focusing on apn through a graduate program
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FOCUSING ON APN THROUGH A GRADUATE PROGRAM. Raisa Gul RN, RM, BScN, MHA Assistant Professor and Director, Diploma Programme Aga Khan University, School of Nursing. PRESENTATION FLOW. Brief Overview of the Country ↓ Nursing Profession ↓ Challenges of MScN Program & - PowerPoint PPT PresentationTRANSCRIPT
FOCUSING ON APN THROUGH A FOCUSING ON APN THROUGH A GRADUATE PROGRAMGRADUATE PROGRAM
Raisa GulRN, RM, BScN, MHA
Assistant Professor and Director, Diploma Programme
Aga Khan University, School of Nursing
PRESENTATION FLOWPRESENTATION FLOW
Brief Overview of the CountryBrief Overview of the Country↓↓
Nursing ProfessionNursing Profession↓↓
Challenges of MScN Program &Challenges of MScN Program &Integration of Advance Practice in Nursing Integration of Advance Practice in Nursing
(APN)(APN)↓↓
Potential Impact Of APNPotential Impact Of APN
PAKISTANPAKISTAN 56 Years56 Years of i of independencendependence
Population of 140 Million; 68% Rural and 32 % UrbanPopulation of 140 Million; 68% Rural and 32 % Urban Population growth 2.2%Population growth 2.2% Poor public health facilitiesPoor public health facilities Literacy 40% Literacy 40% Health care access, strong rural urban disparities Health care access, strong rural urban disparities IMR, 95 per 1000 live birthIMR, 95 per 1000 live birth MMR, 200-700 per 100, 000 MMR, 200-700 per 100, 000 Double disease burden: infectious diseases , Double disease burden: infectious diseases ,
Hepatitis (TB) and Hypertension, diabetes, cancers, Hepatitis (TB) and Hypertension, diabetes, cancers, mental Health problemsmental Health problems
Estimated # of Doctors = >100’000 ; Nurses 33’000 Estimated # of Doctors = >100’000 ; Nurses 33’000 so, 1 nurse: 3-4 doctorsso, 1 nurse: 3-4 doctors
ABOUT THE COUNTRYABOUT THE COUNTRY
NURSING IN PAKISTANNURSING IN PAKISTAN
Have Nurses, Lady Health Visitors and Midwives Have Nurses, Lady Health Visitors and Midwives Entry to nursing education is grade 10-12Entry to nursing education is grade 10-12 Nurses are confined to hospitals, 20-30 patients/nurseNurses are confined to hospitals, 20-30 patients/nurse Predominant use of students for services Predominant use of students for services Quality of nursing education is lowQuality of nursing education is low Nursing Education, diploma and post basic diploma Nursing Education, diploma and post basic diploma Demand for higher education by employer is low Demand for higher education by employer is low
except at AKUHexcept at AKUH Opportunity for higher education is limitedOpportunity for higher education is limited Limitation of nursing leadership and physicians’ Limitation of nursing leadership and physicians’
dominance in Health Care System.dominance in Health Care System.
AGA KHAN UNIVERSITY SCHOOL OF AGA KHAN UNIVERSITY SCHOOL OF NURSING : NURSING : VISION Of THE CHANCELLORVISION Of THE CHANCELLOR
Promotion Of NursingPromotion Of Nursing
Begin with SON in 1980 as a “break through”Begin with SON in 1980 as a “break through” Had an expatriate director and national faculty with Had an expatriate director and national faculty with
post –basic diploma post –basic diploma 23 years later, have national Dean and Directors23 years later, have national Dean and Directors All faculties with at least undergraduate degree, but All faculties with at least undergraduate degree, but
also Masters and PhDsalso Masters and PhDs Programmes developmentProgrammes development: :
1980 –General Nursing Diploma 1980 –General Nursing Diploma 1988-Post RN BScN 1988-Post RN BScN 1997 – BScN1997 – BScN2001- MScN2001- MScN
First program in the country
CHALLENGES OF CHALLENGES OF ESTABLISHING MScNESTABLISHING MScN
a) Conceptual Phasea) Conceptual Phase::Creating awareness, ownership and approvalCreating awareness, ownership and approval
Physicians, it takes nurses away from the Physicians, it takes nurses away from the “real work” “real work”
Employer & university Administration, how Employer & university Administration, how will they be different…do we need to spent will they be different…do we need to spent more money?more money?
