Elements Of Role Transition From RN To NP

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Elements Of Role Transition From RN To NP

Elements Of Role Transition From RN To NP

question #1 APA reference and citation

What are the elements of role transition from RN to NP, and what are you currently experience in this process

question # 2

Mary comes in to the urgent care clinic with a broken nose. She appears to be a young teen, perhaps 13 or 14, but says she is 21 years old. She is disheveled and very quiet, answering only with a few words and keeps her eyes downcast. There is a couple (man and woman) who appear to be in their 30s accompanying the girl to be treated. They continue to stare at her and refuse to leave her side. Your attending physician colleague is busy transferring a trauma patient. What are you next steps in specific order?

The transition from registered nurse (RN) to nurse practitioner (NP) is often a stressful career change. Data are lacking on the factors affecting NP role transition. This study examined the relationships between NP role transition, prior RN experience, and a formal orientation. From a sample of 352 NPs, only a formal orientation contributed significantly to the regression model indicating a positive relationship with NP role transition (b = 6.24, p < .001). Knowledge of the factors that explain NP role transition is important to inform the discipline how best to support NPs during entry into practice.
Keywords: nurse practitioner, role transition, workforce, Meleis, Transitions Theory
The transition from registered nurse (RN) to nurse practitioner (NP) is a significant career role transition. It is often difficult and can be stressful across various settings.1 During this time, there is a shift from an experienced, often expert status in the RN role to an inexperienced, novice status in the NP role.2 This can result in an alteration in professional identity, loss of confidence, and impaired NP role development. Employment continuity and the decision to remain in the profession can be affected when role development is undermined.3 Successful role transition is important in order for NPs to become efficient and effective providers as quickly and positively as possible.3
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Nationally, NPs have received increased attention in recent years. Through The Patient Protection and Affordable Care Act (ACA),4 the United States (U.S.) government has directly called for an increase in the number of healthcare providers to care for the expected millions of Americans, who will become eligible for health insurance. Currently, there is a shortage of physicians in the U.S., which is expected to increase.5 NPs are being viewed as key providers in the collaborative efforts to address these workforce needs.6

However, employment turnover rates for NPs are twice those of physicians.7 Seminal research on NP role transition3,8–10 has identified many difficulties that NPs can experience during this time; and provider outcomes, such as lower job satisfaction and feelings of discontentment, have been associated with increased intent to leave and high turnover.11,12 These findings suggest that poor transition experiences result in NPs leaving positions.

During NP role transition, there are different personal and environmental factors that are thought to promote the transition, and two of these factors include experience and receiving a formal orientation.2 No studies were identified that directly examined NP role transition in relationship to experience, specifically prior RN experience, or receiving a formal orientation. The purpose of this study was to explore NP role transition in relationship to prior RN experience and receiving a formal orientation in the first NP position.

Experience is believed to be important for skill acquisition and developing competency in nursing practice.13 However, the available literature does not explicitly define experience in relationship to NP role transition as prior RN experience or experience in a similar role. Prior RN experience is reported to provide a foundation and help facilitate the transition to the NP role,1,9,14 and NPs with less RN experience are thought to require more time to transition into the new role.3 One study found no significant correlation between years of prior RN experience and NP clinical skills after graduation.15

Within nursing, formal orientations are recommended as beneficial to role transition for RNs,16,17 clinical nurse specialists,18 and NPs.12,19,20 Orientations have been found to relieve stress and help promote a sense of confidence, competence, and satisfaction.12,16 Although extensive training and orientation time are provided to new RNs, similar measures are lacking for NPs, and a lack of structured support has been found to affect NP role transition negatively during the first year of practice.3

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