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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]"

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 National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. This includes the APRN Consensus movement. This website has multitudes of information related to APRN practice; as we get closer to the F2F classes in October, this will become a more valuabel resource.

This article discusses the transition from student to an NP's first job. Patterns identified included isolation, loss of relationships, changes in professional relationships, and loss of control. Positive aspects of the transition included gains in personal satisfaction and a professional network.

The orientation described in this article is something that sounds appealing to me as a new grad. It exposes practitioners to didactic and simulated experiences, focused peer support, formalized resources, and includes a preceptor.

This 2015 article, written in the Journal of Pediatric Health Care, discusses the critical importance of intervening and advocating for APRNs to have full practice authority as opposed to the current varying state-by-state practice laws. The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other providers to practice and receive the full amount for their rendered services. The author supports her argument by including the IOM Committee's view; removing APRN practice restrictions would assist in addressing health care access, high-quality care, and an overall healthier population.

This is an excellent overview of NP history and practice changes written by Arlene W. Keeling PhD, RN, FAAN. It includes a historical narrative for the NP role that includes key figures (Lillian Wald, Mary Breckenridge, Loretta Ford) with seminal legislation, challenges to the practice, and future implications.

Great article on nursing residency programs and the opportunities they provide. BONUS- includes insight from an Emory NP Alum who completed a residency program in Washington!!

Faced with a shortage of primary care doctors, more and more clinics are relying on nurse practitioners to fill the gap. But that creates another gap, in the level of training providers bring to the job. Residency programs--once reserved for physicians--are popping up for nurse practitioners as well.

This article asks the question: "Compared to other providers (physicians or teams without APRNs), are APRN patient outcomes of care similar?" The study is specific to USA and includes data regarding NPs, CNRAs, and CNMs. Outcomes were determined by the following: patient satisfaction with provider/care, patient self-assessment of perceived health status, functional status, blood glucose, serum lipids, blood pressure, emergency department visits, hospitalization, duration of ventilation, length of stay, and mortality (p9).

This article discusses the external and internal stressors a novice nurse practitioner will experience in the first few years of his, or her, career. It then discusses the four phases that an NP can expect to endure as they become more confident in the field. Many stressor come from aspects of the job that include billing, referrals and even ownership of ones role as a primary care provider. This piece offers mitigation to the previous stressors with the introduction of a mentor.

This article entry conveys the importance of APRNs and the need for our country to better understand and use APRNs as they were trained to be used. It also includes a link to an article discussing the dissatisfaction among the profession due to various States' limitations placed on the profession's scope of practice.

I understand that use of this login entitles me to access licensed materials provided to current Emory faculty, students, and staff, including selected Healthcare staff. My use of these licensed materials is for academic study, research and patient care only, and not for commercial purposes.

This article is an excellent resource for new graduate NPs to help them transition from student to proficient NP during the first year of practice. The article is from 3 different perspectives including patient, colleague, and clinic factors which all contribute to the transition period for new graduates.

I like how this article reminds us to include patients/families as part of the Team

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