A balance between well care nursing and ill care nursing in the 4-year baccalaureate nursing programs of the Thai public secto

In Thailand, well care services are urgently needed due to the drastic increase of preventable health problems that were the results of risk behaviors of Thai people. As a health care profession, the Thai nursing profession is obligated to response to this need. Unfortunately, fewer than 10 percent of Thai professional nurses work as well care nurses, such as school, occupational, and community nurses. Few graduates of the 4-year baccalaureate nursing programs of the Thai public sector, the basic professional programs that prepare the largest number of the Thai beginning professional nurses, choose well care practice despite the availably plenty of well care jobs resulting in the shortage of the Thai well care professional nurses. The extrinsic and intrinsic motivational factors causing these graduates to select ill care practice over well care practice were studied. Of 13 nursing schools randomly selected from the 37 accredited nursing schools of the Thai public sector, six curricula were analyzed, 52 nursing educators and 52 prospective graduates were interviewed. The ill care-characterized nursing student was found being a significant causative factor of this maldistribution. The vast majority of nursing students chose ill care practice in hospitals of the Thai public sector. Most of them received the ill care-type financial aid which required them to work in ill care settings after graduation. Most nursing students and their families favored ill care nursing. They believed in their ill care capability more than their well care capability. Most well care competencies were evaluated as fair but not sufficient. Those inadequate well care competencies involved designing well care programs, utilizing information technologies, managing health-related behaviors, gathering data necessary for health assessment of school-age children, assessment of clients' physiological, psycho-social, emotional, and spiritual strengths; and factors that influence health. Reported by nursing educators, the slightly ill care-emphasized learning experiences were provided. An overemphasis on well care nursing was found in most curricula. However, absent well care concepts of most curricula were related to learning experiences that were provided less than other learning experiences and related to inadequate well care nursing competencies that were evaluated by prospective graduates.