Reflect on the development of advanced nursing in your own country.

Read the paper by Ketefian et al (2001):

Ketefian S., Redman R., Hanucharurnkul S., Masterson A. and Neves E. (2001) The development of advanced practice roles: implications in the international nursing community. International Nursing Review 48: 152-163.

Reflect on the development of advanced nursing in your own country. Use Ketefian et al™s sub-headings to structure your reflection.
¢ socio-political environment

In Saudi Arabia advanced practice nursing roles not yet specifically regulated which means nurse is become work in complicated and higher level and involved in any area of health care practice. On the other hand, there exists opportunities that will speed the attainment of the APN roles in the country. The social political environment in Sadia Arabia has played a pivotal role in the advancement of social needs in the society which necessitates the development of APN. Midwifery services, primary health care have been introduced with degree of courtesy and accessible of the social political environment which demonstrates preference of humanistic and health promoting services.
Recently, Saudi Arabia is still make effort to evolving advanced practice nursing roles which educate both gender in nursing master and PhD level in order to provide leadership and ensure the suitable services, training, and regulation of nurses. Also to continued development of nursing is unthinkable without foreign nurses for the predictable future (Tumulty 2001).
¢ the health needs of the population

The health needs of the population in Saudi Arabia are highly cantered in the rural setting unlike USA and UK. This calls for a paradigm shift of priorities from the urban centres to local areas to be able to meet the needs of population. This is achieved through training more health personnel and establishing more health care facilities in rural areas. According to Ministry of health 2009 there is maldistribution of health care services across geographical area .and there is a lack of health service for special group such as older or who have disability in rural area. In order to improve accessibility to health care need to redistribute of health care centre (Almalki et al. 2011)

¢ the health workforce supply and demand

The government of Saudi Arabia considers development of health care services at primary level, sec, and tertiary. However the main challenge they face is proving qualified workers. It is challenged by the shortage of professionals in most local health care™s either nurses or doctors. The number of Saudi nurse was insufficient to meet the nursing workforce needs. Therefore, nursing workforce in Saudi Arabia depend on expatriates who are recruited from different countries which is the majority of them are Indian and Filipino. At the time of Gulf war nurses and other expatriates was
Leaved hospitals critically short of health care personnel was found (Aldossary,While and Barriball 2008).On other hand, the most of patient spoke Arabic language and most of nurses who are working in hospital either Arabic or English language dose not considered as first language. Therefore, for those causes the demand for Saudi nurses has been increased. The government play role to provide Saudi staffs by opening health and nursing schools in order to overcome demand and increased emphasis on œSaudiization that has occurred in the last decade (Almalki, et al. 2011; Aldossary ,While and Barriball 2008).This deters formulation and application of practical strategies to retain and attract professionals particularly in nursing and therefore it™s a clear priority for effective reforms of the Saudi health care system.
¢ government policy and support
Government policy and support are noted to play a very important role towards development of APN roles in Saudi Arabia. This is achieved through funding of nursing programs providing scholarship for nurses. The scholarship program is provided not only for nurses who are working in academic settings such as universities or nursing school but also for nurses whose work in Mistry of health such as hospital and primary health care centre to improve competences. In addition, there is a program was initiated in 2005 for graduated students for all study domains not only health care which was King Abdullah Scholarship Program which aimed to enable students to study abroad (Alamri 2011). Moreover, Ministry of Higher Education was sponsored students at universities in Saudi Arabia.
Recently, the Mistry of health contribute with Mistry of higher education to improve nursing qualification they are closing all diploma schools of nursing to encourage to change to baccalaureate . They are providing bridging programs for nurses who hold diploma certificate to be have BNS degree in nursing. Moreover, King Abdul-Aziz University establishes master program in nursing while PhD program not yet applied in Saudi Arabia (Miller-Rosser, Chapman and Francis 2006, Alamri 2011).
¢ intra- and inter-professional collaboration

Intra and inter professional collaboration stands out as the key to the development of each role in nursing. Collaboration within and between professions gives room for new development of ideas, strategies and approaches to health issues. The level of Intra and inter professional collaboration is still not well established and therefore it greatly affects the up scaling of APN roles. (Ketefian et al. 2001).

¢ the development of nursing education
Development of nursing education in Saudi Arabia was first established in 1958 where it only trained male as nurses only (Tumulty 2001). However, the situation has now changed and currently nursing training extends to the females. In regard to the development of APNs in Saudi Arabia development of nursing education has really helped to advance towards APNs. For example, Mistry of health was opened more institutes with different level of nursing education either 9 years of schooling or 12 years of schooling to enable students to obtain Diploma in Nursing as a qualification. Then, in order to improve nursing education in 1976 Ministry of Higher Education was established first Bachelor of Science in Nursing in King Saud University in Riyadh and Master of Science in Nursing in 1987. Later, PhD scholarship programme was established in 1996. Moreover, other agencies are providing nursing education program both governmental and privet system (Aldossary, While and Barriball 2008). The current situation in Saudi Arabia indicates that there are 15 schools offering Bachelor of Science in nursing program.

¢ evidence of effectiveness of ANP

Saudi Arabia registers of evidence of APN role despite the underpinning challenges they go through in terms of efficiency, effectiveness and quality of the services being offered. These challenges are common to all system worldwide trying to implement APN roles (Goudreau & Smolenski, 2014).
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