The role of physician oversight on advanced practice nurses’ professional autonomy and empowerment

Abstract

Background and purpose Little is known about the effects of physician oversight on advanced practice registered nurses (APRNs). Examination of these relationships provides insight into the strength of independent practice. The purpose of this study was to examine whether APRNs’ perceptions of autonomy and empowerment varied according to type of physician oversight, whether facilitative or restrictive. Data sources A cross‐sectional survey design was used to examine whether APRNs’ perceptions of autonomy and empowerment varied according to physician oversight, geographical location, and practice setting. Five hundred questionnaires were mailed in March 2013 with 274 returned. Participants were asked about autonomy, empowerment, demographics, physician oversight, geographical location, and practice setting. Conclusions Among surveyed respondents, physician oversight was related to increased empowerment, regardless of whether the oversight was defined in facilitative or restrictive terms; both had similar positive effects on empowerment. Implications for practice If APRNs are to be part of the solution to the growing problem of healthcare access, it is important to study factors that contribute to their success. We speculate that increasing opportunities for collaboration and interaction with physicians, and possibly other healthcare professionals, could facilitate APRN empowerment, optimizing their contribution.

An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective

“…This research concurs that NPs in both Ireland and Australia are independent and autonomous in their clinical work, and it is important to note that participants were primarily working in the acute hospital environment and regulation in Ireland and Australia require collaborative agreements with an identified physician. Petersen and Way () reported that collaborative relationships with physicians and NPs effected increased empowerment and autonomy for NPs which may provide an understanding for the autonomy discussed in this research.…”

“…An autonomous nurse practitioner practices with a nursing philosophy and without being dependent upon medicine (Weiland, ). Recent literature reports that NPs working independently of physician oversight had greater autonomy associated with greater job satisfaction (Petersen & Way, ; Poghosyan & Liu, ; Spetz, Skillman, & Andrilla, ). This research concurs that NPs in both Ireland and Australia are independent and autonomous in their clinical work, and it is important to note that participants were primarily working in the acute hospital environment and regulation in Ireland and Australia require collaborative agreements with an identified physician.…”

Developing the advanced practice nursing role in Slovakia: Perception, education, and practice

“…This research supports findings of our research: the importance and need of a development and establishment of an educational curriculum of APN in Slovakia. Petersen and Way (2017) found that medical doctor's oversight was related to increased empowerment of advanced practice registered nurses. Authors recommend that if advanced practice registered nurses are to be part of the solution to the growing problem of health care access, it is important to study factors that contribute to their success.…”

An exploration of perceived neonatal nurse practitioner authority in a restricted practice setting

“…Our study findings on impressions of increased autonomy resulting from the collaboration of NNP and neonatologist on protocols guiding practice support that evidence. However, Peterson and Way (2017) described NPs in urban settings with closer access to physician supervision as more autonomous and empowered. Neonatal Nurse Practitioners in our study reported increased feelings of autonomy in the outlying level-II settings with less physician oversight of management.…”