|Implemented in this survey?|
Between 1993 and 1995, the government of the Netherlands issued a policy aimed to reduce the current differences in the qualification and education of nurse practitioners, and to reduce the shortage of nurses, resulting from the absence of career possibilities. The policy is intended to lower the work load of medical doctors.
In the period 1993-1995, the implementation of a reconstructed educational system for the nursing professions took place in the Netherlands. At this moment there are 5 levels of nursing and
corresponding educational qualification.
There are 5 educational centres, but there are important differences in the content of the various programs.
There is a shortage of nurses in the Netherlands, which is partly the result of the absence of attractive career possibilities. The introduction of the nurse practitioner could make a career in nursing more attractive.
There is a shortage of GPs and medical specialists. Introduction of the nurse practitioner could lower the work load of medical doctors.
The main objective of the government, however, is to decrease the current differences in the qualification and education of nurse practitioners; the policy is directed towards more unification in the education and graduation of nurse practitioners.
There is a broad spectrum of functions at this moment ( advanced nurse, medical assistant, scientist, consultant etc.). Although there are no direct financial incentives given by the government, the government supports the educational centres by subsidies.
The government also facilitates this process by legislation.
More unification in the qualification and education of the Nurse Practitioner
political and not directly financial
educational centres, nursing professions, employers
|Medienpräsenz||sehr gering||sehr hoch|
The government aims to decrease the differentiation on behalf of the NP.
The European Bologna agreement, in which it is stated that bachelor and master programmes should be internationally compatible, is an important contextual factor. See for information about the Bologna agreement: http://europa.eu.int/comm/education/socrates/erasmus/bologna.pdf. Or: http://www.cepes.ro/information_services/sources/on_line/bologna.htm.
|Implemented in this survey?|
The idea for nurse practitioner has been borrowed from international developments, especially in the UK.
Next to this, it can be seen as the logical outcome of the professionalisation of the nursing profession.
The issue is put on the agenda by the government in reaction on several local initiatives for the education and employment of nurse practitioners in the Netherlands.
The main actors involved are the nursing profession, the educational centres for advanced nursing, the doctors and medical specialist and the employers i.c. the hospitals etc.
In 1999, the National Centre for Nursing published a report about the various tasks, functions and responsibilities of the nurse practitioner.
The first step is that the educational centres for advanced nursing must make an agreement about the qualification of NPs. The next step will be the discussion with and within the other groups (medical specialists, GPs, employers, unions).
The general health care labour policy is not to (over-)regulate the domains and qualifications of health professions.
There is, however, currently a discussion going on in the Netherlands about the further legislation concerning the tasks and responsibilities of the nurse practitioner in health care practices in relation to other professions.
There are no opponents. The question is how general practitioners, medical specialists and hospitals will react on this development.
This policy development is consistent with the policy to differentiate and reallocate manpower in healthcare.
At this moment there is discussion about the unification of the qualification and education of NP's. The government stimulates the educational centres to reach more unification in their training programme.
Approximately 100 to 150 NP's are now working in hospitals and the primary care.
This development is likely to proceed, but its implementation has become increasingly dependent on the co-operation of the doctors and employers.
See for information about the Bologna agreement: http://europa.eu.int/comm/education/socrates/erasmus/bologna.pdf http://www.cepes.ro/information_services/sources/on_line/bologna.htm
Han van Dijk