Recruitment Policies of Nursing Department of select Hospitals

Recruitment Policies of Nursing Department of select Hospitals

Abstract : A successful managerially oriented recruitment program is aimed at procuring the most efficient, effective employees. Quality nursing care is a cornerstone for running a hospital efficiently. Hence in order to have efficient nurses it is important to have a good recruitment policy. To know the prevailing recruitment policies in nursing department a study was conducted to examine the recruitment policy in nursing department of three selected hospitals i.e. one autonomous hospital, one private hospital and one state government hospital. The information related to recruitment policies was collected from the nursing office and Medical superintendent office. Results revealed that two extremes were observed in these organisations i.e. all positions to be filled by direct recruitment in private hospital and just contrast to it all the positions except lowermost position (staff nurse) to be filled by promotion only in state government hospital. In autonomous hospital both these systems of recruitment were in operation simultaneously i.e. few positions are filled by direct recruitment and other posts are filled by promotion. Only the post of Nursing Superintendent was filled by 50 per cent through promotion and 50 per cent through direct recruitment. Even the essential qualification recommended by Indian Nursing Council (a statutory body) for Nursing Sister and above was not considered in Autonomous hospital and State Government hospital while framing recruitment rules. A sound recruitment system is required to appoint well qualified and efficient nurses and motivate them to grow in the profession by giving due importance to their talent, qualification and experience .

Correspondence at : Sushma Kumari Saini

Lecturer,

NINE, PGIMER, Chandigarh Key Words :

Recruitment policies, Direct recruitment, Indirect recruitment.

Introduction

Recruitment is a process, which is of vital importance to the administrative system as a whole. It is the "cornerstone of the whole public personnel str ucture". A faulty recruitment policy inflicts a permanent weakness upon the administration, which virtually becomes a heaven for the dull and the incompetent. No amount of in-service training can make wrongly/recruited persons bright and efficient. The need for a sound recruitment policy is, thus clearly vindicated.

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No element of career service is more important than the recruitment policy. In order to have a sound recruitment system three aspects should be kept in mind:

i) Balance between number of people recruited and management's current expectation to recruitment needs in the near future.

ii) Promises made during recruitment should not oversell the institute or job. iii) Recruitment procedures should be well adapted to relevant differences in the kind of employees to be recruited.1

Recruitment procedures include the process and the methods by which vacancies are notified, post are advertised, applications are handled and screened, interviews are conducted and appointments are made. 2

Recruitment covers both the filling of new posts both from internal, i.e. already employed or from external candidates. The first method is properly speaking, promotion and the second one is in the true sense of term. These two methods are not mutually exclusive and all the organisations meet their personnel requirement by taking recourse of them. It may however be pointed out that the lower level positions may be recruited through direct recruitment; for middle level positions it could be direct recruitment combined with a liberal system of promotions; and top level positions should go by well-designed system of promotion

Direct recruitment method works on the principal of democracy. It provides equal opportunities to all and it ensures continuous

supply of fresh employees with ability and competence, while other ensures that the persons who are appointed at higher positions have sufficient experience of work and administration. It provides the employees the ample opportunity for advancement. But in the mean time it narrows down the area of selection. It puts premium on experience and neglects the brilliant fresh persons. Neither of these two systems can exclusively adopt for selection of personnel in any of organisation. In practice a good recruitment policy combine both the systems, in varying proportions to achieve the best results. 3

The critical element of a successful managerially oriented recruitment program is aimed at procuring the most efficient, effective employees. Recruitment is an impor tant function of health manpower management, which determines, whether the required manpower will be available at the work spot when a job is actually to be under taken. Nurses are impor tant health manpower as they constitute the largest proportion of the hospital staff and work closest to the patients 24 hours of the day and seven days of the week. Quality nursing care is a cornerstone for running a hospital efficiently. Hence in order to have efficient nurses it is important to have a good recruitment policy. To know the prevailing recruitment policies in nursing a study was conducted to examine the recruitment policy of nursing department in three selected hospitals.

Methodology

Three teaching hospitals of North India were selected by lottery method. The three

teaching hospitals were having different managerial control i.e. Autonomous Hospital, Private Hospitals and State Government Hospitals. Bed strength of the hospitals was 1359, 657, and 1260 respectively. Permission for data collection was sought from Medical Superintendents of the three select hospitals. The information related to recruitment policies was collected from the nursing office and Medical superintendent office. Secondary data was collected from books, available records, bibliography and review of documents.

