Perspectives of Physicians Related to Advanced Practice Nursing in Emergency Departments in Morocco: A Qualitative Descriptive Study

Abstract

Advanced practice nursing roles are being developed in Morocco to address growing demands on emergency departments, yet physicians’ perceptions of these roles remain poorly understood. The international literature highlights that contextual factors are crucial to the success of advanced practice nursing integration, with physicians as key stakeholders whose collaboration and support are considered essential. A qualitative descriptive study was conducted between June and September 2025, using semi-structured interviews with emergency physicians at a university hospital in Morocco. Participants were selected through purposive sampling, and interviews were audio-recorded, transcribed verbatim, and analyzed using an inductive thematic analysis approach. Nine physicians participated in the study and analysis generated five main themes: 1) The concept of advanced practice nursing: integrating autonomy, technical expertise, and standardized care; 2) Optimizing patient care through the advanced practice nurses: the clinical and organizational pivot; 3) The multidimensional challenge of implementing advanced practices; 4) Prerequisites for successful integration of advanced practices; and 5) The strategic path: the catalytic national context. Overall, physicians recognized the potential of advanced practice nurses to optimize emergency care delivery while highlighting substantial legal, organizational, and cultural barriers to their implementation. These findings require Moroccan emergency nurses to undertake three measures: advocate for a clear regulatory framework that defines the advanced practice nurse’s scope of practice and legal protections; strengthen educational programs to build physicians’ confidence through interprofessional collaboration; and capitalize on opportunities within the Moroccan context to advance the nursing profession. By taking these actions, nurses can ensure safe, effective, and sustainable integration of advanced practice nursing roles in Moroccan emergency departments.