http://doi.org/10.33698/NRF0083 – Sushma Kumari Saini, Charanjeev Singh
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
.Key Words :
Recruitment policies, Direct recruitment, Indirect recruitment.
Correspondence at : Sushma Kumari Saini
Lecturer,
NINE, PGIMER, Chandigarh
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 structure”. 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. 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:
- Balance between number of people recruited and management’s current expectation to recruitment needs in the near
- Promises made during recruitment should not oversell the institute or
- Recruitment procedures should be well adapted to relevant differences in the kind of employees to be 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 undertaken. Nurses are important 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 recruitment rules of Nursing Services of selected hospitals are depicted in Tables – 1-5. It was observed 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- interview or only by interview 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 recruitment 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, Supervisor / 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.
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 recruited 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 hospital | Private hospital | State Government hospital | INC
Recommendations |
| Staff Nurse | ||||
| Method of Recruitment | Direct | Direct | Direct | |
| Age Limit | 18-30 years | 18-35 years | 18-40 years | |
| Qualification | Matriculation Certificate in General Nursing & Midwifery/
B. Sc. Nursing Registered-‘A’ Grade Nurse & Midwifery Test-cum-Interview |
Matriculation Certificate in General Nursing & Midwifery/
B. Sc. Nursing Registered-‘A’ Grade Nurse & Midwifery Test-cum-Interview |
Matriculation Certificate in General Nursing & Midwifery/
B. Sc. Nursing Registered-‘A’ Grade Nurse & Midwifery Interview |
Matriculation Diploma in Nursing & Midwifery
/B. Sc. Nursing Registered ‘A’ Grade Nurse & Midwife |
| Probation Period | 2 years | 1 year | 2 years | |
| Nursing Sister | ||||
| Method of Recruitment | Promotion | Direct | Promotion | |
| Age Limit | N.A. | N.A. | N.A. | |
| Qualification | Matriculation Certificate in General Nursing & Midwifery/ BSc Nursing Registered ‘A’ Grade Nurse & Midwife | B.Sc. Nursing Registered ‘A’ Grade
Nurse & Midwife |
Matriculation Certificate in General Nursing & Midwifery/ BSc Nursing Registered ‘A’ Grade Nurse & Midwife | Diploma in General Nursing & Midwifery Diploma in education & Administration/ B.Sc. Nursing Registered A-Grade Nurse & Midwife |
| Experience | 5 years as Staff Nurse/ Sister Grade-II | 5 years as Staff Nurse | 5 years as Staff Nurse | 5 years as Staff Nurse |
| Period of Probation | 2 years | 1 year | – |
NA= Not applicable
Table – 2 : Recruitment rules of nursing staff of select hospitals (ANS/DNS/Matron)
| Designation | Autonomous hospital | Private hospital | State Government hospital | INC
Recommendations |
| ANS
Method of recruitment Age limit Experience Qualification
DNS/Matron
Method of recruitment
Age limit
Experience
Qualification |
Promotion 100% |
Direct |
||
| N.A. | N.A. | |||
| 5 years as Grade-I | 5 years of teaching experience | N.A | 5 years as Nursing Sister | |
| A’ Grade registered ‘ Nurse & Midwife certificate in General
Nursing & Midwifery / B.Sc. Nursing |
M.Sc. Nursing |
AGrade Registered Nurse & Midwife Certificate in General Nursing & Midwifery Certificate in Education and Administration or | ||
| B.Sc. Nursing | ||||
|
Promotion |
Direct |
Promotion |
||
|
N.A. |
N.A. |
N.A. |
||
|
5 years as Assistant Nursing Superintendent |
5 years as Assistant Nursing Superintendent |
5 years as Nursing sister |
5 years as Assistant Nursing Superintendent |
|
|
‘A’ Grade registered Nurse & Midwife certificate in General Nursing & Midwifery/ B.Sc. Nursing |
M.Sc. Nursing ‘A’ Grade registered Nurse & Midwife |
‘A’ Grade registered Nurse & Midwife certificate in General Nursing & Midwifery/ B.Sc. Nursing |
A Grade Registered Nurse & Midwife Certificate in General Nursing & Midwifery Certificate in Education and Administration or B.Sc. Nursing |
NA= Not applicable
Table 3: Recruitment rules of nursing staff of selected hospitals (DNS/Chief Nursing Officer
| Designation | Autonomous Hospital | Private Hospital | State 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 5 years as NS | N.A. | N.A |
| Age limit | Upto 45 years |
NA= Not applicable
Table – 4 : Recruitment rules of nursing staff of select hospitals (Nursing Supervisor)
| Designation | Autonomous Hospital | Private Hospital | State 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
Table – 5: Recruitment rules of nursing staff of selected hospital (Nursing Superintendent)
| Designation | Autonomous Hospital | Private Hospital | State Government Hospital | INC
Recommendations |
| Nursing Superintendent | ||||
| Method of recruitment Qualification | 50% by promotion 50% by direct recruitment Desirable M. Sc. Nursing
B.Sc. Nursing Registered ‘A’ Grade Nurse & Midwife 8 years experience in Administration and 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 |
Direct recruitment
M.Sc. Nursing Registered ‘A’ Grade Nurse & Midwife |
Promotion
B.Sc. Nursing Registered ‘A’ Grade Nurse & Midwife OR Certificate in General Nursing and Midwifery |
M.Sc. Nursing |
| Experience | 5 years as DNS or DNS Educator or | 5 years experience as Deputy Nursing | 5 years experience as a Matron | Ten years experience |
| DNS Epidemiologist | Superintendent | 3 years as Deputy | ||
| Nursing Superintendent
OR 7 years as Assistant Nursing Superintendent |
NA= Not applicable
qualifications was B.Sc. Nursing but in case of non-availability, a diploma in General Nursing and Midwifery 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 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 observed 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 recruitment rules 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 recruitment 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 further help in satisfying the patients which is the primary aim of every hospital.
References
- Pigors Paul, Myers Charles Personal Administration. 4th editrion. McGraw-Hill Book Company; New York 1961:261-262.
- Basavanthappa Nursing Administration. 1st edition. Jaypee Brothers Medical Publishers; New Delhi 1998.
- Avasthi Amreshwar, Maheshwari Public Administration. 9th edition. Luxmi Narain Agarwal; Agra 1978:275-277.
- ndian 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 Nursing Journal of India 1985;76:259-265
- High Power High Power Committee on Nursing and Nursing Profession – conclusion and recommendations. Nursing Journal of India 1990; 81:141-144,161-164