1. Nurse Practitioner Role Transition Essay.
Nurse Practitioner Role Transition Essay. See attached the selected article needed for
writing. Carefully follow all the instructions given below.Select one of the articles from this
week's Electronic Reserve Readings to use as the basis for this assignment. Article
selected(Nurse Practitioner Role Transition: A Concept Analysis)Create 18 to 20-slide
Microsoft® PowerPoint® presentation on the article with detailed speaker notes.Include
the following in the presentation:-Describe the credentials of the author(s): academic
credentials, position held, and any other information available which is usually located at
the bottom of first page of article or after the reference list.ORDER A PLAGIARISM-FREE
PAPER HERE-Explain why you selected the concept analysis.-Describe each step of concept
analysis from the article. The number of steps in the concept analysis will depend on the
method selected by the author(s).-Describe how you could apply the concept analysis to
your practice.Provide references for all sources cited on a separate slide and format
according to APA guidelines.AbstractBackgroundTransitioning from registered nurse to
nurse practitioner (NP) can be challenging personally and professionally. Insight into
transition experiences may help validate the experiences of new NPs and provide greater
understanding of the challenges faced during their professional journey.PurposeThe
purpose of this article is to report a concept analysis of transition from registered nurse to
NP. The article provides new knowledge, understanding, and clarity about the concept of
transition.Data sourcesWalker and Avants’ framework for concept analysis was used to
identify the attributes, antecedents, and consequences of the concept. A literature review of
refereed journals was undertaken. Model cases from an ethnographic study conducted in
Australia provide real life examples of the attributes of transition.ConclusionsTransitioning
to the role of NP is complex and dependent on the individual and the attitudes of healthcare
colleagues. Change and adaptation are required of both the NP and members of the
healthcare team. Failure to adapt by either party undermines the potential for NPs to
deliver improved health care.Implications for practiceMentorship along with a nurturing
environment may be effective strategies for increasing the NP's self‐confidence and
ensuring a smooth and successful transition period.Nurse Practitioner Role Transition
Essay.Facing the challenges and improving the outcomes.In the 2012-2013 academic year,
15,000 nurses began the exciting transition from RN to NP.1 Research shows that these new
NPs will experience a significant role transition in their first year of practice. The available
research on this topic is limited in defining the factors involved in a successful role
transition, especially in examining the relationship between prior RN experience and the
2. transition to NP. Yet, the consensus of admission requirements for entry into NP programs
at the top-ranked nursing schools includes at least 1 year of prior RN experience before
starting NP clinical rotations.2This article examines whether prior RN experience is an asset
for the new NP to build upon, an obstacle that necessitates attention, or a combination of
the two. This exploration is guided by the following questions: What are the scope of
practice differences between RN and NP? Is there a significant transition process from RN to
NP? Is RN experience a factor in successful RN-to-NP role transition? What are realistic
expectations for an experienced RN to consider in the advanced practice role?Scope of
PracticeDuring clinical rotations, NP students are often asked, “How long have you been a
nurse?” NP preceptors ask this question because they may assume that having prior RN
experience will lead to a smoother clinical rotation and ultimately an easier transition to
becoming an NP. However, the scope of practice of an RN and the scope of practice of an NP
are entirely different, which places even the experienced RN in a position to encounter a
challenging, yet exciting, transition into this new role.Nurse Practitioner Role Transition
Essay.The scopes of practice for the RN and NP vary according to state laws and boards of
nursing, but they are broadly defined by the American Nurses Association, the American
Association of Critical-Care Nurses or other specialty nursing organizations, the American
Nurses Credentialing Center, and the American Association of Nurse Practitioners.These
associations state that both the RN and NP share the mindful practice of critical thinking
and have extensive training in diagnostic reasoning. The RN and NP have both been trained
to systematically organize the care of patients using physical assessments, development of
care plans, and evaluation of outcomes.3 The RN has the capability, through his or her
distinct training, to develop care plans for patients to ensure positive patient outcomes.
These care plans are developed through nursing diagnoses.Nurse Practitioner Role
Transition Essay.This CE article is sponsored in part through an education grant from
Chamberlain College of Nursing.For example, the RN can diagnose a patient with “activity
impairment related to a pain.” In this example of a nursing diagnosis, the RN can
independently decide to give pain medication prior to activity. The RN assesses whether the
pain medication relieved the patient’s pain and reports the finding to the NP or physician to
collaborate on an alternative plan of care in coordination with the RN’s pain assessment.
