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Nurse Practitioners' Experiences of Transitioning to and Working in the Pioneering Nursing Role: An Interview Study
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Municipal Healthcare Hässleholm, Management Care & Welf, Hässleholm, Sweden.ORCID iD: 0000-0002-4714-4752
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0003-0077-9061
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-3594-3944
2024 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Nurse practitioners (NPs) play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare and reduced hospital admissions and cost-effectiveness. They usually hold a master's degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals.

Aim: To explore how nurses who are or have been employed as NPs describe their experiences of transitioning to and working in the NP role in Sweden.

Design: A qualitative interview study.

Method: This study explores the experiences of 15 NPs in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews in April and May 2022 and analysed with inductive content analysis.

Findings: The present study explores the experiences of NPs as they transition from experienced nurses to NPs, emphasising motivations, educational challenges, acceptance and autonomy. Transitioning into the NP role initially brought isolation that evolved into acceptance. They recognised their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescription rights and dependency on physicians, underscored the need for a protected professional title and national guidelines.

Conclusion: This study enriches the evolution of the NP role in Sweden, offering vital insights into the ongoing national-level dialogues on NP role development in Sweden.

Impact: The paper's relevance extends globally by providing valuable perspectives on NPs practicalities and fostering international understanding and advancement.

Reporting method: Standards for reporting qualitative research.

Patient or public contribution: Not applicable.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024.
Keywords [en]
experiences, interviews, nurse practitioners, qualitative, transition
National Category
Nursing
Identifiers
URN: urn:nbn:se:mau:diva-72020DOI: 10.1111/jan.16560ISI: 001339755900001PubMedID: 39441033Scopus ID: 2-s2.0-85207687387OAI: oai:DiVA.org:mau-72020DiVA, id: diva2:1911704
Available from: 2024-11-08 Created: 2024-11-08 Last updated: 2024-12-16Bibliographically approved
In thesis
1. Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare
Open this publication in new window or tab >>Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The nurse practitioner role is undergoing a global evolution to meet the increasing demands of healthcare. The growing population of older adults with chronic illnesses and complex healthcare requirements presents a significant challenge to healthcare resources. These patients require person-centred care with consistent access to healthcare providers, a need that the nurse practitioner role might be equipped to fulfil. Nurse practitioners are seasoned professionals who have pursued additional education, typically at the master’s level. Their specialized expertise in advanced nursing and expanded medical skills enable them to autonomously manage both nursing and medical needs in clinical practice. In Sweden, the advancement of the nurse practitioner role is in its early phases, it lacks national regulation and formal recognition as a professionally protected title. Nonetheless, local initiatives to develop the role have been undertaken, and there is ongoing dialogue at the national level with interest from the Swedish Government in formalizing the role. This aligns with the evolving healthcare reform, and the transition from hospital-based care to home-based care. Consequently, this transition necessitates a heightened level of nursing expertise in municipal healthcare, a demand that could potentially be met by the nurse practitioner role. Nevertheless, the development of the nurse practitioner role is complex and necessitates further research and preparation. Therefore, the overall aim of this thesis is to explore the pioneering Nurse Practitioner role by situating it within the Swedish context, across diverse viewpoints to guide its potential role development into municipal healthcare. The thesis comprises four studies: three qualitative (I, III, IV) and one employing iterative qualitative and quantitative components (II). Study I involves a scoping review, that uses qualitative content analysis to examine 16 papers on content in nurse practitioner education. Study II, uses a Delphi survey approach in corporating three rounds of questionnaires with the aim of establishing consensus on challenges and opportunities for nurse practitioner role development. Content analysis was followed by descriptive statistics in subsequent rounds. Study III, a focus group study, uses thematic analysis to help identify the preparatory work required before introducing the nurse practitioner role into municipal healthcare. The final study (IV) is centred on Swedish nurse practitioners’ experiences working in this pioneering nursing role. The data collection for the fourth study involved 15 semi-structured individual interviews, which were examined using content analysis. The findings from these studies offer insights into the nurse practitioner role in a Swedish context across diverse viewpoints to guide potential role development in municipal healthcare. Study I presents the core content of nurse practitioner education, while Study II identifies challenges and opportunities. Study III deals with the preparatory work needed before role development and encompasses areas such as education, national and local regulation, and strategies to foster acceptance for the nurse practitioner role within the healthcare team. The findings from Study IV provide insights into the reality of working as a nurse practitioner in Sweden, providing crucial perspectives to consider in on-going role development. The thesis as a whole offers insights that can be of value in the preparatory phase for developing the nurse practitioner role. There must be a clear and compelling intention to enhance patient satisfaction when developing the NP role. For it to be accepted as a new professional nursing role, national guidelines are required to bolster local role development in healthcare teams.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2024. p. 96
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277 ; 2024:8
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:mau:diva-67407 (URN)10.24834/isbn.9789178774586 (DOI)978-91-7877-457-9 (ISBN)978-91-7877-458-6 (ISBN)
Public defence
2024-05-24, Allmänna sjukhuset, HS aula AS:E002, Jan Waldenströms gata 25, Malmö, 09:15
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Supervisors
Note

Paper IV in dissertation as manuscript

Paper IV is not included in the fulltext online

Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-12-17Bibliographically approved

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Ljungbeck, BirgittaCarlson, ElisabethSjögren Forss, Katarina

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