STAFFING HOSPITAL NURSING SERVICES IN DIFFERENT UNIT

INTRODUCTION:-
Nursing profession is considered a caring profession to begin with, it was an art and a vocation. Now it is considered
a scientific profession nursing care is defined as the care of the patient with regard to nursing needs, with he ever
increasing dimension of medical sciences quantitatively and qualitatively6 nursing care is becoming more and more
complex with its management services.

Nursing Services:-
Nursing service is the part of the total health organization which aims at satisfying the nursing needs of the
patients/community. In nursing services, the nurse works with the members of allied disciples such as dietetics,
medical social service, pharmacy etc. in supplying a comprehensive program of patient care in the hospital.

Definition of Nursing Services:-

WHO expert committee on nursing defines the nursing services as the part of the total health organization which
aims to satisfy major objective of the nursing services is to provide prevention of disease and promotion of health.

ORGANISATION OF NURSING SERVICES:-

CHIEF NURSING OFFICER

|
NURSING SUPDT
|
DY. NURSING SUPDT.
|
ASSTT. NURSING SUPDT.
|
WARD SISTER-CLINICAL SUPERVISOR
|
STAFF NUIRSE ----STUDENT NURSE

OBJECTIVE OF NURSING IN WARD:-

 Maximum comfort and happiness by way of pleasant surroundings.
 Qualitative/comprehensive care to the patient.
 Care based on the patient’s needs.
 Accurate assessment of illness.
 Adequate material resources at all times.
 Health education to the patient and attendants.
 Managerial skills as and when required.
 Privacy at all levels.

EFFECTIVE NURSING:-
An effective nursing is always based on nursing process which is an organized and systematic approach to nursing
care, that prioritizes patient assessment and management.

Entire nursing process consists of four phases:-

 ASSESSMENT- not only initial but integral ongoing component of the whole nursing
process.
  PLANNIG AND IMPLEMENTATION- in this the nurse formulates and implements
the care.
 EVALUATION- decides whether the action taken has met the identified needs or not.
This is the final step of care. Also, review of the whole care plan. Without this no quality
care or comprehensive care is possible to provide.

FACTORS TO BE CONSIDERED IN PLANNING HOSPITAL NURSING SERVICES:-

 Number and type of patient.
 Number of beds and type of ward.
 The services required.
 Procedures/techniques necessary for care.
 Number and type of personal needed to perform care effectively.
 Physical facilities.
 Provisional of equipment and supplies.

S.I.U NORMS:-
 1 Nursing sister for 3:6 staff nurses.
 1 ANS for 4:5 nursing sisters.
 1 DNS for 7:5 ANS.
 1 Nursing supdt for 250-500 beds.
 1 CNO for 500 or more beds.

PROBLEMS AND CHALLENGES FACED BY THE NURSING ADMINISTRATOR:-

 Lack of adequate training.
 Problem of personnel management.
 Inadequate number of nursing staff.
 Shortage of trained manpower.
 Lack of motivation.
 No involvement in planning.
 No career mobility.
 Poor role model.
 Non-nursing activities.
 No research scope.
 No proper aurthority.
 Professional risk/hazards.
 No autonomy in nursing activities.

CONSTRAINS AND BARRIERS IN NURSING SERVICES ADMINISTRATION:-

 Planning of nursing manpower.
 Management and development.
 Staff development.
 Development/awards.
 Nursing legislation.
 Trained nurse managers.
 Diversification in nursing profession.
 Leadership inadequacy.
 Lack of strength, weakness, opportunity and threat.
  Lack of awareness to meet social, economic and technical changes in the society and consumer
protection act.
 Lack of communication.
 Nursing care audit.

DAY TO DAY PROBLEM IN NURSING SERVICES:-

 Shortage of nurses.
 Lack of motivation.
 Negative attitude.
 Lack of training.
 Lack of team approach.
 Inactive participation of programs.
 Lack of I.P.R.
 Less involvement in patients care by the nursing supervisors.
 Lack of supervision.

