta~n facts on the percentage of
total time spent on nursing act~vit~es and on non
nursing activ~t~es.
EMft/J'RS./149 WHO EMRO page 34
iii. As a demonstra~~on proJect, tra~n personnel in
onehosp~tal to carry out non-nurs~ng act~vit~es.
Study th~s s~tuat~on, before and after the re
allocat~on of non-nursing activit~es, to demon
strate the increased quant~ty and quality of
nurs~ng care received by pat~ents.
i v • Ra~se the status of the staff nurse I to emphasize
the importance of qual~fied personnel Biv~ng
nursing care to patients.
v. Demonstrate the necessity of a minimum anount
of suppl~es and equ~pment. Try to discontinue the
practice of personnel pay~ng for loss or breakage
of eq~pment so that ava~lable equipment w~ll be
used for patient care. Trust personnel to use
supplies and eq~pment well, after staff education
in its cost and proper use.
b. Interim centralization of supply activ~t~es.
i. Linen should be centralized, with laundry personnel
completely resPOns~ble for keep~ng the clean linen
supply up to the agreed upon quota, and for remov-
ing soiled linen. If laundry workers cannot do
this, housekeeping could handle the linen.
ii. Ster~le supplies - the decontam~nation, packag~ng,
ster~llzat~on. delivery of ster~le suppl~es and
the p~Ck-Up of so~led could be central~zed ~n one
area. More eq~pment would be required but the
cost of operat~on would be less and the process~ng
would be better.
WHO EMRO EM/NURS./149 page 35
i~i. Non-sterile ""ed1 C'11.1-surgj "al 'luPl"llies and sundries
could be del~ve!'ed on a quota bas~s. A conunittee
of nursjng, med~(al and pharm~cy personnel should
adv~se on purcuasing.
i v. If supply act~ vi t~es cannot be centralized in a single
uni t, they could all be p:'aced in one area of each
ward, with a non-nursE' in c.large. The best
phys~cal arrangement is one room for all clean and
ster~le supPl~es and equ~pment and one small room
for the clean up or holding of used supplies and
eq~pment, if decontamination is centralized.
v. Many partic~pants believed that a qual~fied nurse
should be ~n charge of the process~ng of sterile
supplies in this Reg~on, at least until all pro-
cedures and t~ays are standardized. Others thought
a non-nurse could be tra~ned immed~ately to super
vise the decontam~nation; packaging and steriliza
tion of supplies.
c. The activities of delivering stock medications and narcotics
on a quota basis could be the respons~b~l~ty of the pharmacy.
Stock medicatlons could be delivered by a pharmacy employee
and narcotlcs and dangerous drugs could be dellvered to the
head nurse by a pharmacist. Standard stoc.~s for each unit
would be established by the nurs~ng, pharmacy and wedical
personnel.
d. The activities of del~verlng and servll1g food could gradually
be taken over by the dletary department. Since dietitians
are in short supply, food serv~ce managers who have had a
hotel food serVlce course could direct the dletary department.
EMjNuRs./l49 page 36
WHO EMRO
Aides could be glven on-the-Job trainlng in serving food and
delivering it to patlents. A qualifled nurse would continue
to superVlse the therapeutic diets un~il qualified dietitians
are available. Th1S transfer of dletary activ1ties could be
fac1l1tated 1f d1etit1ans were employed in the M1nistries of
Health.
e. Nurses could be relleved of clerlcal activ1ties by employing
lnterested and lntelllgent glrls as ward secretar1es and
glVlng them a good on-the-job training programme.
f. Housekeeplng activitles could be reallocated by employing a
mature person, as chlef housekeeper, to be respons1ble for all
such actlvities and for the maids who carry these out. The
housekeeper could take the same course as hotel housekeepers
and be glven addltional on-the-Job preparation in the control
of infectl0n and aseptic techniques.
It was agreed by all that reallocatl0n of non-nurslng act1vit1es to
the appropriate departments must be done gradually and only when the
appropriate departmental personnel are adequately tr~ned to carry them
out. It was believed that this is more easl1y done when there is a
trained hospltal adminlstrator to work wlth nurs1ng service personnel.
As thls reallocatlon lS carrled out, nurslng serV1ce personnel must have
in-service educatlon on what are true nursing activ1tles and how to
1mprove nursing care.
I
I
I
WHO ENRO
I
RELATIONSHIPS OF HOSPITAL SERVICES
1\ c. Transport'ltion
\ \
- - - .. -._ ..
EM/NURS./149 page 37
Laundry r/r " \
B. I &: Linen
'\ Electro- ,/ " , Clerical
/~ Central
Stores
I .... , I
I
/
Medical
,cardiogram
X Ray
Therapy
\ - .......... /' A Medical ""'-
"'ursin!! Care j " /
X-Ray
Stores \~, "/ \ f ,Care. ./ Admi tting
'\ i ,-'--__ \ Radio- ~ --. Soc1al,- --" .... " \
--- , Laboratory Special Oooupa-, Patient Pathology !
~ork (" -.....~:::.~~/ \ Clinical
\ Equipment tional' !a .. i Therapy , ____ I
\ \ _",/ ',,-. Spiri tual -,---... f , Physical I -, - , care I '---_ Housekeeping I
/ ,I" I i
Therapy ' • ../ ,l'harmar Nutrl,\ / Radio- I
\ "."" ... /
' Sterile : cology, tiO: \.. / isotopes ;
supplies &: I - ~ /~, -'1---- \ ! \ ,Decontamina-/ l I
'",. , tlon /Pharmacy Diet \ / ~ ... . ' ..... j \ Purchasing / I '\ // ' ~ Stores Therapy ~"Engineering /11
" '''1- --- -\ \ ",,/ I Food Services \ \ /
'<;. Maintenance '\? ~ i Personnel ",.-
........... I \ ~r
~L l---~ ---- - --
WHO EMRO PlII/NURS./l49 page 39
5. THE ROLE OF '!HE NURSJNG AND O'lHER PIDFESSICNAL STAFF IN MEFl'ING
'!HE CRITERIA FOR SUITABLE FIELD PRACTICE AREAS FOR THE EDUCATION
OF NURSING STUDENTS.
