Perception, perceived scope, and potential barriers towards developing nurse practitioners cadre among health care providers and beneficiaries: A pilot study from Northern India

Abstract

BACKGROUND: The role of nurse practitioner (NP) emerged in early 1965 when general practitioners began working with nurses. Evidence across the world highlights the benefits achieved by the NP role. The Indian Nursing Council (INC) implemented a country-wide NP in critical care (NPCC) program with the approval of the ministry of health and family welfare (MoHFW) in 2017. The NP role is in its infancy in India. Hence, there is a need to assess the perception among beneficiaries and healthcare personnel. This study was conducted to assess the perception, perceived scope, and potential barriers for developing the role of NPs in India among beneficiaries and healthcare providers. MATERIAL AND METHODS: A descriptive, cross-sectional pilot study was conducted at AIIMS Rishikesh, Uttarakhand, India, among 205 participants (84 beneficiaries, 78 nurses, and 43 physicians) using a proportionate stratified random sampling technique. Likert scales and socio-demographic sheets were used to assess the perception, perceived scope of practice, and potential barriers in developing a NP cadre in India. Descriptive and inferential statistics were used for analyzing data. RESULTS: The mean age of beneficiaries was 37.98, nurses was 27.58, and physicians was 28.13 years, respectively. 121 (61%) of participants were highly favored, and 77 (38%) were in favor of developing NP cadre in India. They considered it to be necessary, feasible, and acceptable in India. The feasibility and necessity of the perception domain were highly significant ( P < 0.001 and P < 0.003, respectively). Nurses (mean ± SD: 35.36 ± 3.55) considered that NPs could have a wide range of practice followed by beneficiaries (mean ± SD: 38.17 ± 3.68) than physicians (mean ± SD: 34.75 ± 5.95). Lack of awareness, the nonexistence of cadre structure, lack of acceptance of the role of physicians, and lack of clear policy were the key potential barriers to develop an NP cadre in India. CONCLUSIONS: In this study, participants had favorable views on employing NPs in India; thus, this role will improve healthcare access for beneficiaries. NPs can carry out a wide range of practices.However, a lack of awareness, no cadre structure, and a lack of a clear policy may hinder the development of the NP cadre in India.

Empowering nurses: exploring self-managed organizations in Indian healthcare

“…Job and financial security concerns among general practitioners create resistance to nurses assuming roles traditionally performed by the managers [8]. The negative public image of the nursing profession discourages individuals from pursuing nursing careers, insinuating a need for finding meaningfulness in the nursing job, while a lack of public awareness about the education and role of nurse practitioners limits their acceptance and utilization [9,10].…”

“…Firstly, there is a significant void in the literature as no prior research has delved into the nursing experience within these organizations, hindering an understanding of how nurses navigate their roles, challenges, and dynamics within self-managed structures in the Indian context [19]. This gap limits the knowledge base concerning the unique aspects of nursing practice, job satisfaction, and overall experiences in the specific context of self-managed homecare organizations in India [10,11].…”

“…The absence of a replicable model or guide for Indian organizations, particularly in the homecare sector, attempting to transform into SMOs, hampers the successful adoption of self-management principles, hindering the potential enhancement of nursing experiences in the Indian context. Lastly, the integration of technology in self-managed homecare organizations in India remains unexplored in previous research [10,17]. This gap signifies a lack of understanding of how technological integration influences nursing practice, patient care, and overall healthcare outcomes in the Indian context, leaving a crucial aspect unaddressed in the existing literature.…”