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The purpose of this hermeneutic phenomenology (van Manen, 1990) was to gain insight into the meaning and lived experience of nurse practitioners (NP) with at least one year of work experience regarding their initial transition from new graduate to hospital-based practitioner. This study provided information regarding NP hospital-based transition experience that had not been revealed in the nursing literature. The meaning of transitioning into hospital-based practice was discovered through analysis of nurse practitioner letters and interviews in this phenomenological study. Six themes emerged from this research including: Going from expert RN to novice NP; system integration; "Don't Give Up"; Learning "On the Fly"; They Don't Understand my NP Role; and Succeeding Through Collaboration.   Master's prepared, board-certified NPs in North Carolina (NC) with between one and three years of NP practice experience in a hospital setting comprised the population of interest for this study. Twelve participants were purposefully sampled from nine hospitals in NC. Individual, voice-recorded, in-depth, open-ended telephone interviews were conducted with each participant.   The majority of the participants indicated a timeframe that ranged from six to 18 months regarding how long it took them to feel more comfortable in their NP role, the lack of comfort was most intense during the first nine months of practice. Participants confronted multiple obstacles and challenges as new NPs. These challenges included navigating and negotiating a new health care provider role; becoming integrated into a hospital system in what was a new role for them and sometimes for the system; learning how to function effectively as a NP while simultaneously working to re-establish themselves as proficient clinicians with a newly expanded practice scope; building key relationships; and educating physicians, hospital leaders, clinical staff, patients, and families about the NP

The following is the abstract as stated by the author: "Purpose: To describe factors that ensure a smooth transition from nurse practitioner (NP) student to independent NP during the first year of practice. Data sources: Two contrasting case examples, the authors' experiences, and selected professional literature. Conclusions: Key points to consider upon searching or taking a first NP job include patient, colleague, and clinic factors. Patient factors include mix of patient presentations, complexity of patient presentations, insurance status, and population. Colleague factors include mentorship, charting, mix of providers, and availability of providers. Perhaps most importantly, clinic factors include productivity expectations, practice mission, charting systems, on-call requirements, supervision of other staff, and teaching status. Together, these factors can largely determine whether an NP's days are satisfying or frustrating in a new job. Implications for practice: The transition from NP student to independent NP can be daunting. Although nursing schools and practice sites have responsibilities to ensure the transition is smooth, the new NP is ultimately responsible for the transition. [ABSTRACT FROM AUTHOR]"

up to date NP statistics

An integrative review analyzed the perception of NPs and physicians working in primary care settings. The aim of this study was to evaluate these relationships in order to understand the success of collaboration and factors that strain these relationships. Multiple barriers were identified partly due to the autonomy of the NP. Furthermore, physicians who have never worked with NPs found more negative attitudes collaborating with NPs. Both NPs and physicians report concerns collaborating, but also value advantages.Unfortunately, a collaboration between NPs and physicians is a slow process, however, more exposure to this collaboration can help overcome these barriers.

This article discusses the barriers to NP practice with the current healthcare reform by addressing the shortage of primary care providers and the limitations of APRN practice. Barriers that were emphasized include state practice and licensure, physician related issues, education, and role perception. This article stresses that an APRN should be able to practice to the fullest extent of their training.

This is an excellent overview of common barriers to APRN practice that effect the Triple Aim for healthcare: better care (individuals), better health (populations), and lower cost.

This article first provides a brief history on APRNs. It also discusses barriers to the APRN scope of practice.

Timeline on the role of the NP/APRN from the beginning. I like that it's done by decade.

Brief history of AANP

Very helpful timeline of the creation and establishment of NPs

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Research article that discusses practice setting characteristics that were either helpful or stressful to new grad NPs during their first year of practice. Primary care settings in Canada were sites used in this study, but the results would likely apply to acute care settings as well.

↵Correspondence: Maureen Sullivan-Bentz, University of Ottawa, School of Nursing, Simulation Laboratories, 200 Lees Ave, Ottawa, ON K1S 5S9; telephone 613 298-3022; e-mail mbentz{at}uottawa.ca OBJECTIVE To examine role transition and support requirements for nurse practitioner (NP) graduates in their first year of practice from the perspectives of the NPs and coparticipants familiar with the NPs' practices; and to make recommendations for practice, education, and policy.

The transition of newly graduated nurse practitioners (NPs) into practice can be challenging for the employer and the NPs. A new-graduate residency model for NPs along with evaluative criteria is presented from a primary care setting. Residency models are of benefit for new-graduate NPs to ease the transition to practice and promote patient care quality, and nurse retention, and satisfaction.

When I typed in "APRN history" into Google, this was the first item to populate. The article is from the American Association of Nurse Practitioners website and is a timeline of significant events that have occurred over the course of APRN history. I was surprised to see that one of the first NP programs was created at Boston College. My mother is a graduate from their BSN program! The AANP was developed in 1985 and has since helped pioneer the career. Enjoy!

This site breaks down the role of a nurse, how much they've grown, and organizations that have developed, decade by decade.

This was a great overview of the nurse practitioner role. There was also a very interesting infographic on the website as well.

Literature review regarding initial use of NP in the ICU. Briefly discusses origination in mid '90's of certifying body for ACNP as well as their role and how it has changed.

This article provides good tips as a new NP on the job!

This article discusses the stressors that a novice NP may face in providing quality care. Many programs provide adequate content and clinical exposure, but mentorship may be an effective strategy for novice NPs to transition into the role of a competent healthcare provider.

This link shows all the certifying bodies available and has links to those websites The American Association of Nurse Practitioners (AANP) is the largest and only full-service national professional membership organization for nurse practitioners (NPs) of all specialties.

Scope of practice for Gerontological NP

This document (from the Gerontological Advanced Practice Nurses Association) reviews NP scope of practice, gerontological NP scope of practice, and the merging of the adult and gerontology NP specialties.

This article touches on a topic of particular interest to me, specifically how APRN's can help fill a critical shortage of primary care providers in HIV medicine. The article validates that APRN's (NP's) are more than capable of providing high quality care to those living with HIV. Moreover, we are well positioned to fill the provider shortage that is only expected to grow over the next decade and beyond.

As NPs, many of us who have not practiced as nurses, it might be difficult to get your foot in the door of that first job. This is a personal strategy that I came up with to try and help mitigate that for myself, I'm obviously hoping that it works! For those of us who know where we want to work, for me that's in HIV medicine, I think it's important to develop the competencies that your employer will be looking for when you walk in the door. This article does a nice job of laying those out for entry level NPs looking to get into HIV medicine. What I'm trying to do is add as many of these skills to my resume while I'm attending school. My hope is that will give me an edge over NPs that I'm competing with who may not have been in the specialty specific time. If you can identify your desired areas of practice then its just a matter of looking for opportunities to add to your skillset. Look for faculty that have a shared interest, see if you can work on a research project with them. Look for nursing organizations in that specialty. There are two HIV specific organizations for APRNs looking to get into HIV medicine (ANAC and AAHIV). Join them and start networking. Take as much CNE as you can in your specialty topic - much of its free and can be done online at your own pace.

This is just a quick PDF about a new grad NP's transition as a healthcare provider in family medicine. She gives some tips and advice for those who will be going through a similar transition.

I enjoyed this concise description and advice column by a fellow NP who gives an honest account of her struggles and ways to support yourself in the transition from NP student to practicing NP.

This article goes over how nurse practitioners were able to obtain provider status. The audience, however, is for pharmacists. Thought it was an interesting perspective

Nice overview of how NP became primary care providers

History of NP since it was started in 1965