A former district nurse and midwife said yesterday that she believes Bermuda is lagging behind other nations by not giving specialised nurses more autonomy.

Cecille Snaith-Simmons has for 64 years either worked in the profession or kept in touch with its development.

She worries that the healthcare system is at a “standstill”, with advanced-practice nurses unable to make use of their full skill-set.

The Ministry of Health said last week that it had held “exploratory” discussions after receiving interest from nursing professionals and other stakeholders about “potential adjustments” to APN scope of practice.

However, the Bermuda Medical Doctors Association is staunchly opposed and wants to maintain a “physician-led model of patient care”.

The Bermuda Nurses Association yesterday confirmed its support for increasing autonomy for advanced-practice nurses.

APNs — educated to at least master’s degree level and capable of prescribing, diagnosing and treating conditions — can only prescribe certain medicines in Bermuda if they have an agreement with a registered physician.

Elsewhere, including in Canada, the US and Britain, they are afforded more power.

Ms Snaith-Simmons, an author and historian, said: “Nurses today are more highly trained and they [the BMDA] are objecting to this but the world is moving on.

“These are highly trained individuals in special areas and they will be an asset to healthcare in Bermuda.”

In its opposition, the BMDA said that the difference in training hours between nurses and physicians was a “fundamental” issue, while the doctor-to-patient ratio, which the association said was just under one doctor per 1,000 residents, was branded “sufficient”.

Ms Snaith-Simmons replied that it was insulting for the BMDA to say that doctors train longer.

She explained that nurses are constantly taking part in training courses and also questioned the point about the number of general practitioners.

Ms Snaith-Simmons added: “If there are enough doctors, why are they bringing in doctors? I question this, I really do.

“There are not enough doctors here and that’s why we need these skilled nurses — to pick up the slack.”

Explaining the advantages of increasing APN power, she said: “I think it would be more cost-effective.

“I think care would be more efficient. When I say more efficient, I mean not sitting for two hours in a doctor’s office.

“We are lagging behind. We are talking about people who are waiting for days in emergency response and hours in a doctor’s office.

“We need to move on — the world has moved on.”

Ms Snaith-Simmons added: “We are all in it for what’s beneficial for Bermuda, not what’s beneficial for ourselves.

“Nurses always want to progress — what can we do next? What’s better?

“As long as I’m here, I’ll fight and say that the nurses should be respected.

“I have seen the progress of the healthcare here. Right now it’s at a standstill and it needs to move forward.”

Ms Snaith-Simmons, who has written an op-ed on the issue for The Royal Gazette today, qualified from St Mary’s Hospital in Portsmouth as a registered nurse and midwife in 1965.

Further training courses followed at The University of the West Indies, in Jamaica, the Marie Stopes Clinic, in London, and at the Bermuda College.

She helped to lobby successfully for the unionising of nurses within the Department of Health and also helped to negotiate the amalgamation of the two racially segregated nurses’ associations, which today forms the Bermuda Nurses Association.

Karen Grant-Simmons, the president of the association, said yesterday that the charity was also in support of increasing autonomy for APNs.

She cited the role they play in primary prevention and mentioned how countries elsewhere had found employing specialised nurses to be more efficient and cost-effective.

Dr Grant-Simmons said: “It’s an area I believe Bermuda can improve in — primary prevention.

“For a long time we have been running after the horse after it has already bolted.”