{"title":"高级执业注册护士过渡到实践在长期护理设置:民族志。","authors":"Alisha Harvey Johnson, Tracie Culp Harrison","doi":"10.1177/23333936221108701","DOIUrl":null,"url":null,"abstract":"<p><p>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: <i>where's my authority</i>, <i>institutional acceptance</i>, <i>personal role fulfillment</i>, <i>provider relationships</i>, and <i>individual versus organizational care</i>. 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.</p>","PeriodicalId":45940,"journal":{"name":"Global Qualitative Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/99/10.1177_23333936221108701.PMC9272163.pdf","citationCount":"0","resultStr":"{\"title\":\"Advanced Practice Registered Nurse Transition to Practice in the Long-Term Care Setting: An Ethnography.\",\"authors\":\"Alisha Harvey Johnson, Tracie Culp Harrison\",\"doi\":\"10.1177/23333936221108701\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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: <i>where's my authority</i>, <i>institutional acceptance</i>, <i>personal role fulfillment</i>, <i>provider relationships</i>, and <i>individual versus organizational care</i>. 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.</p>\",\"PeriodicalId\":45940,\"journal\":{\"name\":\"Global Qualitative Nursing Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2022-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/99/10.1177_23333936221108701.PMC9272163.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Qualitative Nursing Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/23333936221108701\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Qualitative Nursing Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/23333936221108701","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Advanced Practice Registered Nurse Transition to Practice in the Long-Term Care Setting: An Ethnography.
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.
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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