Trends

TRENDS AND ISSUES IN MED SURG&OVERALL SCENARIO IN INDIAWho were.. THE FIRST NURSES?

PRE HISTORIC PERIODGOD,EVIL ,SIN CAUSE DISEASEMAKING HOLES IN BODY TO WARD OFF DISEASE MIDDLE AGE care was provided primarily by religious orders , mainly by nun sisters

NURSING AS A PROFESSIONEmerged in late 19th centuryCredit is given to Florence Nightingale

IN INDIAKING ASHOKA, CHARAKA,SUSRUTHA ARE IMPORTANT PERSONSEAST INDIA COMPANY INTRODUCED NURSINGMilitary Nursing

Military nursing was the earliest type of nursing. In 1664 theEast India Companystarted a hospital for soldiers in a house atFort St.George,Madras. The first sisters were sent fromSt Thomas' Hospital,Londonto this military hospital.

Maternity

In 1797 a Lying-in-Hospital (maternity) for the poor of Madras was built with the help of subscriptions by Dr.John Underwood. In 1854 the Government sanctioned a training school for midwives in Madras.

Florence Nightingale

Florence Nightingalewas the first woman to have great influence over nursing in India and had a close knowledge of Indian conditions, especially army. She was interested in the nursing service for the civilian population, though her first interest was the welfare of the army in India.In 1865, Miss Florence Nightingale drew up some detailed "Suggestions on a system of nursing for hospitals in India". Graduates were sent out from the Nightingale School of Nurses at St.Thomas Hospital, England to start similar schools in our country. St Stephens Hospital at Delhi was the first one to begin training the Indian girls as nurses in 1867.

Training schoolsIn 1871, the first School of Nursing was started in Government General Hospital, Madras with 6 months Diploma Midwives program with four mid-wife students.Four lady Superintendents and four trained nurses from England were posted to Madras. Between 1890 and 1900, many schools, under either missions or government, were started in various parts of India. In the yearly twentieth century, National Nursing Associations were started.In 1897, Dr. B. C. Roy did great work in raising the standards of nursing and that of male and female nurses.

The 20th century

In 1908, the trained nurses association of India was formed as it was felt necessary to uphold the dignity and honor of the nursing profession.In 1918, training schools were started for health visitors and dais, at Delhi and Karachi. Two English nurses Miss Griffin and Miss Graham were appointed to give training to and to supervise the nurses.In 1926, Madras State formed the first registration council to provide basic standards in education and training. The first four year basic Bachelor Degree program were established in 1946 at the college of nursing in Delhi and Vellore.

With the assistance from the Rockfeller Foundations, seven health centers were set up between 1931 - 1939 in the cities of Delhi, Madras, Bangalore, Lucknow, Trivandrum, Pune and Calcutta.In 1947, after the independence, the community development programme and the expansion of hospital service created a large demand for nurses, auxiliary nurse midwives, health visitors, midwives, nursing tutors and nursing administrators.The Indian Nursing Council was passed by our ordinance on December 31, 1947. The council was constituted in 1949.

In 1956, Miss Adrenwala was appointed as the Nursing Advisor to Government of India. The development of Nursing in India was greatly influenced by the Christian missionaries, World War, British rule and by the International agencies such as W.H.O. UNICEF, Red Cross etc.The first masters degree course, a two-year postgraduate program was begun in 1960 at the College of Nursing, Delhi. In 1963, the School of Nursing in Trivandrum, instituted the first two years post certificate Bachelor Degree program

The associations such as International Council of Nurses, the nurses auxiliary of the CMA of India, T.N.A.I. Indian Nursing council and State level Registration Council are closely connected with promotion and the upliftment of the nursing profession.CURRENT HEALTH STATUSTOP CAUSE OF DEATH IN INDIACAUSEDEATH/ 1OOOIHD15LRTI11CEREBRO VASCULAR DISEASE106COPD88TUBERCULOSIS36DIARRHOEAL DISEASE65HIV/AIDS46W H O(2008) DISEASE WISE POPULATION IN INDIADISEASEPOPULATIONCOPD & ASTHMA 4.6 MILLIONDIABETIC3.5 MILLIONHIV POSITIVE 2-3 MILLIONEPILEPTIC0.5 MILLIONCANCER1 MILLIONCARDIO VASCULAR3.3 MILLIONMENTAL HEALTH7.5 MILLIONTUBERCULOSIS1.8 MILLIONBLINDNESS16 MILLION (11TH FIVE YEAR PLAN )

MEDICAL AND NURSING STUDIES CONDUCTED IN INDIA

(CLINICALTRIAL.GOV 2008)NO OF RESEARCH STUDIES CNSCOPDCVDCANCERTbDMHIVPSYCHIATRY591 51 1014916614115404617TRENDSHEALTHCARE INDIA Beds = 0.7/1000 peopleExtra Beds needed = 75000 beds / per year Expected spend on = Rs.2000 billion by 2012 Healthcare % of GDP =0.9% to grow up to 8.5% of GDP Govt. Spend expected = up 6% by 2010 GDP- sum of the income generated by production in the country in a period TECHNOLOGY - TRENDS(Healthcare will be the largest user of technology and the largest Employer)`Micro-processor based implantable in patients.CPU-driven technology supported by artificial intelligence.Robotics in OTsRobotics in Path-labs / Research.Laser Technology in surgeryInstrumentation in medical and surgical practices.Biotechnology, Genomics, Molecular Biology and Stem cell research.

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Healthcare Provider (Consultation- Pri/Sec; Delivery of Medicines,)Connectivity

ConnectivityInternet KioskVillage A

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Connectivity

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Limits to Modern Medicine24Spectacular Advances Low CostNutrition, Immunization, Antibiotics, Aseptic surgery, Maternal and child care, Healthy life stylesGrey Areas High Cost

Degenerative diseases, Autoimmune diseases, MalignanciesDark Areas

Idiopathic, Iatrogenic, Hospital Infections, Progressive, irreversible disordersLok SattaHospitalization Financial StressOnly 10% Indians have some form of health insurance, mostly inadequateHospitalized Indians spend 58% of their total annual expenditure on health careOver 25% of hospitalized Indians fall below poverty line because of hospital expenses25Lok SattaPercent of Hospitalized Indians falling into Poverty26

Lok SattaDifferentials in Health Status (States)27Sector Population BPL (%) IMR/ Per 1000 Livr Births (1999 SRS)