The notable differences in standards of practice between the RN and NP emerge as the NP
student learns advanced assessment skills in order to create a differential medical
diagnosis. With this knowledge, the NP can initiate further lab orders, diagnostic studies,
and treatment options including prescription medication to be administered by the RN. The
NP is also responsible and trained to interpret testing, as well as perform any associated
procedures within the NP’s scope of practice to identify patient outcomes in an autonomous
and independent fashion.3In the example above, the NP may diagnose the patient with a
femur fracture and subsequently order opioids, obtain diagnostic imaging of the hip, and
potentially consult an orthopedist. The NP will examine the testing and outcomes of these
treatments, and will independently adjust the plan of care to correlate with the given
diagnosis of the patient. This autonomy to implement and adjust the plans of care based on
a medical diagnosis exemplifies the significant difference in scope of practice between an
RN and NP.Understanding the TransitionAcknowledging the scope-of-practice differences
3. between these two positions is imperative to understanding the transition that occurs as an
experienced RN becomes an NP. Historically, nurses have relied on Benner’s Theory of
Transition, which outlines that a nurse begins as a novice and transitions into an expert.4
This theory is widely expressed within nursing practice but does not specifically apply to an
expert RN who is transitioning back to the novice role as a new NP.Nurse Practitioner Role
Transition Essay.Benner’s theory can be applied to hypothesize that the experienced RN
feels established in his or her role as a nurse and now senses insecurity as a novice NP. To
further emphasize this instability, a recent concept analysis of the RN-to-NP role transition
describes a loss of confidence and increased anxiety as the expert RN becomes a novice
NP.5 In particular, this concept analysis reveals that the height of such an instability occurs
within the NP’s first year of practice.Nurse Practitioner Role Transition Essay.In a more
specific study performed in 1997, Brown and Olshansky interviewed 35 RNs-to-NPs at 1, 6
and 12 months after graduation from a family nurse practitioner (FNP) program and
described the stages each experienced.6 The authors described the stages as: Laying the
Foundation, Launching, Meeting the Challenge, and Broadening the Perspective.6During the
first stage, “Laying the Foundation,” the new NP has recently graduated. He or she is
juggling the worry of seeking employment while simultaneously studying for the boards,
becoming certified, and navigating the licensing and credentialing process. Within this
stage, the novice NP lays the groundwork for future employment and career opportunities
by choosing a specialty area and determining the best practice setting.In the “Launching”
stage, the NP starts his or her first job and may feel anxiety about his or her performance.
Brown and Olshansky believed that the main issue during this stage is the difficult task of
managing anxiety related to the responsibility of diagnosing and treating patients as a new
provider.6 In addition to feelings of anxiety, the new-to-practice NP may also experience the
“Imposter Phenomenon” in this stage. New NPs have described this phenomenon as having
a sense of being fully trained and qualified for the job while simultaneously experiencing
feelings of inadequacy.7After the first several months of practice, the new NP may begin to
“Meet the Challenge.”6 In this stage, the NP starts to feel more comfortable and excited in
the new role and begins to develop strategies to become more efficient. These strategies
may include a more systematic approach to reviewing patient results and treatments. It is
anticipated that the NP will be able to increase his or her patient load while feeling more
independent.Finally, the theory concludes in the “Broadening the Perspective” stage, in
which the NP adds new challenges and becomes more involved in the advanced practice
nursing community.6 This may include joining committees in the workplace or joining
national, state or local NP organizations.After examining these transitional theories of the
past and scope-of-practice differences, it is evident that even the seasoned or expert RN can
experience role confusion from RN to NP. Cusson and Strange surveyed70 experienced
neonatal RNs who transitioned into neonatal NPs and found that the new-to-practice NPs
experienced increased anxiety related to role confusion during the transition.8 Specifically,
the NPs in this survey felt insecurity in having the responsibility and decision making
capacity to diagnose and write orders for patients instead of following orders in the RN
role.8 These novice NPs explained that the stress of the new role was related to a significant
