NURSING EDUCATION I N BARBADOS I N A COMMUNITY COLLEGE S E T T I N G

Norma J . I. Holder, Deputy Principal

B a r b a d o s Community College.

nllCnTInq pqsnnsnnnc 1.1 A ~ n v f i i [ ~ q ~ ~ v ' ' r f i ~ j ~ ~ C ~ W T T ~ & by N o r m a ' 3 . I . H o l d e r , Oe(-ut;. P r i n c i p a l , B a r b a d o s Community C o l l e g e

B A C K G R O U N D TO NURSING EDUCATION I N B A R B A D O S

N u r s i n g E d u c a t i o n h a s t r a d i t i o n a l l y been b a s e d i n h o s p i t a l

c o n t r o l l e d s c h o o l s and B a r b a d o s , w i t h two s u c h s c h o o l s , h a s p r o v e d

no e x c e p t i o n t o t h i s p a t t e r n . A S c h c ~ o l o f N u r s i n g was e s t a b l i s h e d

a t t h e B a r b a d o s G e n e r a l H o s p i t a l i n 1908 and i n 1966 i t was

t r a n s f e r r e d t o i t s p i z s ~ n t l o c a t i o n , c l o s e t o t h e Queen E l i z a b e t h

H o s p i t a l , a s t h e T e r c e n t e n a r y S c h o o l o f N u r s i n g . The P s y c h i a t r i c

H o s p i t a l S c h o o l o f N u r s i n g was e s t a b l i s h e d i n 1960 . T h e s e t w o

s c h o o l s o f f e r t h e f o l l o w i n g n u r s i n g programmes t o s t u d e n t s : -

T e r c e n t e n a r y S c h o o l o f N u r s i n g

(1) a t h r e e - y e a r programme i n b a s i c n u r s i n g e d u c a t i o n l e a d i n g

t o t h e R e g i s t e r e d N u r s e C e r t i f i c a t e .

(21 a o n e - y e a r n o s t b a s i c programme i n m i d w i f e r y f o r g r a d u a t e

g e n e r a l t r a i n e d n u r s e s , l e a d i n g t o t h e R e g i s t e r e d Midwi fe

C e r t i f i c a t e .

( 3 ) a n 18 t o 21 month programme f o r s i n g l y o u a l i f i e d p s y c h i a t r i c

t r a i n e d n u r s e s t o c o m p l e t e t h e b a s i c n u r s i n g e d u c a t i o n '

programme a t (1) a b o v e .

( 4 1 a o n e - y e ~ r c o u r s e f o r n u r s i n g a s s i s t a n t s .

P s y c h i a t r i c H o s p i t a l S c h o o l o f N u r s i n g

(1) a t h r e e - ! , e a r p s y c h i a t r i c n u r s i n g programme l e a d i n g t o t h e

R e g i s t e x d M e n t a l N u r s e C e r t i f i c a t e .

( 2 ) a n 18-month programme f o r t h e g r a d u a t e g e n e r a l t r a i n e d

n u r s e who m i g h t w i s h t o c o m p l e t e t h e P s y c h i a t r i c n u r s i n g

programme.

I t s h ~ u l d be n o t e d t h a t t h i s programme i s oDen t o a n y g e n e r a l

t r a i n e d n u r s e w o r k i n g - i n t h e R u b l i c S e r v i c e 1 it i s n o t

r e s t r i c t z d . - - t o g r a d u a t e s o f t h e T e r c e n t e n a r y S c h o o l o f

~ u r s i h g . -

O v e r t h e y e a r s , t h e s e schoo ; s have s u p ~ k i e d R a r b a d o s w i t h a n

a d e o u a t e number o f s t a f f n u r s e s t o meet t b n e e d s o f t h e v a r i o u s

n u r s i n g s e r i i c e d s ~ z r t merits and h a v e f r a j n e d s t u d e n t s . . 'from o t h e r w . . i ' - . . . C a r i b b e a n c b u n t r i ' e s a t t k e . r a t e o f P t o 1 0 p e r y e a r . '--TliF s c % ~ j d , l s

- 3 . I C t > r a

e n j o y a good r e p u t a t i o n i n t h e r e g i o n and o v e r s e a s a n d many o f

tiheir g h d u a t a s h a v e a c h i e v e d n o t a b l e s u c c e s s * -

T h e r e a r e t h r e e i d e n t i f i a b l e componen t s i n a h o s p i t a l - b a s e d

n u r s i n g e d u c a t i o n programme:-

l a ) a n acad.emic componen t ,

I b ) a c l i n i c a l component ,

( C ) a s e r v i , : e component ,

w i t h g r ea t e s t e a p h a s i s b e i n g p l a c e d on t h e s e r v i c e compbrieirt. Tk+ d e p l o y m e n t d f s t u d e n t n u r s e s i n , s s ~ v i c e i s 'rnoW., o f t e n t h a n r io t . r > . ,

d e t e r m i n e d by t h e s t a f f i n g n e e d s o f t h e h o s p i t a l ' t h a n by t h e " ' p r a c t i c e . n e e d e d by* s t u d e n t s i n t h e d e v e l o p m e n t d f ,nurtitiog s k i J l s . --. -1 i n t h e r e q u i r e d a r e a a t t h e r e q u i r e d time. T h i s .is n o t s u s p r i s i n g s i n c e a h o a p i t 11 i s , a f t e r a l l , an i n s t i t u t i o n o n e o f , whose..main . . o b j e ~ t i v d s i s p a t i e n t c a r e . S t r e n u o u s e f f o r t s , b y Government an$.. i n p a r t i c u l a r by t h e M i n i s t r y of HePl%h, h a v e r e s u l t e d i n improvkd

s t a n d a r d s o f n u r d n g e d u c a t i o n fr&iirL t h e first a t t e m p t a t f o n n a l -' ,

t r a i n i n g of rsurses i n 192R t o t h e p r e s e n t s y s t e m w i t h two s c h o o l s

o f n u r s i n g , ~ u t t h e r e is s t i l l ' s c p d s i f o r impro;etieht.

