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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

BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

From this article, it acknowledges the importance of inter-professional collaboration. At the end of the residency program, NPs held a stronger appreciation for the roles of other health care professionals as well as the benefit from getting feedback from different specialties. NP fellows learned from each other's strengths and weakness and how to function as a team.

From nurse to NP.

Repost. The original post I placed below did not have a description. The article explores student's perception of what it means to transition from RN to NP, done at the end of their first semester of graduate nursing,

Is the transition from RN to APRN that begins during the start of school. How students struggle with balancing academics, life, and other demands. This article shows how nursing faculty can aid and mentor students successfully in their transition into practice.

Is the transition from RN to APRN that begins during the start of school. How students struggle with balancing academics, life, and other demands. This article shows how nursing faculty can aid and mentor students successfully in their transition into practice.

This article explores the process of transitioning from an RN to a FNP.

Article showing an application of teamwork in a primary care setting to develop a behavior health intervention. See the abstract below! J Am Board Fam Med. 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042. Abstract PURPOSE: This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. METHODS: This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. RESULTS: Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. CONCLUSION: Primary care and behavioral health clinicians, through their interactions, c

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]"

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.

This is an older but fascinating article about a midwife working in Gardener, Massachusetts in the 19th century. Hanna continued to attend births of mostly the immigrant population of the city despite being told by courts to cease. She was convicted of "practicing medicine without a license" and had to pay many fines and spend 3 months in a correctional facility. Note that the charges brought against her were never from clients, but from the physicians working in the area.

The APRN role is one that is continually evolving globally due to health care provider needs. This article looks specifically at barriers APRNs face that hinder them from practicing to the full extent of their scope and how to face these barriers to promote full scope of practice and address healthcare needs.

Pediatric NP's began training in 1965 in order to enhance the role of the pediatric nurse; however, since then PNP's are seeking increased autonomy from MD's in order to work to the full extent of the knowledge and skills. The article describes how PNP's are aptly trained to assess kid's who are abused, exploited, neglected, or need immunizations. As a result, PNP's have a unique role, separate from MD's, to enhance any practice.

"I have come to believe that one of the hallmarks of a great midwifery practice is ability to integrate new midwives."

Great study using the stages from novice to expert highlighting the challenges that RNs face when transitioning to being a FNP.

Is the transition from RN to APRN that begins during the start of school. How students struggle with balancing academics, life, and other demands. This article shows how nursing faculty can aid and mentor students successfully in their transition into practice.

This is an article that discusses possible frameworks for phases of transition from student RN to becoming an FNP. With the limited research that has been done in the area it is difficult to know exactly how to support students in their transition to be a provider, but this is a foundation which can be built upon.

Article about using mentoring to help transition from student to NP