Critique on Private and Public Nursing Education in Pakistan

Heads of the Institutions: In addition, the principals (Heads of the institutions) in both institutions were not Ph. D though it is mandatory for degree nursing institutes by PNC. Since, both institutes have none Ph.D faculty for master program but PNC has recognized master program of one of the institute although Ph.D faculty is mandatory for master program in nursing [1]. Moreover, private college has diverse undergraduate and graduate programs; however, public institute is offering only degree program and different specialty programs.

Committees: Besides that, in the context of educational management, there were few committees alike in these institutions such as social/recreational committee, admission/progression committee and mess/food committee. Furthermore, private college has some additional committees as research/publication committee, board of studies committee, library committee, and skills lab committee; it is clearly stated in PNC guidelines for effective and structured governance of the nursing institutes.
Extracurricular activities: Likewise, there were few alike extracurricular activities for the students in terms of annual religious ceremonies and social activities for students. Moreover, there was no transport facility for day scholar students in both the institutions. However, private college provided financial facility to the students in terms of stipend but public college has no financial support system for the students. There was accommodation for students at both institutes; however, the public institute does not have sufficient hostel rooms as compared to total number of students at college. This may create difficulty for the students to access the college who belong to far areas.

Strengths and weaknesses of public institution
Both the institutes were distinct in some of their strength and weaknesses in the context of their faculty, study programs, curriculum, and governance. Public college is PNC recognized institute and has sufficient, qualified, and highly experienced faculty for the undergraduate programs which is in line with PNC guidelines. Besides that, being a public health institute, it has affordable fee structure for the students. In addition, the class rooms were well ventilated and abundant in relation to number of students. Furthermore, it has effective leadership and governance which has set by their faculty members in the form of different committees for different tasks. Moreover, the faculty and students of the college attend annual symposium for continues education.
On the other hand, it has some shortcomings such as the faculty of this college was not involved in any scholarly activities since there were six MScN graduate faculty members. Moreover, the college was short of clinical instructor to supervise students on their clinical placement. According to World Health Organization report, Global standards for the initial education of professional nurses and midwives nursing and in terms of capacity and resources [5]. Class rooms were fewer in number and inadequate capacity to accommodate students according to PNC criteria [2]. Besides that, there was no auditorium or lecture hall for students. There were limited resources at library and fewer computers at computer lab in relation to the number of students which hinders students' web based learning. Web based learning is the most important approach for enhancement of self-directed learning and it also bridges gap between students and teacher interaction [6].

Constraints along with their bases and possible solutions for public institution
In this competitive era, every organization strives to compete with limited resources for quality education. In the similar way, both the institutes have a number of challenges in their context. For instance, public sector does not comply with the career ladder because of bureaucracy. This issue could be overcome by two ways; one is at organizational level and the other is at national level. At organizational level, employees could strengthen their association for raising their voices for career structure by building linkages with the same provincial public institutes. At national level, Pakistan Nursing Federation (PNF) can advocate for functional career ladder of nursing professionals at national assembly. Moreover, this institute has enough positions for clinical instructors but the positions are vacant due to ban for recruiting employees by legislative shift from federal to provincial level. This constraint could be resolved by building linkages with other public institutes to explore the same issues and develop a summary of all vacant positions and put forward to chief minister of respective province. Even if it is unresolved then a petition can be submitted to the law court with the cooperation of PNF. Since public institute was established in 1956 and after a period of more than five decades it was unable to progress from undergraduate to graduate programs so far because the institute has no PhD faculty as per PNC criteria and this is a national level constraint particularly in public sectors. There is dire shortage of nursing faculty as per higher education commission, Pakistan's standards all over the country [7]. The root cause of this problem is inefficient organizational policies by administration leading to lack of motivation among nursing professionals for higher education. This can be dealt by strategic planning for faculty development as well as enforcing the effective implementation of policies.