"Whether t h e s c h o o l opur3 tes under a M i n i s t r y , Board

o r h o s p i t a l , p a t i e n t ca re i s a p r i m a r y r e s p o n s i b i l i t y

and n u r s i n g educa t ion c o n t i n u e s t o be seen as a

secondary f u n c t i o n " . 1

RECOMMENDATIONS ON THE UPGRADING OF NURSING EDUCATION BY SENIOR

NURSES I N THE REGION.

Reg iona l workshops and seminars, as d e t a i l e d below, have been p a r t

o f t h e p l a n n i n g a c t i v i t i e s f o r t h e upg rad ing and r e o r g a n i s a t i o n

o f n u r s i n g e d u c a t i o n i n t h e Caribbean, and s e n i o r n u r s i p g

p e r s o n n e l have, d u r i n g t h e l a s t decade i n p a r t i c u l a r , made s t r o n g

recommendations . , f o r t h e upgrad ing o f n u r s i n g educa t ion programmes.

I n 1975, t h e Car ibbean S e c r e t a r i a t convened, i n Barbados, a

Working p a r t y on N u r s i n g Educa t ion t o ( a ) re-examine t h e p r e s e n t

system and p r o j s c t e d p l a n s f o r n u r s i n g e d u c a t i o n i n t h e r e g i o n

i n t h e l i g h t o f t h e i r r e l e v a n c e t o t h e needs o f t h e peop le o f

t h e Caribbean, and i b l mako reco rn~ondn t ions .

The f o l l o w i n g were among t h e recommendations made by t h e Working

P a r t y : -

(1) t h a t t h e ducati ion o f nurses shou ld be i n t e g r a t e d i n t o t h e

g e n e r a l system o f educa t ion .

(2) t h a t , i d e a l l y , t h e educa t ion of nurses shou ld t a k e p l a c e i n

an i n t e r d i s c i p l i n a r y s e t t i n g .

Subsequent t o t h e s e recommendations, a n o t h e r Workshop on N u r s i n g

Educa t ion was h e l d i n J u l y 1976 i n An t igua t o

( a 1 " d e v e l , p c u r r i c u l u c n g u i d o l e i n e s f o r a B a s i c N u r s i n g E d u c a t i o n

Programme which would b e i n t e g r a t e d i n t o t h e g a n e r a l e d u c a t i o n

s y s t e m #

( b J d e v e l o p g u i d e l i n e s f o r t h e o r g a n i s a t i o n a n d a d m i n i s t r a t . , i o n . , , . o f

s u c h i n t e g r a t e d n u r s i n g programmes9

( c ) d e v e l o p s t e p s t o b e t a k e n i n i m p l e m e n t i n g t h e i n t e g r a t i o n

of n u r s i n g progrzmmes i n t o t h e g e n e r a l e d u c a t i o n s y s t e m .

T h i s workshop wae a t t e n d e d by n u r s i n g e d u c a t o r s and a d m i n i s t r a t o r s

f r o m a l l Car icom c o u n t r i e s , t h e Bahamas and t h e B r i t i s h V i r g i n ,

I s l a n d s . The C a r i b b e a n Nurses A s s o c i a t i o n , t h e R e g i o n a l N,qpeing

Body, t h e U n i v e r s i t y of t h e W . I . , and PAHO/WHO a l s o p a r t i c i p a t e d .

I n December 1 9 7 7 , a g r o u p o f s e n i o r h e a l t h p e r s o n n e l f r o m e l e v e n

C a r i b b e a n c o u n t r i e s and S u r i n a m e m e t i n B a r b a d o s t o d i s c u s s some

o f ' t h e i s s u e s c u r r e n t l y f a c i n g n u r s i n g . T h e s e issues a r o s e f r o m

G o v e r n m e n t s ' p r o p o s a l s t o e x t e n d h e a l t h c a r e c o v e r a g e t o t h e

e n t i r e p o p u l a t i o n . To t h i s e n d , a g r e a t d e a l o f e m p h a s i s was

p l a c e d on t h e need f o r s t r e n g t h , e n i n g t h e d e l i v e r y o f P r i m a r y

~ e a i t h C a r e s e r v i c e s . O f m a j o r c o n c e r n was how b e s t t o p r e p a r e

n u r s i n g p e r s o n n e l a t b a s i c ' a n d p o s t - b a s i c l e v e l s i n t h e l i g h t o f

t h e h e a l t h c a r e n e e d s o f t h e p e o p l e , a f t h e C a r i b b e a n and t h e . /

p r o p b a a l i f o r c h a n g e s i n t h e d e l i v e r y o f h e a l t h c a r e . F o l l o h i n g

d i s c u s s i o n s , t h e work g r o u p recommsnded, among o t h e r t h i n g s , ,

t h a t :

( a ) N u r s i n g s c h o o l s i n t h e r e g i o n r e - d b s i g n t h e i r c u r r i c u l a t o

i n c l u d e r e l e v e n t l e a r n i n g e x p e r i d m c e s f o r s t u d e n t s i n

community s e t t i n g s , i n k e e p i n g w i t h t h e s h i f t i n e m p h a s i s

f r o m i n s t i t u t i o n a l t o community b a s e d h e a l t h c a r e .

[ b ) Governmeits be urged t o t a k e a c t i o n t h a t w i l l e x p e d i t e and

enhance e f f o r t s now b e i n g mads by t h e Reg iona l N u r s i n g Body (RNBI

t oward s t a n d a r d i s a t i o n and r e c i p r o c i t y i n n u r s i n g e d u c a t i o n i n

t h e r e g i o n . , .

