Page 32 - Nursing Education in Malaysia

NursiNg EducatioN iN Malaysia

(c) Nurses are expected to provide holistic and comprehensive care involving the
use of a scientific approach using six systematic steps: assessment of health
needs, making nursing diagnosis, formulation of patient outcomes, planning of
care, implementation of the care plan, and evaluation of care. Nurses must be
concerned with the whole person under the full range of patient’s needs which
may include health teaching, discharge planning, extending care to the home,
etc.

(Nik Safiah, 2010)

additional requirements to practice nursing
Medical advancement/specialization has a significant effect on nursing education and
practice. The role of nurses constantly changes in response to the growth of biomedical
knowledge, changes in patterns of demands for health services and the evolution of
profesional relationships among nurses, doctors and other healthcare professionals.

While there is a need for nursing to adopt multiskill approach and for nurses to be
versatile, at the same time, there is a need to keep abreast with medicine, for example,
with trends in cardiology, oncology, transplant, burns and plastic surgery, the various
aspects of nephrology and renal care, etc. Nurses, like doctors, need to extend their roles
in specialized fields because specialization ensures a continuing commitment to practice
that demands expert knowledge and skills. Nurses’ role as experts must include direct and
continuous care of sick patients as well as health promotion for individuals who are well.

Practice settings
Nurses have an opportunity to practice in a variety of settings in many roles. But,
hospitals have remained the primary worksite for Registered Nurses (RN). Approximately,
two-thirds of nurse population in the world work in hospitals and of these 90% are employed
as Staff Nurses (McNeese & Donna 2003).

Hospital nursing has always been physically and mentally gruelling and contemporary
nurses must cope with patients who are sicker and who require more complicated care than
ever before. From time immemorial, hospital nurses work either an eight hour or a 12-
hour shift and this scheduling must be maintained irrespective of nurse-patient ratio. This
24 hour scheduling in rotation is the only option for nursing and for all hospital nurses,
without exception.

It is also common knowledge today that hospital nursing, for majority of nurses, is
done only to gain experience and some do not often stay long in anyone hospital. Reasons
could be that nurses today have a greater array of job opportunities to choose from, many of
which pay better and offer more flexible schedules than the eight hour or 12 hour shifts that
hospital work requires. Research has shown that effective leadership can help retain nurses
at the bedside. Promoting the right individuals into leadership and managerial positions