INTRODUCTION:

A professional association (also called a professional body, professional organization, or

professional society) is usually a nonprofit organization seeking to further a particular
profession, the interests of individuals engaged in that profession, and the public interest.
The roles of these professional associations have been variously defined: "A group of
people in a learned occupation who are entrusted with maintaining control or oversight
of the legitimate practice of the occupation;" also a body acting "to safeguard the public
interest;" organizations which "represent the interest of the professional practitioners,"
and so "act to maintain their own privileged and powerful position as a controlling
body. This, in turn, places the burden of enforcing a Profession ban upon these
associations as well.
Such bodies generally strive to achieve a balance between these two often conflicting
mandates. Though professional bodies often act to protect the public by maintaining and
enforcing standards of training and ethics in their profession, they often also act like a
cartel or a labor union (trade union) for the members of the profession, though this
description is commonly rejected by the body concerned. Therefore, in certain dispute
situations the balance between these two aims may get tipped more in favor of protecting
and defending the professionals than in protecting the public. An example can be used to
illustrate this. In a dispute between a lawyer and his/her client or between a patient and
his/her doctor, the Law Society of England and Wales or the General Medical Council
will inevitably find itself plunged into a conflict of interest in (a) its wish to defend the
interests of the client, while also (b) wishing to defend the interests, status and privileges
of the professional. It is clearly a tough call for it do both. Many professional bodies are
involved in the development and monitoring of professional educational programs, and
the updating of skills, and thus perform professional certification to indicate that a
person possesses qualifications in the subject area. Sometimes membership of a
professional body is synonymous with certification, though not always. Membership of a
professional body, as a legal requirement, can in some professions form the primary

formal basis for gaining entry to and setting up practice within the profession; see
licensure. Many professional bodies also act as learned societies for the academic
disciplines underlying their professions. In countries where the law entitles defendants to
a jury by their peers, the general public may not be considered sufficiently
knowledgeable in a field of practice to act as a peer in some legal cases. For example,
the Professional associations do not always concern themselves with licensure or the
equivalent or government regulations. In the United States, journalists seek to avoid
government involvement in their work or "official" definitions.

OBJECTIVES OF ORGANIZATIONS AND UNIONS:

1. Promote sharing, better communications and closer relationships between its
members.
2. Provide expert professional advice.
3. Scholarships for advanced study.
4. Financial assistance for professional meetings and seminars.
5. Running an office through which funds can be received through members contribution
and from government grants
6. Wages: employees and their union can be expected to ask for wages which are
comparable to those in similar jobs in the local market.
7. Promotions: unions will insist that length of service be a factor in promotions.
8. Layoffs: the union will insist that seniority play a part in regulating layoffs;
qualifications being equal, the junior service employees will be paid off first.
9. Discipline: employees will be disciplined for just cause; this is standard in all labor
agreements.
10. Grievances procedures: the union will insist that a grievance procedure be
established whereby management decisions will be reviewable by representatives of

management and the union; if there is still disagreements, the dispute will be referred to
arbitration.
11. Fringe benefits: pensions, vacations and holidays, social insurance, and general
welfare programmes will be part of the negotiations, with an attempt to make them
comparable to the trend in our society.
12. Promote cooperation and encouragement among members.
13. Promote efficiency in education and service.

IMPORTANT ORGANIZATIONS AND UNIONS:

Trained Nurses Association of India (TNAI)
The trainees association of India is the national body of practitioners of nursing at
various level. The main idea behind the establishment of the association in 1908 was to
upheld in every way the dignity and honor of the nursing profession
Definition
It is the non-secretarial, non political, professional organization whose membership is
open to all RNs who held certificate in nursing and are recognized by INC.
Objectives:
a) To uphold in every way the dignity and honour of the nursing profession and to
promote a sense of esprit de corps among all nurses.
b) To promote high standard of health care and nursing practice
c) To advance professional ,educational ,economic and general welfare of nurses

Membership:
Membership in TNAI is obtained by application by submission of a copy of own state
registration certificate .membership can also be transferred from SNA by transferring a
certificate from institution within 6 months of completing the course. It consists of full

members, those who are fully qualified RN. Associated members are health visitors,
midwives, ANMs, Student nurses and members of affiliated organizations. The
Government of India has recognized the association as a service organization and
societies doing good work in their realms of concern.
Activity Performed By TNAI
1. Conference: The TNAI holds its national conference biannually .it was planned in
1972 to hold these conference quadrennial, but was felt in 1980 that four year gap
between conference was so long and again it backs to earlier practice of biennial
conference.
2. Continuing Nursing Education Programs: the association organizes continuing
education programs for nursing personnel oriented to different aspects of education and
administration.
3. Publications: the associations brings out a monthly magazine ,the nursing journal of
India. The association has brought out some books on aspects of nursing practice and
education at low price.
4. Socio-Economic Welfare Programs: one of the objective of TNAI is to provide
socio-economic welfare to the nurse. Currently TNAI in collaboration with ICN is
conducting a socio-economic training project.
5. Nursing Regulation Project: another objective of the association is to raise the
standard of nursing education and practice through necessary legislation. Activity under
this project is to conduct one national level and four regional workshops to orientate the
functions of registration councils and nursing leaders to the existing nursing regulations.
6. Scholarships: One of the ways in which the TNAI carries out its educational
objectives and serve the cause of nursing is being the trustee for various scholarships.

Functions of TNAI:
1) To establish functions, standards and qualifications for nursing practice.
2) To enunciate standards of nursing education and implement these through appropriate
channels.

3) To enunciate standards of nursing service and implement through appropriate

channels.
4) To establish a code of ethical conduct for practitioners.
5) To stimulate and promote research designed to increase the knowledge on which the
practice of nursing based.
6) To promote legislation and to speak for nurses in regard to legislative action.
7) To promote and protect the economic welfare of nurses.
8) To provide professional counseling and placement service for nurses.
9) To provide continuing professional development for practitioner.
10) To represent nurses and serve as their spokesman with allied national and
international council of nurses.
11) To serve as official representative of the TNAI as a member of the international
council of nurses.
12) To promote the general health and welfare of the public through all association
programs, relationship and activities.
Benefits:
1) Feeling of belongingness
2) Different conference and workshops are held which may be at the national level and
state level
3) Different publication like The Nursing Journal Of India
4) Continuing nursing educational programs and upgrade knowledge on relevant topics
at regular interval.
5) Socio-economic welfare programs provide allowance for women.
6) Regular research studies conducted for benefits of members.
7) National awards given to nurses by TNAI.
8) Nurses day celebration on 12th may every year.
9) Welfare funds are the annual grants to sate branches to sustain activities.
10) Railway concession is given 25% to its members.
11) Guest room facilities for guest at headquarters in Delhi and some other states.

Achievements:
1) Raising the standard of nursing training of both general and midwifery
2) Established nurses registration council in many states.
3) Establishment of college of nuring in new delhi
4) Promotion of health.