Mr. J. Amin Mrs. M.P. Khan Mrs. B. Mengesha Miss K.I. Raffai M~ss A. Riahi
M~ss F. Hargett - Moderator
The panel presentation was in the form of role playing. Depicted
was a meeting in which the d~rector of a school of nursing, the matron
of a hospit~ an ~nstruotor, a doctor and a physiotherapist were dis
oussing situations in which a nursing student was performing poorly in
her clinioal experience on a nursing unit. The effect of the attitudes,
actions and reactions of nurs~ng service and other professional personnel
on the student and her learning was clearly demonstrated. The lack of
support received by the student in carrying our nursing procedures was
shown to interfere with her appl~cation of pr~noiples in the nursing care
she gave. A student looks to qualified nurses as an example of how she
should behave and when they carry out procedures with poor techn~ques the
student tends to do so also. Some of the professional personnel were
viewing the student as another pair of hands to do the work, not as an
individual and a learner. The positive effeots of the professional
personnel respeoting the student as an ~ndiv~dual and treating her as a
learner were demonstrated. The importance of good interpersonal relation-
sbjps among professional personnel, of their understanding the purposes
of the student's experience and of cooperating in providing pat~ent care
were emphasized. The group believed that suudents need assistance in
applying the~r knowledge of the social scienoes to acquire an under-
standing of human behaviour. The great advantage of all the profession-
al disoipl~es sitting down together to d~scuss the obJect~ves, to
EM/NURS./149 pc.ge 40
WHO EMRO
become oriented to the cl~~cal nursing exper~ence of the student, to
plan the experience and to solve problems was clearly brought out. In
conclusion, the panel stressed that only by worldng together can nursing
education, nursing servioe and allied professional personnel develop
f~eld practice areas ~n which the nurs~ng student can learn to give,
and the patient will rece~ve, effect~ve nurs~ng oare.
WHO El>1RO
CHAPTER III
SUMrrlARY OF RECOMMENDATIONS
EM/NURS./l49 page 41
Recommendat~ons were proposed in the study group sessions. These
were st~ed and summarized by the Corrunittee on Recorrunendations, m
consultat~on with the Resource Staff. The following recommendations
were accepted by the part~c~pants in the last plenary session of the
seminar:
1. That a regional workshop be convened on how to conduct nursing
stud~es through us~ng s~mple research methodology such as
problem solving techniqUes, for the improvement of health
services through better nurs~ng education and nursing service;
that this workshop be held w~thin two years.
2. That there be conducted stud~es and evaluation of national
nursing needs, nursing resources and the utilization of
nursing personnel, with the purpose of finding ways to pro-
vide for the optimum util~zation of professional and auxiliary
nurs~ng personnel and the reallocation of non-nursing activities
to other tra~ned personnel. This would mvolve both study
of nat~onal needs and resources by a national body as well as
work sampling stud~es to show the ut~lization of nursing
personnel in one nursing service department.
3. That practical programmes of in-service and post-basic education
be established to improve current situat~ons.
4. That there be nurse members on all corrunittees which are respon
sible for planning, setting standards of, and evaluating nursing
education and nursing serv~ce.
5. That two or more countries, wi th sim~lar problems and resources,
plan workshops for head nurses and instructors to study ways of
EM,/NURs./i49 page 42
WHO EMRO
improv1ng nurs1ng care of pat1ents, and the f1eld practice
experiences of nurs1ng students, 1n one or more of the
following areas:
a. Med1cal-Surgical Nursing
b. Maternal and Ch1ld Health NurS1ng
c. Public Health Nursmg
d. Methods of Teaching
e. Adm1n1strat10n of the nursing un1t
f. Supervis10n of nursing care and of nursing personnel
6. That central nurs1ng d1visions, na~ional nurses associat1ons
and legislat10n be estab11shed as soon as poss1ble.
7. That nurses with potential be encouraged to perfect writing
skills, w1th the a1d of fellowships as necessary, so that
textbooks, Journals and teach1ng a1ds can be prepared in the
mother tongues of the countr1es of the Reg1on.
8. That procedures be established so that information on programme
changes and new developments 1n nursing 1n any s1ngle country
of this Reg10n can be known by the nurses of other countries.
WHO E:4RO
CRAnER IV
EM/NURS./149 page 43
EVALUATION OF THE SE1>UNAR AND SUGGESTIONS FOR Ft1I'URE SENlNARS
Evaluation of the seminar was discussed by the Resource Staff. This
group decided to conduct an evaluation at the close of the Seminar and
recommended that two follow-up questlonnaires be sent to participants.
A committee of four was selected to draw up the questlonnaire for use
at the close of the Seminar.
Fifty-eight questionnaires were distrlbuted and 7~ of these were
returned. The questlonnaire asked for answers to:
1. How much did you learn?
2. How much can you implement when you go home?
3. How much did you enjoy the Seminar?
The respondents were also requested to comment on the content and
conduct of the Seminar and to present suggestions for future regional
nursing seminars.
Eighty-eight percent of the total number of people attending the
Semlnar learned a conslderable amount or a great deal. The learnings
included:
a. An appreclatlon of the need for nursing service and nursing
education personnel to cooperate in plannlng, programming
and evaluatl0n.
b. A beginning understanding of the ways by which problems are
id~ntifled and solved.
c. An appreciation of the value of the exchange of ideas and of
discussion of the causes and possible solutions of mutual
problems.
EMjNuRs./149 page 44
WHOEMID
d. An lntroductlon to new ldeas and trends and a realistic
approach to developing and lmprovlng nurslng sltuations.
e. An understandlng of the need to free nurses for nurslng
by reallocatlng non-nurslng activltles to others.
f. An ldea of writlng Job descrlptlons and nurs~g procedure
manuals
g. An understandlng of the role of the auxlllary and
lnstltutl0nal serVlces.
The 12% of the total partlclpants whlch learned a little belleved
lea~ng to be llmlted because of:
a. the language barrler
b. the scope of the materlal presented belng too llmited.
Slxty-five percent of the total attendants believed that they would
be able to implement a great deal or a conslderable amount when they
returned home. They thought they could:
a. Improve working relatlonships between nursing education
and nurslng serVlce personnel;
b. Improve the utillzatlon of nurslng personnel;
c. Ga~ more support from governmental and medlcal authoritleSj
d. Begln In-service educatlon;
e. Establish central supply serVlces and nurslng procedure manuals;
f. Work further towards the establlshment of legislatlon for
nursing and a nurslng dlvlSlon at the cen~ral level.
The 28% of the total group which thought it posslble to lmplement
only a Ilttle on return home belleved the barriers to lmplementation
were:
WHO EMRO EM/NtJRS./l49 page 45
a. lack of leg~slation and a nat~onal nursing association;
b. lack of understand~ng and support on the part of the allied
profession::;;
c. lack of effect~ve relationship between nursing education
and service;
d. inadequate basic educat~on of nursing recruits;
e. the ~ll-def~ned nat ure of nurs~ng.
Ninety percent of all those attend~ the seminar enjoyed it
oonsiderably or a great deal.
The suggest~ons made for future seminars were in relation to:
a. Length - the maJority favoured a two-week seminar.
b. Content and conduct.
i. The programme should be less crowded.
ii. Plenary sessions should not be interrupted.
iii. Included should be panel mscussions, presentations
of material by experts, addresses by specialists,
small group discussions.