FORSEEN FOR BETTER NURSING SERVICE ADMINISTRATION IN THE NEXT MILLENIUM:-

 Accountability.
 Autonomy of professional activities.
 Awareness of C.P.A.
 Independent nursing practices.
 Renewal of licenses based on education and examination.
 Specialty nursing
 Nursing care audit.
 Qualitative nursing care.
 Separate nursing budget.
 Diploma in nursing management.
 Nursing research .
CNO (CHIEF NURSING OFFICER)

1. She/he will be responsible for efficient running of Nursing Services of the Main
hospital and various centres of AIIMS.
2. She will assist the Director in formulating broad policies concerning Nursing
Services.
3. She will disseminate the AIM, objectives and policies regarding patient care to all
cadres of nursing services.
4. She will implement policies and procedures of Institute regarding nursing services.
5. She/he will plan future requirements of nurses and carry out recruitment of nurses
from time to time.
6. She/he will plan and disseminate programmes for continuting education re-
orientation programmes for nurses.
7. She/he will closely interact with other hospitals regarding improvement of patient
care.
8. She/he will encourage research by nurses in their work areas.
9. She/he will guide and conunsel the sub-ordinate nursing staff.
10. She/he will keep herself abreast of latest happenings in nursing care by attending
National / International conferences.
11. She will strive to implement standard nursing practices and maintain highest
quality of care.
12. She will critically analyse the budgets for nursing services from Main hospital and
various centers before being forwarded to Director.
13. Evaluate confidential reports of higher level nursing officers and recommend for
promotion.
14. She will be assisted in her duties by nursing Supdt.’s, of Main Hospital and from the
centres.
15. She will keep the Director informed about the happening concerning the hospital.
Nursing Superintendent is responsible to the C.N.O. for planning organisation and
development of nursing services in the hospital in consultation with Medical Supdt./Chief
of centres.

1. She will be responsible and overall In-charge of Nursing Services in a hospital or

specialized centres irrespective of the number of beds.
2. She will be responsible to the Medical Supdt. or Addl. MS or chief of Centres of the
hospital or centre as the case may be.
3. She will be responsible for implementing hospital/centre policies amongst various
nursing units.
4. She will assist the CNO in formulation of hospital policy, particularly concerning
nursing services.
5. She will officiate as CNO in the absence of CNO (The senior most amongst the NS will
do so).
6. She will recommend personnel and material requirement for nursing various
nursing service departments of the hospital.
7. She will assist MS/Addl. MS or Chief of Centres in recruiting nursing staff.
8. She will carry out regular rounds of the hospital.
9. She will accompany MS/Addl. MS while making hospital rounds.
10. She will ensure safe and efficient care rendered to patients in various wards etc.
11. She will prepare budgets for nursing services.
12. She will be a member of various condemnation boards for linen and other hospital
stores.
13. She will be responsible for counseling and quidance of sub-ordinate staff.
14. She will attend hospital/intra hospital meetings and conferences.
15. She will investigate all complaints regarding nursing care and personnel, and take
suitable corrective action.
16. She will initiate and encourage research in nursing services.
17. She will evaluate confidential reports of her sub-ordinate staff and recommend for
promotion, higher studies etc.
18. She will maintain cordial relations with patients and Medical Social workers.
19. She will periodically interact with clinical heads to discuss problems in patient care.
20. She will educate nursing staff of all categories by conducting awareness programme
on universal Precautions.
DEPUTY NURSING SUPERINTENDENT
Deputy Nursing Superintendent is responsible to the Nursing Supdt. and assist her in the
administration of nursing services in the hospital.