Indian Nursing Council

INC was constituted to establish a uniform standard of education for nurses, midwives
health visitor and GNMs. The INC act was passed by an ordinance on December 31st ,
1947 and inc is constituted in 1949.
Historical perspective:
1946-the health survey and development committee recommended formation of INC
in order to establish uniform standard of nursing training in the country.
1947-indian nursing council act passed
1949-inc established and started functioning
1950-inc act amended as Indian nursing council (amendment)act1950
1951-general nursing and midwifery course framed and adopted.
1954-special provision made in syllabus for men nurses. Council integrated public
health in basic nursing curriculum of G.N.M course.
1965-G.N.M course revised
1980- circular issued making permission of state govt. mandatory for opening schools
/colleges of nursing
1981-b.sc nursing syllabus revised
1983-council introduced inspection fee for inspection of schools/colleges of nursing
by INC
1986-gnm curriculum revised and course made 3 years duration.
1999-INC completed 50years
2000-golden jubilee conference was organized in Delhi

2006-b.sc., nursing syllabus revised.

Purpose of INC:
a) Regulation of uniform standard of nursing education for nurses, midwives and
multipurpose health worker.
b) Reciprocity in nursing registration throughout the country.
c) Inc act of 1947 which mean when amended in 1957 gives additional responsibility to
provide registration of foreign nurses and maintenance of Indian nursing register for
maintaining information as a man power of the country.

Functions of the council:

The Indian nursing council is the supreme governing body of nurses in India. It performs
a number of varied functions to uplift and establish uniform standard of nursing
education in India.
1) Prescribing of syllabi: purpose of nursing education is to prepare nurses who will
function as a member of the health beginning with competencies for first level position
in both hospital and community. The programme are developed according to the health
needs of the country ,the community and the individual and it will serve as a basis for
advanced study and specialization.aas the council was constituted to establish uniform
standards, it has power to establish uniform standards to preserve curricula for the
various courses for nursing personnel .the curricula are available for ANM, GNM, BSC,
MSC, MPHIL, Diploma in public health and various short term courses. The syllabi of a
particular course contain minimum requirement for the recognition of the programme
.they had laid specification about
a) Teaching staff and their qualifications, additional staff, external lectures, physical
facilities, clinical facilities, hostel facilities.
b) Students-terms and conditionals of admission, health services, vacations and holidays.
c) Training programs:
year wise distribution of weeks, days and hours of training.

total time requirement

minimum fields experience requirement in hours as per subjects to be taught.
records to be maintained for each students.
scheme of examination

2) Implementation of syllabi
3) Inspection of examination centre and school of nursing.

The executive committee appoints inspectors from among members of the council or
otherwise any institution recognized as a training institution. Inspectors report o the
executive committee on the suitability of the inspection for the purpose of training and
adequacy of training.
4) Maintenance of Indian nurses registers.
The inc maintains the registers of nurses, midwives, gnms and health visitors. It is the
duty of secretary of the council to keep the registers in accordance with the provisional
of
this act and from time to time revise the register.
5) Withdrawal of recognition for departing nursing institution
THE STUDENT NURSES ASSOCIATION (SNA)
The Student Nurses Association was organized in 1920, is associated with and under
jurisdiction of the TNAI. In addition to providing a means of personal and professional
development for the nursing student. The assistant secretary of the TNAI serves as
advisor for the SNA.
PURPOSES AND FUNCTIONS:
1. Help student Nurses learn how the professional organization serves to uphold the
dignity and ideals of the nursing profession.
2. Promote a close rapport with other student Nurses.

3. Furnish student Nurses advice in their courses of study leading up to professional

qualifications.
4. Encourages leadership ability and help students to gain a wide knowledge of the
nursing profession in all of its different branches.
5. Encourage both professional and recreational meetings, Games and Sports.
6. Encourage students nurses develop a co-operative spirit with other student nurses
which will help them in future professional relationships.

ACTIVITIES:
1. Fund raising for the TNAI.
2. Fund raising done for fine arts and sports competitions and conferences.
3. Special prizes given for outstanding achievement in specific areas of nursing
education.
4. Unit activities include maintaining the diary of unit activities, giving quarterly reports,
preparing articles for publication and distributing application forms for membership in
the TNAI.
MEMBERSHIP:
Fees are minimal and easily met by the nursing student. Nursing students who
participate in the Student nurses association have a valuable opportunity to begin to
develop leadership skills, competitive skills and an interest for the profession as a whole.
THE NURSES LEAGUE OF THE CLINICAL MEDICAL ASSOCIATION
The Nurses league of the clinical medical association of India was founded in 1930. It
became affiliated to the TNAI in 1936 and promotes membership in this organization.
Objectives:
Promote cooperation and encouragement among Christian Nurses.
Promote efficiency in nursing education and service.

 Secure the highest standards possible in Christian nursing education through the
Christian schools of nursing.
Considering the special work and problems of Christian nurses wherever employed.
Activities:
Activities include national and area conferences and retreats for its members.
Development of leadership abilities is encouraged by participation in these meetings.
Each meeting also allows for sharing of problems common to the Christian nurse.
Provides expert professional advice.
Provides scholarships for advanced study.
Provides financial assistance for professional meetings and seminars

Membership:
Membership fees are required and a life membership is available. Nursing students may
become associate members of the league. Membership in the Nurses league may be a
requirement for certain nursing positions under control of Christian employing
authorities.
The Christian Medical Association of India
The CMAI began in 1905 as a fellowship of Christian missionary doctors to provide
spiritual sharing and support. It gradually developed into a larger organisation which
included other Christian health professionals and health institutions
Functions
To provide professional training through formal and informal education, publication
of textbooks and other materials and scholarships.
To encourage community health work through training, advisory services and
technical support.
To assist and support churches and health institutions with study and training.

 To disperse health related information which will help with health education and lean
towards a more healthy and just society. Membership
Membership is open to doctors, registered nurses and ANM/Health workers, all health
professionals. Students in health professional courses may also become members

UNION:
Nurse as an employee in any health care institution or hospital has right to become
a member of any union or association for many reasons i.e. collective bargaining for
protecting their interest, condition and improvement. Employees essentially join a union
or association to increase their power to get certain response from management. Poor
quality of working condition, job inequalities in wage increments, promotions and
benefits cause distress. Poor quality of immediate supervision, arbitrary treatment from
management and poor communication between employer and employee are major
reason for unionization. Instead of quitting their jobs and giving up their seniority,
security and friends to move to another job, they form a union.
A trade union is a complex institution. It has many facets economic, social, political
and psychological. However, one of the most important characteristics of all trade union
is the adaptability to change with the change in the environment. Trade unions are
formed to protect, maintain and improve economic, social and vocational interest of their
members and to strengthen their bargaining power.
Dale yoder has defined trade union as a continuing, long term association of employees,
formed and maintained for specific purpose of advancing and protecting the interest of
members in their working relationship. GLHCole defined a trade union as an association
of workers in one of more professions an association carried on mainly for the purpose
of protecting and advancing their members economic interest in connection with their
daily work.

Following are the basic characteristics of trade union.