( c ) Governments be urged t o implement t h e recommendation o f p r e v i o u a

workshops - t h a t educa t ion o f n u r s i n g pe rsonne l ( b a s i c , p o s t -

b a s i c and c o n t i n u i n g ) t a k e ;)lace i n an i n t e r - d i s c i p l i n a r y

s e t t i n g , and w i t h i n i n s t i t u t i o n s whose p r i m a r y purpose i s

educa t ion .

S i m i l a r recommendations have a l r e a d y been made by l e a d e r s i n

n u r s i n g i n N o r t h America and B r i t a i n - an i n many cases t h e main

t h e s i s , i . e . t h e t r a n s f e r o f n u r s i n g educa t ion t o an i n s t i t u t i o n

whose p r i m a r y purpose i s educat ion , has a l r e a d y been p u t i n t o

p r a c t i c e .

ESTABLISHMENT OF THE BARBADOS COMMUNITY COLLEGE

A t t h i s s tage, I shou ld l i k e t o f o c u s on t h e Barbados Community

Co l lege, i t s o v e r a l l aims and e d u c a t i o n a l o b j e c t i v e s and t h e

programmes wh ich i t o f f e r s . The Barbados Community C o l l e g e was

e s t a b l i s h e d i n January 1969, w i t h t h e o v e r a l l a im o f c a t e r i n g t o

t h e e d u c a t i o n a l needs, a t t e r t i a r y l e v e l , o f t h e s o c i e t y . I t s

c u r r i c u l u m o b j e c t i v e s t h e n s t a t e d :

"...The c u r r i c u l u m o f t h e Barbados Community C o l l e g e

i s des igned t o encourage i n i t s c t u d e n t s b o t h

development as persons and growth i n t h e knowledge

and s k i l l s i n t h e ca ree rs o f t h e i r choice. . . . The

o v e r a l l c u r r i c u l u m o b j e c t i v e s a r e based on t h e b e l i e f

t h a t t h e g r a d u a t i n g s t u d e n t s w i l l be b e t t e r equipped

t o pursue t o t a l s e l f developmentn. 2

I n i t i a l l y , t h e C o l l e g e c o m p r l a e d ! D i v i s i o n s o f Commerce, L i b e r a l

Arts and S c i e n c e 1 D i v i s i o n s o f T e c h n o l o g y and F i n s Arts were

a d d e d i n 1973, and 1974 r e s p e c t i v e l y . A D i - ~ i ' s i o n o f H e a l t h

' ~ c i s h c e s was a l s o added i n 1974 and i n J a n u a r y , 1980 t h e D i v i s i o n

o f H o s p i t a l i t y S t u d i e s ( f o r m e r l y t h e B a r b a d o s H o t e l S c h o o l ) was

i n c o r p o r a t e d . i n t o t h e C o l l e g e . The Rclr-bados Community C o l l a g e

i s a t r u l y m u l t i - d i s c i p l i ~ a ~ y t e ? c h i n g / l e a r n i n g i n s t i t u t i o n ,

c o v e r i n g , , t h e . w i d e s t c d u c a r i o n a l speccrurn i n B a r b a d o s and i q d e e d

p o s s i b l y i n t h e C a r i b b e a n . % ,

The C o l l e g e , w h i c h f a l l s u n d e r t h e M i n i s t r y of E d u c a t i o n , is

admini t3 tere .d by a Board o f Management. T h e r e i s a C o l l e g e 'i

A d v i s o r y Commit toe c o m p r i s i n g t h e P r i n c i p a l , Deputy P r i n c i p a t , .

S e n i o r T u t o r s ( i . e . D i v i s i o n a l Heads ) , R e g i s t r a r , B u r s a r , L i b r a r i a n ,

G u i d a n c e C o u n s e l l o r , P h y s i c a l E d u c a t i o n O f f i c e r , G e n e r a l StdudSes

T u t o r and two r e p r e s e n t a t i v e s f r o m t h e S t u d e n t s ' C o u n c i l . T h i s

Commit tee c o n c e r r s i t s e l f w i t h a l l a s p e c t s o f C o l l a g e l i $ e a q d makes - _.-- -- r e c o m m e n d a t i o n s d i r e c t e d t o w a r d s $mgrov&kg--the'b*(ier;a~-l- o p e r a t i o n s

o f t h e C o l l e g e . , . - . ,

,.,, - '

DIVISION e0F"HEdLTH SCIENCESOF THE BARBADOS FOMMUNI~TV~COLLEGE ,

I ' I

r Th. C o l l e g a p a r i i c i p a t d s , t h r o u g h t h i s ' ~ i v i s i o n , i n t h e PAHO/WHO

R e g i o n a l P r o j e c t f o r t h c E d u c a t i o n a n d T r a i n i n g of A l l i e d H e a l t h

P e r s o n n e l . S ; u d e n t s f r o m B a r b a d o s and o t h e r C a r i b b e a n c o u n t r i e s

a r e c u r r e n t l y 3 e i n g t r a i n e d a s P h a r m a c i s t s , P u b l i c H e p l t h

I n s p e c t o r s , M r d i c a l L a b o r a t o r y T e c h n i c i a n s , M e d i c a l L a b o r a t o r y

T e c h n i c i a n s , Y e d i c a l Record T o c h n i c i a n s , and D i e t e t i c T e c h n i c i a n s .

The D i v i s i o n made h i s t o r y in J a n u a r y 1980 when i t s f i r s t n u r s i n g

programme, e p o s t - b a s i c d i p l o m a programme f o r Community H e a l t h

N u r s e s was implemented .

A t t h e i n a u g u r a l ceremony i n 1974 t o mark t h e e s t a b l i s h m e n t o f

t h f s D i v i s i o n , t h e f i r s t o f f i c i a l r e f e r e n c e t o t h e i n t e g r a t i o n o f

N u r s i n g Educa t ion w i t h t h e O i v i s i o n o f H e a l t h Sciences was made.

