Journal of Social Change


This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from the framework provided a guide for the design of eight main questions and 19 subquestions. Data was collected from 17 participants through in-depth interviews and group discussions and analyzed using Charmaz’s three simplified methods for qualitative data. Findings were that (a) registered nurses and midwives are constrained to perform advanced duties, (b) doctors delegate advanced roles to nurses and midwives, (c) nurses and midwives lacked pathways for advancement, (d) APN would substitute for doctor shortage, and (e) advocacy and lobbying has to done by the Nursing and Midwifery Council of Nigeria to change the current policy. The social change implication is that it offers insight into the potentials for APN in healthcare delivery. Keywords: advanced practice