Nurse Leaders, sense of insecurityNurse Leaders, sense of insecurity
Contd…Contd…
Strategies:Strategies: Communication, rationalization with Communication, rationalization with
current trends in nursing educationcurrent trends in nursing education Success of the developed CountriesSuccess of the developed Countries Assuring for strong consideration to Assuring for strong consideration to
enhance clinical knowledge, i.e. 22/59 enhance clinical knowledge, i.e. 22/59 credits (37 %) as core courses in the credits (37 %) as core courses in the curriculumcurriculum. .
b) Planning Phaseb) Planning Phase
Approval of the Board, concern for Approval of the Board, concern for resources both human and financialresources both human and financial
Strategies:Strategies: Faculty development plan, Faculty development plan,
sponsorship for graduate studies sponsorship for graduate studies Expatriate faculty, visiting and short Expatriate faculty, visiting and short
term contractsterm contracts Collaboration with other universities Collaboration with other universities
abroad, Sheffield University and abroad, Sheffield University and MinnesotaMinnesota
2. Curriculum composition, specialist 2. Curriculum composition, specialist
versus generalist Masterversus generalist Master
Took generalist approach, with emphasis on Took generalist approach, with emphasis on Research and Clinical Practice due to:Research and Clinical Practice due to:
Limited pool of nurses with BscN at the national level Limited pool of nurses with BscN at the national level Diversity of potential candidates for MScNDiversity of potential candidates for MScN Envisaging greater impact through developing Envisaging greater impact through developing
leadersleaders
3. Developed transition programme in 3. Developed transition programme in view of the national needsview of the national needs
MScN CURRICULUMMScN CURRICULUM
Nursing Practice ResearchEducation ElectivesManagement
Total Credit hours – 59
c) Implementation Phasec) Implementation Phase
Availability of expatriate faculty , 9/11/2001Availability of expatriate faculty , 9/11/2001 Undesirable effects of Faculty development Undesirable effects of Faculty development
planplan Variation in employer’s demandVariation in employer’s demand Visa and licensure issues for students’ Visa and licensure issues for students’
advance clinical practicum abroadadvance clinical practicum abroad Students perspectives, program credibility, Students perspectives, program credibility,
cost benefits analysiscost benefits analysis Pool of potential students further Pool of potential students further decreaseddecreased
affecting enrollment in MScN.affecting enrollment in MScN.
StrategiesStrategies
Pooling of resources within the Pooling of resources within the university: university:
Inter departmental collaborationInter departmental collaboration Physicians as preceptors for Physicians as preceptors for
Advance clinical PracticumAdvance clinical Practicum Visiting and Sessional facultyVisiting and Sessional faculty
Our Experience of Advance Our Experience of Advance Clinical PracticumClinical Practicum
Students’ comments :Students’ comments :““Culturally it is appealing, will have more Culturally it is appealing, will have more
respect.”respect.”““Our role of counseling and teaching was very Our role of counseling and teaching was very
much appreciated.”much appreciated.”
““50% of patients need counseling and teaching 50% of patients need counseling and teaching to cope with their diagnosis.”to cope with their diagnosis.”
“ “ patient were receptive to get examined or patient were receptive to get examined or advised by a nurse.”advised by a nurse.”
ContdContd……
““Doctors were learning from us and we learned from Doctors were learning from us and we learned from them” this “Will definitely impact nurses’ image.”them” this “Will definitely impact nurses’ image.”
““If we identified what was missed out, they [Physician] If we identified what was missed out, they [Physician] were appreciative rather then defensive.”were appreciative rather then defensive.”
““Me and my preceptor have begun to work on research Me and my preceptor have begun to work on research project.”project.”
Physician remarked “I am afraid if you have a clinic Physician remarked “I am afraid if you have a clinic next to me. I will loose my patients to you.”next to me. I will loose my patients to you.”
Students, Patients and Students, Patients and Physicians perspectivesPhysicians perspectives
Chance of independent decision makingChance of independent decision making Application of knowledge, especially Application of knowledge, especially
counseling and patient education counseling and patient education Enhancement of assessment skillsEnhancement of assessment skills Projects nurses strengths and potential, Projects nurses strengths and potential, Source of mutual and enrich learning Source of mutual and enrich learning
experienceexperience Strengthening Nurse- Physician collegiality Strengthening Nurse- Physician collegiality Enhance awareness among public about the Enhance awareness among public about the
scope of nurses’ workscope of nurses’ work..
Advance Practice in Nursing (APN)Advance Practice in Nursing (APN)Concept to implementationConcept to implementation
Need a visionNeed a vision Availability of human and financial resourcesAvailability of human and financial resources Educational preparation of nurses at Educational preparation of nurses at
graduate levelgraduate level Creation of systems to recognize the APN Creation of systems to recognize the APN
rolerole Requires credentialing and licensure by the Requires credentialing and licensure by the
regulatory body of nursing in the country. regulatory body of nursing in the country. Note: Importance of the decision maker should Note: Importance of the decision maker should
never be overlookednever be overlooked
CONCLUSIONCONCLUSION
Although the issue of role creation and Although the issue of role creation and Licensure by Pakistan Nursing Council Licensure by Pakistan Nursing Council for Advance Practice in nursing (APN) for Advance Practice in nursing (APN) yet to be addressed, the potential yet to be addressed, the potential Impact of APN in Pakistan appears Impact of APN in Pakistan appears promising with greater awareness and promising with greater awareness and outcome in future.outcome in future.
Chances for APN role are bright in the Chances for APN role are bright in the private sector, but it will take time for private sector, but it will take time for acceptance in the public sector.acceptance in the public sector.
ACKNOWLEDGMENTACKNOWLEDGMENT
Graduate Nursing Committee, Aga Khan Graduate Nursing Committee, Aga Khan University School of NursingUniversity School of Nursing
Madrean SchoberMadrean Schober
THANK YOUTHANK YOU