Educational and Workplace Challenges of Nurse Practitioners in India: Findings from a Nationwide Cross-Sectional Survey

Abstract

Background: Nurse Practitioners (NPs) play a transformative role in healthcare worldwide, bridging physician shortages and improving patient outcomes. In India, the NP in Critical Care (NPCC) program was initiated in 2016; however, implementation has been slow due to multiple barriers in education, practice, and recognition. Methods: A descriptive cross-sectional online survey (N = 126) was conducted in August 2025 among Nurse Practitioners, NP students, and allied professionals. The structured questionnaire explored state-wise respondent distribution, education-related challenges, workplace barriers, and suggestions for strengthening NP roles. Quantitative responses were analyzed using descriptive statistics, while qualitative responses were categorized thematically. Results: Most respondents were NPs in Critical Care (69%), followed by NP students (19%) and others (12%). Educational challenges included inadequate training (40%), shortage of faculty (31%), curriculum-related issues (22%), and lack of recognition of NP qualifications (32%). Workplace challenges comprised lack of recognition (37%), limited scope of practice (32%), workload (25%), and career progression barriers (21%). Suggestions included government recognition (21%), defining scope of practice (20%), awareness campaigns (16%), faculty training (14%), and structured career pathways (13%). Thematic analysis revealed three dominant themes: (1) Educational Barriers, (2) Workplace Challenges, and (3) Suggestions for Strengthening NP Role. Conclusion: Nurse Practitioners in India face systemic educational and workplace barriers. This study provides baseline evidence for policymakers, educators, and health administrators to develop legal frameworks, strengthen educational infrastructure, and ensure structured career pathways for effective NP integration.