A. NURSING ADMINISTRATION:
1. Supervise the nursing care given to the patients in various departments by taking
regular round of her area.
2. Act as a liasion officer between Nursing Supdt. and the nursing staff of the hospital.
3. Interpret the policies and procedures of the Nursing service department to sub-
oradinate staff and others.
4. Attend the emergency calls concerning nursing services or hostel problems.
5. Receive evening and night reports from the Assistant Nursing Supdt./Supervisors.
6. Keep records and reports of Nursing Services.
7. Maintain the records of attendance of nursing staff and leave of any kind.
8. Conduct regular physical verification of hospital stocks, i.e. drugs, equipments etc.
9. Initiate procedure for condemnation and procurement of hospital equipment/linen
etc.
10. Maintain the confidential report and records of nursing personnel.
11. Assist the nursing supdt. in making master duty roster of nursing personnel.
12. Assist the nursing superintendent in Recruitment of nursing staff.
13. Assist the nursing supdt. on planning and organising nursing services in the
hospital.
14. Officiate in the absence of nursing supdt.
15. Attend the official meetings.
16. Keep the senior nursing Officials (CNO & NS) informed of the happenings in the
wards.
B. EDUCATIONAL ACTIVITIES:-
1. Assist in planning/organising and implementing staff development programmes.
2. Ensure clinical experience facilities for student nurses in various clinical areas of the
hospital.
3. Provide guidance and counseling to nursing staff.
4. Arrange orientation programmes for new nursing staff.
5. Maintain discipline among nursing personnel.
6. Organise educational programmes for graduate/post graduate students from
different hospitals with the co-ordiantion of clinical instructor/lecturer college of
nursing.
C. GENERAL DUTIES:-
1. Escorts special visitors, Nursing Superintendent, Medical Superintendent for hospital
rounds.
2. Arranges and participates in professional and social functions of the staff and
students.
3. Maintains good public relations.
4. Any other duties assigned to her from time to time.
ASSISTANT NURSING SUPERINTENDENT
Asstt. Nursing Supdt, is responsible to Deputy Nursing Supdt. for the total nursing care of
patients, management and development of the unit assigned to her: -
A. NURSING CARE:-
1. Assist the total needs of patients in the unit and prepare planned nursing care.
2. Demonstrate and Supervise the nursing care of patients in the unit.
3. Attend regular round in the unit with the medical and nursing personnel.
4. Reviewing reports from Sr. Gr. I regarding the nursing care of patients in each shifts.
5. Give counseling and health education to the patients and their attendants.
B. WARD MANAGEMENT:-
1. Plan and arrange duty for nursing personnel posted under her.
2. To ensure availability of adequate nursing staff in all shifts.
3. Maintain cleanliness of unit its annexes and environment.
4. Interact with the engineering service department for proper up keep of the unit.
5. Keeping Deputy Nursing Supdt., Nursing Supdt. informed of the needs of the patient
care areas and bring it to their notice any special problems.
6. Guide the Sister Grade-I to ensure supplies and equipments of different stores, and
re-checking their use and care.
7. Daily check of emergency and dangerous drugs, life saving equipments i.e. monitors,
ventilators, defibrillators, suction machines and O2 points etc., to ensure their
proper functioning.
8. Periodical check of all stocks and supplies.
9. Maintain good inter-personnel relationship with all categories of staff, patients and
their relatives.
10. Maintain good public relation with patients relatives and the public, and project
positive image of the hospital.
11. Maintain disciple of nursing and domestic staff.
12. Interpretation of Hospital policies, rules and regulations.
13. Daily check of attendance and reporting the lapses.
14. Investigate complaints if any.
15. Work evaluation and confidential reports.
16. Guidance and counseling of nursing staff in the unit.
17. Project the annual requirements of drugs supplies and equipments for the units.
18. Take care of legal aspects and report about the medico legal cases in the ward.
C. TEACHING AND SUPERVISION:
1. Plan and implement a proper orientation programme for new nursing staff, student
nurse and domestic staff.
2. Participate in In-service education of nursing personnel and attend the meetings.
3. Give incidental and planned teaching to nursing personnel in the unit, as well as
domestic staff.
4. Participate in clinical teaching for student nurses in Co-operation with the nursing
tutor.
5. Perform any other duties assigned to her for time to time.
NURSING SISTER GRADE-I
The Nursing Sister Grade-I is responsible to the Assistant Nursing Superintendent or the
total care of patients in the wards and supervision of the Nursing Sister Grade-II, student
nurses and Domestic staff. She would also be assisted by Nursing Sister Grade-II, Clinical
and Domestic staff. The main aim of the sister Grade-I should be to foster team spirit in her
area of works as a team leader.

