Healthcare is changing dramatically due to the advancement of medical sciences and technology, the abundance of clinical research and the higher demands of consumers. As a key profession of healthcare, these changes represent a significant challenge to the nursing profession and nursing education in terms of maintaining the quality of services and preparing nurses for the future (Aluwihare-Samaranayake, Ogilvie, Cummings, & Gellatly, 2017; Fealy et al., 2018; R. S. Jayasekara, 2009; WHO, 2016). Effective systems for regulation, education, research and management are the key to strengthening the contribution of nursing services to achieve the required improvement in health outcomes (WHO, 2016). This review explores issues and challenges concerning nursing services, regulation and education in Sri Lanka and their influence on professionalism in nursing. Major challenges for the nursing profession in Sri Lanka are discussed with some recommendations, enabling the identification and development of an appropriate policy direction. Reviewing the current situation and future development of the nursing profession in Sri Lanka enables one to understand not only the nature of its successes and problems but more importantly, in what way plans for the future will impact on the profession.
Method
A comprehensive literature and policy document search was conducted using MEDLINE and CINAHL limited to articles in the English and Sinhala languages published between 1976 and November 2018. The reference lists of all identified reports and articles were searched for additional studies. Personal communication, unpublished reports and government records and websites were also used to obtain information on nursing service, regulation, administration and education in Sri Lanka. Hand searching of relevant Sri Lankan journals and government reports was undertaken to reveal any additional literature.
Discussion
Throughout the history of nursing in Sri Lanka, it has been recognized that nurses are a crucial part of the workforce delivering health services to the nation in terms of caring for patients, preventing illnesses and promoting the health status of the country. However, it may be concluded that the profession is being very slow in asserting its professional standing in the health sector. There has been a minimal effort to improve the standards of nursing services and education, mainly because of inadequate and disjointed involvement of those who are responsible for developing the health services in Sri Lanka. However, nursing services and education in Sri Lanka are under scrutiny as nurses today are more concerned about their professional roles, education and status.
Recommendations
The nursing profession in Sri Lanka needs to reflect on its contemporary needs and the current and future demands of health care. This section provides detailed recommendations to inform the planning process of nursing services, regulation, administration and education for the country (Jayasekara & Amarasekara, 2015; Jayasekara, 2009).
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