1. Trade unions are association of either employers or employees or independent
workers.
2. Trade unions are generally permanent combinations.
3. Trade unions basic objectives are to protect and advance economic, social and
vocational interest of their members.

4. Trade unions are ready to meet the challenges from the changes in technology and in
environment

A trade union is a continuous association of the wage earners for the purpose of
maintaining or improving their conditions of their working it can be regarded as an
institution for overcoming managerial dictatorship to strengthen individual worker and
to provide them opportunity for regulation of condition under which they have to work.
Trade union is first and foremost an organizing center. It provides a forearm of
collecting the forces of working class. The trade unions are more highly developed than
even before; they undertake a wider range of function and they have a clear perception
of their ultimate aim. Trade unions are considered as an essential tool for industrial use.
Trade unions of today are not only involved with protecting and improving wages and
conditions of labour but are concerned with all matters by which the workers are likely
to be affected.
FUNCTIONS OF TRADE UNIONS:
Trade unions today are pluralist in character and cannot survive the demands made upon
by the fast changing environment. The different functions of trade unions are
1. Intra mural
2. Extra mural
3. Political

Intra mural functions:

Intra mural functions include the welfare schemes of unions. It includes improvement of
activities like wages, sanitation, safety, seniority, rest interval and so on. All these
functions of unions are termed as Militant functions as reliance to perform them is
placed on the strike and other economic weapon in case of collective bargaining fails.
Extra mural functions:

These are the functions of the unions which are carried on to help the members in times
of need and also include provision of educational, recreational and housing facilities by
the unions. The unions raise funds in the form of subscriptions from their members to
grant number of benefit to the members. Such functions are also of importance as they
inculcate the spirit of cooperation among the members who are to subscribe funds for the
common interest.
Political functions:
The history of trade unionism in this country records profound effects of political leaders
like Thilak and Gandhiji. The political colour given to the unions is to strive for
realization of its economic objectives through legislative and administrative measures.
The unions are authorized to have a fund for political purpose which imply incurring of
expenditure on election of representatives and also for holding meetings.Beside the
primary functions discussed earlier, trade unions in India are committed to undertake
under mentioned function.
1. To acquire the control of industry by workers.
2. To provide workers self confidence and feeling of identity in the organization.
3. To make up welfare measures for improving moral of the workers.
4. To imbibe sincerity and discipline in workers.
5. To broaden the understanding of workers and facilitate technological advancements.
6. To secure fare wages for workers.

COLLECTIVE BARGAINING:
Definition
Collective bargaining is a mode of fixing the terms of employment by means of
bargaining between an organized body of employees or an employer or an association of
employees usually acing through duly authorized agents. It is fundamentally a method of
joint regulation as it necessarily involves both the parties directly. The essence of
collective bargaining is a bargaining between interested parties and the readiness of both
the parties to regulate industrial relation. Collective bargaining aims a reaching some
settlement. Collective bargaining has been defined in encyclopedia of social science as a
process of discussion and negotiations between two parties, one or both of whom is a
group of persons acting in concert. More specifically it is the procedure by which an
employer and a group of employees agree upon a condition of work.
Characteristics of collective bargaining.
Collective bargaining has been characterized as a form of industrial democracy and
industrial government. The management and the union representatives sit down at the
bargaining table where they deliberately, persuade, try to influence, argue and reach an
agreement which they regard in the form of contract. Generally speaking the union and
the management must learn to live with one another whether they like it or not. They
must accommodate each other under the labor law of the land. Once bargaining
relationship have been commenced both sides must be honestly seek an agreement.
Prerequisites of collective bargaining
i) Freedom of associations and independence of unions.
ii) Stability of organizations of workers and employers.
iii) Favorable political climate the Government should not only be sympathetic but
also encourage collective bargaining and agreements.

iv) Mutual trust and respect and also willingness on the part of the parties concerned to
settle all matters by collective bargaining or negotiations.
v) Bargaining power of each party depends on the (a) strength of its organization (b)
knowledge and skill of negotiation of its representatives (c) trade recession, or boom and
shortages and (d) surplus of labour, particularly in regard to semi-skilled and unskilled
workers.
vi) There should be absence of any external pressure either on the employer or on the
worker to come to the king of agreement desired by the authority exerting the pressure.
vii) There should be an existence of a progressive and strong management conscious of
its responsibility and its obligation to the industry, the employee, the consumers and the
country.
viii) There should be delegation of authority to local managements where there are
several units of a company. Delegation of authority is very essential for collective
bargaining as for successful management in general. the man at the bargaining table
must have wide powers to negotiate the contract and the people at the other side of the
table must aware of it.

The collective bargaining in India has not made that of much headway as in some other
countries because of the following factors,
1) Absence of enlightened management .a few managements or employers are still
allergic to trade unions.
2) Weakness of trade unions due to their multiplicity, intra and inter union rivalries, poor
financial conditions, lack of leadership.
3) Easy availability of govt.interventions for conciliation and compulsory adjucation of
disputes.
4) Surplus manpower

5) Restricted rights of workers and employers tostrike and lock out.

6) Different political affiliation of union and consequent political rivalry make difficult
to settle the disputes amicably by mutual negotiations
7) Lack of mutual trust, respect and sprit of give and take
8) Unfavorable political and economic climate since the government through want to
encourage collective bargaining is not prepared to allow endless trails of strength for
fear of planned economy of the country long disrupted.

Nature of collective bargaining.

Collective bargaining has existed in united state since the early 1800s.however, it didnt
develop to its resent form until recently. In the early days the general practice was that
either employer or unions, depending upon their relative economic strengths, would
notify the other party of wage rates and other conditions of employment which is
indented to put into effects. there as very little negotiations and discussion between the
parties. if one party refused to accept the terms imposed by the other, then either a strike
or lockout as ensured. The bargaining is collective in the sense that the chosen
representative of employees in carrying out negotiations and dealing with management.
The process may also be considered collective in the cases of the corporation where paid
professional manager represents the interest of the stock holders and the board of
directors in the bargaining with the union leaders. On the employer side it is also
collective on those common situations where companies have joined together as an
employer association for the purpose of bargaining with a union.
Subject matter of collective bargaining:
1) Union recognition and scope of bargaining unit.
2) Managements rights.
3) Union security.

4) Strikes and lock outs.

5) Union activities and responsibilities
6) Wages
7) Working hours and conditions
8) Discipline, suspension and discharge
9) Grievance handling and arbitration.
10) Health and safety
11) Insurance and benefit programs

Objective and scope of collective bargaining:

The objective of collective bargaining is a labor-management agreement.colective
bargaining is generally referred to as a contract. In early days, agreements were merely
list of wages to be paid to the various occupational groups covered. Today, there are
tremendous variations in labor management agreements. The negotiations of wages are a
very complicated matter. Different arguments are put forward .the criteria put forward
by unions used in wage negotiations are,
i) Changes in the cost of living
ii) Wage uniformity
iii) Changes in productivity
iv) The ability of employer to pay.