A. NURSING CARE OF PATIENTS:

1. Assess the total needs of patients and prepare plan of nursing care.
2. Admission and discharge of patients.
3. Demonstrate and carry out efficient nursing care, taking care of personal comfort
and toilet of patients, administration of drugs and treatment, observation and
recording of vital parameters.
4. Supervise patients diet.
5. Attending rounds with Medical/Nursing personnel.
6. Assist Medical staff in examination of patients and treatment.
7. Participate and help with clinical investigations/procedures.
8. Demonstrate and carry out preoperative and post-operative care of patients.
9. Maintenance of patient’s records.
10. Care of patient’s personal effects in accordance with hospital rules.
11. Giving and receiving reports.
12. Follow prescribed rules in case of accident or death of a patient.
13. Give information and health education to patients and their attendants.
14. Intimation to nursing supervisors of any emergency or unusual occurrence in the
ward.

B. WARD MANAGEMENT:
1. Handing over and takeover charge of patients at the end of the shift.
2. Assignment of work to nursing sister grade-II and domestic staff.
3. Co-ordinate and facilitate work of other staff, e.g. physical therapist, social worker,
dietitian, voluntary worker etc.
4. Maintaining good inter personal relationship among all categories of staff and with
patients and their relatives.
5. Maintain cleanliness of ward, its annexes and environments. Proper upkeep and
repairs of linen and ward equipment.
6. Make indents for drugs, surgical supplies, stores and issue.
7. Keep custody of dangerous drugs and record of their administration.
8. Daily check of emergency drugs and life savings equipments.
9. Maintenance of stock registers, inventories.
10. Investigate complaints if any.
C. TEACHING AND SUPERVISION:
1. Orientation of new staff and student nurses.
2. Participate in service education of nursing personnel and attend staff meetings.
3. Impart planned and incidental teaching.
4. Supervise sister grade-II and student nurses.
5. Supervise domestic staff.
6. Consult and co-operate with nursing tutor in arranging clinical teaching.
7. Perform any other duty as may be specified from time to time.
NURSING SISTER GRADE-II
Nursing sister grade-II is directly responsible to Nursing Sister Grade-I (Ward In-
Charge) for total nursing care of the patient assigned to him/her.

A. DIRECT PATIENT’S CARE:

1. Admission and discharge of the patients.
2. To maintain the personal hygiene of the patients, including bathing, care of mouth,
back, nails, hair etc.
3. Care of pressures points as needed.
4. To assist the patient in elimination, offering and removing the bed pans and Urinals.
5. Bed making.
6. Assist in feeding the weak and debilitated patients.
7. Writing of diet sheet, Supervision and distribution of diets.
8. Assist in physiotherapy, ambulation and rehabilitation.
9. Carry-out patient’s teaching and demonstration according to the need.
10. Counseling the patients, and relatives.
11. Care of the dying and dead.
12. Administration of Medicines and Injections to the patients.
13. Assist in administration of intravenous injections, infusion and Transfusion.
14. Observing, recording and reporting of vital signs e.g. T.P.R. and Blood pressure.
15. Carry out technical procedures, such as Naso-gastric intubation, Gastric Gavage and
Lavage, Oxygen Therapy, Dressing and Irrigation, Enema, Catheterization hot and
cold applications, suction etc.
16. Collecting, labeling and dispatch of specimens.
17. Preparation for and assistance in clinical tests and medical/surgical procedures.
18. Urine testing for sugar, and albumin.
19. Observation, recording and reporting of all procedures and tests.
20. Escorting serious patients to and from the department/wards for investigations.
B. WARD MANAGEMENT:
1. Handing over and taking over charge of patients, and ward inventory in each shift.
2. Maintenance of therapeutic environment in the ward.
3. Keeping the ward clean and tidy.
4. Routine care and cleaning of dressing trolleys, cupboards apparatus, mackintosh etc.
5. Care of clean and soiled linen.
6. Disinfection of linen, beds, floor and bed pans, and fumigation of rooms etc.
7. Preparation of room, trolleys, and sets for procedures.
8. Preparation of surgical supplies.
9. Maintaining interpersonal relationship with patients, relatives and health team
members.
10. Orientation of new staff/students.
11. Demonstration and guidance to student nurses.
12. Participation in staff education and staff meetings.
13. Participation in professional activities.
14. Demonstration and supervision of domestic staff.
15. Report about the medico-legal cases if any admitted in the ward. To keep the senior
nursing officials informed of the happenings / in the ward like fire, absconding
patients, theft etc.
16. Any other duty that may be assigned by sister grade-I from time to time.
 NURSING IN-SERVICE EDUCATION

