The Status Quo of Nursing in Nepal: Challenges, Opportunities and Future Prospects

Abstract

            The nursing profession in Nepal has seen tremendous upheaval in the last five years, with both advancements and persisting problems. This essay delves into the current state of nursing in Nepal, focussing on concerns such as career advancement, working conditions, training requirements and the persistent problem of brain drain. It investigates inequities between government and private hospitals, insufficient resources, interprofessional conflicts, professional stagnation, gender disparities and the effects of high patient-to-nurse ratios. The essay compares Nepal's nursing condition to that of other South Asian countries, emphasising distinct issues and potential solutions. It also examines novel career prospects, such as positions in hospital-based care, community health, business endeavours and international projects. The future of nursing in Nepal is promising with the integration of artificial intelligence, more advanced practice roles and increased advocacy for reforming policies.  Telehealth and digital health services offer additional ways to enhance healthcare access and quality. The essay finishes by stressing the significance of joint efforts to address systemic difficulties and utilise innovations, enabling Nepal to potentially set new standards in global healthcare.

           The nursing profession in Nepal is navigating a complex landscape of systemic challenges and transformative opportunities, shaped by socioeconomic, cultural and geopolitical dynamics. Over the past decade, Nepal has made strides in expanding nursing education and integrating nurses into primary healthcare systems, yet critical gaps persist. As of 2023, Nepal’s nurse-to-population ratio remains alarmingly low at 0.5 nurses per 1,000 people, compared to the WHO-recommended 3 per 1,000, exacerbating healthcare inequities in rural and marginalized communities. Despite producing over 3,000 nursing graduates annually, the sector is crippled by brain drain, with an estimated 2,500 nurses emigrating yearly for better wages and working conditions abroad. Meanwhile, nurses in Nepal face chronic understaffing, gender-based discrimination and interprofessional hierarchies that undermine their roles. The COVID-19 pandemic further exposed vulnerabilities, with nurses enduring hazardous workloads and societal stigma. However, emerging trends such as digital health innovations, community-led care models and global partnerships signal a path toward resilience. This essay critically examines Nepal’s nursing ecosystem through recent data (2018–2023), contrasting it with regional peers like India and Bangladesh and proposes evidence-based strategies to address workforce retention, educational reform and policy advocacy. By leveraging technology and redefining nurses as leaders in healthcare delivery, Nepal can transform its nursing sector into a cornerstone of equitable and sustainable Universal Health Coverage (UHC).

Keywords: Nepal, nursing, bedside nursing, career growth, working conditions, education, brain drain, healthcare challenges