~v. The meet~ngs and accommodation for participants
should be at the same place.
v. Resource staff should give more guidance to parti
cipants.
vi. Other levels of nurs~ng personnel should be calSidered
as partic~pants. depend~ng on the topic.
vi~. There should ce more observers from allied ~sclplines.
vii~. The prov~sional programme should be sent out in advance.
ix. There should be more time for small group and general
discussions •
EM/NURS./l49 page 46
c. Topics
were:
i.
ii.
iii.
iv.
v.
v~.
v~i.
WHO ]l.lRO
- the suggested top~cs wh~ch received the most support
In-service education.
Def~nition of nursing and non-nursing respons~b~lities.
Relat~onship between nurs~ng and medical personnel.
Research in nurmng.
Post-basic and degree programmes in nurs~g.
Interpersonal relat~onships ~n nursing.
The development and implementat~on of legislation for
nurs~ng.
v~~i. The basic nursing curriculum.
WHO El'IIRO
CWSING SESSION
EMjNuRs./l49 page 47
Among those who honoured the Sem~nar with their presence at the
elosing Session were ~s Excellency Dr. M. Shahgholi, Minister of Public
Heal th, Imperial Iranian M~nistry of Public Health and Dr. A.H. Taba,
Director, Eastern Med~terranean Reg~on of the World Health Organizat~on.
Dr. Taba addressed the assembly briefly, thanking the Government
of Iran and Dr. M. Shahghol~ for their cooperation in the conduct of the
Seminar and for all they had done to make the experiences of the parti-
cipants in Iran so worthwh~le and enJoyable. Dr. Taba then expressed
his confidence that the Seminar discussions would bear fruit in all coun
tries in the Region and wished the part~cipants well as they further
improve nursing educat~on and the nursing care of patients on their
return home.
Gratitude and apprec~ation were expressed by Mrs. L. Kamel on behalf
of the Reg~onal Panel of Nurses and by Mrs. M.P. Rban on behalf of the
part~cipants.
The participants dec~ded unanimously to request that a cable be sent
to Her Imperial Majesty Queen Farah thanking her for her grac~ousness in
granting them an audience.
The closing remarks of Miss Margaret D. McLean, WHO Se~nar Consultant
were:
"Since we met together for the f~rst time on 9 November we have been
very busy - have worked hard, slept l~ttle and have learned many things.
We know each other better than we d~d. We have seen more beautiful
Jewels than we could have ima~ned in our most fanciful dreams, when we
viewed the Crown Jewels; we have experienced the great hospitality and
kindness of groups of Iran~ans at the receptions, teas and dinners given
to us by Iranian associations, companies and the Min~stry of Health; we
EM,/NURS./149 page 48
WHO a-mO
have appreciated the thoughtfulness of ~ndividual Iran~ans who helped
us in so many ways. We have learned more about nursing in Iran by
the professional vis~ts which were arranged for us. We have learned
about the ~queness and beauty of Pers~an art and architecture, at
the Golestan Palace and in Isfahan. We saw the majesty, fr~endl1Dess
and naturalness of Persia ~n the person of her Imperial MaJesty the
Queen Farah. We have found ways to ~mprove the education of nursing
students ~n the field practice areas and to improve the nursing care of
patients. We will not forget any of these things. But we have not
achieved the stated obJective wh~ch was 'to strengthen and ~mprove the
learning exper~ences afforded the nurs~ng stUdent ~n the field practice
areas' nor have we ~mproved nurs~ng care of patients in the hospitals,
the maternal and c~ld health centres, the publ~c health centres and the
dispensar~es of this Region. ~s you have to do.
start to do this when you return to your own country.
Each of you must
To a great extent
it will not be done unless you do it, and I am very confident as ~s
Seminar closes that ~mprovement of cli~cal nursing exper~ences for
s~udents and nursing care of patients w~ll come. I am conf~dent because
I know more about you than I did, I know more about the Re~on than I
did. You can accomplish th~s and I bel~eve that there w~ll be more
cooperation between nurs~ng educat~on and nurs~g service in planning,
carryil.ng out and evaluatL.!(3 the cr~ ter~a for cl~ical nursing education
and nurs~ care. I believe you w~ll ~mprove the relationship of nurs~ng
w~th the allied professional, ~st~tut~onal and other health services. I
am sure you ~ll each be more consc~ous of what ~s a nursing activity and
what ~s a non-nursing activ~ty. You will all do someth~ng; you may even
make mistakes. Humans do make errors. If you do, recognize the ~stake
and correct it for if you do not correct a mistake, you have made another ,
~stake. Yes, you will all achieve some steps toward your obJect~ve for
your mistakes w~ll be few, far less than your successes.
WHO m.mo EM/NUR'3 • /149 page 49
And now let us all keep the following anonymous quotation in our
minds:
'God give me courage to change the things I can, serenity to
accept the things I cannot change and the wisdom to know the difference.
Finally, thank you all for what you have ~ven to me.
and all the best to you."
Au revoir
WHO EMRO
ACKNOWLEDGEMENr
.!'>1/NURS./l49 page 50
Sincere appreciation is expressed to the Government of Iran for
their collaboration in the planning and organization of the second
Reg~onal Nursing Sem~nar and for the provis~on of physical fac~l~ties,
without which the Seminar could not have been held. Thanks are due
especially to His Excellency Dr. M. Shahgholi, the Minister of Public
Health, Imperial Iranian Ministry of Public Health, Mrs. F. Salsal1,
Ch~ef Nurse, Nursing Division, Ministry of Publ~c Health,
I"'ir. A.N. Amirahmam, Procurement Officer, M~~stry of Publ~c Health,
and the members of the National Planning Co~ttee for their able
assistance ~ planning the Seminar, the provision of supplies and
equipment, the arrangement of f~eld trips and for their most generous
hospitality, and to all those compan~es, associat~ons and individuals
who made the sOJourn of participants in Iran such an enjoyable and
memorable one.
WHO EIv1RO
AGENDA
1. Operung of the Seminar.
EMjNuRs./l49 ANNEX I page i
2. Election of Officers: Chairman, two Vice-Chairmen and a Rapporteur.
3. Adoption of the Agenda.
4. Nursing: Its Nature and the Needs of this Region.
5. The Achievement of Understanding, Cooperation and a Desirable Work~ng Relationship Between Nursing Service and Nursing Education.
6. The Cr~teria for Suitable Field Practice Areas for the Education of Nursing Students, in Relation to:
a. The organization and administration of nursing and other services;
b. personnel;
c. physical facilities;
d. equipment and suppl~es.