NEED:

A need was felt by the nursing administrators that a planned nursing in-service
education needs to be started so as to increase the knowledge base of practicing nurses in
order to improve & maintain high standard of nursing care at the AIIMS Hospital.

Aims / Objectives:
1. To increase the existing knowledge base of nurses practicing clinical nursing.
2. To improve and maintain high standard of nursing care to patients at the AIIMS
Hospital., which would increase the satisfaction level of patients / relatives.
3. To improve communication skills among nursing personnel at AIIMS.
4. To update knowledge regarding handling / upkeep of latest & sophisticated
instruments and gadgets.
5. To enable nurses to secure credit points for renewing their nursing license by
the DNC.

The Program:-

Nursing in-service education is one of the cornerstones in professional development

of nursing personnel working in AIIMS. A need based nursing in-service program has been
started w.e.f. January 2011. This is started with the aim of updating clinical nursing
knowledge on the premise of continuing nursing education. The program is well
structured with thrice a week classes.( Two classes for bedside nurses and one class for
Sister in-charges and above)

This is done for practicing nurses to increase their knowledge base in order to
improve the standard of nursing care at the AIIMS. Once a week classes are conducted for
middle level managers focusing on Nursing Administration and Management. In the month
of January 2011, a well organized induction & orientation program was conducted for 133
newly recruited nurses at the main hospital by the In-service nursing educator.

In 2012, a total of 297 newly recruited nurses got oriented by designated nursing
personnel in two sessions, regarding various aspects viz. hospital layout, various
departments, OPD schedules and their professional duties and responsibilities.

The Personnel Involved:-

Facilitator :
Officer In-charge & Mentor :
Educator/ Co-ordinator :
 C.N.E. Schedule:-

The following C.N.E.classes were conducted for the year 2012 in the Main Hospital

1. Classes for Sister Incharges/ANS/DNS/NS/CNO

· Human Relations in Nursing
· Materiel Management
· Ethical and Legal issues in clinical nursing
· Conflict Management
· Stress Management
· Nursing Administration

2. Classes for bedside nurses

· Patient safety
· Nursing Process
· Human Relations in Nursing
· Ethical and Legal issues in clinical nursing
· Pre and post operative Nursing Management
· Stress Management
· Medication Administration Safety
 Surveillance of Hospital Infections at AIIMS
Role of Infection Control Nurses:

Introduction:

From the historical perspective, the History of Infections Control Committee at

AIIMS dates back to Nov., 1973. Nurses from other hospitals were trained in Hospital
Infection Control Policies/Protocol at AIIMS. It was initially chaired by the head of the
Microbiology Deptt. & known as HIFCOM (Hosp. Infection Control Organizing
Machinery). The HIFCOM Committee consisted of the following members:-
a) Nursing Supdt.
b) HOD Microbiology
c) HOD Medicine
d) One Infection Control Nurse

However, later on it was re-constituted under the Chairperson Ship of the Medical
Supdt.

Hospital Infection Control Committee (HICC):

Present:
Ø Chairman - Medical Supdt.
Ø Members - CNO/Nursing Supdt., Officer In-charge MOT
Ø One Senior faculty from specialty like Medicine, Ortho, Anesthesia, G.E., Gynae,
Surgery Microbiology, Paed. Surgery and Hospital Admn.
Ø Three Infection Control Nurses in Main Hospital, One ICN in CTVS, One ICN in NSC,
One ICN in AIRCH, Two ICNs in Dr. RPC, One ICN in JPNA Trauma Centre, total 9
ICNs in the whole hospital.
Ø Member Secretary- faculty from Hospital Administration.