The M i n i s t e r o f H e a l t h ment ioned t h e d e s i r a b i l i t y o f havingstude&

t r a i n e d i n an e d u c a t i o n a l s e t t i n g and e n j o y i n g f u l l s t u d e n t s t a t u s .

The o r g a n i s a t l o n o f tkis C i v i s i o n r c f l n c t s t h e need f o r c o n t i n u a l l y

assess ing t h e s u i t a b i l i t y o f s p e c i f i c programmes i n t h e l i g h t o f

t h e chang ing h e a l t h needs o f peop le o f t h e c o u n t r y and r e g i o n .

F o r example, f o r each programme t h e r e i s an a d v i s o r y sub-committee,

t h e compos i t i on of wh ich i n c l u d e s p r o f e s s i o n a l s f r o m Govornment

and t h e p r i v a t e s e c t o r work ing i n t h a t aroa, r e p r e s e n t a t i v e s f r o m

r e l a t e d p r o f e s s i o n a l a s s o c i a t i o n s and r e l e v a n t r e g u l a t o r y bod ies .

The i n p u t o f such sub-committees i s v i t a l t o t h e success o f t h e

programmes - t h e y a r e t h e d i r e c t l i n k between t h e e d u c a t i o n a l

i n s t i t u t i o n and t h e work ing onvi ronmunt f o r wh ich t h e s t u d e n t s a r e

b e i n g prepared. I n f a c t , such sub-committees a r e c o n s t i t u t e d

w h i l e t h e progrsrnmes a r e i n t h e p l a n n i n g s tages and g i v e i n p u t i n t o

t h e shap ing o f c ~ ~ r r i c u l a so t h n t thi2 t r ~ i n i n g OF s t u d e n t s i s

r e l a t e d t o l o c n l 2nd r e g i o n 3 1 h e a l t h ncads. On-going assessment

o f programmes bv these sub-commit tcss e j v e s guidance t o t h e C o l l e g e

i n t h e m o d i f i c a t i o n o f c u r r i c u l a .

I n a d d i t i o n t o these programme.sub-committees, t h e r e i s a

D i v i s i o n a l Adv i so ry Committee w h o s ~ memhcrs i n c l u d e t h e Head o f

t h e C i v i l Se rv i ce , s e n i o r o f f i c i a l s f r o m t h e M i n i s t r i e s o f

E d u c a t i o n and Hea l th , ;i r e p r e s e n t e t i v o f r o m t h e T r a i n i n g D i v i s i o n ,

t h e D i r e c t o r o f t h e Q.E.H., a r e p r o s o n t a t i v e f rom t h e Genera l

N u r s i n g Counc i l , a r e p r e s e n t a t i v e f r o m t h e F a c u l t y o f Medic ine,

U.W.I., t h e C h i e f N u r s i n g O f f i c e r , t h e S e n i o r T u t o r o f t h e D i v i s i o n ,

t h e Direc tor o f t h e PAHO/WHO R e g i o n a l P r c j e c t and t h e D i r e c t o r o f

P r o j e c t HOPE. T h i s CommZttee a d v i s e s on t h e o v e r a l l d i r e c t i o n of t h e e d u c a t i o n o f h e a l t h p e r s o n n e l . in t h e C o l l e g e e s p e c i a l l y i n t h e

l i g h t o f l o c a l and . r e g i o n a l d e v e l o p m e n t s and n e e d s , 2 .

C u r r i c u l a h a v e b e e n ' d e v s l o p e d k a i n l y by p r o f e s s i o n a l s i n t h e

C a r i b b e a n r e g i o n . For e c t c i i ' ? ~ o f e s s i o n a l programme, t h e r e i s an

o v e r a l l c o - o r d i n a t o r whose r e s p o n s i b i l i t i e s i n c l u d e t e a c h i n g some '

o f t h e p r o f s s s i o n a l 'courses ' , and I d e n t i f y i n g i n c o n j u n c t i o n w i t h

t h e D i v i s i o n a l Heads , s u i t a b 1 e ~ : l e c t u r e r s f o r o t h e r componen t s o f

t h e programme. I n t e r d i s c i p l i n a r y t e a c h i n g i s a r e a l i t y ,.,- i n t h i s

D i v i s i o n w i t h many c o r e c o u r s e s s h a r e d by s t u d e n t s i n d i f f e r e n t

programmes. As t h e D i v i s i o n e x p a n d s , it i s i n t e n d e d t h a t a more ' < '

c o m p r e h q n s i v e c o r e c u r r i o u l u m w i l l b e d e v e l o p e d . 1

t ' I

M o d e r a t o r s e x t e r n a l t o t h e programmes, f r o m U . W . I . , U n i v e r s i t y af., , -

Guyana and o t h e r e d u c a t i o n a l i n s t i t u t i o n s i n t h e r e g i o n , a r e u s e d

w i d e l y f o r f i n a l e x a m i n a t i o n s t o e n s u r e o b j e c t i v i t y a n d t h e

m a i n t e n a n c e o f c o m p a r a b l e r e g i o n a l s t a n d a r d s f o r p r o f e s s i o n a l

h e a l t h e d u c a t i o n .

DECISION OF BARBADOS GOVERNMENT ON N U R S I N G EDUCATION

I n May 1 9 7 9 , t h e Government of B a r b a d o s a g r e e d t h a t :

t i ) n u r s i n g e d u c a t i o n s h o u l d be i n t e g r a t e d i n t o t h e g e n e r a l

e d u c a t i o n s y s t e m and , t r a n s f e r r e d f r o m t h e M i n i s t r y o f

H e a l t h t o t h e M i n i s t r y of E d u c a t i o n and C u l t u r e ,

s p e c i f i c a l l y t o t h e B . C . C . i n i t s D i v i s i o n o f H e a l t h

S c i e n c e s .

