India must empower nurses as healthcare leaders

Source: The post India must empower nurses as healthcare leaders has been created, based on the article “The yearly ‘thank you’ to nurses is not enough” published in “The Hindu” on 16 May 2025. India must empower nurses as healthcare leaders

UPSC Syllabus Topic: GS Paper2-Governance-Issues relating to development and management of Social Sector/Services relating to Health.

Context: International Nurses Day on May 12 brings attention to nurses’ critical role in healthcare. However, the recognition often fades quickly, while deeper reforms to empower nurses in India remain unaddressed.

The Role and Potential of Nurses in India

1. Underutilisation of Nurses: Nurses and midwives make up 47% of India’s health workforce but are often seen only as assistants to doctors. Their contributions to leadership and clinical decision-making remain limited.
2. Global Trends in Nurse Autonomy: Many countries, including the US, UK, Australia, and Brazil, have embraced Nurse Practitioners (NPs) as independent care providers. NPs diagnose, treat, and prescribe with autonomy, especially in underserved areas.
3. India’s Slow Integration of NPs: India recognised the need for NPs in the National Health Policy 2017. Programmes like the NP in Critical Care (2017) and NP in Primary Health Care have been initiated. However, progress is slow due to unclear legal status, undefined roles, and lack of formal recognition.

Challenges in Nurse Practitioner (NP) Implementation

1. Lack of Legal Clarity: NPs face confusion over licensure, scope of practice, and prescriptive rights. Titles are unprotected, and their roles lack legal and regulatory backing.
2. Medical Resistance and Power Dynamics: Some in the medical community oppose NP roles, fearing a loss of authority. Gender and cultural biases also reinforce the idea of nurses, mostly women, as subordinates.
3. Educational and Institutional Gaps: Some institutions offer in-house training for specialised roles like stroke nurses or diabetes educators, but these lack national recognition. Many nursing colleges suffer from poor regulation and corruption.

Learning from Australia’s Nurse Practitioner Model

1. Policy and Political Backing: Australia’s NP movement succeeded through legal protections, structured licensure, and formal career ladders. Nurse-led care centres proved effective even without physician oversight.
2. Role of Nursing Movements: Australia’s reforms were supported by strong nursing advocacy in policymaking. In India, the absence of such collective movements weakens nurses’ influence on health policy.

The Path Forward for Nursing in India

1. Systemic Educational Reforms: India must shut down substandard colleges, improve faculty quality, and include leadership, ethics, and policy training in curricula.
2. Legal and Professional Recognition: NPs need legal status, licensure, and defined practice rights. Career pathways and fair pay must replace current stagnation.
3. Promoting Nurse Leadership: Nurses must drive reform through policy engagement and grassroots movements. Beyond yearly appreciation, India must empower nurses as equal leaders in healthcare delivery.

Question for practice:

Examine the challenges and opportunities in empowering Nurse Practitioners in India and how lessons from global models like Australia can guide reforms.