Let us pave the way for a brighter and healthier Pakistan by accepting the concept of Nurse practitioners (NPs) in Pakistani – By: Rashida Manzoor
I trust this message can help to open the minds and eyes of those healthcare providers opposing the nurse practitioners’ proposal.
I wish to shed light on a topic of paramount importance for Pakistan’s healthcare landscape, and the indispensable role of nurse practitioners in the healthcare system of Pakistan in the near future. As we navigate through our nation’s evolving healthcare challenges, it becomes increasingly evident that nurse practitioners are poised to play a pivotal role in addressing the complex needs of our population. To support this argument, allow me to share some features of the nursing profession and compelling trends and evidence that underscore the significance of nurse practitioners in Pakistan, and around the world.
Nursing, being a profession of paramount importance, necessitates a comprehensive understanding of its fundamental elements, including regulatory bodies, distinct academia, scholarship, curriculum, institutions, and associations. These essential components collectively define and solidify nursing as a distinct profession. Consequently, considering nursing merely as assistants to the medical field or an appendix of paramedics would be erroneous and biased, failing to acknowledge the intricate complexities of this esteemed profession.
Furthermore, the evolution of nursing practice is not a solitary phenomenon; it occurs within a dynamic context. Over time, nursing roles have evolved from traditional care providers to encompass a diverse array of specialties, such as registered nurses, community health nurses, occupational health nurses, and school health nurses. The profession has also seen the emergence of advanced practitioners in specialized nursing fields. To support these varied roles and competencies, the education system has undergone a significant transformation. Gone are the days of three-year diploma programs; now, nursing education offers Bachelor of Science (BS) in Nursing, Master of Science (MS) in Nursing, Doctor of Philosophy (PhD) in Nursing, and Post-Doctoral programs, in response to the evolving demands of healthcare systems worldwide.
In essence, nursing stands as a dynamic and evolving profession that adapts and innovates to meet the changing healthcare landscape. By embracing the advancements in education and practice, nursing professionals continue to play a pivotal role in delivering compassionate and evidence-based care to individuals and communities, thereby contributing significantly to the well-being of society.
The history of nurse practitioners, often rooted in addressing healthcare shortages, has been well-documented in countries like the United States. Originating in the 1960s, nurse practitioners were a response to primary care gaps. Their proven ability to provide quality care, conduct health assessments, diagnose and treat common illnesses, and collaborate with physicians has led to their recognition and integration into mainstream healthcare systems in the 1960s. at present, Nurse practitioners (NPs) play crucial roles in healthcare systems around the world, including in the United States and various other countries. Their roles encompass a wide range of responsibilities and specialties, contributing significantly to patient care, health promotion, and disease prevention. Here’s an overview of nurse practitioner roles in developed countries such as the United States of America, Canada, Australia, and the united kingdom where nurses work as Primary Care Providers: NPs deliver comprehensive primary care services, including diagnosing and treating common illnesses, conducting physical examinations, ordering diagnostic tests, and prescribing medications.
Specialized Care: NPs specialize in areas such as family practice, pediatrics, geriatrics, women’s health, and mental health, providing specialized care and treatment within their chosen field. Acute Care: NPs in acute care settings, such as hospitals and emergency departments, manage complex medical conditions, perform procedures, and collaborate with physicians and other healthcare providers. Chronic Disease Management: NPs play a crucial role in managing chronic diseases like diabetes, hypertension, and heart disease, focusing on patient education, monitoring, and preventive measures. Health Promotion and Education: NPs engage in health promotion, disease prevention, and patient education, empowering individuals to make informed decisions about their health and well-being. Diagnostic and Screening Services: NPs conduct screenings, perform diagnostic tests, and interpret results to facilitate early detection and intervention. Prescriptive Authority: NPs have prescriptive authority, allowing them to prescribe medications, including controlled substances, in all 50 states and the District of Columbia. Collaborative Practice: Canadian NPs often work collaboratively with physicians and other healthcare professionals to ensure comprehensive and coordinated patient care. Advanced Clinical Practice: Nurse practitioners in the UK engage in advanced clinical practice, providing comprehensive assessment, diagnosis, treatment, and management of patient’s health and well-being.
The concept of nurse practitioners (NPs) in developing countries like India and China already initiated the concept of NP in 2021. In India, Advanced Practice Nurses (APNs) are gradually gaining recognition, expanding beyond traditional nursing duties to encompass advanced clinical responsibilities. They specialize in areas like primary care, pediatrics, geriatrics, and women’s health, with varying levels of regulation and recognition across states. In China, Clinical Nurse Specialists (CNS) or Advanced Practice Registered Nurses (APRNs) are emerging, specializing in critical care, oncology, pediatrics, and more.
By the evidence of the supporting document, filling the healthcare gap in Pakistan is crucial to come over the high prevalence of chronic diseases and viral infections for that there is a burgeoning population and escalating demands on our healthcare system. In addition, there is an evident shortage of healthcare providers in Pakistan, there is the burden of patient flow in tertiary care hospitals due to a lack of health management at primary and secondary care levels. Therefore, the new proposed model of nurse practitioners could be a logical, and evident based initiative to overcome the current challenges in the health care system. NP with their specialized training and skills, can provide essential primary care, health promotion, and disease prevention services to society. This crucial role bridges the gap between healthcare demand and supply, ensuring more accessible and effective holistic care. Echoing global trends, nurse practitioners in Pakistan are adopting a holistic approach to patient care rather than it is competition with other healthcare providers. Nurses with higher education are equipped to provide comprehensive and patient-centered healthcare, they can address not only physical well-being but also mental health and preventive strategies. In addition, nurse practitioners are trained in evidence-based practice, enabling them to deliver high-quality, up-to-date, and effective care. Their ability to integrate the latest research findings into clinical decision-making significantly contributes to improved patient outcomes. Nurse practitioners are increasingly pursuing specialized areas as the Pakistan nursing council already offers different two years specialized programs in a specific field of practice in Pakistan, ranging from pediatrics to geriatrics and women’s health, anesthesia, ophthalmology, critical care, cardiac care and so on. Their diverse skill can set allows for more targeted and specialized patient care. Moreover, nurse practitioners are trained to operate autonomously while also collaborating with other healthcare professionals, ensuring comprehensive and effective care delivery.
By addressing the concerns raised by PMDC, I realized that it is natural for differing perspectives to arise, including those voiced by some doctors who may question the integration of nurse practitioners into our healthcare system. However, it is crucial to acknowledge and understand that nurse practitioners are not replacements but valuable additions to the healthcare team to improve societal health and quality of life. Their training, evidence-based practice, and ability to offer specialized care complement the efforts of physicians, enhancing overall patient care and expanding healthcare access. To further enrich this document I would like to mention the globally recognized model of primary health care under the administration of Aga Khan Health Services in Pakistan where the mortality and morbidity rate drastically decreases especially, in five years old and maternal mortalities. If the same approach adopts by the Pakistani health care system supported by professional organizations and associations, advocating for policy reforms that recognize and harness their potential. These efforts can contribute to shaping a more responsive, efficient, and patient-centric healthcare system.
As we collectively envision a healthier future for Pakistan, it is undeniably clear that nurse practitioners hold the key to unlocking improved healthcare access, enhancing patient outcomes, and fostering a more sustainable healthcare ecosystem. I urge all of us to actively support and champion the growth of nurse practitioners in our country, ensuring that their invaluable contributions are maximized for the benefit of all.
Rashida Manzoor
Ph.D. scholar
Institute of Nursing and Health Sciences
Zhengzhou University
Henan, China
