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Reconstructing nursing: a study of role transition in advanced nurse practitioners

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Abstract

As the demands on the NHS increase, nurses are facing the challenge of attempting to implement innovative and new roles in clinical practice. Changes such as the reduction in junior doctor hours, evidence based practice, and recognition of nursing's contribution to health care delivery, have acted as catalysts for professional
development. At the same time, the UKCC's ongoing quest to have nursing establish itself as a major professional discipline has resulted in the recognition of different
levels of nursing practice. The highest and most complex level is that of the "advanced nurse practitioner" (ANP), who is expected to be prepared at the Master's degree level.

This study set out to explore the transitional process of nurses undergoing the academic and clinical preparation to become ANPs. A qualitative design, utilising five
case studies, was used as the main research strategy. In addition to the ANP, each case comprised a number of medical, managerial, educational, and nursing staff.
Data was collected by individual interviews, observations and documentary analysis. Supplementary data was collected through the completion of role development
diaries by an additional 8 ANPs. Data collection was completed over a two year period and analysed with the assistance of the NUD-IST computer program.

It was found that the transitional process of becoming an ANP involved the reconstruction of nursing in seven personal and practice domains. Both the transitional process and outcome were contingent upon the influence of key stakeholders within each institution. Consequently, role transition resulted in one of three operational outcomes: practice replication; practice fragmentation; or practice innovation. Regardless of outcome however, all ANPs sought to establish a new and unique identity as a way of escaping the organizational and occupational constraints placed upon them, and to gain recognition and professional empowerment.

Publicly Available Date Mar 28, 2024

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