Core Group:
Ø Chairman - Medical Supdt.
Ø One faculty each from Microbiology, Paediatrics, Intensive Care & Hospital
Administration.
Ø One Nursing Supdt., In-charge for Hospital Infection Control.
Ø Three Hospital Infection Control Nurses.
Ø One M.H.A. Resident.

I. Activities of ICN
 Environmental surveillance.
 Surveillance of air in OT’s/ICUs
 To check for sterilization & dis-infection practices.
 In-use test of disinfectants
 Autoclave checks
  Water testing

II. Monitoring of infections based on culture positivity. Its purpose being to

know the organisms causing infections in the hospital and to monitor the anti-
microbial resistance. Tabulation of data is done for individual departments
every month.

III. Continuous surveillance of infections for early detection of outbreak for

which, appropriate control measures are undertaken.

IV. Surveillance of any community outbreak viz. Dengue, meningitis, diphtheria,

meningococcemia etc. to prevent spread within the hospital amongst HCW’s.

V. Staff health activities are carried out with the objectives:

 Educating personnel about the Principles of Infection Control and
stressing individual responsibility for Infection Control.
 Collaborating with the infection control team in monitoring and
investigating potentially harmful infectious exposures and outbreaks
among personnel.
 Providing care to personnel for work related illnesses or exposures.
 Continuous training and on going education is carried out for freshly
recruited residents, nurses and sanitation staff.
 Identifying work-related infection risks and instituting appropriate
preventive measures.

The goals are met by using vaccines optimally to prevent transmission of vaccine
preventable diseases. Management of Job related illnesses and exposures is done by
following the decisions on work restrictions as per the advice of the treating
doctors. Records are maintained of all accidental HAI acquired by the staff with
utmost confidentiality.

VI. Advising HCS’s regarding terminal dis-infection of unit /Laundry, Proper

Hospital Waste Management.

Conclusion: The role of ICNs at the main hospital has:

 Contributed to a gradual decline over the years in the CIR at the AIIMS, Main
Hospital.
 Helped the individual departments to formulate empirical antibiotic
treatment strategies.
 Seen a cut in the cost of treating infections by the identification of
 impending outbreaks due to active surveillance indirectly.
 Helped in changing practices viz. A switch over to digital thermometers
from clinical thermometers, using distilled H2O ampoules to dissolve
injections rather than using common stock solutions, wet mopping over dry
sweeping, using ecoshield for fumigation over the use of formaldehyde etc.
 Have helped in changing attitudes of HCW’s over the years and have made
them more sensitive towards the infection control policies and protocols at
AIIMS.

Inspite of increased antimicrobial resistance

Increased number of ICU’s / HDU’s
Increase in number of transplant patients admitted in the hospital, the
infection
rate has continued to be the same meeting the International standards.

Average length of stay of patients in the hospital has declined from 5.9 in
1997-98 to 4.8 in 2006-07.
 GENERAL INFORMATION ABOUT NURSING

RECRUITMENT:-
· INTERNAL RECRUITMENT
Departmental promotion (based on experience qualification, ACR, medical
fitness and DPC meetings.)
· EXTERNAL RECRUITMENT
All the activities are under the control of the recruitment cell, A.I.I.M.S.

STEPS:-
· Post creation.
· Advertisement.
· Scrutinizing (qualification and set standards).
· Preparing list of candidates.
· Written exam.
· Fixing interview date.
· Forming interview board.
· Informing candidates.
· Holding interviews.
· Compiling and declaring result.
· Issuing appointment letter.

INDUCTION/ORIENTATION PROGRAMME:-
TYPE OF DUTIES:-
· Shift duties.
· Straight duties.
· Split/break duty.