( i i l t h a t t h e M i n i s t r y o f H e a l t h s h o u l d s e t i n t r a i n t h e

n e c e s s a r y m a c h i n e r y l e a d i n g t o t h e t r a n s f e r o f n u r s i n g

e d u c a t i o n .

( i i i ) t h a t a c u r r i c u l u m f o r a t h r e e y e a r i n t e g r a t e d n u r s i n g

Orogramme s h o u l d bc d e v e l o p e d t o f i t i n t o t h e programmes

o f t h e BCC where t h e s t u d e n t n u r s e can p a r t i c i p a t e

a c t i v e l y i n t h e g e n e r a l a c a d e m i c e n v i r o n m e n t .

The i m p l i c a t i o n s o f t h e s e d e c i s i o n s a n n u r s i n g e d u c a t i o n w i l l b e

examined f u r t h e r .

I. INTEGRATION OF NURSING EDUCATION INTO THE GENERAL EDUCATION SYSTEM

AND SPECIFICALLY TO THE D I V I S I O N OF HEALTH SCIENCES OF THE B.C.C.

The d e c i s i o n t o t r a n s f e r n u r s i n g e d u c a t i o n i n B a r b a d o s t o t h e

s d u c a t i o n a l s y s t e m i e c o n s i s t e n t w i t h t h e new a p p r o a c h b e i n g

t a k e n by Governments i n t h e r e g i o n i n p l a n n i n g f o r t h e d e l i v e r y o f

h e a l t h c a r e . Two i m p o r t a n t a s p e c t s o f t h i s new a p p r o a c h a r e -as

f o l l o w s : -

1. The e m p h a s i s i n h e a l t h c a r e d e l i v e r y is b e i n g p l a c e d on t h e

p r o v i s i o n o f p r i m a r y h s a l t h c a r e f o r a l l s e c t o r s o f t h e

p o p u l a t i o n .

2. The i n t e r d i s c i p l i n a r y a p p r o a c h t o t h e d e l i v e r y o f h e a l t h

c a r e must ba s t r e n g t h e n e d .

The i n t e r d i s c i p l i n a r y a p p r o a c h e n v i s a g e s a g r o u p o f h e a l t h p r o f e s s i o n a l s

uf v a r i o u s c a t e g o r i e s , w o r k i n g t o w a r d s a common g o a l - t h a t o f t h e

o v e r a l l h e a l t h o f t h e c l i e n t . T h e s e h e a l t h p e r s o n n e k i n c l u d e n u r s e s

p h a r m a c i s t s , d i e t i t i a n s , n u t r i t i o n i s t s , l a b o r a t o r y t e c h n i c i a n s ,

m e d i c a l r ~ c o r d s t e c h n i c i a n s and d i e t e t i c t e c h n i c i a n s . The

c o m p o s i t i o n ' o f i n - i n t b r d i s c i p l i n a r y hez i l th t e a m and t h e , r e l a t i v e

r e s p o n s i b i l i t i e s o f its members w i l l v a r y w i t h t h e d i f f e r e n t

n e e d s o f c l i e n t s * s i n c e t h e m a i n t e n a n c e o f h e a l t h i s m u l t i s e c t o r a l

a n d no o n e d i s c i p a i n e m a n be e x p e c t e d t o p r o v i d e a l l t h e n e c e s s a r y

i n p u t s . W i t h i n t h e C a r i b b e a n , t h e i n t e r d i s c i p l i n a r y t e a m

a p p r o a c h haG n o t been s u f f i c i e n t l y e m p h a s i z e d e i t h e r i n t h e

e d u c a t i o n s y s t e m o r i n t h e d e l i v n r y o f h e a l t h c a r e . Each d i s c i p l i n e

h a s p u r s u e d i t s g o a l s i n i s o l a t i . o n and a t t i m e s t o t h e e x c l u s i o n

o f o t h e r h e a l t h d i s c i p l i n e s . T h i s o f t e n r e s u l t s i n u n n e c e s s a r y

d u p l i c a t i o n of e f f o r t and w a s t a g e of r e s o u r c e s . An e f f e c t i v e

i n t e - r d i - s c i p i i n - a s y . h e a l t h , team _ .. _ _ s h o u l d _. b o o s t m o r a l e and p r o v i d e a s e n s e o f s a t f a f a 6 t i o n - . i n ' a l l i ts.-mtimbe% w h a t e ( r & r t h s i b l e v e l

o f t r a i n i n g , i t s h o u l d a l s o p r o v i d e optimum h e a l t h c a r e t o its- c l i e n t e and u t i l i z e t h e c o u n t r y ' s r e s o u r c e s more e c o n o m i c a l l y .

.? and e f f i c i e n t l y .

ROLE OF THE PROFESSIONAL NURSE

The i m p o r t a n t r o l e o f n u r s e s i n t h e h e a l t h c a r e sys , t em c a n n o t b e

o v e r - e m p h a s i z e d . Advances i n m e d i c a l k n o w l e d g e ' a r e impoging

new r e s p o n s i b i l i t i e s on memhers o f t h e n u r s i n g p r o f e s s i o n .

Modern c o n c e p t s i n h e a l t h c a r e w i t h i n c r e a s e d e m p h a s i s on h e a l t h

p r o m o t i o n and m a i n t e n a n c e r e q u i r e n u r s e s t o a c t a s t e a c h e r s and

c o u n s e l l o r s t o p a t i e n t s and t h e i r f a m i l i n s . ~ u r $ e s w i l l be

r e q u i r e d t o p a r t i c i p a t e more a c t i v e l y i n i h e -1p lann ing o f

p r i m a r y and o t h e r h o a l t h c a r e s e r v i c t ? ~ . , S t r e n g t h e n i n g o f t h e

i n t e r d i s c i p l i n a r y t eam a p p r o a c h w i l l demand i n c r e a s e d r e s p o n s i -

b i l i t y f r o m n u r s e s .

