Nurses’ understanding of a developing nurse practitioner role in the Norwegian emergency care context: A qualitative study

Abstract

In Norway the nurse practitioner (NP) role is still in its infancy. To succeed with implementation of this new role stakeholder involvement is important, and there should be an explicit need for change. The aim of this study was to explore registered nurses’ understanding of how the NP role could contribute to meeting patients’ needs for care in the emergency care context, and nurses’ perceptions about the implementation process. The study is a qualitative interview study. The interviews were analysed by means of qualitative content analysis. Two themes presented themselves: the NP role being an autonomous role suitable for non-urgent patients, and the NP role being diffuse as well as a threat to colleagues and organizational structures. The results indicate that the NP role can make a valuable contribution to meet current challenges in the emergency care context. However, for successful implementation, the management team plays an important role in leading change and engaging co-workers to be part of the process. In further research, it is recommended to evaluate the forthcoming implementation process and, later on, to evaluate the outcomes of NP practice in the emergency care context in Norway.

Evidence‐informed policymaking: Modelling nurses' career pathway from registered nurse to advanced practice nurse

“…APN policy. Therefore, soliciting for collaboration and finding common ground for mutual visions between policymakers, practitioners, managers, educators, and politicians in the nursing and APN role development are of upmost importance(Bryant-Lukosius & DiCenso, 2004).There is an international need to specify requirements for generalist, specialist, and advanced practice, to alleviate confusion about the various roles and clarify role expectations (see, eg, Boman, Egilsdottir, Levy-Malmberg,& Fagerström, 2018;Dury et al, 2014;Jokiniemi, Meretoja, & Pietilä, 2018). While policy incentives can encourage the uptake of new nursing roles, the final decisions to recruit and employ RNs in advanced roles are made by the organizations(Maier et al, 2017).…”

‘The Lynchpin of the Acute Stroke Service’—An envisioning of the scope and role of the advanced nurse practitioner in stroke care in a qualitative study

“…and health policy domains. The potential for power dynamics within the interprofessional team to reduce the scope of ANPs was a key finding in emergency care research undertaken by Boman et al (2018). The nurse practitioner role was perceived as a threat to colleagues and organisational structures, with the consequence that their autonomous status only pertained to care of individuals with non‐urgent clinical needs.…”

“…What will differentiate the ANP from the beside stroke nurse will be advanced assessment skills, prescribing and administering the lysis regime, and autonomous clinical decision‐making, in line with the imperative that ANPs will execute diagnostic, analytical and clinical judgemental skills (NIPEC, 2016). The literature demonstrates that the implementation of advanced nursing practice in new clinical fields needs careful planning (Boman et al, 2018; Casey et al, 2018). Role clarity is a significant area that must be addressed, before implementation of ANPs (Casey et al, 2018).…”

“…A key finding in the present study was the broad support for an interprofessional model of supervision for the developing ANP trainee. A model of interprofessional supervision team has potential to build the quality of collegial cohesion that will be able to address organisational contexts, power dynamics and role clarity (Boman et al, 2018; Casey et al, 2018).…”

‘Thinking outside the box’: advanced geriatric nursing in primary health care in Scandinavia

“…The leaders must guide, motivate, support and communicate, and use various leadership styles to bring about actual change. It is not just a question about introducing a new routine, but about establishing a cultural change in patterns, values and attitudes [32, 33].…”