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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

This study reviewed the struggles new APRNs were having when transitioning to new healthcare providers. It discussed the benefits of a formal residency program for new APRNs and used the benefits the programs provided for new MDs to support the findings that these formal residencies could provide for new APRNs.

This articles takes about the importance of a structured residency program for new nurse practitioners. A structured residency program helps to the NP to get acclimated in the new role of being a provider and ensures patients are receiving quality care.

New advance practice nurses can use these tips to help them face the challenges of their new positions.

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practical tips for new APRNs and vivid description of the first days of new APRNs

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

This article describes feeling like a fraud once in a new role as an advanced practice nurse. It also speaks to how this is a normal feeling and suggests different ways to cope with these feelings to make the transition easier.

This is research article discussing if the "residency" programs that are starting to pop up for new grad APRNs are helpful. I found this interesting because we briefly discussed the residency positions during the new job panel.

Here's a good, quick article that gives tips for the transition from RN/student to an APRN in the workplace.

By Stephanie Tillman, CNM, MSN I have come to believe that one of the hallmarks of a great midwifery practice is ability to integrate new midwives....

This is a nice synopsis of key moments in history that have triggered the growth and development of the NP role in the US.

This article shares an experience of an NP in Nevada who had been trying to care for patients in under served areas but was having difficulty finding MDs to sign agreements with in those areas. This inhibited her ability to treat people in need but, thankfully, a new law was passed July 1 that enabled her to treat these people to the full extent her education taught her to, without having to rely on an agreement with an MD. It is important for us to remain aware of our scope of practice but also to fight for our ability to practice to the full extent we're being taught to do.

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]"

Discusses challenges faced by new NP grads as they transition from student to NP.

This article describes feeling like a fraud once in a new role as an advanced practice nurse. It also speaks to how this is a normal feeling and suggests different ways to cope with these feelings to make the transition easier.

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.

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.

Brief paper from a recent Sigma Theta Tau Nursing Research Congress. The emphasis is on mentoring to fill the gap of little to no NP orientation for new grads.