M a j o r a s p e c t s of t h e r o l e o f t h e p r o f e s s i o n a l n u r s e i n t h e h e a l t h

c a r e sys tem a r e o u t l i n e d b y D r . Mery S e i v w r i g h t u n d e r t h e

f o l l o w i n g c a t e g d r i e s :

2. E d u c a t i o n a l

3. Administrative/Maoa:ement

Fur the rmore , t h e r o l e o f t h e n u r s e canno t be s t a t i c . H e a l t h c a r e

needs o f a s o c i e t y change as i t s economic, s o c i a l and c u l t u r a l

needs change^ so t o o must "he r o l e o f t h e n u r s e change.

EDUCATION OF THE NURSE I N RELATION TO HER ROLE

' I

The e d u c a t i o n o f t h e n u r s e m u s t t h e r e f o r e p r e p a r e h s r t o f u l f i l h e r

r o l e e f f e c t i v e l y . To t h i s end, a r e v i s e d c u r r i c u l u m w i t h an

i n t e g r a t i v e approach and w i t h g r e a t e r emphas-is on community. heal.th

n u r s i n g i s c u r r e n t l y b e i n g imp lemepted a t t h e T e r c e n t e n a r y S c h o o l

o f N u r s i n g , I v a d d i t i o n , however, s t u d e n t n u r s e s s h o u l d s h a r e

e d u c a t i o n a l , s o c i a l and c u l t u r a l e x p e r i e n c e s w i t h o t h e r f u t u r e

members o f t h u h e a l t h team^ n u r s e t u t o r s s h o u l d a l s o s h a r e i n

an academic, s o c i a l and c u l t u r a l env i r onmen t w i t h t u t o r s o f o t h e r

h e a l t h p r o f e s s i o n a l s .

" T h i s is E com!~ctiti . : .! 2nd s q 5 s n t i f i . c aqe. If n u r s i n g

c a n n o t meas t i re t,n a d u c , ? t i o n a l l y t o o t h e r p r o f e s s i o n s ,

i f it f a i l s t o n r o ~ i d ~ : iksalf w i t h t n e b r o a d n a t u r a l ,

b i o 1 o ~ : c a l 3rld s o c i 3 l s c i o q c e b a s i s r e o u i r e d f o r p r e s e n t

and f u t u i - 6 cr r~:mi t rnents and i f it l a c k s t h e a b i l i t y t o

d e l i n e a t e c i s a r i y i t s . c u n c t i o n a l p o t e n t i a l a s o t h e r

p ~ m f e s s i o n d - ' b u s t f a l l b e h i n a i n t h e o u a l i t y o f

t h e c o n t r i b u t i o n i t c a n makc t o m a n ' s w e l f a r e and d e s t i n y ,

and i n t h e a t t a i n m e n t c f a s 3 c u r e and h o n o u r e d s o c i o -

economic s t a t u s . ,, 4 . - .-

The t r a n s f e r o f n u r s i n g e d u c a t i o n t o t h s D i v i s i o n of H e a l t h

S c i e n c e s o f t h e B a r b a d o s Community C o l l e g e s h o u l d f u r t h e r assist

s t u d e n t n u r s e s by (1) r e i n f o r c i n g t h e r e a l i t y o f a n i n t e r d i s c i p l i n a r y

a p p r o a c h t o t h e p l a n n i n g and d e l i v e r y o f h e a l t h c a r e and 12) p r e -

p a r i n g them. t o f u l f i l t h e i r e v e r - c h a n g i n i r o f e . I

11. ADMINISTRATIVE ASPECTS OF THE TRANSFER OF N U R S I N G EDUCATION FROM

THE MINISTRY OF HEALTH TO THE MINISTRY OF EDUCATLON - I n o r d e r t h a t s u c h a t r a n s f e r m i g h t be e f f e c t e d s m o o t h l y , a w i d e

r a n g e o f a d m i n f s t r a t i v e m a t t e r s had t o b e t h o r o u g h l y s t u d i e d and

r e c o m m e n d a t i o ~ s made. I t was c l e a r l y s e e n t h a t b o t h M i n i s t r i e s

i n v o l v e d , t h e B . C . C . , o t h e r r e l e v a n t i n s t i t u t i o n s and a g e n c i e s

and t h e n u r s i n g t u t o r i a l s t a f f needed t o have t h e i r r o l e s and

r e s p o n s i b i l i t i e s c l e a r l y d e f i n e d . To t h i s e n d , a S t e e r i n g Commit tee

was a p p o i n t e d by t h e M i n i s t e r of H e a i t h u n d e r t h e c h a i r m a n s h i p

o f the C h i e f N u r s i n g O f f i c e r t o p r e p a r e a ~ r o p o s a l f o r t h e t r a n s f e r .

The a r e a s r e p r e s e n t e d on t h i s Commit tae w e r e a s f o l l o w s : -

1. M i n i s t r y o f E d u c a t i o n

S e n i o r E d u c a t i o n O f f i c ~ r ( T e r t i a r y ) It ?I It ( P l a n n i n g )

A s s i s t a n t S e c r c t n ~ y I T o r t i a r y l

2. B a r b a d o s Commun:ty C o l l e2e

R e p r e s e n t a t i v e o f Board o f Management

P r i n c i p a l

S e n i o r T u t o r , D i v i s i o n o f H e a l t h S c i e n c e s

3 . Queen E l i z a b e t h H o s p i t a l

A s s i s t a n t Matron

P r i n c i p a l T u t o r , T e r c e n t e n a r y S c h o o l o f N u r s i n g

S e n i o r T u t o r ,

T u t o r ,

4 P s y c h i a t r i c H o s p i t a l

P r i n 2 i p a l N u r s i n ~ O f f i c e r

S e n i o r T u t o r , S c h o o l o f N u r s i n g

5. B a r b a d o s T e g i s t e r e d N u r s e s A s s ~ ~ c i a t i o n - a r e p r e s e n t a t i v e

6. G e n e r a l N u r s i n g C o u n c i l - a r e p r e s e n t a t i v e

7 . B a r b a d o s A s s o c i a t i o n o f M e d i c a l P r a c t i t i o n e r s - two r e p r e s e n t a t i v e s

8. PAHO/WHO - A d v i s o r , N u r s i n g E d u c ~ t i c n

9 . N a t i o n a : Union o f P u b l i c Workers - a r e p r e s e n t a t i v e .