Results

The recr uitment r ules of Nursing Services of selected hospitals are depicted in Tables - 1-5. It was obser ved that in Autonomous hospital Sister Grade-II, Deputy Nursing Superintendent (Epidemiologist), Deputy Nursing Superintendent (Educator), Nursing Superintendent (50 percent) and Chief Nursing Officer were to be directly recruited and selected by either test-cum-inter view or only by test-cum-inter view as per recruitment rules. But in actual practice the posts of Deputy Nursing Superintendent

(Epidemiologist), Deputy Nursing

Superintendent (Educator) were filled by promotion only. Education qualification for Sister Grade-II was Diploma in General Nursing and Midwifery; for Deputy Nursing Superintendent (Educationist) and Deputy Nursing Superintendent (Epidemiologist) was B.Sc. Nursing. For Nursing Superintendent M.Sc. Nursing was desirable, but in case of non-availability B.Sc. Nursing or Diploma in General Nursing and Midwifery along with

Certificate in Education and Administration with 5 years of experience as Deputy Nursing Superintendent could also be considered. For Chief Nursing Officer, the qualification was M.Sc. Nursing and 15 years experience as Assistant Nursing Superintendent or 10 years as Deputy Nursing Superintendent or 5 years as Nursing Superintendent. Posts of Nursing Sister Grade-I, Assistant Nursing Superintendent and Deputy Nursing Superintendent were filled only through promotion with 5 years experience as Nursing Sister Grade-II, Nursing Sister Grade-I and Assistant Nursing Superintendent, respectively. Qualification requirement for these posts was Diploma in General Nursing and Midwifery. Annual confidential report of previous five years was considered while promoting the candidate to higher position. There was probation period for 2 years for all direct recr uitment posts and no such probation period for promotional posts.

In case of Private hospital all the Nursing posts were filled by direct recruitment. The qualification for Staff Nurse was a Diploma in General Nursing and Midwifery and selection by test-cum-interview. For Nursing Sister and Supervisor (Hospital based only) the qualifications required were B.Sc. Nursing and for dual designations i.e. Nursing Superintendent / Professor, Deputy Nursing Superintendent / Reader, Assistant Nursing Superintendent / Reader, Super visor / Professor, Supervisor/ Reader Supervisor / Lecture and Nursing Sister / Clinical Instructor the qualifications required were M.Sc. Nursing with 5 years experience in the previous post.

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There was one-year probation for each of the post. Nurses with dual designation were given dual responsibility i.e. supervising nursing staff and teaching nursing students in College of Nursing. This helped in promoting close association and collaboration of nursing education and nursing service department

In State Government hospital only staff nurses were recr uited by the direct recruitment method. Rest of the nursing posts i.e. Nursing Sister, Matron and Nursing Superintendent were recruited by promotion with 5 years experience as Staff Nurse, Nursing Sister and Matron, respectively. For Nursing Superintendent the desirable Table -1: Recruitment rules of nursing staff of select hospitals (Staff Nurse/ Nursing Sister)

Designation Autonomous Private hospital State Government INC

hospital hospital Recommendations

Staff Nurse

Method of Direct Direct Direct

Recruitment

Age Limit 18-30 years 18-35 years 18-40 years

Qualification Matriculation Matriculation Matriculation Matriculation Certificate in General Certificate in General Certificate in General Diploma in Nursing Nursing & Midwifery/ Nursing & Midwifery/ Nursing & Midwifery/ & Midwifery

B. Sc. Nursing B. Sc. Nursing B. Sc. Nursing /B. Sc. Nursing Registered-'A' Grade Registered-'A' Grade Registered-'A' Grade Registered 'A' Grade

Nurse & Midwifery Nurse & Midwifery Nurse & Midwifery Nurse & Midwife Test-cum-Interview Test-cum-Interview Interview

Probation Period 2 years 1 year 2 years

Nursing Sister

Method of Promotion Direct Promotion

Recruitment

Age Limit N.A. N.A. N.A.

Qualification Matriculation B.Sc. Nursing Matriculation Diploma in General Certificate in General Registered 'A' Certificate in General Nursing & Midwifery Nursing & Midwifery/ Grade Nursing & Midwifery/ Diploma in education

BSc Nursing Nurse & Midwife BSc Nursing & Administration/ Registered 'A' Grade Registered 'A' Grade B.Sc. Nursing

Nurse & Midwife Nurse & Midwife Registered A-Grade Nurse & Midwife

Experience 5 years as 5 years as 5 years as 5 years as

Staff Nurse/ Staff Nurse Staff Nurse Staff Nurse Sister Grade-II

Period of Probation 2 years 1 year

Table - 2 : Recruitment rules of nursing staff of select hospitals (ANS/DNS/Matron) Designation Autonomous Private hospital State Government INC

hospital hospital Recommendations

ANS

Method of recruitment Promotion 100% Direct

Age limit N.A. N.A.

