An exploration of perceived neonatal nurse practitioner authority in a restricted practice setting.
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
18 May 2021
18 May 2021
Historique:
received:
07
01
2021
accepted:
31
03
2021
pubmed:
21
5
2021
medline:
9
2
2022
entrez:
20
5
2021
Statut:
epublish
Résumé
Perceptions of autonomy in practice affect Neonatal Nurse Practitioner (NNP) job satisfaction, retention, and motivation to pursue NNP roles. However, Novice to Expert theory describes the processes for transitioning to nurse practitioner roles are not in relationship with NNP practice autonomy. Relationships between Advanced Practice Registered Nurse (APRN) practice authority, state restrictions, APRN volume, and health care access exist. However, do APRN perceptions of autonomy relate to motivation to pursue practice authority? This study provides an exploration of perceptions of NNP practice autonomy in this context. Semistructured interviews conducted with NNPs and neonatologists practicing in a restricted setting explored perceptions of practice expertise and autonomy, based on Patricia Benner's Novice to Expert theoretical framework. Laddered methodology organized survey questions, and the Framework Method was used for analysis of results. The majority of eligible NNPs (n = 12, 67%) and neonatologists (n = 8, 67%) agreed to study participation. Identified themes were grouped into larger concepts, including "NNP practice authority," "NNP expertise," and "NNP autonomy." For example, "NNP expertise" included the theme "determining NNP expertise" and associated factors included "procedural skills," "years and acuity of practice level," and "confidence in management plan and emergent situations." Both neonatologists and NNPs perceived neonatologists as a practice authority with support for NNP autonomy. Factors indicating NNP expertise correlated with domains in Benner Novice to Expert theory. These findings support previous work concerning the evolution of expertise and transition to practice. More inquiry to understand perspectives of APRNs in restricted practice settings is indicated.
Sections du résumé
BACKGROUND
BACKGROUND
Perceptions of autonomy in practice affect Neonatal Nurse Practitioner (NNP) job satisfaction, retention, and motivation to pursue NNP roles. However, Novice to Expert theory describes the processes for transitioning to nurse practitioner roles are not in relationship with NNP practice autonomy.
PURPOSE
OBJECTIVE
Relationships between Advanced Practice Registered Nurse (APRN) practice authority, state restrictions, APRN volume, and health care access exist. However, do APRN perceptions of autonomy relate to motivation to pursue practice authority? This study provides an exploration of perceptions of NNP practice autonomy in this context.
METHODOLOGY
METHODS
Semistructured interviews conducted with NNPs and neonatologists practicing in a restricted setting explored perceptions of practice expertise and autonomy, based on Patricia Benner's Novice to Expert theoretical framework. Laddered methodology organized survey questions, and the Framework Method was used for analysis of results.
RESULTS
RESULTS
The majority of eligible NNPs (n = 12, 67%) and neonatologists (n = 8, 67%) agreed to study participation. Identified themes were grouped into larger concepts, including "NNP practice authority," "NNP expertise," and "NNP autonomy." For example, "NNP expertise" included the theme "determining NNP expertise" and associated factors included "procedural skills," "years and acuity of practice level," and "confidence in management plan and emergent situations."
CONCLUSIONS
CONCLUSIONS
Both neonatologists and NNPs perceived neonatologists as a practice authority with support for NNP autonomy. Factors indicating NNP expertise correlated with domains in Benner Novice to Expert theory.
IMPLICATIONS
CONCLUSIONS
These findings support previous work concerning the evolution of expertise and transition to practice. More inquiry to understand perspectives of APRNs in restricted practice settings is indicated.
Identifiants
pubmed: 34014893
doi: 10.1097/JXX.0000000000000608
pii: 01741002-202202000-00020
doi:
Types de publication
Journal Article
Langues
eng
Pagination
328-339Informations de copyright
Copyright © 2021 American Association of Nurse Practitioners.
Déclaration de conflit d'intérêts
Competing interests: The authors report no conflicts of interest.
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