Advanced Practice Registered Nurse Transition to Practice in the Long-Term Care Setting: An Ethnography.

IF 2.2 Q1 NURSING Global Qualitative Nursing Research Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI:10.1177/23333936221108701
Alisha Harvey Johnson, Tracie Culp Harrison
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Abstract

Advanced practice registered nurses are successful in improving quality outcomes and filling provider care gaps in long-term care. However, little is known about the nurse's transition to practice in this setting. A 12-month ethnography was conducted via participant-observation with nine advanced practice registered nurses in five long-term care facilities to understand practice environment influence on the nurses' transition and on the reciprocal influence of the nurse on the practice environment. Transition was fraught with uncertainty as documented by five themes: where's my authority, institutional acceptance, personal role fulfillment, provider relationships, and individual versus organizational care. These findings suggest that transition in this setting is complex, characterized by insecurity whether the individual is new to advanced practice or experienced. Transition in long-term care could be strengthened by formal programs that include clinical practice, reconceived mentorship for advanced practice registered nurses, and education designed to improve comfort and expertise with indirect care.

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高级执业注册护士过渡到实践在长期护理设置:民族志。
高级执业注册护士在提高质量结果和填补长期护理提供者护理差距方面取得了成功。然而,很少有人知道护士的过渡到实践在这种情况下。通过参与式观察,对5家长期护理机构的9名高级执业注册护士进行了为期12个月的民族志研究,以了解执业环境对护士转型的影响以及护士对执业环境的相互影响。转型过程充满了不确定性,具体表现在五个方面:我的权威在哪里、机构的接受程度、个人角色的实现、提供者关系、个人与组织的关怀。这些发现表明,在这种情况下的过渡是复杂的,其特点是不安全感,无论个人是新进入高级实践还是有经验。长期护理的过渡可以通过正式的项目来加强,这些项目包括临床实践、对高级执业注册护士的重新设想的指导,以及旨在提高间接护理的舒适度和专业知识的教育。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
41
审稿时长
12 weeks
期刊介绍: Global Qualitative Nursing Research (GQNR) is a ground breaking, international, peer-reviewed, open-access journal focusing on qualitative research in fields relevant to nursing and other health professionals world-wide. The journal specializes in topics related to nursing practice, responses to health and illness, health promotion, and health care delivery. GQNR will publish research articles using qualitative methods and qualitatively-driven mixed-method designs as well as meta-syntheses and articles focused on methodological development. Special sections include Ethics, Methodological Development, Advancing Theory/Metasynthesis, Establishing Evidence, and Application to Practice.
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