change from nursing care and that the NP role was more centered on the medical diagnostic
4. aspect of care.8Additional literature produced to describe the transition process from
experienced RN to NP emphasizes the importance of integrating the medical model of care
with the nursing model of care to facilitate successful role transition. In order to integrate
these two very different models of care, an experienced RN should have the skills to use his
or her innate ability to organize the care of a patient and mobilize these established skills to
become the leader in care implementation as an NP.Nurse Practitioner Role Transition
Essay.In a study of 25 experienced ICU RNs who completed advanced practice studies to
become NPs, the NPs who recounted a more positive transition experience had the ability to
synthesize their RN experiences with advanced medical expertise as an NP. Furthermore,
these RNs believed that having RN experience was a necessary component but not an all-
inclusive factor in a successful transition.9 This study illustrates the importance of applying
prior RN experience to the medical model while simultaneously alerting the new-to-practice
NP that an element of role confusion will persist in the first year of practice.From these
personal accounts of experienced RNs, it is clear that the transition from RN to NP is
significant and warrants attention. Yet a gap in research exists with regard to the factors
that influence the RN-to-NP transition. More specifically, no current studies support the
notion that proficiency as an NP is directly related to the amount of RN experience – even
though most graduate schools require RN experience prior to admission.Nurse Practitioner
Role Transition Essay.Although RN experience is considered important for entry into an NP
program, some evidence conversely supports that such prior experience may, in fact, hinder
the initial new-to-practice NP transition. A study conducted in 2004 indicated that nine RNs
with a range of 0 to 32 years of nursing experience reported role confusion during the
transition to FNPs.10 These FNPs recalled feeling conflicted between RN approaches to care
and NP approaches to care, often feeling compelled to revert back to their practice as
confident RNs. Conversely, one RN who continued her education from baccalaureate
through graduate studies without any RN experience did not have any role confusion as a
new NP.10 This RN stated that her progression into the FNP role was more seamless. She
further described the process of going from RN to FNP as a continuous building of her
education.10Supporting TransitionAlthough research about the RN experience and its
impact on the transition to becoming an NP is limited, the general factors involved in NP
role transition are being investigated. Recent studies have found positive outcomes
associated with smoother transitions in factors such as formal orientations for new NPs,
early recognition of role transition during graduate school, and the establishment of a
relationship with a mentor.As of 2015, only one known study has examined the relationship
between RN experience and successful NP transition. The descriptive, cross-sectional
survey of 352 NPs concluded that the opportunity to experience a formal orientation when
starting a new job was a more significant influence on successful transition than having RN
clinical experience.11 The NPs in the study who received a formal orientation described a
more streamlined transition and said they felt more confident and satisfied in the new
role.11The Institute of Medicine recommends formal orientations, also known as transition-
to-practice programs or residencies, for new NPs or experienced NPs who are changing
specialty areas.12,13 Research supports that these programs are being developed based on
the belief that creating a smoother transition for new-to-practice NPs can also increase the
5. retention of NPs more broadly.13Even with these recommendations from the IOM, no
universal standard for orienting the new-to-practice NP exists, and the structure of NP
orientations varies from institution to institution. Further research is needed to define the
orientation and training necessary in the first year of practice to increase confidence levels,
decrease staff turnover, and ensure support during the transition.Nurse Practitioner Role
Transition Essay.Researchers argue that earlier recognition and anticipation of the change
in role from RN to NP is essential to fully prepare the new-to-practice NP. Spoelstra and
Robbins performed a qualitative study of 24 NP graduate students that concluded a role
development course early in the first semester of the NP program increased student
understanding of the new role.15 The course included an interview between the students
and an experienced NP, in which the students could ask questions about the new role.
