Page 21 - Nursing Education in Malaysia

3/ tHE status of NursiNg iN Malaysia

under the legal title Registered Nurse (RN) and the technical nurse with an associate degree
be licensed under the legal title Associate Nurse (AN). These changes must be legislated
so that such changes would have major implications on diploma nurses. According to
“Timelines for Transition” (1987), the US is expected to practice nursing by all degree
nurses by 2010. However, an expert stated that “what is best for nursing may not coincide
with what is best for society at large. Financially, to have all BN-RN staffing in the US
(whose needs range from three to four million nurses) may not be possible. Currently US
has degree nurses, associate degree and diploma nurses (Kozier, Erb and Blais, 1992).

In Canada, the entry requirement into professional nursing practice by 2000 was the
Bachelor of Nursing. The issue of titling and licensure remains unresolved (Kozier, Erb
and Blais, 1992).

The Future of the Diploma Programme – Learning from the US experience, it is
foreseeable that the Diploma programme will continue to be conducted. It is also foreseeable
that diploma graduates will be required to service less priority areas which are areas that
can tolerate a staff mix of degree and diploma nurses with or without specialization. Such
areas include adult general care and paediatric services. In addition, all non-patient care
areas must be adequately staffed by registered nurses prepared at minimum the diploma
level. Such areas include specialist Centre Services, Operating Rooms, Centralized Sterile
Supply Unit, and the like.

Nursing’s plan must include the notion that by 2012, all universities must cease to
prepare diploma graduates and that only recognized colleges with affiliate hospitals will
continue to prepare diploma nurses. The number of graduates must be determined based
on future service requirements. It is expected that the number required would be much
reduced and that by 2020, the number will be less than the degree nurses.

the Degree Programme

Any programme higher than diploma must give a significant impact to the profession
and to the employers. The Department of Public Services (JPA) is expecting a degree
nurse to function in the clinical setting, not just teaching and managing. This expectation
is not out of context because a degree nurse is a first line nurse. He/she is a skillful nurse,
someone who is able to assess what patients need and plan for the care with the full
knowledge of all other aspects (such as psychological and social components) and to do it
in a compassionate and caring way. It is the ability of the nurse to be a critical thinker, to
work well in a team and to think on his/her feet that makes a difference. Indeed, a degree
nurse is expected to serve in all priority areas of patient care which require collaborative
and independent decision making. These areas include all critical care services (ICU,
CCU, PICU, NICU, Burn Centre, Emergency Room, Trauma Centre and Delivery Suites);
extended programmes requiring independent decision making such as Home Care Services,
Day Care Surgery, Infection Control and all Community Health Programmes.

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