SECOND YEAR (First 6 months)
NURSING COURSECLASSROOM HOURSEXPERIENCE
S.No.Course title and description TheoryDemonstrationTotalHospitalCommunity Total
i.Midwifery200160360220160 380
II.Health Center Mana gement 4040 8060 60
III.Total Hours240200440220220 440
Total 880 Hours
SECOND YEAR (Internship period)
NURSING COURSEEXPERIENCE
S.No.Course title and description HospitalCommunity Total
i.Midwifery240 240480
Antenatal ward 40
Intranatal/labour room 120
Post natal ward40
Neonatal care unit40
II.Child Health80 160240
III.Community Health and Health center management 160160
Total Hours880
Total = 880 hours in the internship period
Grand Total = 1760 hrs.
Guidelines for internship :

a. The ANM students (in a group of 4-5) should be posted in the sub center/primary health center with a regular ANM for one month/4 weeks for supervised independent practice in the community which should be residential.

b. The students should participate in all the National Health and Family Welfare programs during their clinical experience.

c. At least 80% of all the clinical requirements should be completed before appearing for the final (Second year) examination.
d. The principal of the ANM school should certify for each student that she has undergone successfully the internship program, 100% clinical requirements and acquired the requisite competencies as listed in the syllabus before the award of the certificate/diploma by the state nursing councils/examination boards.

e. The casebook and competency record book should be completed and signed by the competent authority of the school.

Scheme of Examination

Theory and practical examinations at the end of the first year
PaperCourseExternal Assessment Internal Assessment Duration
Theory Paper I Community Health Nursing 75253 hrs
Theory Paper II Health Promotion75253 hrs
Theory Paper III Primary Health Care Nursing 75253 hrs
Theory Paper IV Child Health Nursing75253 hrs
Practical ICommunity Health Nursing and health promotion 100 100
Practical IIChild health Nursing100100
Total500300
Grand total for first year 800 marks
Theory and practical examinations at the end of the Second year
PaperCourseExternal Assessment Internal Assessment Duration
Theory Paper V Midwifery75253 hrs
Theory Paper VI Health Centre Management 75253 hrs
Practical IIIMidwifery100100
Practical IV Primary health care and health center management 100100
Total350250
Grand total for second year 600 marks
Venue for Practical Examination :

1. Govt. District only (if the District Hospital is not having School or College of Nursing attached to the District Hospital) even then practical examination of 2nd

year ANM students should be conduct at District Hospital.

2. All the ANM Schools run by Government or Private Schools in the District, their examination should be conducted in district hospital.

3. If large number of private Schools exist in the District, proper planning and phasing to be done by examination board to cover all students.

Midwifery
Expected competencyHospital ExperiencesCommunity Experiences
Assessment and care of normal pregnant woman Detecting pregnancy using pregnancy testing kit. Registration of antenatal mothers. Pre conception counseling Measuring the blood pressure, pulse and fetal heart rate, checking for pallor and edema and determining the fundal height, fetal lie and presentation accurately. Hemoglobin estimation and testing urine for protein and sugar Examine 20 antenatal women (in the hospital and community) Provide IFA supplements and administer TT injection to 10 women. Registration and management of vital events registers. Conduct antenatal examinations at home Participate in antenatal clinics in the sub center Malaria testing for pregnant mothers. Counseling on birth preparedness, complication readiness, diet and rest, infant feeding, sex during pregnancy, domestic violence and contraception.
Conduct normal delivery Recognize different degrees of tears give emergency care and refer. Maintain midwifery case book Conduction pelvic assessment to determine pelvic adequacy. PV examination 5 Plotting the partograph and deciding when to refer the women. Conduction 10 safe deliveries (in the hospital and community), with active management of the third stage of labour, using infection prevention practices, Assist in the suturing of 5 episiotomies and tears Conduct deliveries in the community (health centers preferably and home)
Assessment and care of postnatal mothers and newborns Provide essential care of the newborn 10 Basic resuscitation of the newborn 5 Managing/counseling on post-partum care and nutrition Counseling/supporting of mothers for breast feeding and preventing/managing breast feeding problems Counseling for kangaroo mother care Care of postnatal mothers 10 (in the hospital and community) Conduct health education for groups of mothers and individuals – 3 each Follow infection prevention and biomedical waste management in the labour room and sub center Follow up of 10 postnatal mothers for 10 days with at least 3 home visits. Care of newborns at home -10 Conduct health education for groups of mothers and individuals -2 each Integrate the accepted practices of AYUSH
Assessing and referring mothers at risk Identify high-risk mothers and give care Prepare for caesarean sections -2 Observe caesarean section - 2 Observe abnormal deliveries 5 Prepare for MTP and observe procedure -2 Take care of women with abortion -2 Insert an intravenous line. Insert a urinary catheter in women Preparation and administration of magnesium sulphate injection. Preparation and administration of oxytocin drip. Bimanual compression of the uterus for the management of PPH Care of mother with HIV. Digital removal of retained products of conception for incomplete abortion. Provide post abortion care. Do a case study of complicated childbirth in the village Conduct a village meeting for emergency transport of women at risk Identify and refer women with unwanted pregnancy for MTP Interview any 10 women and list reasons for unsafe motherhood and abortion Identify high risk mothers 5 and newborns 5 and refer them to the higher center
Counsel eligible couples about different methods of contraception Prepare acceptors for sterilization and IUCDs Direction of cervical cancer Counseling of mother/couples for family planning. Prepare and assist for sterilization of 5 female and 2 male cases (in the hospital or community) Insertion of intra uterine devices and prescription of contraception of contraceptives. Perform 2 IUCD insertions (in the hospital or community) Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5 Visual inspection of the cervix and taking a pap smear test -2 Counsel eligible couples on different methods of contraception Perform 2 IUCD insertions (in the hospital or Community) Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5 Visual inspection of the cervix and taking a pap smear test -2
Clinical requirements to be completed during the internship period :-

In addition to practicing and gaining competency in the above mentioned skills, the students are expected to complete the following requirements during the internship period :

Expected competencyHospital and community experiences
Assessment and care of normal pregnant woman Examine 15 antenatal women (in the hospital and community)
Assessment and care of postnatal mothers and newborns Provide essential care of the newborn -10 Basic Resuscitation of the newborn -5 Care of postnatal mothers 10 (in the hospital and community)
Assessing and referring mother at risk Take care of women with abortion -2
Counsel eligible couples about different methods of contraception Prepare acceptors for sterilization and IUCDs Detection of cervical cancer Prepare and assist for sterilization of 5 female and 2 male cases (in the hospital or community) Perform 3 IUCD insertions (in the hospital or community) Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5
Management of sick neonates and children (IMNCI) Assessment and care of 5 sick neonates and 5 sick children as per the IMNCI protocols.
Clinical requirements to be completed during the 2nd year :-
Competency1st 6 months of 2nd year InternshipTotal during 2nd year
ANC 20 (hospital + Community) 15 (Hospital + community) 35 (hospital + community)
Conducting normal deliveries with AMTSL 10 (Hospital + community*) 10 (Hospital + community) 20 (Hospital + Community)
Assist suturing of Episiotomy/tears 5 5 10
Care of new born10 10 20
Basic resusc. Of normal new born 5 510
P/V Examination5 5 10
Postnatal cases 10 (hospital + Community) 1020 (hospital + community )
Management of sick neonates and children (INCI) - 5+5 5+5
IUCD insertion 235