Several of the criteria used by the unions in seeking wage increases are also used by
managements in resisting such demands. It is often argued by managements that
increases in productivity are not the result of greater labor effects but stem of improve
products and production process. If these s gains are sustained, managements feels that

sizable part of the earnings need to be ploughed back into new equipments.
Managements in most cases is willing to concede that workers should have a share in
gains resulting from productivity .but the issue is the proportion that should go to
workers of a particular company. It is frequently claimed by management that if higher
wages are granted that increase cost will lead to drop in employment. While union press
for wage uniformity, management greatly objects to this criterion serve as a code
defining the rights and obligations of ach party in their employment relations with one
another.
Factors of success of collective bargaining
Lester and sister outline factors which determine the success of collective bargaining.
They have been grouped into
i) Economic environment factors
ii) Psychological factors and structure of power relation
iii) Nature and characters of the product market.
iv) Nature of labor market
v) Capital requirement and cost conditions
vi) Types of industrial relationship.
Nurse manager role in collective bargaining:
Nurse Manager should evaluate their management skills and take continuing education
course to improve them. Motivational techniques are particularly important for nurse
administrator to possess because they work through others. They must listen carefully to
staff concerns abd represent staff associations wishes to top management .nurse
administrators need to know about labor relations.
The director of nursing should not serve as the chief negotiator during collective
bargaining because it would put the director in an advisory role. The agency legal
representative is usually the negotiator. During negotiations, the director of nursing

defines what is best for the nursing care of patients. Once the contract has been
negotiated, nurse managers must learn the terms of the contract and have copies of the
contract available to them. problems should be solved through problem solving
techniques as they arise.
Steps In Collective Bargaining
Assemble a group of nurses who support collective bargaining.
Arrange a meeting with a representative of the state nurses association.
Assess the feasibility of an organizing campaign.
Conduct necessary research to develop a plan of action.
Establish an organizing committee and subcommittees.
Begin the process of obtaining union authorization cards.
Schedule an informal meeting for nurses eligible for the collective bargaining
unit.
Keep the lines of communication open with nurses.
Seek voluntary recognition from the employer.
Move toward formal organization of the unit.
Seek certification by the National Labor Relations Board as the exclusive
bargaining agent of the unit.
Initiate contract negotiations
Nurse Managers Role In Collective Bargaining
Unions may increase the cost for the hospital and limit the authority of its
managers.
Know the law, and make sure rights of the nurses as well as management are
clearly understood.
Act clearly within the law, no matter what the organization delegates to you as
manager.
Find out the reasons the nurses want collective action.
Discuss and deal with the nurses and the problems directly and effectively.

 Distribute lists of disadvantages of unionization, such as paying dues.

Distribute examples of unions that did not help with patient care issues.
Nurses / Employees Role In Collective Bargaining
Know your legal rights and the rights of the manager.
Act clearly within the law at all times.
If a manager acts unlawfully, e.g., by firing an employee for organizing, report the
employers actions to the National Labor Relations Board.
Keep all nurses informed through regular meetings held close to the hospital.
Set meeting times conveniently around shift changes and assist with child care
during meetings.

HEALTH CARE LABOUR AND RELATED LAWS IN INDIA

Healthcare in india features a universal healthcare system run by the constituent states
and territories. Law is an obligation on the part of the society imposed by the component
authority and non-complience may lead to punishment in the form of monetory fine or
imprisonment or both. Laws governing the commissioning of the hospital are the laws to
ensure that the hospital facilities are created after due process of registration, the
facilities created are safe for the public using them.
LAWS GOVERNING THE SALE, STORAGE OF DRUGS AND SAFE
MEDICATION:
Blood bank regulation under drugs and cosmetic (2nd amendment) Rules 1999
Drugs and cosmetic act 1940
Excise permit to store spirit, central exercise act 1944
IPC
o section 274 adulteration of drugs
o Section 276 sale of adultred drug
o Section 284 negligent conduct with regard to poisonous substances
Narcotic and Psychotropic substance act
Pharmacy act 1948
Sales act 1948
Sales of good act 1930
The drug and cosmetic rule 1950
VAT act 1956
LAWS GOVERNING ENVIRONMENTAL SAFETY
Air pollution act 1981
Biomedical waste management handling rules 1998
Environment protection act and rule 1986, 1996

 NOC from pollution control board

Public health bye law 1959
Water act 1974
The cigarettes and other tobacco products bill 2003
Prohibition of smoking in public places rules 2008
IPC
o Section 278 making atmosphere noxious to health
o Section 269 negligent/ unlawful to infectious disease waste
LAWS GOVERNING EMPLOYMENT AND MANAGEMENT OF MANPOWER
Citizenship act 1955
Employee PF and Miscellaneous provision act 1952
Employment exchange act 1959
Equal remuneration act 1976
ESI act 1948
Indian trades union act 1926
Industrial dispute act 1947
Maternity benefits act 1961
Minimum wages act 1948
Negotiable instrument act 1948
Payable bonus act 1956
Payment of gratuity act 1972
Persons with disability act 1995
Public provident fund act 1968

LAWS GOVERNING THE SAFETY OF PATIENT, PUBLIC AND STAFF

WITHIN THE HOSPITAL PREMISES
The radiation surveillance procedures for the medical application of radiation
1989,
Radiation protection rule 1971
Arms act 1950
Boilers act 1923
Explosive act 1884
Gas cylinder rules 2004
Insecticide act 1968
IPC
o 336 endangering life or personal safety of others
o 337 causing hurt by act endangering life or personal safety
NOC from chief fire officer
Periodic fitness certificate for operations of lifts
Petroleum act and storage rules 2001

OCCUPATIONAL HEALTH SAFETY

Occupational safety and health (OSH) also commonly referred to as
occupational health and safety (OHS) or workplace health and safety (WHS) is an
area concerned with the safety, health and welfare of people engaged in work or
employment. The goals of occupational safety and health programs include to foster a
safe and healthy work environment. OSH may also protect co-workers, family members,
employers, customers, and many others who might be affected by the workplace
environment. In the United States the term occupational health and safety is referred to
as occupational health and occupational and non-occupational safety and includes safety
for activities outside work Occupational safety and health can be important for moral,
legal, and financial reasons. In common-law jurisdictions, employers have a common
law duty (reflecting an underlying moral obligation) to take reasonable care for the
safety of their employees Statute law may build upon this to impose additional general
duties, introduce specific duties and create government bodies with powers to regulate
workplace safety issues: details of this will vary from jurisdiction to jurisdiction. Good
OSH practices can also reduce employee injury and illness related costs, including
medical care, sick leave and disability benefit costs.
KEY PRINCIPLES IN OCCUPATIONAL SAFETY AND HEALTH
Occupational safety and health is an extensive multidisciplinary field, invariably
touching on issues related to scientific areas such as medicine including physiology
and toxicology ergonomics, physics and chemistry, as well as technology, economics,
law and other areas specific to various industries and Activities. Despite this variety of
concerns and interests, certain basic principles can be identified, including the following:
All workers have rights. Workers, as well as employers and governments, must ensure
that these rights are protected and must strive to establish and maintain decent working
conditions and a decent working environment.
More specifically:

