Nursing in Turkey: its advances and challenges

Abstract

In order to understand advances and challenges in nursing in Turkey requires knowing the structure and historical development of the country that located between Asia and Europe and carrying the values of eastern and western cultures.

The Republic of Turkey was founded in 1923 on the ruins of the Ottoman Empire which managed according to Islamic religion values and sultanate. Ataturk (Mustafa Kemal) has been established and first president of the Turkish Republic. Turkey, a state at 86 years, was trying to develop in line with revolutions of republicanism, nationalism, populism, statist and secularist⁽¹⁾.

The first population census last 1927 presented 13,648,270 inhabitants. According to the 2008 census in Turkey, 6% of the 72.561.312 populations were 65 years old or older and 50% is 26 years old or younger. Half of them were women, half were male. Rapid industrialization and urbanization in Turkey is one of the major reasons of the fact that approximately 75% of population are living in the cities⁽²⁾.

In Turkish the word “nurse” means “sister” and nursing has been perceived as a women-job in Turkey. Initially it was learned through on-the-job training by those who volunteered their services and in the time post Turkish independence a school-based curriculum was developed. Further advancements in the status of women gained importance in Turkey after the Republic. Therefore, nurses and nursing profession has become more important⁽³⁾.

The first nursing education in Turkey started in 1920 at the Admiral Bristol Nursing School introduced in Istanbul within American Hospital as caregiver course with the private foreign school status^(3-5). Red Crescent Nursing School started to education in 1925, in the Republic period, as the first Turkish nursing school. Modern nursing education started in Turkey with this school and nursing occupation gained professional identity^(3,5).

The first nursing profession organization in Turkey was founded by volunteer nurses in 1933 as “Turkish Medical Attendants Association’’. This association was reorganized in 1943, its management was taken over by school graduate nurses and its name was changed to “Turkish Nurses Association’’ (TNA) (Türk Hem?ireler Derne?i- THD). The association became a member of International Council of Nursing in 1959. The media organ of the Association started its publishing life in 1953 and is still being issued nowadays⁽⁵⁾.

In 1946, the Ministry of Health and Social Welfare founded the Nursing-Laboratory Schools, which offered a three-year program to high school graduates⁽⁵⁾. The Ege University School of Nursing, founded in 1955, was the first academy in Turkey that offered the university level education(4). In 1958, the Nursing-Laboratory Schools, which had adopted a more hands-on approach, was extended to four years and was offered by vocational high schools as well.

From 1989 to 1995, the Ministry of Health and Social Welfare increased the number of vocational health schools from 75 to 326⁽⁴⁾. In 1992, after the “re-constructing health training project’’ of the Ministry of Health, nursing and midwifery training requirements in Turkey were decided to be carried out at the university level. As per the Supreme Council of Health decision in 1995, Council of Ministers decision in 1996 and the joint protocol introduced by the Council of Ministers and the Higher Education Council, as well as in accordance with national and international regulations. Then, Vocational Schools of Health were restructured on the basis of 8-year formal education and were transferred to universities to offer Bachelor’s (BS) Degree/University education to high-school graduates. However, five years later, in 2000, the Supreme Council of Health decided that nursing, midwifery and health official trainings should be given once again at the high-school level, by the Ministry of Health⁽⁵⁾.

The higher education of nursing has fifty-five years of background in Turkey. As well as the other trainings at the graduate level, it is given for four years after a total twelve years of primary, secondary and high-school education⁽⁵⁾. All graduate levels of education in the country are controlled by the Turkish Council of Higher Education (Yuksek Ogretim Kurumu – YOK). This Council sets the standards for all universities applying for a new Higher Degree (Master and Doctorate) program and requires new institutions to meet their standards. In 1968, the University of Hacettepe initiated the Master of Science in Nursing Program and in 1972, the Doctorate in Nursing Program⁽⁴⁾. Nursing doctoral education began as a single program in nursing, and actually in Turkey, the covered fields for graduate education in nursing are Fundamentals of Nursing, Medical Nursing, Surgical Nursing, Gynecology and Obstetric Nursing, Pediatric Nursing, Psychiatry Nursing, Public Health Nursing, Management at Nursing and Education at Nursing^(4-5).

Over the past years, there has been an increased interest in nursing research in Turkey. 39.0% of 231 academicians in the area of nursing had 124 articles in journals indexed in citation indexes (SCI, SCI-exp. SSCI). The number of articles started to increase in 2002 and had reached to a peak point (33.1%) in 2004⁽⁶⁾.

In an effort to promote their studies internationally, doctored nurses have organized a variety of nursing conferences, such as the International Turkish Nursing Conference, the International Turkish Nursing Administration Conference, the International Turkish Surgical Nurses’ Conference, the International Conference in Women’s Health, etc.  When the first conferences began, it was attended mostly by lecturers from nursing schools. Today, more and more clinical nurses are attending them⁽⁴⁾.

Especially doctorate program graduates prefer working mostly in the academic area. According to 2006 data there are 182 nurse academicians in Turkey, of whom 54 are professors, 25 associate professors and 103 assistant professors. Since the introduction of post-graduate and doctorate programs in nursing (1968–1972), there has been a steady increase in the number of nurses advancing to academic duties following graduation⁽⁵⁾.

The Nursing Law of 1954 was changed in 2007. According to the changes in this Law, men is considered able to do nursing, because in the Law before only women could do nursing. Also according to this reviewed Law, nurses on duty are authorized to apply the treatment written by physicians - except in emergencies situations, to identify health-related needs of the individual, family and community in the context of nursing diagnostic process to plan, implement, monitor and evaluate the nursing care within the identified needs. In addition, they do the tasks in the legislation based on the effect of this Act with the law provisions about family medicine practice^(7-8).

The Turkish Nursing Association was responsible, in 2009, to identify the Nursing Ethics Principles for Nurses, which has become a guide for action based on social values and needs⁽⁸⁾. Thus, despite of facing serious problems in the past, today, the major advances and challenges were saved with legal and ethical regulation in Turkish nursing.

REFERENCES

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