Advanced Practice Nursing in Belize

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Psychiatric Nurse Practitioner

Nationally Certified:
Yes

Recognize Foreign Licensure:
Yes

Treatment Authority:
Yes

Prescribing Authority:
Yes (Psychiatric Nurse Practitioner only)

Practice Autonomously:
Yes

Contact:
Belize Ministry of Health

Role

The state of health in Belize has a lack of health professionals in general (BMOH, 2014).  With the lack of a current medical school in the country, providers are frequently trained by neighboring countries as Cuba, Guatemala, Mexico, Nicaragua, and Costa Rica (PAHO, 2009b). As can be imagined, Belize in turn relies heavily on regional international support for their health resource management and it is estimated that up to 30% of their medical providers are immigrated from those other countries.

Because of the lack of health professionals in general, frequently registered nurses autonomously provide care at an advanced practice level including basic diagnosis and treatment at rural health posts (PAHO, 2009b; BMOH, 2014).  Most often, the advanced role in such nursing situations are based on algorithms and protocols for decision making. Frequently they are used as triage agents to determine if an patient may be treated at the rural health post or needs to make the cumbersome trip to a higher level of care and see a medical provider.

Nursing in Belize is regulated by the Ministry of Health through the Nursing and Midwifery Act (Chapter 321, 2003), which currently is under revision by Belize legislature. Nursing according to the 2003 revision is identified according to the curriculum requirements for registration as a registered nurse, but no specific scope of practice is identified. Volunteer opportunities are available for Nurse Practitioners to work according to their scope of practice in their own country.  If an individual desires to work at this level, the would be encouraged to work as a part of a local Non-Governmental Organization and may need to inquire with the Ministry of Health if there are any limitations on their scope of practice.

In general prescribing is permitted for medical doctors and dentists exclusively (Misuse of Drugs Act, Ch. 103, Rev. 2003).  However, as long as there is an overseeing physician, nurses can write and dispense medications according to their understood protocol.

Education and Certification

Certifications for all three nursing specialties are available through the University of Belize.

Specialties

Based on the greatest needs of the Belize population, the University of Belize (2016) currently offers three certificates for an advanced role:

  • Psychiatric Nurse Practitioner
  • Rural Health Nursing
  • Practical Nursing

The main differentiation is that Psychiatric Nurse Practitioners are permitted to prescribe psychochotropic medications within certain protocols (PAHO, 2009b).

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References:
Belize Ministry of Health [BMOH] (2014). Belize Health Sector Strategic Plan 2014-2024.  Retrieved from: http://health.gov.bz/www/attachments/article/801/Belize%20Health%20Sector%20Strategic%20Plan%202014-2024-April%202014.pdf

Pan American Health Organization [PAHO] (2009a). WHO-AIMS report on mental health system in Belize. Retrieved from: http://new.paho.org/blz/index2.php?option=com_docman&task=doc_view&gid=63&Itemid=250

Pan American Health Organization (2009b).  Health Systems Profile: Belize.  Retrieved from: http://www.paho.org/blz/index.php?option=com_docman&view=download&alias=64-health-sytems-profile-belize-monitoring-and-analyzing-health-systems-change-reform-july-2009&Itemid=250

University of Belize (2016).  Program offerings.  Retrieved July 14, 2016 from: http://www.ub.edu.bz/fnahsw/program_offerings.phpUpdated: July 14, 2016

Advanced Practice Nursing in South Korea

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Advanced Practice Nurse

Nationally Certified/Registered:
Yes

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Uncertain

Prescribing Authority:
Uncertain

Practice Autonomously:
No

Contact:

Role

Advanced Practice Nurses in South Korea date back to the 1950s (Sheer & Wong, 2008).  There are various roles of APNs in South Korea including (Sheer & Wong, 2008):

  • Nurse Midwife
  • Community Health Nursing
  • Nurse Anesthetist
  • Mental Health Nurse

While the advanced practice nurses have also existed in their country for more than 20 years, a strong value of the physician role has inhibited the professional respect to allow advanced practice nurses their own autonomy and peer collaboration.  Lack of local support in Korea further is represented as there is only one hospital in the nation that hires APNs in the nurse practitioner role, and even then the position reflects more of a senior nursing position than that of a medical provider (Maryland Nurses’ Association, 2012).

Education & Certification

Advanced Practice Nurses in South Korea are educated at the masters level of graduate education (Kang, 2005; Sheer & Wong, 2008).  The Advanced Practice Nurse role in South Korea is governed and certified by the Ministry of Health (Sheer & Wong, 2008).

Specialties

Advanced Practice Nurses in South Korea have various specialties (Kang, 2005; Sheer & Wong, 2008):

  • Anesthesia
  • Community Health
  • Critical Care
  • Emergency Medicine
  • Gerontology
  • Home Care
  • Infectious Disease
  • Industrial Health
  • Palliative/Hospice
  • Psychiatric/Mental Health

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References:
Kang, Y. (2005).  Development of advanced practice nurses in South Korea.  Applied Nursing Research, 18(4), 226-227.

