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Indian Nurses Still Struggling For Recognition, Improved Status And Autonomy? A Qualitative Study Of Nurses And Nurse Students In Maharashtra, India | 45882
Journal of Community Medicine & Health Education
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Background: Studies of Indian nurses and the nursing profession have emphasized the problems of recruitment from a wider range of
social groups within the Indian population other than Christian minorities and lower income groups due to the relatively low status
traditionally attributed to nursing in the society. Traditionally the nature of work in nursing carried a low value due to the fact that it
was considered a menial work and a ‘polluting’ occupation based on a hierarchical framework of the caste system and its occupational
division of labour. Social attitudes towards nursing regarding it as not a very respectable job with low status was related to tasks
dealing with unclean substances and bodily work with all sorts of people, doing the service for others and occupying a subordinate
role and position in the health services affected the recruitment to nursing adversely turning it into a non-preferred occupational
career among the majority of Hindus and Muslims in India.
Objective: To explore to what extent and in what ways the image of nursing is changing and for whom due to effects of modernity,
increased education, India’s fast growing economy, globalization and employment opportunities in the international health market.
To what extent do Hindu women and men in Maharashtra respond to these external conditions and what are the implications for the
changing meaning and status of nursing profession.
Design & Setting: This qualitative study is based on semi-structured interviews with 40 nurses, student nurses, and teaching staff
working in government and private hospitals, and private nursing colleges in the city of Pune, state of Maharashtra, India. The sample
comprises both Hindus from Maharashtra and Christians from Kerala.
Results: Increased competition in higher education and employment, especially in government service combined with the value of
job security has affected recruitment to nursing with a larger portion of local Maharashtrians, including a few males responding to job
opportunities abroad. The status of nursing is slowly and gradually improving due to the social mobility that international migration
and secure jobs in government hospital represents. Nurses are in high demand both nationally and internationally, increased awareness
of what nurses do, better educational qualifications and secure employment opportunities contribute to elevate the status and respect
for the nursing profession although it is not evenly distributed but varies between rural and urban contexts, class divisions, types of
health services, ideas and values that nursing is embedded within. The paper argues that the social status of the nursing profession
is also influenced by the relationship between nurses and physicians and the very high status of the medical professions in India,
the pay and working conditions in the government and private sector hospitals which directly affects the recognition and autonomy
of nursing staff. The status of nurses is also interconnected with perceptions of gender role and the position and status of woman
in the family and Indian society, which rises challenging questions whether the role of nurse is compatible with the role of mother
Oddvar Hollup has a PhD in Social Anthropology from University of Bergen, Norway dealing with the construction of Ethnic identity among Indians in Mauritius. Presently, he is a Professor in Social Science at the Faculty of Health and Social Studies, University College of Southeast Norway. His research interest is in the social and cultural construction of the nursing profession in an international perspective. He has published two articles, concerning recruitment to nursing in Mauritius, have been published in International Journal of Nursing Studies (2012-2014). Now he is working on the changing status of the nursing profession in western India.