Constraints along with their reasons and possible solutions for private institution
Likewise, private college was also facing a number of challenges for example; the most significant constraint is infrastructure and learning resources as this institute is going through the transitional phase from undergraduate level to the graduate level and recently it has started multiple programs. The most probable reason for this could be monetary constraints as the institute is not very recent and there is less revenue. The possible solution for monetary constraints could be the generation of funds through collaboration with different nongovernmental organizations (NGOs) which are working for education. The other could be revision of fee structure. We have also observed that there was lack of strategic planning because institute has started master program without prior planning for faculty development to the level of PhD and other learning resources for graduate program including library, computer lab etc. Strategic planning facilitates key decision makers to resolve challenges and also assists them to figure out current constraints with regard to upcoming consequences [8]. This is very obvious that there was frequent change in leadership and governance of college due to turnover of managerial staff of institute. To overcome midwifery, qualified nurses and midwives with their clinical expertise are responsible for students' supervision on their clinical and practical place [2]. Clinical nurse faculty does not only possess required qualification, but also has effective leadership skills as a role model for the students at clinical settings [3]. In addition, there was lack of motivation among faculty for their own higher education as stated by the principal, CON. It is significant for employee satisfaction and efficient organizational performance [4]. In addition, it was also observed that the college has ineffective maintenance of the college building as the white wash was not done on the walls and window glasses were broken. Another flaw related to safety measures was noticed as there were no indicators for emergency exits and fire extinguishers in the public institute. According to World Health Organization report, Global standards for the initial education of professional nurses and midwives nursing and midwifery, educational institutes must have ensured safety measures for students and faculty [2].
Moreover, it has its vision and mission to produce leaders and educators while there was no succession plan for faculty development; and this does not conform to their vision and mission statement of the institute. Furthermore, public institute seems stagnant in terms of program development as the MScN program has been clogged by PNC.

Strengths and weaknesses of private institution
Private college is an autonomous, PNC recognized institute and it has a clear vision and mission statement mentioned in student's hand book as well as on its website. The vision and mission statement was conformed to faculty progression plan as some of their faculty members were enrolled in master program. In addition, there were sufficient faculty members for undergraduate programs as well as guest speakers. The publication committee of this college is responsible for faculty's scholarly work which was considered asset of the college for faculty professional growth and development. Furthermore, this institute has its own biannual journal of nursing which motivates faculty towards scholarly work and offers an opportunity to share information with others.
Besides that, they have an academic committee who was involved in curriculum planning, revision, and approval. Furthermore, they have advisor for students to facilitate them if they face any personal and academic problems. Moreover, it has their own developed World Wide Web link for online access to the institute which is a good resource of information regarding college assets for the public. In addition, students have diverse clinical exposure for integration of theory into practice as they assign their students at different campuses/ institutes for their practical work. Besides that, they have system to evaluate their faculty's performance through students' feedback and annual performance appraisal through direct observation by head of department which enhances motivation and dedication among faculty towards their professional career/ladder. This institute has enough capacity to accommodate their faculty with family which attracts and retain faculty at institute. Moreover, they have the student hostel with enough number of rooms so the students who came from remote areas can be accommodated at hostel. The college has the strategy to retain their graduates at their institutes by offering stipend/scholarship through mutual undertaking. In addition, it has quality assurance cell which is responsible for internal audits of its affiliated institutes to assure the standard practices in teaching and learning. However, it does not have Ph.D faculty to sustain their graduate programs. In addition, infrastructure of private college was not conformed to PNC [2] guidelines in terms of capacity and learning resources for students. Infrastructure of any school should not hinder staff or student learning this problem, the institute can recruit leadership position by signing contract for at least five years of services.

Conclusion
There are many PNC recognized nursing educational institutes which offer different nursing educational programs at public and private sectors; however, similarities and differences among them is obvious through observation. Besides that, the standard of nursing education is inclined by the emerging health issues and disease burden of the population worldwide specifically in the developing countries. Moreover, shortage of qualified faculty is also an alarming issue specifically in Pakistan. To overcome these issues strategic planning is the key element for the educational leaders and managers to implement faculty development programs as well as other teaching and learning resources to compete nursing educational standards. Nurse educators and leaders are the key players to identify constraints and weaknesses of educational institutes and further highlight these issues to the higher authorities.