Today’s class

 Review history of nursing in Pakistan

 Discuss Pakistan Nursing Council
(PNC) Federation (PNF)
 Challenges, issues and trends in nursing
Future
 Why History is important?
Looking Back To Look Ahead
Helps to understand:
Origin of profession
Our founder leaders
The practice of heath care
Image of nurse
Scope of nursing
Privileges and
benefits
It is important to know where we came from in order to
plan what we can become.
 Evolved with development of Mankind. Dates back to 4000
BC in which mother nurse worked with priest.

• Role of wife, mother, daughters, sister-traditional

female
role of care and nurturing, comforting
• Later ancient Egyptians created an
advanced civilization
• Physicians got specialized in certain diseases,
wrote textbook
• Hired women, later known as midwives-as first
• Florence Nightingale, born on May 12, 1820,
became a nurse at a time when the
profession was considered a degrading
occupation and hospitals were cesspools of
disease. Nightingale changed that.
 Holistic framework Emphasis:
Generous education as a foundation for Nursing practice
Environment that promotes healing
Need for a body of nursing knowledge that was distinct form
medical knowledge
Consultant for establishment of hospital , School of Nursing and
educational organization
Identified need of nurse teacher.
Identified concept of public health.
Improved social welfare system, social work.
Reformer of nursing
Established career for women
Advocated for:
Systematic method of assessing clients
Individualizes care on the basis of clients needs
Maintaining confidentiality
• Her meticulous and tender dedication to
healthcare, as seen in her day-to-day work as
well as her published writings, including
Notes on Nursing: What It Is, and What It Is
Not and Notes On Hospitals, helped to elevate
the nursing profession and change hospital
layouts, among other things. That her
techniques and best practices seem common
to us today only proves the debt owed to
"The Lady with the Lamp."
 First Formal Nurse
• When we think about leaders in nursing,
most imagine a picture of Florence
Nightingale
• Rufaidah bint Sa’ad Al Aslamiyah was the
First Nurse in Islam; many centuries before
Florence Nightingale
• Nursing was considered the first profession
for women in Islamic history
•
 Nursing in Islam:
• The first record of nursing activity originated in the
time of prophet Mohamed in the holy wars
• Muslims women used to treat injured soldiers
during the Islamic war
• Prophet Mohamed acknowledged their work
and counted it as JEHAD and rewarded them.
• Muslim women did nursing during time of peace,
• Nursing in Islamic war did not focus only on treating
injured soldiers, but also providing spiritual support
to encourage them to fight.
• Nurses in the Islamic era were called different names
“Al Assiya” “Al Qawam”
• In the Islamic history nursing was the role of women
 Development of Nursing
• Handful of nurses at time of partition
• Education of nurses with grade 8,
apprenticeship model
• Appeal by distinguished ladies such as
Fatima Jinnah and Begum Rana Liaquat Aly
Khan
• Three hospitals in Pakistan :
– Lady Reading Hospital, Peshawar
– Civil Hospital, Karachi
– Mayo Hospital, Lahore
 First School of Nursing
1948 1. Lahore’s Sir Ganga Ram Hospital
2. Jinnah Post graduate Medical
Center
1952 First class of seven girls completed
three years of general nursing

This development was followed by the

commencement of other schools of nursing
in Bahawalpur, Hyderabad and Multan
1950
Men were not allowed to take the nursing assistant
course or general nursing
Curriculum
Anatomy and Physiology,
Medical Surgical
Nursing, Fundamentals of
Nursing, Hygiene and
Sanitation
WHO helped with the curriculum.
• In 1959, PNC upgraded the entrance
educational level
• Matric for general nursing education
• Grade 8 for midwifery education
• 1956 first JPMC-College of Nursing
established with help of WHO and USA
(Chief nurse International Health Services
based in Washington) for training of
nurse teachers
 Lack of faculty members
In the late 1950s funds were allocated to send
faculty to go to USA and UK to get BScN
and MScN degrees

