Principal Nursing Officer in Dominica
The Principal Nursing Officer (PNO) holds a high-level position in Dominica’s Ministry of Health, serving as a bridge between policy and practice for the nursing profession. By providing strategic direction, the PNO ensures that the nation’s nursing workforce is equipped to maintain excellence in patient care while managing the daily complexities of the public health system.
The PNO serves as the technical lead for nursing services, bridging the gap between clinical practice and the Chief Nursing Officer’s policy-making functions. The PNO is central to Dominica’s mission of building a climate-resilient health system, managing the deployment of staff across the island’s health districts and the Dominica China Friendship Hospital (DCFH).
Role and Strategic Responsibilities
The PNO is responsible for the quality of nursing care delivered at all service points. This involves a complex balance of human resource management, professional regulation, and clinical oversight.
- Workforce Planning and Management: The PNO oversees the distribution of approximately 420 nursing positions nationwide. This includes managing recruitment and addressing the acute challenges of nurse migration and attrition by advocating for better remuneration and incentives.
- Standards of Practice: Ensuring that all nurses adhere to the Nurses Registration Act. The PNO works with the General Nursing Council and the Dominica Nurses Association (DNA) to monitor professional ethics and clinical competence.
- Disaster and Pandemic Response: The office serves as the focal point for nursing mobilization during emergencies. During the COVID-19 pandemic and the aftermath of Hurricane Maria, the PNO coordinated the integration of local nurses with collaborators from countries like Cuba.
- Education and Mentorship: The PNO liaises with the Dominica State College (DSC) and institutions like All Saints University to ensure that nursing curricula are aligned with national health needs and international standards.
Notable Principal Nursing Officers
The position has been held by several influential figures who have helped transition Dominican nursing from a colonial model to a modern, community-focused system.
| Name | Tenure/Period | Key Contributions |
| Marylene Paul | c. 1990s – 2000s | Served as a key administrative lead during the expansion of primary healthcare. |
| Caesarina Ferrol | c. 2010 – 2018 | Oversaw the nursing service during critical periods of migration and spearheaded regional policy reforms. |
| Terrilia Ravaliere | 2019 – Present | Led the nursing response to the COVID-19 pandemic and is currently spearheading the 2026 “Nursing Framework Modernization” initiative. |
The Nursing Service Today
The PNO’s office is focused on Health Systems Transformation. This includes the transition toward the Dominica Hospital Authority governance model, where clinical decisions are more decentralized to allow for rapid response at the hospital level. The PNO remains the primary advocate for nurses’ welfare, currently managing the rollout of a leadership initiative aimed at creating clearer career advancement paths within the public service.
References
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1.
Dominica's Health Systems Transformation – PAHO/WHO Reports https://www.paho.org/en/stories/dominicas-health-systems-transformation
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2.
The Nurse Workforce in the Eastern Caribbean – Semantic Scholar https://pdfs.semanticscholar.org/932c/b58fbab3b771c1785fe5c869627d04de1743.pdf
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3.
Message by Mrs. Terrillia Ravaliere on International Nurses Day https://emonewsdm.com/message-by-mrs-terrillia-ravaliere-principal-nursing-officer-ag-on-the-occassion-of-international-nurses-day/