Maryland Nurses’ Association (2012).  A trip by Korean nurse practitioners to observe the U.S. nurse practitioner’s practice.  Maryland Nurse.  Retrieved from: http://www.thefreelibrary.com/A+trip+by+Korean+nurse+practitioners+to+observe+U.S.+nurse…-a0293416966

Savrin, C. (2009). Growth and development of the nurse practitioner role around the globe.  Journal of Pediatric Health Care 23, (5),310-314.

Sheer, B. & Wong, F.K.Y. (2008).  The development of advanced nursing practice globally.  Journal of Nursing Scholarship, 40(3),204-211.

Advanced Practice Nursing in Namibia

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Midwifery and Neonatology Specialist Midwife (Midwifery and Neonatology)
Critical Care Nursing Specialist Nurse (Critical Care)
Psychiatric Nursing Specialist Nurse (Mental Health)

Nationally Certified/Registered:
Yes

Recognize Foreign Licensure:
Yes

Treatment Authority:
Yes

Prescribing Authority:
Yes

Practice Autonomously:
Uncertain (Yes in rural areas)

Contact:
Nursing Council of Naimibia

Role

The nursing role in Namibia today is expected to train all nurses to also be midwives because of the high need to assist in pregnancies.  As a result, all nurses practice to this level.  Because of the lack of physicians in more rural areas, the nurses in these regions may offer thorough assessment, diagnosis, and treatment based on their being the isolated health provider in a rural area.  Training at the bachelors level has been developed as of 2008 and encouragement from the Namibian government has been to continue to expand the education of nursing (Klopper & Uys, 2010).

As of 2008, the Nursing Council of Namibia also identifies there are several specialties in nursing by which an individual can be trained as a (Health Professions Councils of Namibia, n.d.):

  • Midwifery and Neonatology Specialist Midwife (Midwifery and Neonatology)
  • Critical Care Nursing Specialist Midwife (Critical Care)
  • Psychiatric Nursing Specialist Nurse (Mental Health)

Education & Certficiation

Individuals in the nursing roles can be trained at the bachelor level (Klopper & Uys, 2010).  While all the nurses trained in Namibia have been expected to perform midwifery care, individuals from surrounding countries who come to Namibia to work may not be trained in this task.  As a result, the Namibian schooling offers training to teach those individuals to additionally have the skills to work as a midwife (Klopper & Uys, 2010).

The individuals who pursue the specialties obtain a Masters degree in their specific subject (Health Professions Councils of Namibia, n.d.).

Specialties

The Nursing Council of Namibia does identify several specialties as nurse specialists as mentioned previously as: Midwifery and Neonatology, Critical Care, and Mental Health nurse specialists.  Nurses are also able to obtain a nursing diploma in general nursing as a: midwife, nurse with midwife capabilities, or dermatology (Health Professions Councils of Namibia, n.d.).  According to the Nursing Council of Namibia, there is government sanctioning that identifies additional advanced diplomas that allow a nurse to gain further education in various specialist subjects (Health Professions Councils of Namibia, n.d.):

  • Advanced University Diploma in Operating Room Nursing Science
  • Diploma in Opthalmological Nursing Science
  • Advanced University Diploma in Health Promotion, Clinical Diagnosis and Treatment
  • Advanced Diploma in Nursing Education
  • Advanced Diploma in Critical Care Nursing
  • Advanced Diploma in Dermatology
  • Advanced Diploma in Anesthetics
  • Advanced Diploma in Health Service Management
  • Advanced Diploma in Unit Management for Registered Nurses
  • Advanced Diploma in Clinical Nursing Science, Health Assessment, Treatment and Care
  • Advanced Diploma in Community Health Nursing Science
  • Advanced Diploma in Midwifery and Neonatal Nursing Science
  • Advanced Diploma in Occupational Health Nursing Science
  • Advanced Diploma in Gerontological Nursing Science
  • Advanced Diploma in Child Nursing Science
  • Advanced Diploma in Orthopedic Nursing Science
  • Advanced Diploma in Oncology
  • Advanced Diploma in Neonatology
  • Advanced Diploma in Trauma Nursing Science

While this list of advanced diplomas is extensive, it is uncertain the accessibility of these advanced diploma programs, as only the first five were identified to be offered by the University of Namibia (Health Professions Councils of Namibia, n.d.).

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References:
Health Professions Councils of Namibia (n.d.).  Nursing council of Namibia.  Retrieved from: http://www.hpcna.com/nursing_min.php

Klopper, H. & Uys, L.R. (2012). The state of nursing and education in Africa: A country-by-country review [Google eReader version]. Sigma Theta Tau.  Retrieved from: http://books.google.com/books?id=SzgiwENnd4UC&source=gbs_navlinks_s