The care model of the future: supporting APRNs through an innovative transition to practice program

Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners

INTRODUCTION

We examined factors influencing pediatric hospital-based APPs' career decisions and described the transition to practice experiences.

METHOD

We conducted a cross-sectional, descriptive electronic survey using a novel instrument to examine APP career decisions and transition to practice experiences among APPs in four Southeastern children's hospitals.

RESULTS

There were 158 respondents composed of family nurse practitioners (NPs) (30%), primary care pediatric NPs (24%), and acute care pediatric NPs (18%). APPs chose their career to further their education (46%) and because of interest in pediatrics (18%). Most APPs had experience in pediatrics on APP graduation and were well prepared for the role (47%) and to care for pediatric patients (56%). Nearly two-thirds of APPs had an orientation.

DISCUSSION

Early exposure to pediatrics influenced APP career choices and increased career preparedness. Although most APPs had an orientation, future studies should assess the impact of orientation on patient, professional, and organizational outcomes.

Clinical Nurse Specialist Transition to Practice

PURPOSE

A quality improvement/evidence-based practice project identified the critical components of clinical nurse specialist (CNS) transition-to-practice (TTP) needs based on the experiences and perceptions of entry-level CNSs (n = 4), experienced CNSs (n = 7), and directors of nursing (n = 6) employed in a tertiary healthcare center. Structured 60- to 90-minute face-to-face discussions were conducted.

DESCRIPTION

As knowledge workers, CNSs are critical to investigating, solving, and transforming some of the most challenging current and future healthcare problems. Lack of standardized CNS TTP may result in variable levels of practice, knowledge, skill attainment, and ability to attain interdisciplinary practice competencies.

OUTCOMES

Findings included identification of entry-level CNS TTP key components: 16 categories with 8 critical categories identified as imminent needs. Challenges identified included stakeholders' lack of knowledge/understanding of the CNS role and scope; enormous TTP expectations of entry-level CNSs; transdisciplinary relationships and collaboration; leadership culture and collaboration; organizational culture; deliberate practice; and lack of support, resources, and basic needs.

CONCLUSION

Critical components for advanced deliberate practice within a CNS TTP program include an organizational culture and subculture that understands and values the CNS, along with tiered sustainable support from preceptors, mentors, and support CNSs across the setting and system.

Job Satisfaction and Retention of an Advanced Practice Registered Nurse Fellowship Program

The purpose of this study was to determine how an advanced practice registered nurse (APRN) fellowship program affects job satisfaction and retention after the first year of practice. The Misener Nurse Practitioner Job Satisfaction Scale was administered to nine novice APRNs at a large Midwestern children's hospital after program completion. Job satisfaction scores and retention rates were measured. Results indicate that transition-to-practice programs are helpful in bridging the gap between graduation and professional practice as an APRN.

Communication, leadership and organizational support facilitate successful transition into practice for nurse practitioners in the emergency department

BACKGROUND

Postgraduate programs, specialized academic programs, and national health organizations such as the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills, and factors for successful transition into practice.

PURPOSE

The purpose of this study is to examine the relationships and differences among the personal and community resources that promote successful transition for nurse practitioners (NP) who practice in the emergency department (ED) and the skills or procedures they find difficult to perform independently.

METHODS

A descriptive, correlational, comparative study design was conducted using an online survey administered to a convenience sample of NPs with 6 months to 5 years of experience as an NP.

RESULTS

Findings from this study identified factors associated with successful and unsuccessful transition into practice and help support positive outcomes for health care institutions, ED patients, and NPs practicing in this specialty area.

IMPLICATIONS FOR PRACTICE

Support in transition recognizes recommendations set by health care organizations in promoting professional development, safe clinical practice, job satisfaction, and retention. Further study will provide clarity in financial gains and improved patient health outcomes during a time in which complex disease processes and provider shortages continue to weigh heavily on society.

Novice nurse practitioner workforce transition and turnover intention in primary care

PURPOSE

Little is known about the workforce transition and turnover intention of novice nurse practitioners (NPs) in primary care (PC). This research aimed to describe the individual characteristics, role acquisition and job satisfaction of novice NPs, and identify factors associated with their successful transition and turnover intention in the first year of PC practice.

DATA SOURCES

A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a PC setting for 3-12 months.

CONCLUSIONS

This study demonstrated that greater professional autonomy in the workplace is a critical factor in turnover intention in novice NPs in the PC setting.

IMPLICATIONS FOR PRACTICE

Further research is needed regarding the novice NP workforce transition to provide adequate professional autonomy and support during this critical period.

Exploring the Factors that Influence Nurse Practitioner Role Transition

The transition from registered nurse (RN) to nurse practitioner (NP) is often a stressful career change. Data are lacking on the factors affecting NP role transition. This study examined the relationships between NP role transition, prior RN experience, and a formal orientation. From a sample of 352 NPs, only a formal orientation contributed significantly to the regression model indicating a positive relationship with NP role transition (b = 6.24, p < .001). Knowledge of the factors that explain NP role transition is important to inform the discipline how best to support NPs during entry into practice.