Ms Wazir Begum first nurse to have BScN

1960s Mrs Imtiaz Kamal first to have MScN
1960s
Dr Yasmin Amarsi first nurse to have PhD 1998
 Status of Nursing in Pakistan in 1980s
• 3 cadres in Nursing – RN, RM LHV
• Nursing diploma via apprenticeship model
• Matron head of school and service; with no control over budget
• Acute shortage of nurses, reverse nurse doctor ratio
• Scarcity of nurse educators;
• Most of the lecturers were physicians
• The regulatory body- PNC was confined to one room
• Manual registration system
• Nursing had low social standing
• This all resulted in poor quality of nursing care

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Pakistan Nursing Council (PNC)

The PNC is an autonomous, regulatory body

constituted under the Pakistan Nursing Council
Act (1952, 1973) and empowered to register
(license) Nurses, Midwives, Lady Health
Visitors (LHVs) and Nursing Auxiliaries to
practice in Pakistan. PNC was established in
1948.
 Functions of PNC
• PNC sets the curriculum for the education of Nurses, Midwives, LHVs
and Nursing Auxiliaries.
• Inspect educational institutions for approval based on established standards.
• provides registration (license) to practice.
• maintains standards of education and practice.
• works closely with the all Provincial Nursing Examination Boards
• plays an advisory role for the overall benefits of nurses, Midwives, LHVs
and Nursing in the country.
• maintains an advisory role for the Federal and Provincial Governments regarding
nursing education and nursing services.
• Communicates policy decision regarding nursing education and scope of
practice, taken in council meeting, to provincial and federal governments Nursing
institutions NEBs and Armed Forces Nursing services for implementation.
• PNC prescribes penalties for fraudulent registration by intention of pretense, and
removes person form the register for professional misconduct.
 The Pakistan Nurses Federation (PNF)

• Is an independent non-governmental
professional association of nursing in Pakistan.

• The PNF was registered on July 6, 1972, by the

Assistant Registrar, Joint Stock Companies, Lahore
Region, under Societies Act 1860, as a successor to
the Trained Nurses Association of Pakistan which was
founded and duly registered in 1949.
 The Functions of the PNF are
• To work for the welfare and betterment of nurses, midwives and health
visitors in Pakistan.

• To pursue and enter into negotiations with concerned Government

regarding matters pertaining to the welfare of nurses.

• To advance high ethical and professional standards among nurses.

• To bring professional knowledge and skills to the service and care of

the sick.
• To publish a journal providing updated information in nursing.

• To provide legal aid to members, within needed by them for

the protection of their professional rights.
• To improve nursing practice through in-service education.
 International Council of Nurses
• The International Council of Nurses (ICN) is a
federation of more than 130 national nurses
associations (NNAs). It was founded in 1899
and was the first international organization
for health. It is headquartered in Geneva,
Switzerland
• ICN is representing more than 20 million
nurses worldwide. ICN is the world’s first and
widest reaching international organization
for healthcare professionals.
 ICN
Operated by nurses and leading nurses
internationally, ICN works to ensure:
• quality nursing care for all,
• sound health policies globally,
• the advancement of nursing knowledge,
• the presence worldwide of a respected nursing
profe
• and a competent and satisfied nursing workforce.
 Sigma Theta Tau
International (STTI)
• The Honor Society of Nursing, STTI is a nonprofit
organization whose mission is to support the
learning, knowledge and professional development
of nurses committed to making a difference in
health worldwide.
• Founded in 1922, STTI has 130,000 members in 86
countries.
• Sigma Theta Tau was founded in 1922 by six nursing
students at Indiana University to "advance the
status of nursing as a profession
Main Challenges Facing Nurses in Pakistan
 Strengthening of nursing systems: PNC,
PNF, Career structure, Service structure
 Mushrooming of schools of nursing,
 Archaic curriculum , academic and
service structure
 Recruitment, retention and promotion policies
not based on merit
 Lack of representation of nursing leaders in
MOH at the provincial, federal and central
government
 Lack of political will
 Low status of women
 INNOVATIVE ROLES OF NURSES
New and innovative types of services are
needed more community and home-based,
more holistic and people-centered, with
increased focus on prevention and making
better use of technology
Nursing roles to be introduced such as :
 Public Health Nurses,
 Advanced Nurse Practitioners
 Nurse Anesthetists,
 Forensic nurse
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