Exploring family nurse practitioner professional identity formation at rural health care facilities

Abstract

Background: Nurse practitioners (NPs) are being used to meet the increased demand for rural primary care. Purpose: The purpose of this study was to explore the perceptions and experiences of rural NPs while they transitioned from being registered nurses to family NPs (FNPs). In addition, the study examined if and how new FNPs experienced their professional identity formation in their first year of rural primary care practice. Methodological orientation: A qualitative phenomonological research design was used. Sample: A sample of 12 FNPs who graduated from one of three Midwestern university programs, worked, and provided primary care at a rural health care facility located in one of four full-practice states were used within the study. Conclusions: Participants experienced new nurse practitioner professional identity formation beginning in their education programs, which continued throughout their first year of practice. Four themes emerged from the data analysis: learning new knowledge, skills, roles, and responsibilities; interactions with patients, providers, and interprofessional team members; incentive to learn and practice in rural health care; and professional identity formation. Implications for practice: The emerging model, The Process of Professional Identity Formation for Rural Family NPs, shows potential for use as a framework to guide rural NP curriculum and professional development programs. Policy makers must also continue the push to increase the number of states allowing NPs full independent practice. These efforts could promote rural NP support, recruitment, and retention that will be key to meeting the primary care needs of rural and vulnerable populations.

Nurses' and nursing students' intent to stay

“…Recent research discovered that a variety of competitive pay and benefits policies promote nurse intent to stay, recruitment, and work satisfaction. 3,5,20 Findings for this current study were similar; however, the present study adds to research gaps since its sample included practicing nurses at all practice and educa-tion levels and soon-to-graduate nursing students at a variety of education levels.…”

“…4 Another recent study found comparable results for NPs. 5 In addition, allowing NPs to practice within their full scope of practice was important to NP's work satisfaction and intent to stay. 5 Incivility negatively impacts the work environment by having a detrimental effect on individuals, teams, organizations, and patient safety, and is a major reason why nurses leave their positions.…”

“…5 In addition, allowing NPs to practice within their full scope of practice was important to NP's work satisfaction and intent to stay. 5 Incivility negatively impacts the work environment by having a detrimental effect on individuals, teams, organizations, and patient safety, and is a major reason why nurses leave their positions. 6 Incivility is defined as "a wide range of lower intensity acts of aggression, including failing to act when action is warranted, that may result in psychological distress for the individuals involved."…”

Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries

“…The Global Strategic directions for nursing and midwifery 2021–2025 [ 47 ] provides policy priorities, aligned with the guidance above, to ensure that nurses maximally contribute to national health goals and UHC. Policy-relevant evidence on what specifically contributes to nurses’ retention in health and care settings [ 48 – 51 ], including for advanced practice nurses in rural and remote settings, is increasingly available [ 52 – 54 ]. Institutionalizing these aspects requires a context-specific aligning of the education, training, and lifelong learning of nurses with optimized roles of nurse in the health system, updating and strengthening professional regulations, providing leadership and career advancement opportunities, ensuring safe and supportive service delivery environments, and competent management, planning and forecasting of the nursing workforce to ensure nurses are where they are most needed [ 31 , 47 ].…”

The influence of professional identity on work engagement among nurses working in nursing homes in China

“…According to the social identity theory, identity can influence individual thinking, emotion and behaviour (Liu et al, 2021); therefore, professional identity will inevitably have an impact on the nursing practice (Shun, 2021). Nurses with a higher professional identity have a stronger sense of professional benefit, and can experience more pride, efficacy, achievement and happiness at work; therefore, their work enthusiasm and caring ability are higher (Luo et al, 2018; Owens, 2020). On the contrary, nurses with low professional identity will tend to exhibit negative attitudes and behaviours at work and reduce their sense of belonging, and then reduce their work engagement when they perceive that their self‐worth is not reflected in work and that their profession is not recognized by the society (Wang, Hu, et al, 2019).…”