The Future of Evolving Advanced Practice Nursing Roles in the Saudi Health Care System

Abstract

Background: Nursing practice is affected by changing healthcare needs, and their influencing factors. Thus, nursing is re-inventing itself continuously, such that it has endorsed advanced practice nursing (APN) roles. However, most of the Saudi healthcare institutions have not integrated the roles into their system due to the delivery system’s culture, structure and process issues. Still, there are many nurses practising at an advanced level, without formal recognition. Objectives: There is a lack of literature on APN in Saudi Arabia (SA), making it important to explore the status of APN roles and to examine professional, health and economic factors that may be impeding the profession of nursing initiating such a career pathway. Research Questions: The study examines the expectations of implementing the APN roles within the Saudi healthcare system by exploring the current nursing situation in the country and how advanced practice nurses could be implemented whilst considering what health system challenges affect APN education and regulation. Method: Semi-structured interview was chosen for data collection and situational and thematic analysis were employed for data analysis. The research included 38 participants who were specialist nurses and decision-makers in the health, education and regulation systems from three regions in SA. Findings: There are initiatives to introduce the APN roles in SA. However, serious issues need to be addressed first before establishing the roles. There is a complete lack of scope of practice and differentiation among nursing groups. Nursing leaders are not in agreement and there is no proper nursing regulatory authority. Most of the nurses are not vocal with many representing nursing poorly. The nursing profession in SA is still under the control of physicians, so for establishing its unique professional identity and establishing APN roles, it is vital to restructure the way nurses are managed and change their attitudes to their work.