Exploring the Challenges and Opportunities for Continuing Professional Development fo Nurses: A Qualitative Study with Senior Nurse Leaders in Nepal

Abstract

Background: Continuing professional development for nurses is internationally recognised as a key factor in improving quality of care, career progression, job satisfaction and professionalization. Meeting the global and national challenge of Universal Health Coverage will require a flexible and skilled workforce. Since nurses are the backbone of health care in Nepal, their professional development is a key contribution to this task.
 Objective: To explore the views of senior nurses on the need and opportunities for continuing professional development in nursing in Nepal and current barriers to its development.
 Methods: Purposive sampling was used to identify participants and semi-structured interviews were conducted until saturation was reached. Interviews were transcribed verbatim and analysed using thematic analysis. 19 senior nurses, female (n=17) and male (n=2) working across the sector as clinicians, teachers and managers in Nepal participated in this study.
 Results: Analysis revealed several themes and subthemes, including: the conceptualisation of CPD in Nepal; provision and funding; barriers – fiscal, political and geographical challenges; and future priorities which included a discussion around basic skills versus advanced practice.
 Conclusions: The study provides an overview of opportunities and challenges for equitable access to continuing professional development in Nepal. Our findings illuminate the need for nurse leaders to work with policy makers and nursing organisations to establish the priorities for continuing development in light of increasing demand and expectations of health services.

Nurses' perceptions of quality of work life in private hospitals in Enugu, Nigeria: A qualitative study

“…Nurses were blamed for most gaps in patient care, which is consistent with the blame culture found in prior studies [30] , [40] . Also, nurses lacked voice in the decision-making in private hospitals, as was found in other studies [6] , [20] , [32] . Consistent with existing evidence [3] , [21] , [31] , the support from nursing supervisors was mostly lacking.…”

“…Consistent with existing evidence [3] , [21] , [31] , the support from nursing supervisors was mostly lacking. Yet, promotion opportunities were inadequate and not based on performance evaluation, which is similar to existing scholarship [3] , [32] . Equally, nurses attending continuing professional development programs risk losing their jobs due to restrictive training policies [32] .…”

“…Yet, promotion opportunities were inadequate and not based on performance evaluation, which is similar to existing scholarship [3] , [32] . Equally, nurses attending continuing professional development programs risk losing their jobs due to restrictive training policies [32] . In the same vein, insecurity led to a poor quality of nursing work life, resulting in the unsafe environment found in preceding studies [28] , [31] .…”

“…Helpfulness and assistance from colleagues were associated with a high quality of nursing work life [13] , [28] , [29] . Nonetheless, blame culture [30] , a lack of sufficient resources [6] , [11] , [18] , [21] , [22] , [29] , [31] , a lack of supportive organizational leadership and policies [3] , [20] , [21] , [28] , [32] , a lack of support from the nursing supervisor [3] , [21] , [31] , medical dominance [6] , [31] , a lack of participatory decision-making [6] , [20] , [32] , a lack of promotion [3] , [32] , few professional training opportunities [32] , a lack of personal protective equipment [19] , [20] , [29] and an unsafe environment [28] , [31] contributed to a low QWL among nurses.…”

“…Two studies found that job pride improved the quality of nursing work life [22] , [28] . In the private sector, inadequate remuneration [29] , [32] and reduced opportunities for continuing professional development constrained the quality of nursing work life [32] . In the public sector, low compensation [8] , a lack of financial incentives [3] , low public perception [8] , [33] , [34] and a loss of job pride [8] are associated with a low quality of nursing work life.…”