Experience 5 years as Grade-I 5 years of N.A 5 years as Nursing Sister teaching experience

Qualification A' Grade registered AGrade Registered

' Nurse & Midwife M.Sc. Nursing Nurse & Midwife

certificate in General Certificate in General

Nursing & Midwifery Nursing & Midwifery

/ B.Sc. Nursing Certificate in Education

and Administration or

B.Sc. Nursing DNS/Matron

Method of recruitment Promotion Direct Promotion

Age limit N.A. N.A. N.A.

Experience 5 years as Assistant 5 years as Assistant 5 years as 5 years as Assistant

Nursing Nursing Nursing Nursing

Superintendent Superintendent sister Superintendent

Qualification 'A' Grade registered M.Sc. Nursing 'A' Grade registered A Grade Registered Nurse & Midwife 'A' Grade registered Nurse & Midwife Nurse & Midwife

certificate in Nurse & Midwife certificate in Certificate in General General Nursing & General Nursing Nursing & Midwifery Midwifery/ & Midwifery/ Certificate in Education

B.Sc. Nursing B.Sc. Nursing and Administration or

B.Sc. Nursing NA= Not applicable

133 Table 3: Recruitment rules of nursing staff of selected hospitals (DNS/Chief Nursing

Officer

Designation Autonomous Private State

Hospital Hospital Government

Hospital DNS (Educator)

Method of recruitment Direct N.A. N.A.

Age limit 35 years

Qualification B.Sc. Nursing Registered

'A' Grade Nurse & Midwife Sister Tutor Post Diploma Course DNS (Epidemiologist)

Method of recruitment Direct N.A. N.A.

Age limit 35 years

Qualification B.Sc. Nursing with knowledge of

Microbiology and principles of prevention of infection Two years experience in administration

and teaching Chief Nursing Officer

Method of recruitment 100% direct recruitment

Qualifications M.Sc. Nursing

Registered 'A' Grade Nurse & Midwife

Experience 15 years as ANS or 10 years as DNS or N.A. N.A

5 years as NS

Age limit Upto 45 years

Table - 4 : Recruitment rules of nursing staff of select hospitals (Nursing Supervisor)

Designation Autonomous Private State

Hospital Hospital Government

Hospital Supervisors

Recruitment Direct

Hospital based

Qualification B.Sc. Nursing

Registered 'A' Grade Nurse & Midwifery

Experience 5 years as Nursing Sister

Professor/Supervisor

Qualification M.Sc. Nursing

Registered 'A' Grade Nurse & Midwifery

Experience NA 5 years as Reader/Supervisor NA

Reader/Supervisor

Qualification M.Sc. Nursing

Registered 'A' Grade Nurse & Midwifery

Experience 5 years as Lecturer/Supervisor

Lecturer/Supervisor

Qualification M.Sc. Nursing

Registered 'A' Grade Nurse & Midwifery

Experience 5 years as Clinical Instructor /

Nursing Sister after MSc Nursing NA= Not applicable

135 Table - 5: Recruitment rules of nursing staff of selected hospital (Nursing Superintendent)

Designation Autonomous Private Hospital State Government INC

Hospital Hospital Recommendations

Nursing Superintendent

Method of 50% by promotion Direct recruitment Promotion recruitment 50% by direct recruitment

Qualification Desirable M. Sc. Nursing M.Sc. Nursing B.Sc. Nursing M.Sc. Nursing B.Sc. Nursing Registered 'A' Registered 'A'

Registered 'A' Grade Nurse & Midwife Grade Nurse & Midwife

Grade Nurse & Midwife OR

8 years experience in Certificate in General Administration and Nursing and Midwifery teaching after B.Sc. Nursing at 5 years to be spent as large institution OR Matriculation Registered 'A' Grade

Nursing & Midwife Certificate in Nursing Administration and/or

teaching from a recognized institution

Experience 5 years as DNS or 5 years experience 5 years experience Ten years experience DNS Educator or as Deputy Nursing as a Matron

DNS Epidemiologist Superintendent 3 years as Deputy

Nursing Superintendent OR 7 years as Assistant Nursing

Superintendent

qualifications was B.Sc. Nursing but in case of non-availability, a diploma in General Nursing and Midwifer y could also be considered while for all other posts the qualifications required was diploma in General Nursing and Midwifery or B.Sc. Nursing. Only Staff Nurses had probation for 2 years. The candidates for all the above posts should be passed Matric with Hindi as a language. Discussion

The qualifications of staff in private hospitals were higher than other two hospitals. Nurses were motivated towards higher education because only then, they could be promoted to higher posts. Nurses with diploma in GNM remained Staff Nurse only, and were not promoted to the post of Nursing Sister until she completed B.Sc. Nursing. Similarly, Supervisors were not given higher positions until they completed M.Sc. Nursing. Since all the positions were filled by direct recruitment, hence employees with an outstanding performance had chances to rise faster. These types of opportunities were very few in State Government hospital and autonomous bodies as most of the positions were filled through indirect recruitment and one had to be in queue for a long time to get a higher position. Hence two extremes were observed in these organisations i.e. all positions to be filled by direct recruitment in Private hospital and just contrast to it all the positions except lowermost position (staff nurse) to be filled by promotion only in State Government hospital.

