Nursing is an international profession characterized by a bond of caring services with people in need of health care. Consistent with the vision of Florence Nightingale, nursing services in the Middle East are provided to people whenever and wherever they require them: in hospitals; the community and public health centres; the home; work places; schools; and the battlefield. Nursing's evolution, for decades, has seen international efforts focused on strengthening nursing regulation, advancing and extending the scope of nursing practice and encouraging nursing research. Modern systems of nursing education, which are commensurate with the nursing role and comparable with other professions, are considered to be fundamental to the professional development of nursing at this point in nursing history.

In a context of the Middle East, international organizations such as the World Health Organisation (WHO) and the International Council of Nurses (ICN) have supported transformational change. In particular, the Eastern Mediterranean Regional Office of the World Health Organisation (EMRO) mandate to promote strategies to strengthen the capacity of the nursing workforce is measured in approach, through targets and action plans for the development of nursing and initiatives on scaling up transformative education and training in nursing. There are ambitious targets for the enhancement of interprofessional education, collaborative practice and nursing research (WHO EMRO 2010).

Nursing in the Middle East is in a stage of transition, and there should be greater acknowledgement and appreciation of this through international commentary on nursing from outside the region. There is a deficit in reporting on nursing in the Middle East; however, all too often when such commentary is made, it is uninspiring and unfair, and fails to recognize the progress made in recent years. The indigenous growth of nursing across the region has been affected by a strong history of medicine, a culturally derived poor perception of nursing and a readily available and majority expatriate nursing workforce. In some countries of the Middle East, the expatriate nursing workforce may be as high as 80%. Given the unfavourable world economy and the favourable Middle East taxation regime, the region continues to be an attractive place of employment for nurses. However, expatriate nurses are a transient workforce, and this results in a lack of stability in creating a nursing workforce, which further presents a challenge in establishing and sustaining indigenous nursing developments.

There is now recognition in individual countries, for example Bahrain, that to develop and make progress in health services, the recruitment of local nationals to nursing is important for growth of the role of the nursing profession in the delivery of health services. In Bahrain, there are two universities providing undergraduate nursing and greater numbers of young Bahraini women and men are applying for entry to nursing. In the most recently established university (RCSI; www.rcsibahrain.edubh), the number of Bahraini student nurses commencing the programme between 2006–2014 increased by over 150% and the number of males entering the programme increased by 25%.

A specific attraction of nursing education in Bahrain is the provision of an undergraduate BSc (Hons) programme, and sponsorship of student fees and all associated costs, including the provision of a laptop computer. Such developments are notable, given that many countries outside the Middle East – despite sustained years of effort – have not achieved a graduate nursing education programme. In Bahrain, there is research evaluating the perceptions of undergraduate nursing students and the results are positive, with one of the key findings being the need for strategic efforts to strengthen nursing recruitment and promotion locally (Tawash et al. 2012).

In the past, Middle Eastern nurses, in the absence of postgraduate education locally, were required to travel to other countries for postgraduate studies. Therefore, postgraduate education was undertaken at great personal effort, given family commitments and cultural differences; also it was provided at great cost to the country. Very limited numbers of nurses could avail of postgraduate education. However, there is now an MSc Nursing programme in Bahrain and this opens up new opportunities and plans to develop postgraduate specialist nursing programmes. Professional discussions are taking place and the nursing profession is well advanced with the proposed formation of a Chapter of Sigma Theta Tau International (Rufaida;

Similar to all parts of the world, in the Middle East the nursing profession is the major segment of manpower in health care. The constancy and influence of nurses on the front line of health services delivery can be transformational in supporting the healthcare objectives of a nation. Targeted efforts at cultivating and promoting nursing leaders will provide the necessary competence to improve the nation's health care, whilst advancing the scope of clinical nursing practice.

There is much optimism about the future of nursing practice and education in Bahrain. Nursing is establishing its identity, schools of nursing are located in universities, postgraduate education is growing and nursing research is under development. The investments in nursing are taking place with students receiving free fees to study nursing, and postgraduate nursing education sponsorship is available. The strengthening of nursing strategy and nursing regulation is the next stage in development. Nursing leadership will emerge as the nursing seeds of the future have been planted and are growing in Bahrain.


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  2. References
  • Tawash E., Cowman S. & Anunciacion E. (2012) A triangulation study: Bahraini nursing students' perceptions of nursing as a career. Journal of Nursing Education and Practice 2, 8192.
  • WHO EMRO (2010) Strategic Directions for Strengthening Nursing and Midwifery Services 2011–2015. World Health Organisation, Geneva.