 work should take place in a safe and healthy working environment;

conditions of work should be consistent with workers well-being and human dignity;
work should offer real possibilities for personal achievement, selffulfilment and
service to society (ILO, 1984).
Occupational safety and health policies must be established. Such policies must be
implemented at both the national (governmental) and enterprise levels. They must be
effectively communicated to all parties concerned.
A national system for occupational safety and health must be established.
Such a system must include all the mechanisms and elements necessary to build and
maintain a preventive safety and health culture. The national system must be maintained,
progressively developed and periodically reviewed.
A national programme on occupational safety and health must be formulated. Once
formulated, it must be implemented, monitored, evaluated and periodically reviewed.
Social partners (that is, employers and workers) and other stakeholders must be
consulted. This should be done during formulation, implementation
and review of all policies, systems and programmes. Occupational safety and health
programmes and policies must aim at both prevention and protection. Efforts must be
focused above all on primary prevention at the workplace level.Workplaces and working
environments should be planned and designed to be safe and healthy.
Continuous improvement of occupational safety and healthmust be promoted.
This is necessary to ensure that national laws, regulations and technical standards to
prevent occupational injuries, diseases and deaths are adapted periodically to social,
technical and scientific progress and other changes in the world of work. It is best done
by the development and implementation of a national policy, national system and
national programme.

 Information is vital for the development and implementation of effective programmes

and policies. The collection and dissemination of accurate information on hazards and
hazardous materials, surveillance of workplaces, monitoring of compliance with policies
and good practice, and other related activities are central to the establishment and
enforcement of effective policies.
Health promotion is a central element of occupational health practice. Efforts must be
made to enhance workers physical, mental and social well-being.
Occupational health services covering all workers should be established. Ideally, all
workers in all categories of economic activity should have access to such services, which
aim to protect and promote workers health and improve working conditions.
Compensation, rehabilitation and curative services must be made available to workers
who suffer occupational injuries, accidents and work related diseases. Action must be
taken to minimize the consequences of occupational hazards.
Education and training are vital components of safe, healthy working environments.
Workers and employers must be made aware of the importance of establishing safe
working procedures and of how to do so. Trainers
must be trained in areas of special relevance to particular industries, that they can
address the specific occupational safety and health concerns.
Workers, employers and competent authorities have certain responsibilities, duties and
obligations. For example, workers must follow established safety procedures; employers
must provide safe workplaces and ensure access to first aid; and the competent
authorities must devise, communicate and periodically review and update occupational
safety and health policies.
Policies must be enforced. A system of inspection must be in place to secure
compliance with occupational safety and health measures and other labour legislation.

CHARATERSTICS OF OCCUPATION HEALTH AND SAFETY

MANAGEMENT
All OHSMS owe something to the legacy of general systems. Systems theory
suggests that there should be four general requirements for an OHSMS, although how
these requirements are met in practice allows for considerable diversity. The four
general requirements are as follows:

System objectives (for OHSMS these may be ethical, economic, legal and
organisational goals; not all systems need have the same objectives).

Specification of system elements and their inter-relationship; not all systems need
have the same elements.
Determining the relationship of the OHSMS to other systems (including the
general management system, and the regulatory system, but also technology and
work organisation).
Requirements for system maintenance (which may be internal, linked to a review
phase, or external, linked for example to industry policies that support OHS best
practice; system maintenance may vary between systems).
ELEMENTS OF AN OHSMS
Organisation, Responsibility, Accountability
Senior manager/involvement
Line manager/supervisor duties
Management accountability and performance measurement
Company OHS policy
Consultative Arrangements
Health and safety representatives - a system resource
Issue resolution - HSR/employee and employer representatives
Joint OHS committees

 Broad employee participation

Specific Program Elements
Health and safety rules and procedures
Training program
Workplace inspections
Incident reporting and investigation
Statement of principles for hazard prevention and control
Data collection and analysis/record keeping
OHS promotion and information provision
Purchasing and design
Emergency procedures
Medical and first aid
Monitoring and evaluation
Dealing with specific hazards and work organisation issues

APPROACHES TO OCCUPATIONAL HEALTH SAFETY

There are four steps in the application of occupational health safety in a
management system. They are:
Step 1:
Commitment to a Safe Workplace (framing a policy based on consultation).
Step 2:
Recognising and Removing Dangers (using a danger identification list).
Step 3:
Maintaining a Safe Workplace (including safety checks, maintenance, reporting
dangers, information and training, supervision, accident investigation, and emergency
planning).

Step 4:
Safety Records and Information (including records and standards required to be
kept by law).

ROLE OF NURSE MANAGER IN OCCUPATIONAL HEALH SAETY AND

MANAGEMENT SYSTEM:
It is not possible to describe a highly complex and dynamic process such as
occupational health nursing simply in terms of core activities or tasks. Occupational
health nurses are constantly learning new skills, adapting current practices to meet new
needs and developing new approaches to solving problems and therefore their practice is
not static but is constantly improving based upon a core range of skills . However,
within this limitation it is possible to describe those core areas of knowledge and
competence that occupational health nurses use. The following list is not intended to be
exhaustive, but rather to give an indication of the wide range of competencies that
occupational health nurses demonstrate in practice.
Clinician
Primary prevention
The occupational health nurse is skilled in primary prevention of injury or disease.
The nurse may identify the need for, assess and plan interventions to, for example
modify working environments, systems of work or change working practices in order to
reduce the risk of hazardous exposure. Occupational 30 health nurses are skilled in
considering factors, such as human behaviour and habits in relation to actual working
practices. The nurse can also collaborate in the identification, conception and correction
of work factors, choice of individual protective equipment, prevention of industrial
injuries and diseases, as well as providing advice in matters concerning protection of the
environment. Because of the occupational health nurses close association with the
workers, and knowledge and experience in the working environment, they are in a good

position to identify early changes in working practices, identify workers concerns over
health and safety, and by presenting these to management in an independent objective
manner can be the catalyst for changes in the workplace that lead to primary prevention.
Emergency care
The occupational health nurse is a Registered Nurse with a great deal of clinical
experience and expertise in dealing with sick or injured people. The nurse may, where
such duties form part of their job, provide initial emergency care of workers injured at
work prior to transfer of the injured worker to hospital or the arrival of the emergency
services. In many instances, where hazardous conditions exist at work, or where the
workplace is far removed from other health care facilities, this role will form a major
part of an occupational health nurses job. Occupational health nurses employed in
mines, on oil rigs, in the desert regions or in areas where the health care systems are not
yet fully developed will be familiar with a wide range of emergency care techniques and
may have developed additional skills in order to fulfil this role. For others, who are
working in situations where the emergency services are on hand, they may simply
provide an additional level of support beyond that provided by the industrial first aider.
Treatment services
In some countries occupational health services provide curative and treatment
services to the working population, in other countries such activities are restricted.
Where treatment services are provided the occupational health nurse will be involved in
delivering and monitoring these services, often in close contact with other primary care
providers, such as the family doctor or general practitioner, or company physician, who
is responsible for prescribing the particular course of treatment.
Nursing diagnosis
Occupational health nurses are skilled in assessing clients health care needs,
establish a nursing diagnosis and formulating appropriate nursing care plans, in