7. The Responsibilities of the Hospital Auxiliary and Institutional Services for Meeting the Criteria.
8. The Role of the Nursing and Other ProfessiOnal Staff in Meeting the Criteria.
9. Other Business.
10. Acceptance of the Prov~sional Report of the Seminar.
11. Closing Session.
WHO EMOO
PARTICIPANTS
AFGHANISTAN
CYPRUS
E'lllIOPIA
LIST OF PARl'ICIPANTS AND OBSERVERS
Miss Barawar Amiri Nursing Supervisor AV1cena Hosp1tal Kabul
Mr. Christoforos Avraam Nurse Tutor School of Nursing, Nicosia General Hospital Nicosia
Miss Arax Goevderelian Matron Famagusta Hospital Famagusta
Mrs. Bisrat Mengesha Chief and Supervisor
1iN,/NURs • /149 ANNEX II page i
Hosp~tal Nursing Service Section Ministry of Public Health Addis Ababa
Mrs. Negede Dem1ssie Director Red Cross School of Nursing Addis Ababa
Mrs. Abeba Wolderufael Public Health Nursing Supervisor Ministry of Public Health Addis Ababa
Mrs. Fatemeh Salsali Chief Nurse Nursing D1vision Minl.stry of Health Teheran
Mrs. Nassereh A. Roboob1 Chief Techn1cal ~ffairs Section and Nurse Consultant for Mental Health Nursing Divis10n Ministry of Health Teheran
EMjNuRs./l49 ANNEX II page ii
IRAQ
JORDAN
KUWAIT
WHO EMRO
Miss Fatemeh D~narband Nurs~ng Services Adm~nistration Section Nursing D~vision Min~stry of Health Teheran
Mrs. Ghat'1ar' Mirkamal1 Chief Nurse Health Department Teheran Prov~nce Mi~stry of Health Teheran
Miss Nahim Banou PoorkaJ Hospital Nurs~ng Service Consultant Nursing Div~sion Mi~stry of Health Teheran
Miss Khair~ya N.A. Ja1il Ass~stant Matron Republ~c Teaching Hosp~tal Baghdad
Miss Adele J. Anton Nurse Supervisor Republ~c Teaching Hosp~tal Baghdad
MlSS Loutf~ya Noori Matron Republlc Teaching Hosp~tal Mosul
Mlss Adeebeh J. Mussalam Chief Nurse M~n~stry of Heal th Amman
Miss Nlamati S. Nureddin Cmef Publlc Health Nurse Mlnlstry of Health Amman
M~ss Asma S. Sa'ad Director Kuwai t College of Nur~ng Sabah Hosp~tal Kuwait
WHO EMRO
LEBANON
PAKISTAN
SOMALIA
SUDAN
SYRIAN ARAB REPUBLIC
*D1d not attend
Mrs. Wadad H. Shaya
EM/NURS./l49 ANNEX II page 11i
Assistant Professor of Nursing American University of Beirut Beirut
Mrs. Mantonguni Ba~ragya S~ster Tutor Medical College Hospital Rajshahi*
Mrs. Mumtaz ~nds Khan Nursing Superintendent Sir Ganga Ram Hospital Lahore
Miss Shafali Biswas Sister Tutor Medical College Hospital Dacca"f
Mr. Jibr~l A~n
Nurse Tutor School of Nurs~ng Medical Department Hargeisa
Mrs. Awatif A. Osman Director Khartoum Nursing College Khartoum
Miss KhMiga I. Raffa! Acting Ass~stant Matron El Shaab Hospital Khartoum
M~ss Aisha Nasab Nursing Instructor Nat~onal Nursing School Damascus
Miss Moufida Zalat Nursing Instructor National Nursing School Aleppo
EM/NURS./l49 ANNEX II page iv
TUNISIA
UNITED ARAB REPUBLIC
OBSERVERS FROM HOST COUNTRY
Mr. Amar Daly Nurs~ng Superv~sor
Charles Nicolle Hosp~tal ~s
Mrs. Fathia Moustafa Chief Nurse M~~stry of Public Health Cairo
Mrs. Effat I. Kamel Director of Nursing Services Ahmed Maher Hospital Cairo
Mrs. Nagwa M.H. EI Hagrassy Nurs~ng Superv~sor
Ahmed Maher Hospital Ca~ro
Dr. Mohamed Sadr~ Professor Faculty of Medicine and Superv~sor of Hospital Administration Course Un~versity of Teheran Teheran
Dr. Ahmad Rahirnzadegan Deputy D~rector-General Techn~cal Training Sect~on M~nistry of Health Teheran
Miss Talieh Agah D~rector
Nemazee School of Nursing S~raz Med~cal Centre Shiraz
M1SS I. Bararsanl Dlrector Nurslng Dlvislon Khorassan Province and of JorJani Nurs~ng School Meshed
Mrs. Nayereh M. Fotoohi Director
m.1jNuRs./149 ANNEX II page v
Reza Shah Kabir School of Nursing Teheran
Miss Bhafigeh Herovabadi Director High Institute of Nursing Teheran
Miss Sara Kavati Nursing Instructor High School of Nursing Kermanshah*
Mrs. Fatemeh Khalatbari D~rector of Nursing Ashraf School of Nursing and Pahlavi Hospital Teheran
Mrs. A. Dargahi Director School of Nursing Rasht
Mrs. Mansoureh Shagaf~-Rhademe Director Razi School of Nursing Kerman*
Mrs. A. Mobed Director Midwifery School University of Teheran Teheran
Miss F. Salili Educational Sect~on Nursing Division Ministry of Health Teheran
IRANIAN NURSES ASSOCIATION Mrs. Atefeh BiJan Nurse Adviser
* Did not attend
Faculty of Medicine Univers~ty of Teheran Teheran
EMjNuRs./149 ANNEX II page V1
NATIONAL IRANIAN OIL COMPANY
REPRESENTATIVE'S OF UNITED NATIONS ORGANIZATIONS
Un1ted Nations ~ldren's Fund (UNICEF)
Un1ted Nations Relief and Works Agency for Palestine Refugees (UNRWA)
M1ss Sedaghat f.1atron N.I.O.C. General Hosp1tal Teheran
Mr. W.S. Pawl1k UNICEF Representative Teheran
Miss Gerda Karnstrom Clnef Nurs1ng Divis10n UNRWA Headquarters Museitbeh Quarter Beirut
WHO EMRO
OBSERVERS FROM O'IHER ORGANIZATIONS
Internat10nal Council of Nurses
M1ss T. Hagh1ghat Assistant Director High School of Nursing National Iran1an Oil Company Abadan Iran
United States Agency for M1ss Elizabeth H1lbOrn Internat10nal Development Nurse Adv1ser (US AID) Office of International Health
Public Health Serv1ces Department of Health
American ~nivers1ty of Beirut (AUB)
Educat10n and Welfare Bethesda Maryland USA
Miss Esther L. Moyer D1rector, Bchool of Nurs1nG Amer1can Un1versity of Beirut Be1rut Lebanon
WHO EMRO
