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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 examination of inter-professional relationships and the effect these have on teams and teamwork is extensive. In much of the literature, concepts have been studied separately, and so the linkages to contexts and the broader socio-historical background were notable for their absence. The picture of teams, their work and process is skewed, as emphasis on one topic is often at the expense of another. Conceptual rigour is required if we are to understand what we are talking about.

The examination of inter-professional relationships and the effect these have on teams and teamwork is extensive. In much of the literature, concepts have been studied separately, and so the linkages to contexts and the broader socio-historical background were notable for their absence. The picture of teams, their work and process is skewed, as emphasis on one topic is often at the expense of another. Conceptual rigour is required if we are to understand what we are talking about.

Qualitative study on the experiences of new midwives moving into their professional practice.

A 5 year study on ACNP's on the role in practice and how it was established.

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

This article describes entry-level competencies for NPs practicing in emergency care - it was the first to define these competencies which is key since the roles of APRNs have expanded. A Nurse Practitioner (NP) Validation Work Team was formed and a Delphi study was conducted to verify and gain consensus on professional and clinical competencies for NPs in emergency care.

Hi i'm not sure that I posted on this site correctly... this article explores how relationships between midwives can impact student success in transitioning to the role of a CNM. :) -molly jobe

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.

Biggest study of ACNPs and their role---tracked ~400 NPs over 5 years.

Birth centers run by midwives lead to better outcomes than hospital births

In this article, author Lugo discusses the findings of her study relating limits on full practice authority for APRNs to issues of gender equality. She investigated the link between state support of the Equal Rights Amendment (ERA) and laws in these states allowing APRNs full scope of practice and prescribing rights. Her study showed that states that have historically and currently supported the ERA in fact allow greater APRN scope of practice, and thus she draws conclusions about attitudes towards women's equality and the regulation of advanced practice nursing, which remains to be a woman-dominated profession.

In this May 2016 article published in the Online Journal of Issues in Nursing, Dr. Nancy Rudner Lugo argues that advanced practicing nursing viewed through a gendered perspective due to nursing's history as a predominantly female profession; because of this, APRNS in states that are less accepting of women's equality have a more narrow scope of practice. There is not currently a national-level evidence based method used to determine APRN scope, and is instead decided at the state level. The author seeks to explain the cause of the discrepancy between differing APRN scopes of practice in different states by comparing the APRN scope of practice between states that did and did not vote to pass the Equal Right Amendment, positing that states with cultural attitudes that are more equitable between genders reflect this at the legislative level, thus explaining the wider or full practice authority given to APRNs in these states. In conclusion, Lugo advocates for increasing the number of women in legislative positions, forming relationships between women's equality organizations and groups working towards expanded health care access, and emphasizing the skills and competency of APRNs in achieving positive patient health outcomes.

This article describes past and current barriers to APRN prescribing abilities in the state of Georgia. While legislation has been passed in the state to allow APRN's to prescribe medications to their patients under a collaborating physician, Georgia remains one of the most restrictive states for APRN prescribing. A descriptive study was conducted to analyze the efficacy and safety of APRN prescribing and found that out of approximately 8000 prescriptions written by APRNs, only 0.003% of those were changed by the supervising physician. The study recommended that more data be collected to support the argument for full-prescriptive authority for APRNs in Georgia.

Spoelstra, S. L., & Robbins, L. B. (2010). A qualitative study of role transition from RN to APN. International Journal of Nursing Education Scholarship, 7(1).

Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the current practice of the acute care pediatric nurse practitioner (AC PNP) to inform an update of the Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC) examination content outline.

The article explores how Emergency Nurse Practitioners views their role within the Emergency Department and Emergency Care Team.