Taking on advanced responsibilities with additional training
Amid a nationwide shortage of healthcare providers, Israel is undergoing a significant professional transformation. Recent health policy reforms have expanded the clinical authority of specialist nurses, enabling them to take on advanced responsibilities with additional training. Rambam Health Care Campus (Rambam) is among the Israeli hospitals implementing this emerging model by integrating clinical nurse specialists into key specialties such as oncology, psychiatry, neurology, and intensive care.
A nationwide shortage of both doctors and nurses
Israel currently faces a dual challenge: a nationwide shortage of both doctors and nurses. Physician shortages, particularly in underserved regions and high-demand specialties, further strain the system. In response, the Ministry of Health has introduced reforms to expand the scope of practice for a select group of highly trained nurses. These clinical specialist nurses complete rigorous, field-specific training and are now authorized to perform advanced medical duties which includes prescribing medications, managing complex treatment plans, and conducting specialized procedures.
The training process for specialist nurses spans approximately one year. Candidates must hold a recognized master’s degree—at least one of which must be in nursing. In addition, applicants are required to have four to five years of professional experience in the field and must have completed an advanced (post-basic) certification course in a relevant area of practice.
“This is not about replacing doctors—it’s about meeting urgent system needs with the people who are best prepared to help, and this is a role that breaks the glass ceiling for nurses in Israel,” says Gila Hyams, director of Nursing at Rambam. “Specialist nurses are trusted experts in their field. Their presence reduces delays, improves continuity, and ensures patients receive the care they need when they need it.”
Stepping into lead clinical roles under extreme pressure
One such nurse is Avivit Nitka, nursing coordinator for Rambam’s Department of Otolaryngology – Head & Neck Surgery. With more than 25 years of experience, Nitka completed advanced training to care for patients with head and neck tumors. She now handles both medical and nursing responsibilities as she guides patients through the full course of their treatment. “It’s about trust, efficiency, and compassion,” Nitka explains. “When one professional can handle the full scope of care, the experience is better for everyone.”
The critical value of specialist nurses was underscored during the national emergency that began on October 7, when coordinated attacks in southern Israel left many communities with only nurses who served as the only healthcare providers on-site, stepping into lead clinical roles under extreme pressure. Their ability to triage, stabilize, and care for patients in real time highlighted the need for a more resilient, adaptable health system.
We need clinicians who can think independently, act quickly
“We need clinicians who can think independently, act quickly, and adapt to rapidly evolving situations,” says National Head Nurse and Director of the Nursing Division at the Israeli Ministry of Health Dr. Shoshi Goldberg. “Nurses with advanced authority are vital to the system’s resilience—not only during emergencies, but in everyday care.”
While only 1,300 clinical nurse specialists currently practice in Israel, the Ministry of Health aims to expand that number to 5,000 in the coming years. Rambam is actively investing in training and supporting this growing workforce to offer a scalable, collaborative solution to one of Israel’s most pressing healthcare challenges.
Based on an article in Hebrew on Ynet.