S i x s u b - c r m m i t t e e s w e r e formed t o s t u d y s p c c i f i c a s p e c t s o f

t h e t r a n s f e r , a s f o 1 i o w s : -

( i ) A d m i n i s t r e t i o n and F l q n n ~ Q q c o m m i t t e e -- t q o b t a i n

a d m i n i s t r a ' c i v e ,3pp~-nj3!. f ~ l - t h e s t u d e n t s ' u t i l i z a t i o n o f

c l i n i c a l f s c i : l t i ~ : - : 3 1 d t o 7 r z v a r e t h e d r a f t r e p o r t .

[ i i l Nurs i r lg S e r v i c c Cc--~1jf;.';k3 -- t 3 ?va!.u?t and deter r r l ine

n u r s i n g s ~ r v i c e rf if i3- l iJ ibd€r needs h h i c h m i g h t r e s u l t f r o m

c h a n g e s i n t h e n u r s i n g plogrammes.

( i i i ) T r a n s f e r o f P e r s o n n e l Commit tee - t o examine t h e p e r s o n n e l

i m p l i c a t i o n s o f t h e t r a n s f e r and make r e c o m m e n d a t i o n s f o r

t h e t r a n s f e r o f o f f i c e r s .

( i v ) S t u d e n t W e l f a r e Commit tee - t o f o r m u l a t e p o l i c y g u i d e l i n e s

f o r s t u d e n t n u r s e s a t t h e C o l l e g e i n t h e l i g h t o f e x i s t i n g

s t u d e n t p o l i c i e s a t t h s S c h o o l s o f N u r s i n g and t h e B.C.C.

( v ) Budget Commit tee - t o examine t h e f i n a n c i a l l i m p . l i c a t i o n s

of t h e t r a n s f e r and t o s u b m i t a b u d g e t p r o p o s a l f o r t h e

N u r s i n g Programme on t r a n s f e r .

( v i ) C u r r i c u l u m Development Commit tee - t o d e v e l o p a n i n t e g r a t e d

c u r r i c u l u m f o r t h e b a s i c N u r s i n g programme t o r e f l e c t a n

c m p h a s i s on p r i m a r y . h e a l t h c a r e and Commwnity H e a l t h ,

The i m p o r t a n c e o f t l i i c ; t i r , , c - . c o n s q n i ~ ~ g L X = ~ . C ~ S U c a n n o t b e o v e r -

e m p h a s i z e d . Such an i n v e s t i g a t i g n of a l l a d m i n i s t r a t i v e a s p e c t s

o f t h e t r a n s f e r was n e c e s s a r y and i t was c a r r i e d o u t t h o r o u g h l y

w i t h t h e f u l l c o - o p e r a t i o n o f a i l t h e p a r t i c i p a t i n g a 2 e n c i e s .

The c o m p l e t e d p r o p o s a l i s now u n d e r s t u d y ac t h a t t h e r e q u i r e d

a d m i n i s t r z ~ i v e c h a n g e s which m u s t t a k a p l a c e on t r a n s f e r may be

worked o u t .

111. PARTICIPATION OF THE STUDENT N U R S E - I N THE G E N E R A L ACADEMIC

ENVIRONMENT OF 7HE COLLEGE

T h e r e a r e m?ny f e ~ t u r e s nf t h e g e n c r i , ? ~ c a d e m i c e n v i r o n m e n t o f

t h e C o l l e g e f roln which p a r t i c i 7 a t i n # ! s f , u d e n t s c a n d e r i v e g r e a t

b e n e f i t s . T h c s r i n c l u d e : -

( a ) C o u n s e l l i n g s e r v i c e s . T h e s e a r 2 p r o v i d e d by a t r a i n e d

C o u n s e l l o r and a r e c o n c e r n e d w i t h h e l p i n p s t u d e n t s l e a r n new

ways o f d e a l i n g w i t h and a d j u s t i n g t o l i f e s i t u a t i o n s . T h r e e

componen t s of s t u d e n t s g r o w t h a r e e m p h a s i s e d : - ( a ) s o c i a l and

p e r s o n a l d e v e l o p m e n t ; I b ) e d u c a t i o n a l d e v e l o p m e n t a n d ( c ) c a r e e r

and v o c a t i o n a l d e v e l o p m e n t .

( b l S t u d e n t s q C o u n c i l . T h i s i s t h o c r g a n i s i n g body o f t h e

S t u d e n t s ' G u i l d and it c o m p r i s c s a F r u s i d e n t , V i c e - P r e s i d e n t ,

S e c r e t a r y , Treasurer and a r e p r a s c n t a t i v e f r o m e a c h D i v i s i o n .

T h e r e a r c v a r i o u s c o m m i t t e e s r a s p c n s i b l e f o r s p o r t s , c u l t u r a l

a c t i v i t i a ~ , p u b l i c a t i o n s and wc l fo r r : . The S t u d e n t s ' G u i l d

p l a n s and o r g a n i s e s a v a r i e t y c f s t u d e n t a c t i v i t i e s i n t h e

C o l l e g e and i n t h e community.

