Nurse practitioners in primary health care: the Jamaican experience. Part II

This discussion of Jamaica's experience with nurse practioners in primary health care (PHC) reviews entry requirements, recruitments, and selection; selected specialist tracks; the curriculum; finance, administration, and management; program implementation; initial evaluation and continuing education; the 2nd class; subsequent intakes; class 4; and performance and problems. Minimum entry requirements include: registered general nurse; registered midwife or acceptable substitute post basic course for male nurses; and 5 year post registration practice in a relevant clinical specialty. Major curriculum components include: general subjects aimed at broadening skills in communication, social interaction, scientific problem solving, and other such behaviours; related/supporting sciences; nursing subjects; and medical subjects. There is a 6-week core curriculum followed by a 2-stranded specialist curriculum of 18 weeks, consisting of medical topics relevant to each sub-group. This period is followed by 6 months of internship. The nurse practitioner program is a cooperative/collaborative venture between the Ministry of Health and the Faculty of Medicine. The nurse practitioner program was launced in July 1977 with 25 students -- 18 in family nurse practitioner course and 7 in the course for nurse pediatricians. Following graduation of the 1st class, faculty members undertook a complete review and evaluation of the curriculum. Subsequently, some changes were made, including: increased pediatric content of the family nurse practitioner course; reorganization of content and hours devoted to research/epidemiology; increased pharmacology input; and modification in the scheme for student evaluation. A 2nd group, consisting of 22 students, began the courses on September 1, 1978. To date, 2 additional groups of students have been admitted to the program. To provide data on nurse practitioners' functioning in PHC settings in Jamaica, the Advanced Nursing Education unit encouraged its students to conduct a series of small research studies into various aspects of the nurse practioner progam. 2 studies were conducted and completed in 1979 and 1 study is now nearing completion. Thus far experience shows that the Jamaican nurse practitioner is well received by selected health care personnel with whom she works, and health care consumers express maximum satisfaction with care received from nurse practioners. Major problems associated with the program are of 2 types: those related to education/training; and those affecting the work and service of nurse practitioners. Despite problems, morale among teaching staff and students remains high, and a large majority of nurse paractitioners reported increased job satisfaction in their present role (AU)

Nurse practitioners in primary health care: the Jamaican experience. Part I

In September 1994 the Nurses Association of Jamaica (NAJ) submitted a proposal for the establishment of a nurse practitioner programme in Jamaica to the Ministry of Health. Underlying the development of the nurse practitioner proposal is the collective belief of Jamaican nurses that: access to adequate health care is a basic human right, not a privilege; this care should be available to the individual at the time of need regardless of his/her ability to pay; nursing forms an integral and indispensable part of health care services everywhere and must be available to individuals irrespective of nationality, race, color, social status, creed or political affiliation; the health care delivery system must reflect the inherent value of human life and the dignity of the individual; high level wellness of every man, woman and child is a desirable goal; and the social and economic progress of any country bears a direct relationship to the health status of its population. The nurse practioner is viewed as a senior professional nurse who has completed an approved program of education/training which prepares her to function in the expanded nursing role. The purpose of the nurse practitioner program is to prepare senior professional nurses for greater clinical responsibilities in the health services so as to make available more and better health care to all people. Specifically, the programme seeks to provide experienced nurse/midwives with advanced nursing/medical education and training so that they will be able to meet a wider spectrum of health care needs. To achieve the stated purpose, the ultimate goal is that each graduate of the program will be equiped to perform a series of various activities and functions in clinical