conjunction with the patient or client groups, to meet those needs. Nurses can then
implement and evaluate nursing interventions designed to achieve the care objectives.
The nurse has a prominent role in assessing the needs of individuals and groups, and has
the ability to analyse, interpret, plan and implement strategies to achieve specific goals.
By using the nursing process the nurse contributes to workplace health management and
by so doing helps to improve the health of the working population at the enterprise level.
Nursing diagnosis is a holistic concept that does not focus solely on the treatment of a
specific disease, but rather considers the whole person and their health care needs in the
broadest context. It is a health based model rather than a disease based model and nurses
have the skills to apply this approach with the working populations they serve.
Individual and group care plan
The nurse can act on the individual, group, enterprise or community level. Where
an individual health care plan is designed to meet specific objectives the occupational
health nurse will, where appropriate and with the patients informed consent, liase with
their primary health care provided in order to ensure a comprehensive approach is
maintained.
General Health advice and health assessment
The occupational health nurse will be able to give advice on a wide range of
health issues, and particularly on their relationship to working ability, health and safety
at work or where modifications to the job or working environment can be made to take
account of the changing health status of employees. In many respects employers are not
solely concerned with only those conditions that are directly caused by work, but do
want their occupational health staff to help address any health related problems that may
arise that might influence the employees attendance or performance at work, and many
employees appreciate this level of help being provided to them at the workplace because
it is so convenient for them. In particular the development of health care services to men

at work, younger populations and those from ethnic groups can be most effective in
reaching these sometimes difficult to reach populations.
Research and the use of evidence based practice
In addition to utilising information and knowledge produced by research in
various fields to support activities that relate to the occupational health component of
their role, occupational health nurses will also utilise fully research information available
from many fields to help support the general health of the working population.

Specialist
Occupational health policy, and practice development, implementation and
evaluation
The specialist occupational health nurse may be involved, with senior
management in the enterprise, in developing the workplace health policy and strategy
including aspects of occupational health, workplace health promotion and environmental
health management. The OH nurse is in a good position to advise management on the
implementation, monitoring and evaluation of workplace health management strategies
and to participate fully in each of these stages. Possibility to perform that role will
depend upon level of nurse education, skills and experience.
Occupational health assessment
Occupational health nurses can play an essential role in health assessment for
fitness to work, pre employment or pre placement examinations, periodic health
examinations and individual health assessments for lifestyle risk factors. Collaboration
with occupational physician may be necessary in many instances, depending upon
exiting legislation and accepted practice. The nurse can also play an important role in the
workplace where informal requests for information, advice on health care matters and

health related problems come to light. The nurse is able to observe the individual or
group of workers in relation to exposure to a particular hazard and initiate appropriate
targeted health assessment where necessary. These activities are often, but not
exclusively, undertaken in conjunction with the medical adviser so that where problems
are identified a safe system for onward referral exists.
Health surveillance
Where workers are exposed to a degree of residual risk of exposure and health
surveillance is required by law the occupational health nurse will be involved in
undertaking routine health surveillance procedures, periodic health assessment and in
evaluating the results from such screening processes. The nurse will need a high degree
of clinical skill when undertaking health surveillance and maintain a high degree of
alertness to any abnormal findings. Early referral to an occupational health physician or
other appropriate specialist will be the responsibility of the occupational health nurse
where any abnormality is detected. The nurse will be involved in supporting the worker
throughout any further examination or investigation, and may help to monitor their
health on return to work. Once alerted to the possibility of an adverse health effect
occurring the occupational health nurse is in a good position to co-ordinate efforts to reevaluate working practices in order to help protect others who may be similarly affected.
Sickness absence management
Occupational health nurses can contribute by helping managers to manage
sickness absence more effectively. The nurse may be involved in helping to train line
managers and supervisors in how to best use the occupational health service, in how to
refer staff, what type of information will be required, what to expect from occupational
health. By developing transparent referral procedures, ensuring that medical
confidentiality is maintained and that the workers rights are respected the occupational
health nurse can do much to ensure that employees referred for assessment due to
sickness absence are comfortable with the process. Occupational health nurses, with

their close relationship with workers, knowledge of the working environment and trends
in ill health in the company are often in a good position to advise management on
preventing sickness absence.
Rehabilitation
Planned rehabilitation strategies, can help to ensure safe return to work for
employees who have been absent from work due to ill health or injury. The occupational
health nurse is often the key person in the rehabilitation programme who will, with the
manager and individual employee, complete a risk assessment, devise the rehabilitation
programme, monitor progress and communicate with the individual, the occupational
health physician and the line manager. Occupational health nurses have also become
involved in introducing proactive rehabilitation strategies that aim to detect early
changes in health before such conditions result in absence from work. Improving and
sustaining working ability benefits many groups, the individual, the organization and
society, as costly absence and other health care costs are avoided. In many cases the
occupational health nurse has to work within the organization as the clients advocate in
order to ensure that managers appreciate fully the value of improving the health of the
workforce. Occupational health nurses have the skills necessary to undertake this work
and may develop areas of special interest.
Maintenance of work ability
The occupational health nurse may develop pro-active strategies to help the
workforce maintain or restore their work ability. New workers, older workers, women
returning to work following pregnancy or workers who have been unemployed for a
prolonged period of time may all benefit from health advice or a planned programme of
work hardening exercises to help maintain or restore their work ability even before any
health problems arise. Increasingly the problems faced by industry are of a psychosocial
nature and these can be even more complex and costly to deal with. Occupational health
nurses, working at the enterprise level, are in a good position to advise management on

strategies that can be adopted to improve the psycho-social health and wellbeing of
workers.
Health and safety
The occupational health nurse can have a role to play in developing occupational
health and safety strategies. Where large, or high risk, organizations have their own in
house health and safety specialists the occupational health nurse can work closely with
these specialists to ensure that the nurses expertise in health, risk assessment, health
surveillance and environmental health management is fully utilized into the health and
safety strategy. Occupational health nurses are trained in health and safety legislation,
risk management and the control of workplace health hazards and can therefore make a
useful contribution to the overall management of health and safety at work, with
particular emphasis on health risk assessment.
Hazard identification
The occupational health nurse often has close contact with the workers and is
aware of changes to the working environment. Because of the nurses expertise in health
and in the effects of work on health they are in a good position to be involved in hazard
identification. Hazards may arise due to new processes or working practices or may arise
out of informal changes to existing processes and working practices that the nurse can
readily identify and assess the likely risk from. This activity requires and presupposed
regular and frequent work place visits by the occupational health nurse to maintain an up
to date knowledge and awareness of working processes and practices.
Risk assessment
Legislation in Europe is increasingly being driven by a risk management
approach. Occupational health nurses are trained in risk assessment and risk
management strategies and, depending upon their level of expertise and the level of