Additionally, the students had weekly online discussions about the function of the NP and
role transition. Such topics included: building a framework for nursing, direct patient care
and understanding of NP professional responsibilities.14This direct contact with an NP and
the consistent dialogue about the particularities of advanced practice nursing allowed the
students in this study to clearly identify core elements of the NP role early in their graduate
education.14 With earlier recognition in the first semester of graduate study, the
researchers concluded that students would become more aware of the difference in scope of
practice, and would also learn details about the NP role so that they may sufficiently
prepare for the transition.Nurse Practitioner Role Transition Essay.Mentoring is a
foundational component for a successful transition from RN to NP. A mentor acts as an
advisor and resource through the entire NP role transition. A mentor to a novice NP can
guide the learning and education necessary for acclimating into the new NP role, and help
the NP student develop increased confidence and capability in performing new skills.15
Cusson and Viggiano highlight that mentors create a “safety net” for the NP student, foster
personal and professional growth, and enhance their transition into practice.15 These
authors believe that the responsibility for developing a network of mentorship should begin
at the graduate educational level and extend into the novice NP’s place of employment to
create a “mentoring culture” throughout the transition process.18 Within this network, the
mentor is able to function as a guiding resource for the new-to-practice NP and can serve as
a performance model for emulation.Nurse Practitioner Role Transition Essay.In addition to
these established influencing factors of NP role transition, this article proposes that new-to-
practice NP develops individual transitional tools in order to decrease anxiety, help
anticipate and prevent role confusion, and most importantly, embrace and enjoy the new
role.Although no formal guidelines exist for novice NPs, based on the available research
about RN-to-NP role transition, this article offers five guiding principles for prospective NPs
that may lead to a successful future in advanced practice:Nurse Practitioner Role Transition
Essay.• Understand the Transition: The student should familiarize him- or herself with the
scope of practice differences between the RN and NP role early. If this is not included in the
provided advanced practice curriculum, as an independent learner, the student should
educate him- or herself about the preliminary research and other previous works written
on the transition process. The American Association of Nurse Practitioners is one example
of a resource for novice NPs to learn the scope of practice on a state-to-state level. It may
6. also be helpful to collaborate withany available clinical faculty to arrange an opportunity to
shadow an NP to further investigate and learn the role of the provider. NP students may
also want to take the time to reflect on the transition during clinical rotations by speaking
with clinical faculty on a weekly basis to specifically discuss role transition.• Use Your
Experience Carefully: RN clinical experience prior to NP practice is useful in particular
clinical settings. An experienced RN possesses ingrained familiarity in how to communicate
and treat patients. That being said, during the student NP’s first clinical rotation or
experience, the student may be comfortable and have “intuition” to continue to care for the
provided patients as they would in an RN role. The student may remain focused more on the
execution of a given plan than being the implementer of the care and treatment plan. When
possible, it may be helpful to draw from that RN experience in this new role, but to always
be proactive and prepared with a medically-driven plan in mind.Nurse Practitioner Role
Transition Essay.• Set Realistic Expectations: RNs with years of clinical experience should
still expect to encounter a transition back to a novice advanced nursing provider after years
of being an expert registered nurse. Based on the research and data provided, the student
NP should prepare and expect to have feelings of being new or inexperienced in this
specialty field. The student should embrace new knowledge and be conscious of feelings of
insecurity. The student should also welcome challenges in the learning experience. The RN-
to-NP transition phase may last for several months or years after initial certification, but
knowledge will consistently be gained throughout the NP practice in a continuously
changing and enhancing healthcare field.Nurse Practitioner Role Transition Essay.• Seek a
Formal Orientation: The new NP interviewing for his or her first NP job should inquire
about the possibility of a formal orientation and length of time provided for employer-
provided learning. It can be beneficial to seek out an employer that will support the NP
during this transitional period. In a situation where a formal orientation is not offered, a
preceptor, mentor or assigned clinical leader should provide adequate feedback to ensure
the success of the NP. The NP should request that feedback be predicted by setting weekly
goals to assess achievement and progression. The NP-produced goals and employer
feedback will help keep expectations for transition in perspective and ensure active
learning and open communication between the employer and the NP. Open communication
should remain established between the NP’s employer, peers and colleagues to obtain
guidance about expectations and ensure a productive working environment.• Find a
Mentor: Mentors help navigate elements of the job that may not be articulated in a textbook
or a lecture. Mentors can be preceptors, professors, colleagues or anyone who can offer
insight into the details of the NP role. Mentors have experienced the transition and can
provide personal insight on the subject. Incorporating multiple mentors allows the NP to
gain a variety of perspectives during the advanced practice transition.Nurse Practitioner
Role Transition Essay.RN-to-NP role transition remains an underexamined area of research.
However, the existing literature proves how important it is to recognize and to prepare for
this transition. The new-to-practice NP who is prepared to embrace the challenges during
RN-to-NP transition will be able to navigate successfully within his or her new career. This
recognition will not only improve the NP’s performance on the job, but also extend to
improvements in patient care.Melissa Burke is a currently navigating the transition process
7. from an emergency medicine RN to a nurse practitioner on a medical transplant service at
the Hospital of the University of Pennsylvania in Philadelphia. She has completed a
disclosure statement and reports no relationships related to this article.Nurse Practitioner
Role Transition Essay.
