A Solution to the Healthcare Provider Shortage or a New Problem?

Across the globe, the significant shortage in the number of healthcare providers has prompted thought leaders in healthcare to develop numerous plans of action to meet the needs of the sick. The article “Non-physician clinicians in 47 sub-Saharan African countries,” published online by Lancet on June 14, 2007, discussed how 25 sub-Saharan African nations classified by the World Health Organization as having a critical health worker shortage are enlisting the services of non-physician clinicians (NPCs) to fill the void created by a lack of physicians and nurses.
NPCs, while not trained as doctors, can perform many of the same diagnostic and clinical tasks as physicians. In some African countries, NPCs have received advanced training so that they can carry out more specialized tasks, such as administering anesthesia and performing caesarean sections. NPCs are experienced nurses who receive an additional year of education and a six-month internship or non-nurse secondary school graduates who have three additional years of training and a yearlong internship. The NPC system allows nations to provide their citizens, especially those in extremely rural and poor areas, with much-needed healthcare workers who are trained at a fraction of the cost and in less time than it takes to educate and train physicians.
Are NPCs the answer to the worldwide nursing and physician shortage? According to the Lancet article, the sub-Saharan African countries that have employed the use of NPCs are planning to increase their training programs. They have found that NPCs from rural and poorer areas that returned to practice in those same regions were less likely to leave, as has been the case with physicians and nurses.
Since developing nations have struggled to recruit and maintain a sufficient number of nurses and physicians, there are many who say NPCs are a viable, cost effective solution. However, in America and other developed nations, our certified nurse practitioners, midwives, clinical nurse specialists, and nurse anesthetists are trained and qualified to provide quality care and more enhanced access to healthcare. Leaders, elected officials, and/or healthcare ministers from different countries need to recognize the important roles these nurse specialists play in healthcare, provide them with healthy work environments, compensate them well, and amend laws and regulations that will allow them to function up to their education and experience capacities. Providing more funding for educational programs will also attract more potential nurses to the field and keep them practicing.
The nursing shortage is at a critical stage around the world and it will only become worse as the population ages. It is time to make a commitment to finding qualified healthcare providers and offering creative solutions that do not include developing new categories of workers. NPCs confuse the public, and may decrease women’s and men’s interest in nursing education. Could this accelerate the nursing shortage? What are your thoughts?

A Historic Day for Pennsylvania at Penn Nursing

July was a historic time for the nursing profession and healthcare in Pennsylvania. Our state legislature approved several of the first bills that are a part of Governor Ed Rendell’s Prescription for Pennsylvania healthcare reform plan, including those that expand the scope of practice for nurses, nurse practitioners, clinical nurse specialists, midwives, dental hygienists, physician assistants.

To celebrate this milestone, on July 20 Governor Rendell once again came to our School, where he signed the bills into law. In January, we were excited to host the governor, honored guests, and a standing room-only crowd when Rx for Pennsylvania was unveiled at our School. It is wonderful to see that, with the passage of some of the plan’s components, Prescription for Pennsylvania is coming to fruition.

The governor’s plan is important, not only because it will increase access to affordable medical coverage for uninsured Pennsylvanians and allow all healthcare workers to play an expanded role delivering healthcare services, but also because it places Pennsylvania at the forefront of the nation’s healthcare reform initiatives.
Across the country, elected officials are debating similar legislation. We applaud Governor Rendell for being a visionary and making the hot topic of healthcare one of his administration’s top priorities. We thank him and our state representatives for understanding the capabilities of nurses, nurse practitioners, clinical nurse specialists, and midwives by providing measures in the laws that allow these licensed professionals to use their education in providing evidence-based practice that is not limited because of outdated regulations.

This is just the beginning of healthcare reform in Pennsylvania. For complete adoption, the plan will require the passage of almost 50 bills and the creation of numerous new rules and regulations. At the School of Nursing, we have been actively involved in working for the plan’s approval as it relates to nursing, nurses, and midwives. We established two taskforces that have closely followed the legislative process, contacted elected representatives from across the Commonwealth to encourage their support of the bills, and informed students, faculty, staff, alumni, and the public about the importance of this historic plan and the significance of having their voices heard by their representatives.

We will continue to follow with great interest the progress of the additional components of the Prescription for Pennsylvania plan. For updates, I encourage you to visit http://www.rxforpa.com/.