complexity involved in the risk assessment, the nurse can undertake risk assessments or
contribute towards the risk assessment working closely with other specialists.
Advice on control strategies
Having been involved in the hazard identification and risk assessment the
occupational health nurse can, within the limits of their education and training, provide
advice and information on appropriate control strategies, including health surveillance,
risk communication, monitoring and on the evaluation of control strategies.
Research and the use of evidence based practice
Occupational health nurses utilise research findings from a wide range of
disciplines, including nursing, toxicology, psychology, environmental health and public
health in their daily practice. The principal requirement for an occupational health nurse
in practice is that they have the skills to read and critically assess research findings from
these different disciplines and to be able to incorporate the findings into evidence based
approach to their practice. Research in nursing is already well established and there is a
small, but growing, body of evidence being created by occupational health nursing
researchers who investigate occupational health nursing practices. Occupational health
nurses should ensure that they have access to and the skills necessary to base their
practice on the best available evidence.
At the enterprise level occupational health nurses may be involved in producing
management reports on for example sickness absence trends, accident statistics,
assessment of health promotion needs and in evaluating the delivery of services, the
effectiveness of occupational health interventions. Research skills and the ability to
transfer knowledge and information from published research to practice is an important
aspect of the role.
Ethics

Occupational health nurses, along with other health, environment and safety
professionals in the workplace health team, are in a privileged position in society. They
have access to personal and medical information relating to employees in the enterprise
that would not be available to any other group. Society has imposed, by law, additional
responsibilities on clinical professionals to protect and safeguard the interest of patients.
The ethical standards for each discipline are set and enforced by each of the professional
bodies. Breaches of these codes of conduct can result in the professional being removed
from the register and prevented for practising.
Nurses have a long and well-respected tradition in society of upholding the trust
placed in them by patients. This level of trust in the occupational health nurses
professional integrity means that employees feel that they can be open, honest and share
information with the nurse in the confidence that the information will not be used for
other purposes. This allows the nurse to practice much more effectively than would ever
be possible if that trust was not there. The protection of personal information enables a
trusted relationship between employees and the nurse to be developed and facilitates
optimum working relationships and partnership.
Manager
Management
In some cases the occupational health nurse may act as the manager of the
multidisciplinary occupational health team, directing and co-ordinating the work of other
occupational health professionals. The OH nurse manager may have management
responsibility for the whole of the occupational health team, or the nursing staff or
management responsibility for specific programmes. The nurse manager may be the
budget holder for the department and would have the skills necessary to sit alongside
other line managers within the organization and contribute to organizational
development

Administration
The occupational health nurse can have a role in administration. Maintaining
medical and nursing records, monitoring expenditure, staffing levels and skill mix within
the department, and may have responsibility for managing staff involved in
administration
Budget planning
Where the senior occupational health nurse is the budget holder for the
occupational health department they will be involved in securing resources and
managing the financial assets of the department. The budget holder will also be
responsible for monitoring and reporting within the organization on the use of resources.
Marketing
Where the occupational health service is managed on an internal market system or
undertakes commercial work the occupational health nurse will be involved in marketing
services to customers. Even where no direct financial market exists the customers or
users of an occupational health service will need information and advice on the best use
of services to meet their needs often within financial constraints. The occupational
health nurse is well placed to discuss customers needs and expectations.
Service level agreements
Service level agreements are increasingly used in decentralized organizations inorder to ensure that both the user and provider of services has a clear agreement about
the provision of services. The occupational health nurse may be involved in setting the
service level agreements with internal or external customers and in monitoring the
delivery of services against pre determined service level agreements

Quality assurance
As part of the delivery of a modern comprehensive occupational health service
systems for quality assurance and quality improvement are essential. The occupational
health nurse may be involved in quality assurance, audit and quality improvement
initiatives, both for the delivery of services and for improving the professional standards
within the department. Modern nursing practice is based on a philosophy of quality
assurance and continuous quality improvement and therefore nurses can contribute to
this development.
Professional audit
Audit and continuous quality improvement is an essential component of
professional practice. The occupational health nurse will be involved in auditing the
nursing practices within the department or in the wider clinical audit where all of the
clinical team participate in multidisciplinary audit.
Continuing Professional development
The scope of professional practice in occupational health nursing is constantly
developing. New information, new research, changes in legislation, improved practices,
technology are all areas of constant growth. The occupational health nurse has an
obligation to constantly update their knowledge and skills in order to maintain
competence, deliver high quality services and meet the needs of the enterprises they
serve. Within the profession a commitment to life long learning is expected in order to
protect the clients safety; ensure the delivery of high quality nursing services and to
maintain the appropriate level of competence for clinical practice. The nurse manager
will be well placed to identify their own and their staffs continuing professional
development needs and to ensure that these are met in order to maintain the
competencies of staff employed.

Co-ordinator
Occupational health team
The occupational health nurse, acting as a coordinator, can draw together all of the
professionals involved in the occupational health team. In many instances the nurse will
be the only member of the team who is permanently employed by the enterprise or
present on a particular site. Therefore they have a unique position and have access to
valuable information that can be used to help shape and direct the occupational health
program. In this role the nurse would exercise skills in communication, planning,
involvement, management and in organizing the professional team.
Worker education and training
The occupational health nurse has a role in worker education. This may be within
existing training programmes or those programmes that are developed specifically by
occupational health nurses to, for example, inform, educate and train workers in how to
protect themselves from occupational hazards, non-occupational but workplace
preventable diseases or to raise awareness of the importance of good environmental
health management practices.
Environmental health management
The occupational health nurse, particularly in those organizations, such as SMEs,
who may not have a designated environmental health manager, can advise the enterprise
on simple measures to reduce the use of natural resources, minimise the production of
waste, promote re-cycling and ensure that environmental health management is placed
on every organizations agenda. The occupational health nurse can also identify
appropriate specialists in their locations to advise or deal with environmental health
management. The occupational health nurse may contribute by taking these issues
forward in the absence of other specialists.

Adviser
To management and staff on issues related to workplace health management
Occupational health nurses involved in workplace health management can
sometimes be asked to act as advisers to management and staff on the development of
workplace health policies and practices, and can fulfil an advisory role by participating
in, for example, health and safety committee meetings, health promotion meetings, and
may be called upon to provide independent advice to managers or workers who have
specific concerns over health related risks.
agencies
Occupational health nurses act in an advisory role when seeing individuals who may
have problems that, whilst not directly related to work may affect future work attendance
or performance. The nurse may be involved in advising individuals to seek advice from
their own family doctor or general practitioner, or other external agency that may be
better placed to assist the individual.
Health educator
Workplace Health promotion
Health education as one of the key prerequisites of workplace health promotion is
integral aspect of the occupational health nurses role. In some countries the nurse is
required to support activities aimed at adoption of the of healthy lifestyles within ongoing health promotion process, as well as participate in health and safety activities.
Occupational health nurses can carry out a needs assessment for health promotion within
the enterprise, prioritise activities in consultation with management and workers,
develop and plan appropriate interventions, deliver or co-ordinate the delivery of health
promotion strategies and can play a valuable role in evaluating the delivery and
achievements of the health promotion strategy.