( c ) P h y s i c a l E d u c a t i o n A c t i v i t i e s . Studc2nts p a r t i c i p a t e i n a

w i d e v a r i e t y ~f games and i n a t h l c t 2 c ~ . They a r e a l l o w e d t o

g a i n p r a c t i c a l e x p e r i e n c e i n management by b e i n g a l l o w e d t o r u n s e p a r a t e c l u b s , o n e f o r e a c h s p o r t , w i t h i n t h e C o l l e g e .

S p o r t i n g a c t i v i t i e s a r e c o - o r d i n a t n d by t h e S p o r t s C o u n c i l

which c o m p r i s e s t h e p r e s i d e n t o f cach c l u b a n d t h e P h y s i c a l

E d u c a t i q ~ 3 f f i c e r . The Cc l l e ; ; c h a s a m o d ~ r n gymnasium

which c a n s c a t .?bout 730 g e r s y n s and which i s u s e d w i d e l y

f o r n a t i o n a l and i n t e r n a t i o n 3 1 t o u r n a m e n t s .

( d l G e n e r a l E d b c a t i o n / E n r i c h i n e n t programme. T h i s r)rogramme i s

d e s i g n e d t o complement a l r ~ a d y exist in^ c n u r s 6 s by b r o a d e n i n g

s t u d e n t k n o w l c d ~ o a n 3 s k i l l s and d e v ~ l r ~ r l i n g d e s i r e d a t t i t u d e s .

C o u r s e s i n Communicat ion S k i l l s , S o c i o l o g y , P s y c h o l o g y ,

S u r v e y o f E n g l i s h L i t e r a t u r e , a n d C a r i b b e a n W r i t e r s a r e - - -

c u r r e n t l y o f f e r e d . A f r c - C a r i b b e a n Dance , Modern Dance, ~ r a m a

and V o c a l Music a r e a l s o o f f e r e d a s r e c r e a t i o n a l c o u r s e s u n d e r

t h i s programme.

I t m u s t b e s t r e s s e d t h a t t h e a v a i l a b i l i t y o f a m e n i t i e s and f a c i l i t i e s ,

however modern , aqd of a w i d e r s n g e o f e n r i c h m e n t c o u r s e s i s no

g u a r a n t e e t h a t t h e members c f a n i n s t i t u t i c n w i l l b e n e f i t f r o m

them. S t a f f m u s t p l a y an a c t i v e r o l a by f i r s t l y , h e l p i n g s t u d e n t s

t o r e a l i z e t h e i m p o r t a n c e G F p a r t i c l p e t i ~ g i n a c t i v i t i e s o u t s i d e

o f t h o s e s p ~ c i f i c a l l y r e r i u i r c d by t h a i r c u r r i c u l a and s e c o n d l y ,

e n c o u r a g i n g s t u d e n t s t o make t h e f u l l e s t p r s s i b l e u s e o f a v a i l a b l e

r e s o u r c e s a t t h e C b l l e g e .

The B a r b a d o s Comnunity C c l l e r e i s i n d r 1 7 d CI t e r t i a r y i n s t i t u t i o n

whose p h i l c s o p h y , p n l i c i e s and provrzmmcs p r o v i d e an i d e a l

a t m o s p h e r e f o r t h c e d u c a t i o n 3nd t r a i n i n : : o f a c o m p e t e n t and

p r o f e s s i o n a l n u r s e , aware qf h ~ r r c s y l ? n s i b i l i t y t o and i n t h e

community and i n t u l l e c t u a l l y c-uinr1i:ci t . r assume t h e d u t i e s demanded

by h e r e v e r - c h z n g i n z r o l e ,

SUMMARY

T h i s a r t i c l e o u t l i n e s t h e r;:con1r7endaticrns .n;!cr: and a c t i o n t a k e n

i n t h e u p g r a d i n g of n u r s i n p : ? d u c , l t i o n i n 9ar -badcs e s p e c i a l l y

o v e r t h e l a s t dec; lde . I t exni-lines t h c s u i t a b i l i t y o f t h e

B a r b a d o s Community Col l~qcr! 2s i n s t i t ~ ~ t i o n i n wh ich n u r s i n g

e d u c a t i o n can t a k e p l a c e e s p z c i f l l l y i n t h c c o n t e x t o f new

a p p r o a c h e s t o t h c p l a n v i n e n f h o a l t h s t i r v i c ~ c i n t h e C a r i b b e a n .

I t i s s u g g e s t e d h e r e t h 3 t t h e C ~ ~ l l e ~ c p r c v i d e s an i d e a l a t m o s p h e r e

f o r t h e e d u c a t i o n and t r a i n i n g o f a c o m p e t e n t and p r o f e s s i o n a l

n u r s e .

REFERENCES

1. R e s u r v e y o f S c h o n l s o f N u r s i n g i n t h e C ~ r i b b e a n Area . 1971 . N u r s i n g E d u c a t i o n V o l . 1 1 p,2G.,

2. B a r b a d o s Community C o l l d c c C a l e n d a r 1 9 7 0 - 7 1 p .16

3 . S e i v w r i g h t , Mary J . 1983 . P r i m a r y M c c ~ l t h C a r e : - I m p l i c a t i o v s f o r E d u c a t i c n .3nd r m a i n i n ~ o f P r o f e s s i o n a l

Nurses. P a p e r p r e s a n t e d a t " B l u e p r i n t Workshop" f o r

R e g i o n a l E x a m i n a t i o n s f o r Nurse R z g i s t r a t i o n i n t h e

Commonwealih C a r i b b e a n h e l d i n B ~ r b , 3 d o s , Nov. 1980 ,

4 . H u n t e , E l . ? a n e I . 1978. Ylursing E d u c a t i o n f o r t h e F u t u r e .

C a r i b b e a n H e a l t h S c i e n c c s J o u r n n l V o l . 1 No.1. page 20-21.