Page 42 - Nursing Education in Malaysia

NursiNg EducatioN iN Malaysia

professional nurses to technical nurses to perform the service, the greater the society’s
needs for nursing service, the greater the power it gets to control its services, the more
autonomous is the profession. Malaysian Nursing is denied of all these.

autonomy is an essential element of professional nursing.
there are independent nursing interventions that nurses
must initiate without medical orders

Nursing is not simply a collection of specific skills and nurses are not simply persons
to perform specific tasks. The level of care must be demonstrated by the critical thinking
model known as the NURSING PROCESS: assessment, diagnosis, outcomes identification
and planning, implementation and evaluation (ANA, 2004). The nursing process is the
foundation of clinical decision making and includes all significant actions taken by nurses
in providing care to clients, outside of doctor’s orders.

In Malaysia, the use of nursing process is not part of nursing standards. Nursing is
practiced, for most part, to the extent that doctors’ orders are met. Diploma graduates are
only expected to “implement” the care orders and since, currently, nurses are not expected
to perform health assessment, make nursing diagnosis and plan for the care, the orders in
question would have to come only from doctors. For nursing to be autonomous most of
the nursing care activities must come from nursing orders. Doctors’ orders should only
be part of these activities. To enable a nurse to come up with “nursing orders”, there
must exist a “nursing diagnosis” which requires that the nurse functions at minimum at
analysis, synthesis and evaluation level. Medical doctors function at this level all the time
because they have extensive and in-depth knowledge of the sciences to help them in critical
thinking and problem solving. Hence, it is fair to say that for nurses to be in the same
circumstances, the educational programme must provide extensive in-dept knowledge of
the sciences to enable them to think critically and to solve problems effectively, which only
degree programmes can provide.

Nursing must be seen by the public as active in politics,
professional and financial issues affecting healthcare
and the nursing profession. Professional organizations,
for example, the Malaysian Nurses association, Nursing
Students associations or even Nursing alumni associations
can be strong lobbyists in professional practice issues
which help promote professionalism

In Malaysia, the Malaysian Nurses Association (MNA) exists only to perform certain
activities for its members. It appears to have a lot of constraints in words and deeds and a
far-cry from being a lobbyist. For example, it could have involved itself in the issues of five
day week for nurses, higher entry requirements into nursing, or the issues of mushrooming

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