Counsellor
In the small or medium sized enterprise the occupational health nurse may be the
only health care professional present most of the time and they can assist people working
there in dealing with mental health and work-related stress. For many people the
occupational health nurse, working at the enterprise level, may be the first point of
contact with health care providers and these nurses can do much to ensure that
individuals are referred to the appropriate agency.
Counselling and reflective listening skills
Where the nurse has been trained in using counselling or reflective listening skills
they may utilise these skills in delivering care to individuals or groups. As part of this
approach there should be opportunities for the nurse to receive ongoing supervision and
support and to have access to additional professional services to which particularly
difficult cases can be referred or where additional expertise is needed in order to help the
individual or group.
Problem solving skills
Due to the close working relationship which occupational health nurses have with
the working population, and because of the nurses position of trust, occupational health
nurses are often approached for advice on personal problems. The nurse can use
listening techniques and problem solving skills developed through nurse education and
training to meet this need. The nurse can act as a useful resource for the organization and
where necessary refer individuals on to the appropriate, skilled agencies to help them
with their personal problems. This may be a clinical specialist such as physicians or
psychologists, or to counsellors, employee assistance programmes etc.

Researcher
Health needs assessment
A specialist occupational health nurse will need to be well skilled in undertaking a
nurse-based health needs assessment at both the individual and the organizational level.
This type of assessment can be used as the basis for individual case management or
occupational health program planning. Occupational health nurses may use research
based skills in carrying out the assessment, in handling the data generated in the
assessment and in interpreting the results and advising management acting as a member
of the multidisciplinary team.
Research skills
Nurses are becoming increasingly familiar with both quantitative and qualitative
research methodologies, and can apply these in occupational health nursing practice. In
the main, occupational health nurses working at the enterprise level, are more likely to
use simple survey techniques, or semi-structured interviews, and to use descriptive
statistical techniques in their presentation of the data.
Evidence based practice
Increasingly all health care providers are using an evidence-based approach to
practice that requires the professional to seek the best available information on which to
base their practice. Occupational health nurses are skilled in searching the literature,
reviewing the evidence available, which may be in the form of practice guidelines or
protocols, and applying these guidance documents in a practical situation. Occupational
health nurses should be well skilled in presenting the evidence, identifying gaps in
current knowledge, and allowing others to review critically the implementation of care
plans based on their assessment of the evidence.

Epidemiology
The most widely used and accepted form of investigation into occupational related
ill health and disease is based on large-scale epidemiological studies. Occupational
health nurses are advised to become familiar with the principles and basic methods used
in epidemiology

Concluding remarks
As was indicated at the beginning of this chapter, the complex, highly dynamic
processes used by occupational health nurses to deliver health care interventions to
working populations in diverse organizations can not be described simply in a list of
core competencies, but those described here represent some of the core competencies
and areas of knowledge that occupational health nurses already use in some countries.
An individual nurse, or group of nurses, may not be skilled in all of these areas of
practice equally, but will develop and mould their practice to meet the needs of the
populations they serve. In different countries different health care systems are in
operation and occupational health nurses practicing in those settings will tailor their
efforts to compliment the existing health care systems.

TABLE OF CONTENTS
INTRODUCTION: ............................................................................................................. 1
OBJECTIVES OF ORGANIZATIONS AND UNIONS: .................................................. 2
IMPORTANT ORGANIZATIONS AND UNIONS: ........................................................ 3
Trained Nurses Association of India (TNAI) ................................................................. 3
Indian Nursing Council .................................................................................................. 6
THE STUDENT NURSES ASSOCIATION (SNA) ..................................................... 8
THE NURSES LEAGUE OF THE CLINICAL MEDICAL ASSOCIATION ............. 9
UNION: ............................................................................................................................ 12
COLLECTIVE BARGAINING: ...................................................................................... 15
Definition ...................................................................................................................... 15
Characteristics of collective bargaining. ...................................................................... 15
Prerequisites of collective bargaining .......................................................................... 15
Nature of collective bargaining. ................................................................................... 17
Subject matter of collective bargaining: ....................................................................... 17
Objective and scope of collective bargaining: ............................................................. 18
Factors of success of collective bargaining .................................................................. 19
Nurse manager role in collective bargaining:............................................................... 19
Steps In Collective Bargaining ..................................................................................... 20
Nurse Managers Role In Collective Bargaining ......................................................... 20
Nurses / Employees Role In Collective Bargaining ................................................... 21
HEALTH CARE LABOUR AND RELATED LAWS IN INDIA .................................. 22

LAWS GOVERNING THE SALE, STORAGE OF DRUGS AND SAFE

MEDICATION: ............................................................................................................ 22
LAWS GOVERNING ENVIRONMENTAL SAFETY .............................................. 22
LAWS GOVERNING EMPLOYMENT AND MANAGEMENT OF MANPOWER
...................................................................................................................................... 23
LAWS GOVERNING THE SAFETY OF PATIENT, PUBLIC AND STAFF
WITHIN THE HOSPITAL PREMISES ...................................................................... 24
OCCUPATIONAL HEALTH SAFETY .......................................................................... 25
KEY PRINCIPLES IN OCCUPATIONAL SAFETY AND HEALTH ...................... 25
CHARATERSTICS OF OCCUPATION HEALTH AND SAFETY MANAGEMENT
...................................................................................................................................... 28
ELEMENTS OF AN OHSMS...................................................................................... 28
APPROACHES TO OCCUPATIONAL HEALTH SAFETY .................................... 29
ROLE OF NURSE MANAGER IN OCCUPATIONAL HEALH SAETY AND
MANAGEMENT SYSTEM: ........................................................................................... 30
Clinician........................................................................................................................ 30
Specialist ....................................................................................................................... 33
Manager ........................................................................................................................ 38
Co-ordinator.................................................................................................................. 41
Adviser.......................................................................................................................... 42
Health educator ............................................................................................................. 42
Researcher..................................................................................................................... 44

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NET-REFERENCE
www.academia.edu/4782167/Motivation_of_health_care_workers_review_of_the
ories_and_empirical_practice motivation in health care management
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105554/
http://www.managementstudyguide.com/motivation-in-human-resourcedevelopment.htm
http://www.accel-team.com/human_resources/hrm_03.html
http://humanresources.about.com/od/glossarye/g/delegation.htm

Mother Theresa Post Graduate And Research

Institute Of Health Sciences
(Govt. of Puducherry institution)
Indira nagar, Gorimedu, Puducherry 605006

DIRECTING
CHAPTER -VI

Collective Bargaining, Unions, Professional

Associations, Health Care Labour Laws
Occupation Health and Safety
SUBBMITTED BY

SUBBMITTED TO

Mr. Mohammed Rafi M

Prof. Dr. Rukumani J

II-year, M.Sc Nursing

Principal cum HOD

Dept. Of CHN

Dept. Of CHN

MTPG&RIHS

MTPG&RIHS