Indian Nursing Council ( INC) is a statutory body for nursing profession in India and it has recommended qualifications of Staff Nurse, as certificate in GNM/B. Sc. Nursing and she should be a Registered Nurse and Midwife. For Nursing Sister, Assistant Nursing Superintendent and Deputy Nursing Superintendent the qualifications recommended was either B.Sc. Nursing or Certificate in GNM along with a certificate in Education and Administration and 5 years experience at the immediate lower post. The qualification requirements for Nursing Superintendent were M.Sc. Nursing with ten years experience in Nursing, out of which 3 years should be as Deputy Nursing Superintendent or 7 years as Assistant Nursing Superintendent. However, it has been observed among the select hospitals, that only Private hospital had the required qualifications of nursing staff at par with INC recommendations. Even they considered M.Sc. Nursing a qualification for Assistant Nursing Superintendent and Deputy Nursing Superintendent, for which INC has recommended B.Sc. Nursing or addition Certificate of Education and Administration along with a certificate in GNM. In the other two hospitals the qualification of Nursing Sister, Assistant Nursing Superintendent, Deputy Nursing Superintendent and Nursing Superintendent was lower than the recommendations of the INC.4

The High Power Committee on nursing and nursing profession set up by the Central Government recommended in 1990 that for

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promotion to the post of Nursing Sister, B.Sc. Nursing should be made an essential qualification. The principle of possessing higher qualification than the category to be supervised, should apply for all levels and categories of nursing personnel. It had further recommended uniformity in employment procedures and recruitment rules be made for all categories of nursing posts. The qualifications and experience required for these posts should be uniform throughout the country. 5 _{Looking at recruitment rules closely}

it can be obser ved that these recommendations were not fully accepted by the select hospitals.

It was found that the recruitment of most of nursing positions was by promotion in Autonomous hospital and State Government hospital. While in Private hospital all the positions were filled by direct recruitment. Even the essential qualification recommended by INC for Nursing Sister and above was not considered in Autonomous hospital and State Government hospital while framing recr uitment r ules as lower qualifications were fixed than those recommended by INC. However, in Private hospital the minimum qualifications of Nursing Sisters and higher positions were at par with INC recommendations.

Hence, two extremes were observed in these organisations i.e. all positions to be filled by direct recruitment in Private hospital and just contrast to it all the positions except lowermost position to be filled by promotion only in State Government hospital.

Both these systems of recruitment were in operation simultaneously in Autonomous hospital i.e. post of Nursing Sister Grade-II, DNS Educationist, DNS Epidemiologist, Chief Nursing Officer are filled by direct recruitment and other posts are filled by promotion. The post of Nursing Superintendent was filled by 50 per cent through promotion and 50 per cent through direct recruitment. This criterion should be applicable to all the positions that some proportion of it should be filled through direct recr uitment and other through promotion. So that there is ample opportunity for fresh and brilliant candidates to come forward and in the mean time there is scope of advancement for experienced nurses but such kind of opportunity was not observed in any of select hospitals.

Hence, it can be observed from the analysis that none of the select hospitals at the time of present study had all the positions as recommended by the INC and High Power Committee. However, there was par tial implementation of the recommendations in all the select hospitals. There was a wide scope for improvement in the recruitment policies of these hospitals as regards the nursing personnel is concerned. A sound recruitment system is required to appoint well qualified and efficient nurses and motivate them to grow in the profession by giving due importance to their talent, qualification and experience. It will fur ther help in satisfying the patients which is the primary aim of every hospital.

References

1. Pigors Paul, Myers Charles A. Personal

Administration. 4th editrion. McGraw-Hill Book Company; New York 1961:261-262.

2. Basavanthappa BT. Nursing

Administration. 1st edition. Jaypee Brothers Medical Publishers; New Delhi 1998.

3. Avasthi Amreshwar, Maheshwari

Shriram. Public Administration. 9th edition. Luxmi Narain Agarwal; Agra 1978:275-277.

4. Indian Nursing Council. Professional Education and Experience required for various posts in Nursing Profession Approved by the Indian Nursing Council in its meeting held on 17 March 1985. Nursing Journal of India 1985;76:259-265

5. High Power Committee. High Power

Committee on Nursing and Nursing Profession -conclusion and recommendations. Nursing Journal of India 1990; 81:141-144,161-164