Empowering the nursing sector to fulfill its potential as a healthcare provider would help reduce the national health bill, said participants in two public lectures held by AUB’s School of Nursing at the Issam Fares Hall in March as part of its centennial activities. Currently, nurses in Lebanon act as support staff to medical doctors. But promoting advanced studies and specialties in nursing could open up a new role for nurses, at least in primary care, which is considered the first point of contact between patients and doctors. Primary care involves general practitioners and clinical services, while secondary and tertiary care usually refers to more expensive healthcare that relies on specialists, hospitalization, and management of chronic or end-stage illnesses. The lecture participants said they would like to see more nurses take a role similar to general practitioners, whereby they would screen patients at the primary care stage, treat the simple cases, and refer the more complex ones to doctors. In the most recent lecture, held on March 18, Executive Secretary Mervat Tallawy of the Economic and Social Commission for Western Asia (ESCWA) discussed the issue, “Strategizing in Healthcare: The Importance of Manpower Planning in Nursing,” in which she emphasized the importance of planning and assessing needs through an integrated approach. “In any of our Arab countries, attention is focused on doctors and not nurses. This results in the problems we have today,” she said, adding that even if the region has top-notch doctors, a shortage in qualified nurses undermines the quality of medical services. Tallawy also raised the issue of Lebanon’s imminent accession to the World Trade Organization (WTO), which would compel it to open up its borders to any international health service center wishing to set up shop here, thus increasing competition in this sector. “We have to plan in advance… to fit the needs of the times,” she said. She then presented Dr. Josette Sfeir, who currently heads the Medical Unit at ESCWA, to further develop the subject. Several factors should push decision makers to focus on developing the nursing sector, said Dr. Sfeir. She noted that an increase in hospitalization costs, an ageing population with chronic diseases, and a better informed public are gradually creating an increased demand for preventive medicine, which fits into the category of primary care. In parallel, the field of nursing has developed specialties, allowing nurses to provide a full spectrum of care, from primary prevention to specialist disease management and palliative care, said Sfeir, who is an AUB alumnus. That’s why primary care should not be the glass ceiling for nurses, she explained, as she highlighted the potential roles for them in public health promotion and in delivering continuing care and chronic disease management, in addition to first-contact diagnosis, care, treatment, and referral. The lectures elicited a strong response from the audience, which included president of the Syndicate of Private Hospitals Suleiman Haroun and Dr. Nabil Kronfol, president of the Lebanese Health Care Management Association. Dr. Haroun raised the issue of nurses’ salaries, which he said were one third less than what the same nurses could receive abroad. “The problem is that the more we educate our nurses, the more likely we are to lose them,” he said. Dr. Kronfol, on the other hand, remarked that the loss of nurses to foreign markets stopped being a problem three years ago. Two weeks earlier, Health Minister Mohammed Khalifeh had delivered a lecture at AUB, “Innovations in Healthcare Delivery in Lebanon: The Role of the Nurse.” Dr. Khalifeh, who is a leading researcher in kidney transplants at Kings College in London, said that world health will be affected by several changes, including population growth, reduced resources, occupational health, and technological advances. For this reason, there is a need for healthcare reform in Lebanon to ensure improved quality at lower cost. Dr. Khalifeh was introduced by Dr Huda Huijer Abu-Saad, director of the School of Nursing, who called for the promotion of specialist nurses, which would help reduce healthcare costs while improving quality of care. But Dr. Khalifeh, who lamented the absence of nurses specializing in strategy and policy-making and noted that the prevailing culture still acts as a stumbling block to the advancement of nurses, said, “There is still the perception that a nurse’s place is by the patient’s bed.”
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