DUTY TIMINGS:-
· 7:30 am to 3:30 pm with one hour lunch time.
· 3:00 pm to 9:30 pm
· 9:00 pm to 8:00 am
Half an hour overlap for handing and taking over.

LEAVE:-
· D/Offs 8 days a month (3 extra offs for national holidays)
· Casual leave - 8 + 2 = 10
· Medical leave - 20 half pay
· Earned leave - 30 days
· M.T.P. - 45 days
· Maternity leave - 180 days
(One year extension there after for baby care with loss of seniority and increment)
· Child Care Leave -
· Study leave - can avail only once after 5 yrs of regular service.
 Uniform:-
May 2000 onwards, A.I.I.M.S. nurses have their own uniform decided by the A.I.I.M.S
authorities.

Sr.Gr.I, Sr.Gr.II, Sr.Gr.I HR & ANS (Male Nurses):-

· Half sleeves sky-blue shirt
· Formal pair of dark blue trousers/pants
· Half sleeves white coat (3/4th sleeves length coat for ANS and above)
· Black shoes
· Name plate:- Same as that for female nurses as per cadre
· Winter : Black sweater for Sister Grd I(HR) and ANS

Sr.Gr.I & Sr.Gr.II (Female Nurses):-

· Salwar kameej-blue color (dark)
· Name plate:- Black bac ground with white letters
· Half sleeves white coat
· Black sandals
· Winter : Black sweater

Sr.Gr.I HR & ANS (Female Nurses):-

· Dark blue saree and blouse
· Name plate:-
For Sister grade I(HR) and ANS(UG), white background with black
letters
For ANS (HR) Maroon back ground with white letters
· Half sleeves white coat for Sr.Gr I HR and ¾ th sleeve coat for ANS
· Black sandals
· Winter : Black sweater for sister in charges and ANS

DNS and above till CNO:-

· Light blue saree
· ¾ th Sleeves coat
· Name plate:- White background with black letters
· Black sandals
· Winter : white sweater

STAFF DEVELOPMENT:-
Refers to the continuing improvement of the nursing personnel

COMPONENTS:-
 Orientation.
 In-service training and continuous education.

There are the educational activities planned and organized for the nurses to assist them in
furthering the knowledge and skills required for the improvement of patient care services.
WAGES AND ALLOWANCES:-
 CNO - 15,600 – 39100 GP 7600
 Nsg. Supdt. - 15600 – 39100 GP 6600
 DNS - 15600 – 39100 GP 5400
 ANS - 15600 – 39,100 GP 5400
 Sr. Gr. I - 9300 – 34800 GP 4800
 Sr. Gr. II - 9300 – 34,800 GP 4600 (Direct recruitment)
New Recrutis – Basic Pay 12540

Besides this they are getting following allowances per month:

 Nursing allowance - Rs.3200/-
 Uniform allowance - Rs.500/-
 Washing allowance - Rs.300/-
 ICU/OT allowance - Rs.120/-

JOB DESCRIPTION:-
Contains particulars of the activities to be performed and the characteristics of employees
required.
 Prevent duplication of functions.
 Facilitates recruitment, selection and placement of the personnel.

DISICIPLINE AND DISCIPLINARY ACTION:-

Discipline refers to working in accordance with certain recognized rules and regulation.

DEALING WITH DISCIPLINARY PROBLEMS:-

DISCIPLINARY PROBLEMS:
 Misconduct.
 Rude behavior
 Absenteeism.
 Late coming, early going.
 Negligence, carelessness, disobedience.
 Leaving the work place during working hours.
 Failure to wear uniform.
 Refusal to receive letters, communication from the management.
 Borrowing, taking bribes from patients.
 Failure to observe safety instructions.
 Giving false information.
 Failure to report to supervisors.
 Using hospital facilities for personal gain.
 Tempering with records etc.
DISCIPLINARY ACTION:-
 Warning or censure, memorandum.
 Fine.
 Inquiry.
 Suspension.
  Stoppage to increment.
 Demotion.
 Discharge.
 Dismissal.
An opportunity is always given to the employee to explain his/her stand.