REDIONAL PANEL OF NURSES
RESOURCE STAFF
Miss Azar RJ.alu
EM/NURs./H9 ANNEX n page vii
Nurs~ng Education Consultant Nurs~ng_D~vision
Ministry of Health Teheran Iran
Mrs. Karu.z Jl'lowla Nursing AdViser Ministry of Health, Labour and Sooial
Welfare Islamabad Pakistan
Mrs. Leila I. Kamel Demonstrator Higher Institute of Nursll'lg University of Alexandria AlexandrJ.a United Arab Republic
Miss Batool M. Saad Nursing Instructor Khartoum Nursing College Khartoum Sudan
Mrs. Aida Sultan D~rector
Red Cross School of Nursing Beirut Lebanon
Mr. Khosrow Majidi Director Pahlav~ Hospital Faculty 0;: i'adic~ne Teheran University Teheran Iran
Miss Florence Hargett WHO Senior Nurse Educator Col1e~ of -Nursing Baghdad Iraq
EMjNuRs./149 ANNEX II page vih
Dr. A.H. Taba
Miss L. Creelman
Dr. G. Rlfka
Miss M.D. McLean
M1SS E. Matheson
WHO EMRO
Miss Rita D. Hill WHO Senior Nurs~g Advlser High Institute of Nursing Unlversity of CalrD Cairo United Arab Republic
Miss Rl ta McEwan WHO Nurse Educator Mental Health Servlces Teheran Iran
Miss Elizabeth Mltchell WHO Senl0r Nurse Educator National School of NurSlng Damascus Syrian Arab RepubllC
Mrs. Glorla Press WHO Senl0r Nurse Educator Jordan College of Nurslng Amman Jordan
WHO SECRETARIAT
Dlrector
Chief, Nursing
Publlc Health Admlnlstrator, Educatl0n and Training
WHO SpeCial Seminar Consultant
Regional Adviser on Nursing
Reglonal Office for the Eastern Mediterranean
WHO Headquarters, Geneva Switzerland
Regional Office for the Eastern Mediterranean
Consultant, Hospital NurSlng, Department of Natlonal Health and Welfare, Canada
Reglonal Offlce for the Eastern Mediterranean
Miss C. Cartoudis Conference Officer
Miss A. Hetata Information Officer
Miss A. Papadopoulo Secretary
Miss M. Stylianides Secretary
EMjNuRs./149 ANNEX. n page 1.x
Regional Office for the Eastern Mediterranean
Reg~onal Office for the Eastern Mediterranean
Regional Office for the Eastern Mediterranean
Regional Office for the Eastern Mediterranean
EM/NURS./l49 ANNEX III page i
OFFICERS OF THE SEMINAR
GENERAL CHAIRMEN AND GENERAL RAPPORTEUR
ChairMan:
Vice Chairman:
Rapporteur:
Ml.sS F. Salsali
Mrs. B. Mengesha
Mrs. F. Moustafa
Mrs. N.S. Nureddin
(Iran)
(Ethiopia)
(U .A.R.)
(Jordan)
CHAIFMEN AND RAPPORTEURS OF STUDY GROUPS
Chairman Rapporteur
GROUP A Mr. C. Avraam (Cyprus) Miss F. Dinarband
GROUP B Miss M.B. PoorkaJ (Iran) Mrs. N.M.H. El Hargrassy
GROUP C Miss A. J. Musallam (Jordan) Mrs. A.A. Osman
GIDUP D Mrs. H.P. Kh:m (Pakistan) Miss A. Goevderelian
GROUPE Mrs. N.A. Roboobi (Iran) Miss K.I. Raffai
(Iran)
(U.A.R.)
(SUdan)
(Cyprus)
(Sudan)
WHO EMRO
LIST OF DOCUMENTS
PROVISIONAL AGENDA
PIDGRAMME OF 'lHE SEMINAR
LIST OF PARTICIPANTS
BIBLIOGRAPHY
lNTRODUCTION TO THE SEMINAR
THE NURSING SITUATION IN '!HE REGION
ntE PUBLIC SEES THE NURSE'S IDLE
by Zahia A. Marzouk, Under-Secretary of State for Social Affairs, Alexandria Governorate, United Arab .Republic
'!HE DOCTOR SEES '!HE NURSE I S ROLE
by Anis M.A. Shamy, WHO Visiting Professor of Public Health and Social Medicine, Univers~ty of Baghdad, Iraq
THE NURSE INTERPREl'S HER ROLE TO OTHER DISCIPLINES AND TO THE PUBLIC
by Awatif A. Osman, D~rector, Khartoum Nursing College, Khartoum, Sudan
PERSONNEL MANAGEMEI-lT: A FORCE IN PERSONAL GROWTH AND SATISFACTION
by G.B. Rosenfeld, Senior Consultant Adm~nistration, Department of National Health and Welfare, Ottawa, Canada
HTJVlIl.N COMMUNICATION IN 'lEE SERVICE OF REAL'!H
by Akbar Moarefi, Adviser on Health Education, Eastern Mediterranean Region, World Health Organization, Alexandria, United Arab Repubhc
FM.jNuPs./149 ANNEX IV page i
EM/NURS. SEM./l
EMjNuRs.SEM./2/REV.2
FM./NURS.SEM./3/REV.3
.J<l.1/NURS.SEM./4
EMjNuRs .SEM/5
EM,/NUFls. SEM. /6
.J<l.1/NURS.SEM ./7
EMjNuRs. SEM./8
EM/NURS.SEM·/9
FM./NURS.SEM./lO
EN/NURS./149 ANNEX rv page 11
NURSmG EDUCATION AND NURSING SERVICE: COOPERATION OR CONFLICT IN COMMUNICATIONS?
by J. Shellish, Matron, Nicosia General Hospital, and L. Burke, WHO Nurse Educator, Nursing Education Project, Nicosia, Cyprus
MENTAL HEALTH: THE PIVOT OF HUMAN RELATIONSHIPS
by Nassareh A. Roboobi, Consultant in Mental Health and Psyc~atric Nursing, Chief of Registration and Leg~slation, Nursing Div~sion, Mi~stry of Health, Teheran and R1 ta McEwan, WHO Psychiatric Nurse Educator, Mental Health Serv~ces ProJect, Teheran, Iran
'lHE_ PREPARATION OF '!HE NURSING TEACHER FOR DEGREE PROGRAMMES m THE MIDDLE EAST
by Aleya Bindar~, Lecturer, H~gher Institute of Nurs~g, UniVersity of Alexandria, Un~ted Arab Republ~c
THE PREPARATION OF THE NURSING TEACHER FOR DIPlJJMA PROGRAMMES m THE MIDDLE EAST
by Adeebah Mussalam, Matron, Surg~cal Hospital, Amman, and Glor~a Press, WHO Nurse Educator, College of Nursing, Armnan, Jordan
IN-SERVICE EDUCATION PREPARES NURSING SERVICE PERSONNEL FOR THEIR OONTRlBUTION 'ro THE STUDENT PROGRAMME
by Ann Beckingham, WHO Nurse Educator, Nursl.ng Education ProJect, Ahmed Maher Hospital and School of Nurs~ng, Cairo, United Arab Republic
THE HEAD NURSE AS AN EDUCA'roR
by H. Stefanska, WHO Nurse Educatur, Tra~ng of Health Personnel Project, Tunis, and MJB. Jezierska, WHO Nurse Educator, Nursl.ng Education ProJect, T~s, Tunisia.
