Acute-Care Nurse Practitioner, The: A Transformational Journey

Book Description:

From the moment it was first proposed, the role of the nursepractitioner has been steeped in controversy. In the fields of bothnursing and medicine, the idea that a nurse practitioner can, to somedegree, serve as a replacement for the physician has sparked heateddebates. Perhaps for that reason, despite the progress of the nursepractitioner movement, NPs have been reluctant to speak aboutthemselves and their work, and their own vision of their role has thusremained largely invisible. Current research is dominated byinstrumental and economic modes of discourse and tends to focus on theclinical activities associated with the role. Although informationabout demographics, educational preparation, position titles, reportingrelationships, and costs of care contribute to our understanding, whatwas missing was an exploration of the lived experience of the nursepractitioner, as a means to deepen that understanding as well as ourappreciation for their role.

The Acute-Care Nurse Practitioner is based on in-depthinterviews with twenty-six nurse practitioners working in acute-caresettings within tertiary-care institutions all across Canada. Employinga hermeneutic approach, Rashotte explores the perspectives from whichNPs view their reality as they undergo a transformational journey ofbecoming--a journey that is directed both outward, into the world,and inward, into the self. We learn how, in their struggle to engage ina meaningful practice that fulfills their goals as nurses, theirpurpose was hindered or achieved. In large part, the story unfolds inthe voices of the NPs themselves, but their words are complemented bydescriptive passages and excerpts of poetry that construct an animatedand powerful commentary on their journey. Poised between two worlds,NPs make a significant contribution to the work of their colleagues andto the care of patients and families. The Acute-Care NursePractitioner offers an experiential alternative to conventionaldiscourse surrounding this health care provider’s role.

Contents

List of Figures ix 

Acknowledgements xi

Introduction 1

 The Research Journey 2

 Background of the Study 4

 Connecting Voices 9

 Introducing the Nurse Practitioners 12

 Nurse Practitioners’ Transformational Journey 15

Chapter 1 

Being Called to Be More 21

 Being More Connected 25

 Being More in Control 26

 Being More Visible 29

 Being More Challenged 32

 Being Able to Make More of a Difference 35

 Answering the Call: Initiating the Journey 37

Chapter 2 

Being Adrift 43

 Being Disconnected 49

 Being Uncertain 60

 Being Lost 82

 Staying Afloat 92Chapter 3 

Being a Nurse Practitioner 107

 Being Competent 110

 Being Confident 121

 Being Comfortable 138

 Being Committed 153

 Being Connected 173

 Being Content 192

Chapter 4 

Being Pulled to Be More 211

 Being a Wearer of Two Hats 228

Chapter 5 

Being More 237

 Being an Advanced Practitioner 243

Chapter 6 

Breaking Silence and Giving Voice 257

References 267

Publication Acknowledgments 279