Oman’s nursing profession comes of age

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ursing is widely recognised as a noble profession that combines medical expertise with a sense of compassion in the service of patients. Indeed, the nursing profession has often been rated as second to none in recent international surveys conducted by leading polling agencies, such as Gallup. The findings of these polls also bear out the longstanding public view that nurses have the highest standards of honesty and ethics of any profession, despite the often stressful, physically demanding environment in which they work.

Oman’s thriving community of nursing professionals is equally deserving of these rich accolades. Its rapid growth in recent years, from a fledging group in the early years of Oman’s blessed renaissance, to a roughly 9,000-strong community today is a testament to the enthusiasm and personal commitment of nurses to their profession.

The Nursing and Midwifery Service in the Sultanate has come a long way since 1970, when the profession received a boost in conjunction with efforts by the Government of Oman to develop healthcare services around the country. This is not to suggest that nursing and midwifery were alien to Omani society prior to this era. In fact, in many rural communities, traditional healers and birth attendants continue to play a role – in much the same way they did for the past several centuries. These skills were passed down from one generation to the next, and still persist today in some tradition-bound communities in Oman.

Modern-style nursing was first introduced in the 1950s by a group of American nurses who were attached to the American Missionary Association in Muscat. There were only two hospitals in Oman providing rudimentary healthcare services during this period. These were Al Rahma Hospital in Muttrah and Muscat Hospital. The Al Rahma Hospital also doubled as a training centre for nurses. The first batch of six women and ten men received basic nursing skills at the hands of hospital’s American staff in the mid-1950s.

Then, in 1970, the Al Rahma School of Nursing was established in Muttrah by the American Missionary Association. An initial batch of five male nurses graduated in 1972 after completing a two-year on-the-job training programme. This facility was taken over by the Ministry of Health in 1972 and the first batch of 14 nurse students under MoH management were registered in August 1973. The number of recruited students grew and the length of the nursing programme was increased to three years. Graduating nurses received a Certificate in Nursing.

The nursing profession received a shot in the arm in the 1970s when the healthcare sector grew in tandem with the government’s drive to provide modern medical services to the people of Oman. The Directorate of Nursing Affairs was established at the Ministry of Health. Ms. Sally Sedgwick, a British nursing professional, took charge as the first Director of Nursing. Nursing services, up until 1979, were organised around two key elements: preventive services and curative services.

But, as with most occupations during the early years of Oman’s modernisation, the nursing profession too was dominated by foreign trained nurses drawn mainly from the Indian subcontinent. In the 1980s, the Ministry of Health began recruiting nurses from other countries, like the Philippines, Sri Lanka and so on. The Armed Forces and Royal Oman Police nursing services did likewise.

In the 1980s, however, a vigorous effort was launched to encourage Omanis to join the profession. In 1982, Ms. Asiya Ali Said Kharusi became the first Omani to be appointed Director of Nursing at the Ministry of Health headquarters. At the same time, young Omani nurses were awarded scholarships to go to Britain to gain experience and specialise in different fields of nursing. Other health care providers, notably the Diwan of the Royal Court, the Royal Guard, Sultan Qaboos University Hospital and the private sector continued to gradually increase the number of Omani nurses within their respective workforces.

A major milestone in nursing education was achieved in 1982 when the Institute of Health Sciences was set up at Wattayah. This multi-disciplinary institution, catering exclusively to young Omani men and women, also provided training in other disciplines such as Laboratory Science, X-ray, and physiotherapy.

With the demand for nursing growing at a brisk pace, the Ministry of Health introduced an Assistant Nursing Programme during 1982-1988. A total of 156 students (102 females and 54 males) completed this programme, with the last batch graduating in 1990.

During the last decade, the nursing and midwifery sector underwent a series of far-reaching improvements that helped underpin the creation of a professional, competent and forward-looking cadre of nursing staff. The Directorate of Nursing was restructured to include regional Heads of Nursing in the eight regions of the country. In 1994, a section for Registration & Licensing was added, while Oman was co-opted as a member of the Arab Gulf Cooperation Countries’ Nursing & Midwifery Technical Committee.

The new millennium ushered in further pivotal developments. A Professional Code of Conduct for practising nurses and midwives was introduced nationally in 2000.

Side by side, the Ministry’s training infrastructure grew by leaps and bounds. Starting with the establishment of five nursing institutes in Salalah, Nizwa, Ibri, Sohar and Sur in 1991, new institutes were progressively opened in Rustaq and Ibra, and later in North Batinah, Dhahirah and Dakhiliya regions. The Department of Nursing Studies was carved out from the Institute of Health Sciences in 1994 to become the Muscat Nursing Institute, and in 2000, Oman Nursing Institute opened its doors to receive the first cohort of students. This elaborate network has grown to a total of 12 nursing institutes in the country, which enrol around 500 candidates annually. Graduates are awarded a Diploma in Nursing.

In 2001, the Oman Nursing and Midwifery Council was established by Ministerial Decree (67/2001). Its main aim is to promote professionalism in the service by enforcing the professional code of conduct for nurses, as well as develop high standards in education and nursing practice. The Council is made up of one member each from Sultan Qaboos University, Armed Forces Medical Services, Royal Oman Police, and Diwan Medical Services, as well as three members from the Ministry of Health’s Nursing Service and two from Nursing Education. It plays a key role in promoting competency among Omani nurses through its requirements for licence renewal. Nurses are also required to attend continuing education to maintain competency in practice.

These initiatives have ensured that earlier batches of Omanis who joined the nursing profession without the currently prescribed educational requisites, were able to successfully garner the desired professional skills. Many of them have since advanced up the career ladder to take up key managerial postings within the service.

Crowning these developments was the opening of the Oman Nursing Specialty Institute, also in 2001. The institute provides post-basic training in Neonatal/Paediatric ICU, Nephrology, Nursing Administration and Midwifery, while further specialty programmes in Community Nursing, Mental Health and Critical Adult Care are planned. The present intake capacity is over 100 candidates. Graduates are awarded a post-basic diploma in a respective specialty.

In order to meet the staffing needs of various referral and tertiary institutions, the Directorate of Nursing runs on-the-job training programmes in collaboration with different institutions in the country. These programme cover training in different specialisations, such as Operating Theatre, Accident & Emergency, and so on.

Sultan Qaboos University joined the nursing education effort in 2002 by offering a baccalaureate programme. Masters and PhD programmes in Nursing are also envisaged at SQU in the future.

This comprehensive training infrastructure has led to the creation of a sizeable nursing workforce now approaching 8,000 nurses and midwives, including those attached to SQU Hospital and the Armed Forces Medical Services. The figure tops 9,000 if those in the private sector are taken into account. Omanis make up roughly 50 per cent of the nursing workforce in Ministry of Health institutions.

Indeed, Oman is blazing an exceptional trail in nursing education in the Gulf region. Given the Sultanate’s superior nursing staffing security, the potential for the eventual export of nursing professionals to labour markets in the GCC is significant.