Student nurses' perceived challenges of nursing in India

Background: A profound nursing shortage exists in India. Increasingly nursing students in India are opting to migrate to practise nursing abroad upon graduation. Perceptions and attitudes about nursing are shaped during student experiences. Purpose: The purpose in conducting this research was to illuminate student nurses' perceived challenges of nursing in India. Setting and Sample: This study took place at a hospital-based, private mission non-profit school of nursing in Bengaluru, India. Purposive sampling of nursing students yielded 14 participants. Methods: Photovoice, a qualitative participatory action research methodology, was used. Data were collected between August 2013 and January 2014. A strong international collaboration between researchers resulted in qualitative thematic interpretation of photographs, critical group dialogue transcripts, individual journal entries and detailed field notes. Results: Two main themes were identified including the perceived challenges of a hierarchal system and challenges related to limited nursing workforce capacity. Subcategories of a hierarchal system included challenges related to image, safety, salary and balance. Subcategories of limited workforce capacity were migration, work overload, physical demand, incongruence between theory and practice, and knowledge. Discussion: Nursing as a profession in India is still in its infancy when measured against standard criteria. Implications for Health Policy: Change in health policy is needed to improve salary, safety for nurses, and nurse to patient ratios to address hierarchal and workforce capacity challenges in India.