WHO EMRO
HM/NURS.SEM,/12
ENjNuRs.SEM./13
EM/NURS.,sa.,./14
EN,/NURs.SEM./15
EN/NURS.SEM./17
WHO EMRO
THE NATIONAL ORGANIZATION OF NURSING SERVICES ~fi ,THE BE'i'l'ERMEMT OF NURSING EDUCATION
by the Nurs~ng D~vis~on, Ministry of Public Health, Addis Ababa, Eth~opia
HOSPITAL NURSING S~VICES: THEIR ORGANIZATION, ArMINISTRATION AND ROLE IN NURSlNG EDUCATION
by fu. ta Hill, Senior WHO Nurse Adnser, fugher Inst~tute of Nursing, University of Cairo, Un~ted Arab Re~ub1ic
PUBLIC HEALTH NURSING SERVICES: T'rlEIR ORGANIZATION, ADMINISTRATION AND ROLE IN NURSING EDUCATION
by Leonor A. Deus, WHO Nurse Educ-ator, College of Nursing, ~versity of Baghdad, Iraq
NUTRITIONAL AND DIETARY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAINING OF HEAJi.,TH PERSONNEL
by Houri Besherat, Dietician, National Iranian Oil Company Hosp~tal, Abadan, Iran
FHYSIO'lHERAPY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAlNlNG OF HEALTH PERSONNEL
by Gladys Johnson, WHO Phys~otherapy Tutor, School of Physiotherapy, Teheran, Iran
HEALTH LABORATORY SERVICES: THEIR ROLE IN THE EDUCATION AND TRAINlNG OF HEALTH PERSONNEL
by H.R. Husseini, Adviser on Health Laboratory SerVices, Eastern Mediterranean Region, Alexandria, Un~ted Arab Republ~c
THE CENTRAL SUPPLY ROOM: f\. SERVICE AND A TEACHING UNIT
by Effat Kamel, D~rector of Nurs~g Services, Ahmed Maher Hospital, Ca~ro, and Ruth Burstahler, WHO Nurse Educator, Nursing Education Project, Cairo, United Arab Republ~c
EM/NURS./149 ANNEX IV page ni
EMjNuRs. SFl1. /18
El'IIjNuRS.SFl1./19
EM/NURS.SEM./21
EM,/NURS.SEM./23
EM/NURS. SEIvl. /24
EMjNuRs. /149 ANNEX IV page l.V
'!HE SUPPORT:rnG SERVICES IN 'IRE HEALTH PROGRAMME: THEIR ROLE m PROVIDING SUITABLE FIELD PRACTICE AREAS FOR EDUCATION AND TRAINING
by Fakhry F. Kawar, WHO Hospital Administrator Basic Public Health and Medl.cal Care Servl.ces, Dammam, Saudi Arabl.a
HOSPITAL PLANNING AND PROVISION FOR EDUCATION AND TRAmmG ACTIVITIES
by D. Goldfinch, Hospital Consultant Architect, and AIm C. Crighton, Nurse Planning Consultant of Donald A. Goldfl.nch Assocl.ates, United Kingdom
DRAFl' REPORT OF 'IRE SEMmAR
WHO EMf«)
EM/NURS.SEM./25
EM/NURS .SEM. /26
EM/NURS.SEM./27
WHO EMRO EM/NUFS./149 ANNEX V page i
ORGANIZATION OF THE SEMmAR
INTRODUorION
The f~rst WHO Nursing Senunar to be organized ~n the Eastern
Mediterranean Region of the World Health Organization was held in
Lahore, West Pakistan, from 2;; November to ;; December 1960, in
collaborat~on with the Government of Pak~stan. This Seminar was
convened at a time when constant expansion and ~mprovement of health
services were t~ng place throughout the Region. The part~cipants
were aware that the changing health services would demand consistent
effort on the part of the professional nurse if she were to make a
s~gn~ficant and appropriate contr~but~on. Included ~ the recommendations
made at the Seminar was "to constantly evaluate, review and ~mprove
nursing educat~on programmes so as to provide the comprehensive nurSing
care in keeping w~th the needs of the expanding health services of the 1
country."
Efforts to expand and strengthen the national and international
health services of the Regional countries were cont~nued increasingly
5~nce 1960. The profess~onal nurses of the Region contributed valuably
to these efforts.
In his Annual Report to the Fifteenth Session of the Reg~onal
Committee in 1965, the Director of the World Health Org~zation
Regional Office for the Eastern Mediterranean stated:
"The horizons of nursing are cont~nu~ng to enlarge as schools are expanding and ~ncreasing in numbers, as the role and function of the nurse are ga~n~ng understand~ng and recognition, and as nat~ona1 nurse leaders - capable of shap~ng the profess~on according to the needs of the~r countries - are emerging.
~orld Health Organization Reg~onal Office for the Eastern Mediterranean. Reg~onal Seminar, Lahore, Pak~stan, ~3 November - 3 December 1960, Final Report. Alexandr~a: ElilRO, WHO, EMjNURS.SEM.j22, 1961. p.;;l
m4/NURs./149 ANNEX V
WHO Elv1RO
page ii
It is espec~ally on th1S emergence of nurse leaders that this Reg10n is placlng ltS maln emphasis, to ensure that what does develop becomes an integrated par! of the general growth of health serVlces 1ll each country."
To aSSlst in ach1evlng thlS goal, the Regl0nal Panel of Nurses was
created, w1th nurses from f1ve of the twenty countries of the Re~on
being apPo1nted as members at this stage.
The flrst meetlng of the Panel was held from 9 - 13 August 1965, with
all five members attendlng and M1SS JeW" Barrett, Professor of Nurs1llg,
Yale Unlverslty, actlng as Consultant.
The members of the Panel are:
Mrs. L.I. Kamel, Demonstrator, Hlgher Inst1tute of Nursing, UniversiLy of Alexandrla, Unlted Arab Republic;
Mrs. K. Mowla, NurSlng Adviser, Health Dlvlsl0n, !VIlnlstry of Health, Labour and Soclal Welfare, Islamabad, Pakistan;
!VI1SS A. Rlabl, Nurslng Educatl0n Consultant, M1nistry of Heal th, Teheran, Iran;
Miss B.!VI. Saad, Instructor, Khartoum NurS1ng College, Khartoum, Sudan;
IvIrs. A. Sultan, Director of the Red Cross School of Nurs1ng, Beirut, Lebanon.
