Exploring Advanced Practice Nursing in Liberia

Monday, 7 July 2008
Keneshia J. Bryant, MSN, APRN-BC , Emergency Department, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA

Learning Objective 1: The Learner will be able to identify the need for Advanced Practice Nurses in Liberia

Learning Objective 2: The Learner will be able to identify potential means of educating nurses to become Advanced Practice Nurses through the use of modern technology

Liberia's civil war, which ended after approximately 14 years, left the healthcare system crippled. The average life expectancy at birth in 2004 was 42 years; this provides evidence of the need to improve the healthcare system.

The healthcare available to Liberian citizens is limited due to the fleeing of professionals to other countries. The destruction of hospitals and clinics exacerbated the problem. The current estimated population in Liberia is 3.3 million (2005). When one looks at the current number of healthcare workers in relation to the Liberian population, the acuteness of the situation is obvious: Physicians 103 (2002), Registered Nurses 1072 (2006), Certified Midwives 712 (2006), and Nurse-midwives 52 (2006).

The current nursing programs in Liberia offer certification, associate degrees and bachelor degrees in nursing, averaging three to four years to complete. One university also offer masters in nursing. Currently, a post-RN advanced practice program such as Nurse Practitioner does not exist. Although nurse midwives in the USA are considered advanced practice, in Liberia midwives generally have a lower status than nurses and are paid less. The certified midwife program lasts two years and provides a certification after completion.

Due to the need for additional physicians in the country, many nurses are required to perform as advanced practice nurses. Nurses are required at times to examine, diagnose and treat patients and draw upon their experience, previous observations and instinct to complete these tasks.

Introduction of Advanced Practice roles may be valuable to Liberia's future as it will provide nurses with the theoretical foundations and clinical skills required to provide care independently. Exploratory research is needed to identify which distance learning programs are appropriate for Liberia, such as collaborations with universities in the USA and other countries, interactive television, self-directed modules, Internet-based programs and clinical experiences in local hospitals and clinics.