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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 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.

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

Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), provide and coordinate patient care and they may provide primary and specialty health care. The scope of practice varies from state to state.

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.

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 observational study utilizes census data and geographic distribution of providers to illustrate current trends in distribution of providers, relative to uninsured patients and areas of limited access. Further, they discuss the policy changes aimed at bolstering access to primary care providers, specifically NP's, as a short term solution to a deficit in primary care providers. Additionally, the researchers explore distribution of APRNs, relative to scope of practice restrictiveness.

While this article is not specific to the FNP specialty, I find it interesting because it discusses the evolving global role of APRNs.

This article provides a brief history of the APRN role and the advancement from a CRNA, to midwives, then to FNPs. The focus is the family nurse practitioner role. The author shows the connection with Erik Ericsson's stages of development and provides examples of how the role of the NP progressed through those stages. Examples are also provided from a world development perspective, as each country has also had to move through the same phases of development before moving on to the next. The author concludes that we (the U.S.) are still in the final stage of development (Integrity-older adult).

This resource provides a brief history of APRN and outlines the developmental steps in advanced practice roles that can be helpful know for countries where the role of APRN are being established or growing.

Here is a great article that discuss how to make the transition as a healthcare provider through the use of a nurse practitioner residency program.

Probably posted before me. At any rate I'm attempting some effort here.

Personally I think NP residencies are a very important vehicle for transitioning into practice, and should be financially supported by the government the same way that medical residencies are supported!

Found this an interesting perspective because of the increasing demand for primary care providers.

This article discusses how overall outcomes are better for patients when ACNP are members of a unit or service-based provider team. It also touches on how to hire ACNP for different patient populations.

This article presents the development of APRN in the recent 20 years. Really a giant step regarding to scope of practice and license issue.

This article provides a brief history of the APRN role and how it has evolved over time. There are many links provided within the article that are intersting to better understand th initial thoughs about APRNs and how the role has changed and evolved over a relatively breif period of time.

This article is a great resource for learning a little more about the history of APRNs. It provides some history about the use of certification exams for licensure.

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.

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

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.

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).

When nurses, physicians and other health professionals overcome professional barriers and work together, patients--and provider--benefit.

Describes how new advanced practice providers feel as they make the transition from being a student. There's a period called the "impostor phenomenon" where they feel they are not really an advanced practitioner, but simply appear to be one.

This guide from the American Academy of Nurse Practitioners helps clarify the many facets of contract negotiations and provides a guide to help new NPs prioritize what to focus on during contract negotiations.