One of the purposes of thlS f1rst meetlng was to perm1t the members to
engage 1ll prelimlnary plannlng for the second Reglonal NursLng Se~inar.
which was convened In Teheran from 9 - 19 Nove~ber 1966, 1n collaboratlon
with the Government of Iran. The del1berations of the P~~el in thlS
regard resulted 1n the def1~t1on of the purpose, theme, obJectives and
the maln topics for study.
~o Reglonal Offlce for the Eastern !VIedlterranean. Annual Report of the Re lonal Dlrector to the Flfteenth Session of the Re ·onal Committee, Alexandrla: EMRO, WHO, 1 July 1964 - 30 June 1965, p. 56 (EIvI RC15 2)
WHO .EMRO
PURPOSE
EMjNuRs ./149 ANNEX V page iii
The major and immediate goal of an educational programme for health
personnel is to assist the student to acquire the understanding and
s~lls to prov~de for the optimum level of health of the ~d~vidual and
the commuruty. The major goal of the health services is to provide
imme~ately for the promot~on and restoration of health and the preven-
tion of disease. If provision is to be made to meet these goals,
especially in an age in which health services are expand1ng so rapidly
and involve so many specialities, it is essential that personnel in the
health service and educational programmes work closely together, with
mutual interest, understanding and support. Therefore, in thinking of
the needs of the Region in respect to the 1mprovement of nursing services
and nurs1ng education, the Regional Panel of Nurses determined the purpose
of the Seminar to be:
"To provide an opportunity for nurse educators and nursing service adm1nistrators to study together the education of nurs1ng students as related to the fields in w~ch these students rece~ve the1r practical exper1ences."
~ AND OBJECTIVES
The theme chosen for the Seminar was "held Pract1ce Areas for the
Education of Nursing Students", with the central objective being to
strengthen and improve the lea~ng experiences afforded the nurs1ng
student in the field practice areas.
defined as:
Contributing object1ves were
"1. To promote better understanding of the relationship between nursing educat10n and nursing service.
2. To achieve increased understanding of the necessity of full cooperation between nurS1ng service and nursiUb education.
3. To deter~ne the factors 1n the field practice areas whiab influence student learn1ng.
~or1d Health Organization. Report of the First SessioJ;1. of the Reg100al Panel of Nurses, 9 - 13 August 1965. Alexandria: EMRO, WHO, October 1965,
p.4
EMjNuRs./149 ANNEX V page iv
WHO EMRO
4. To de~~ne the requirements necessary for meaningful learning ~n the field practice areas.
5. To determine the ways in w~ch nurse educators and nursing serv~ce personnel can work together towards the effective ed~cation of students ~n the f~eld practice areas."
Main Topics for Study:
To enable the part~cipants at the Sem~nar to work towards meet~ng ~ts obJeot~ves, the topics selected for study were:
1. Nursing: Its Nature and the Needs of this Reg~on. 2. The Relationship between Educat~on and Service ~n Nurs~ng. 3. The Achievement of Understanding and Cooperat~on between
Nursing SerV1ce and Nursing Educat~on Personnel. 4. The Cr1ter1a for Suitable Field Practice Areas for the
Educat10n of Nurs1ne Students, in Relatlon to:
a. the organization and ad~lnistration of nursing and other services;
b. personnel; c. phYS1Cal fac1Jitiesj d. equipment and suppl1es.
5. The Respons1bil1t1es of Nurs1ng Eduoation and of the Inst1tutional Serv~ces in Meet1ng the Crlteria.
6. The Role of the Nursing and Other SerVlce Staff in the Education of the Students 1n the Field Pract1ce Areas.
Participants, Observers, Resource Staff and WHO Secretariat.
Particlpants:
Fifteen of the countries of the Region were lnvited to partlclpate in
the Seminar. In addltion, the World Health Organizatlon Regional O~flces
for Europe and South East ASla were requested to sponsor part~cipants from
Turkey and A~ghanistan respectively. The crlterla established to guide
the goverru'ents in their selection o~ participants were:
~orld Health O!'ganiza tion. ;;.;R..;.e":-po.;;..r:-:t~o=,f"--th=.;:e"::-,-F....;i..;.r.;;;;s-:t-7S..;.e;;;.ss;;.1,,:o=n=o:,,f,-:,th=e;...;;;R,:,:e ... g";"i_o:-nal--. Panel of Nurses, 9 - 13 August 1965. Alexandria. EMRO, WHO, October 1965, p. 5
'WHO EMRO EMjNuRs./149 ANNEX: V page v
1. Graduat~on from a recoGll~zed school of nurs~ng.
2. Employment ~ a responsible position in nurs~ng service or
education.
3. If only one part~cipant was to attend, he/she was to be engaged
currently in either the preventive or curative branch of the
nursing serv~ces, or be respons~ble for both the formal and
field practice aspects of a nursing course ~n an educational
programme. If two participants were to attend, one was to
represent nursing servicee, being engaged in either the pre
ventive or the curat~ve branch, and the second was to represent
nursing education, being currently respons~ble for both the
formal and field practice aspects of a nursing course.
4. Prof~ciency in English.
5. To be available for the entire period of the Seminar and be
prepared on return to hiS/her country to communicate ideas
acquired to nurses and others concerned.
Twenty-eight partit:lipants attended the Seminar, having been nominated
by the Governments of Afgh~stan, Cyprus, Ethiopia, Iran, Iraq, Jordan,
Kuwai t, Lebanon, Pa..~istan, Somalia, the Sudan, the Syrian Arab RepubliC,
Tunisia and the United Arab Republic.
in Annex III.
Observers:
The~r names and titles are given
The host Government nom~ted twelve observers, ten of whom attended
the Seminar. Also nominated were observers representing the Iranian
Nurses' Association, the NatjonaJ Iraniar. Oil Company, the United Nat~ons
Children's Fund, the Urn ted f,Jatiorz Relief and Works Agency for Palestine
Refugees, the International Council of Nurses, the United States Agency
for Interna~~onal Development and the Amer~can Univers~ty of Beirut. The
observers' expensec were born€ by their respective organizat~ans.
EM/NURS./l49 ANNEX V page vi
WHO EMRO
All observers were welcomed to attend both plenary and study group
sess~ons. Those who attended are listed in Annex III.
