Change to nurses’ role in France: How could patients be affected?
It comes after MPs passed a bill to expand the role, and improve provision in medical ‘deserts’
The new law will aim to expand and improve the care given by nurses in France
David Gyung/Shutterstock
The role of nurses in France is set to change and expand - which could affect patients in rural ‘medical desert’ areas - after a new bill was unanimously voted through in parliament this week.
On March 11, MPs unanimously adopted a bill by 142 votes in favour and 0 against, that will reform the nursing profession.
The bill “recognised (that) the missions of nurses and the evolution of their skills” along with the “difficulties in accessing care and the lack of nursing staff are sources of concern for many patients and practitioners, particularly in rural areas where there is a high rate of medical desertification”, it said.
It was proposed and supported by MP Nicole Dubré-Chirat (Ensemble pour la République) and the former Health Minister (and current president of the social affairs committee) Frédéric Valletoux. It aimed to reform the nursing profession, which is currently outlined by a 2004 decree that has “little relation to [the profession] today”, said Ms Dubré-Chirat.
The bill will now be voted on in the Senate. Health Minister Yannick Neuder has said that he hopes the text will pass quickly, so that MPs can push ahead to refine the law.
“It is time to trust these health professionals and to tell them loud and clear that they are essential to the care of people in France,” said Mr Valletoux.
Read more: Seven questions about ‘medical deserts’ in France
Read also: My experience of ‘medical deserts’ in rural France
How will nurses’ roles change?
Nurses will have more responsibility and new roles, in changes that are partly aiming to take excess load off of GPs and specialists, and enable nurses to take on more tasks in areas that are considered to have a lack of access to healthcare and GPs.
The law proposes the “redefinition” of five core tasks:
The provision of nursing care that is preventive, curative, palliative, or intended for clinical monitoring, and its evaluation
The monitoring of patients' health pathways and their referrals
Prevention, including screening and medical education
Participation in the training of peers
Helping with research
How will this change patient care?
The bill also specifies that nurses will be able to consult, diagnose, and prescribe for certain less-serious conditions. The precise list and scope of these is set to be determined by ministerial decree shortly.
This means that patients may be able to see nurses for certain complaints in the event that a GP is not available (or there is a much longer wait to see a GP).
Yet, these points have been criticised by doctors' unions, which have said they fear that nurses will not be able to consult, diagnose or prescribe safely enough in comparison to GPs.
Read more: How can I find out which parts of France are lacking doctors?
Read also: France’s medical deserts ‘pushing more GPs to turn away new patients’
Read more: New plan to serve areas of France without doctors
Will nurses be qualified enough?
The law also provides for nurses’ career development to enable them to gain more advanced skills; namely the infirmiers en pratique avancée (IPA, ‘advanced practice nurses’).
The text states the goal of making the IPA accessible to nursing professionals “subject to a minimum period of practice and the obtaining of a diploma”. This will allow “the exercise of skills usually reserved for doctors, such as patient monitoring, carrying out clinical examinations or prescribing certain treatments”.
Nurses with APN diplomas will also be able to practice in more places to provide healthcare that is more easily accessible. For example, in schools and in child welfare centres.
Certain specialised nurses (such as anaesthetist nurses, operating theatre nurses and paediatric nurses) will also be able to take part in more advanced practice “without changing their qualification requirements”, as long as they comply with a minimum period of practice.
Nurse pay set to be considered
The bill was voted through unanimously, but some MPs said they regretted that nurses’ pay was not addressed in this particular text.
“There is nothing in the text about pay, or acknowledgement of the toughness [of the role] for pension purposes, or working conditions,” said Green MP Hendrik Davi, reported by Merci Pour L’Info.
Mr Davi, along with LFI MP Elise Leboucher, called for the opening of negotiations on nurses' pay when the decree on the list of procedures and treatments is published. This amendment was adopted.
Nursing in France
There are 565,553 nurses registered with l’Ordre national des infirmiers in France.
As of March 1, 2025, this makes it the “largest healthcare profession in France [and] the only one present in all 1,663 INSEE catchment areas’, the order said in a press release on March 10.
Of these:
Self-employed: 109,440
Public sector: 213,327
Private sector: 150,021
Mixed practice: 22,208
Some nurses are more specialised:
Operating theatre nurses: 6,338
Nurse anaesthetists: 7,479
Paediatric nurses: 14,462
Infirmiers en pratique avancée (advanced nurses): 2,367
The average age of nurses is “around 40”, the order added, stating that around 12,000 are aged over 60.