Resource Staff and WHO Secretar~ato
The Seminar was pr~vileged to have in attendance, throughout ~ts
sessions, Dr. A.H. Tabu D~rectorJ Eastern Mediterranean Regional Office,
World Health Organ~zat~on. Included in the Resource Staff Group were
f~ve members of the Reg~onal Panel of Nurses, a short-term WHO Nursing
Consultant, flve WHO nurses from field projects, a hospltal admlnistrator,
the Regional Public Health Admimstrator (Education and Training), the
Chief, Nursmg, WHO Headquarters and the Reglonal Nursing Adv~ser. The
names and tltles of the Resource Staff and other WHO Secretariat members
are given in Annex III.
Background Papers and Reference Material
Twenty background papers, on subjects related to the maln topics
for study, were wrltten by speclalists in the nursing, medical, health
education, hOSPltal admlnistratl0n and architecture, nutrltion, physio-
therapy and social work fields.
are listed m Annex ri. The titles and writers of the documents
A blbllograpny was prepared by the Nursing Unit, Eastern Mediterranean
Regional Offlce, World Health Organlzation and avallable at the Seminar
were reference books and other documents provided by the EMRO and WHO
Headquarters Librarie~. Also available for use in the presentation of
the topics were a number of fllms on nursing.
The partlcipants brought wlth them various dlsplay Materials, copies
of curricula, nurs~ng manuals, etc.
Briefing for Participants
Upon belng nornnated by their governments, partic~pants in the
Seminar were provided with ~nf~rrnat~on on the theme, central aim,
objectives and maln topics for study.
WHO EMRO EN/NURS./l49 ANNEX V page vii
So that each participant could become acqua~nted with the Seminar
methods and organization, the follow~ng guidance was provided:
"The Seminar w~ll be organized on an infor~al, small study group
basis, with emphasls placed on the indivldual participant's contribution
and problems becoming a ~art of the sroup's th1~ng. A typical seminar
day may include the followin8:
1. A General (Plenary) Session
a. Reports by Rapporteur's of study groups of previous day's discusslons.
b. Introduction of tOP1~ for study.
c. General discus~lon.
2. Study Group Meetings, of one and a half to two hours in duration.
J. Meeting of Group Cl1alrrnan, Rapporteurs and Resource Staff to
prepare summary reports of small group discussions.
Time will be reserved for: the study of reference materials;
individual conferences; discussion of topios of spec~al interest; and
field Visits.
At the end of the sessions, a draft report wlll be presnnted to the
Seminar for acceptance. "
It was recommended that preparat~on for attendance ~nclude pre
Seminar meetings with other participants from the ind2vidual country,
members of the nursing council and/or assoc~ation, and groups of nurses
representing various nursing actlvities and services. It was suggested
that such meetings l'ould be helpful in ldentify1Dg local problems related
to the theme of the Semlnar and ~n formulating possible solutions to
these problems. Further, that on the particlpant~s return to hiS/her
country arrangements could be ~ade to discuss with these same associates
the ways in which +lle idoas ~? ~ecommendat~ons presented at the Seminar
could be put into effect.
EM/NURS. /149 ANNEX V pagevhi
WHO EMRO
It was requested that one part~cipant from each country be prepared
to present a br~ef summary of the overall nurs~ng situa~~on in hiS/her
cotmtry and that the data be c cmp~led under the following headings:
I Resume of nat~onal health planning and maJor problems which influence nurs1Ug.
II Legislation for Nurs~ng.
III The central organization for nurs~ng - nurs~ng section or ~ t w~ thlil the Ministry of Health - and its functions.
IV The nurs~ng council and the nursing assoc~at~on: their obJect~ves, ftmctions and act~v~ties.
V Nurs~nG Services: typeR of lilst~tutions and health services in which nurses and aux~liary nursing personnel are employed; system of nurs~ng services administrat~on; general pol~cies, practices and procedures; nomenclature and numbers of nursing personnel; programme for staff development (in-serv~ce education, refresher courses}; etc.
VI General Educatlon in the country, as it ~nfluences nursing education.
VII Bas~c Nursinr; Educahon: number, level (type) and size of schools (profess~onal and auxiliary); entrance requirements; curr~cula; length of courses; teaching staff; student health and simllar servlces; budget; etc.
VIII Post-bas~c Nursing Education: type; durat~on; adm~strat~ve
control; etc.
IX Plans for the future
X Any other items of special interest or importance.
It was suggested that the partlcipants might w~sh to include COPleS
of the followlng among the materials brought for reference purposes:
laws cove~r{'; the pract~ce and profession of nursl!1b;
constitutlons of nursing council and nurs~ng assoclat~on;
prospect~ of schools of nurs~ng;
proerammes of studlesi
- locally produced v~sual aid materials.
WHO ElYlRO
Administrat~ve Arrangements
EMjNuRs./149 ANNEX V page 1x
In February 1966 a Nat~onal Planning Committee was establ~shed by
the Mirustry of Health, Iran. The members of this Comm~ttee were:
Dr. A. Nozar~, Chief, International Health Relations Department
Dr. K. Shayan, Chi3f, Health Educat~on D~vision
M~ss F. Salsali, Ch~ef Nurse, Nursing Divis~on - CHAIRMAN
Mr. A.N. Amirahmadi, Procurement Offioer - LIAISON OFFICER (Administrative) w~th EMRO
Miss A. Riah~, Nurs~ng Educat~on Consultant, Nursing Divis~on and member of EMRO Panel of Nurses
Dr. L. Lapeyssonnie, WHO Representat~ve, Teheran
Miss R. McEwan, WHO Nurse Eduoator, Mental Health Sernces project (IRAN 0028)
Th~s Committee, to WhlCh additional members were added as necessary,
worked arduously 1n preparing for the Sem1nar and throughout the sessions
proper.
Information bulletins were forwarded ~n advance of the opening of the
Seminar to acqua~nt participants with Iran and to assist in making travel
aooommodat10n and other arrangements. The Nursing Education Unit,
Nursing Divis10n, Min1stry of Health prepared an ~nformation bulletin
on serv1ces available ~n Teheran and the Min~stry of Health
presented to all attendlng the Seminar a specially prepared attraotive
folder whioh contained further ~nformation on Iran and served as a con-
tainer for pr1Uted materlals. The M~nistry also pronded 1dentifying
badges for the partioipants, observers, resource staff and WHO Secretariat.
The members of the Resource Staff Group met for three days prior to
the opening of the Sem1nar, to discuss planrung and organizational matters.
During this period, the prograMme of the Seminar was finalized and
decisions made in relation to the composition of the study groups, the
EM/NURS./149 ANNEX V page x
WHO EMRO
presentation of the topics, setting up the library, developing the eva
luation quest~onna~re and various other individual and committee
responsibilities. Thu group met for two days follow~ng the closure
of the Sem1nart to summarize proceedings, discuss the preparation of
the final report and evaluate the f\mctiomng of the Resource Staff.