Burnout, Resilience and Job Satisfaction in Acute Care Nurse Practitioners.

Emerging from a pandemic only to enter a nursing shortage has placed a strain on the health human resources of the healthcare system. Little attention has been given to nurse practitioners' (NPs') burnout, resilience and job satisfaction. In this quantitative cross-sectional study using the Maslach Burnout Inventory, Misener NP Job Satisfaction Scale and the Connor-Davidson Resilience Scale, an alarming level (80.9%) of NPs reported high to moderate levels of burnout (emotional exhaustion), on average, minimal job satisfaction and high levels of resilience. Hospital leaders play a major role in NP role optimization, NP recruitment and retention and quality of work-life issues.

Advanced nurse practitioner well-being: A 4-year cohort mixed methods study.

AIMS: To examine changes in advanced nurse practitioner (ANP) well-being, satisfaction and motivation over a four-year period. DESIGN: Longitudinal Cohort study. METHODS: Surveys were carried out each year from 2019 to 2022 with the same cohort of ANPs in the United Kingdom (UK). The survey consisted of demographics, questions on contemporary issues in advanced practice, National Health Service (NHS) staff survey questions and validated questionnaires. A core set of questions were asked every year with some changes in response to the COVID-19 pandemic. RESULTS: Response rate ranged from 40% to 59% and appeared to be affected by COVID-19. Staff satisfaction with pay and the well-being score were stable throughout. Other questions on well-being, job satisfaction and motivation saw statistically significant reductions after 4 years. Open-ended questions about ongoing well-being concerns show participants are concerned about exhaustion levels caused by workload, staffing issues, abuse from patients and colleagues' mental health. CONCLUSION: The findings highlight a decline in ANP well-being, job satisfaction and motivation post-COVID-19. Reasons for this, explored in the qualitative data, show that ANPs have faced extremely difficult working conditions. Urgent action is required to prevent a workforce retention crisis as many nursing staff are close to retirement and may not be motivated to remain in post. IMPACT: This study has followed ANPs through the most challenging years the NHS has ever seen. Job satisfaction, motivation and enjoyment of the job all significantly reduced over time. In many areas, the ANP role has been used to fill medical workforce gaps, and this will become harder to do if ANPs are dissatisfied, disaffected and struggling with stress and burnout. Addressing these issues should be a priority for policymakers and managers. PATIENT OR PUBLIC CONTRIBUTION: None as this study focussed on staff. Staff stakeholders involved in the design and conduct of the study.

Maximization of scope of practice and satisfaction among geriatric nurse practitioners in Israel.

BACKGROUND: There is an increasing demand for comprehensive geriatric care. Nurse practitioners (NPs), who undergo specialized training, are situated to provide such care. In Israel, the role of a geriatric nurse practitioner was introduced in the health care system 10 years ago. However, little is known about the rate of professional satisfaction and realization of full potential among these nurses. PURPOSE: The aims of this study are (1) to describe the geriatric NP workforce in Israel, (2) to measure the current geriatric scope of practice, and (3) to measure the geriatric NP satisfaction from their working environment. METHODOLOGY: For this cross-sectional study, a survey, comprising three sections relating to demographics, professional qualifications and scope of practice, and career satisfaction, was sent to 53 geriatric nurse practitioners in Israel who currently work as geriatric nurse practitioners. RESULTS: Forty-seven nurses participated in the survey. Almost 64% reported that they are satisfied with their position, and 72% reported that they are able to fulfill their full scope of practice. The mean score for scope of practice was 68.31 out of a possible score of 100. CONCLUSIONS: A number of qualifications were correlated with satisfaction at work, indicating that nurses tend to be more satisfied at work when they are able to fulfill their potential. IMPLICATIONS: Ensuring nurse practitioners' ability to realize their full potential should be a goal of the health care system. Interventions should be in place to encourage nurses to perform tasks related to their work, for which they are trained.

Nurse practitioners, physician assistants, and trust: A systematic review.

BACKGROUND: The use of physician extenders (e.g., nurse practitioners [NPs] and physician assistants [PAs]) has risen in recent years in the U.S. health care domain, yet some scholars have questioned if physician extenders are being fully utilized in the health care field. PURPOSES: The purpose of this research was to conduct a systematic review to determine if trust in the NP/PA might be influential in the ways these professionals are utilized. We view trust through the lens of Mayer et al. and their model of organizational trust, and we seek to examine how patients, physicians, and NPs/PAs themselves view one another. METHODS: This systematic review spanned from 1996 to 2022 and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. The final sample consisted of 29 articles. RESULTS: The findings point to how the antecedents of trust according to Mayer et al.; i.e., trustee's ability, benevolence, and integrity) influence the trusting relationships between patients and NPs/PAs and between physicians and NPs/PAs. Consequences and outcomes of trust are also discussed. Importantly, a trustor's propensity to trust and repeat interactions over time (e.g., feedback loop) is influential to trusting relationships. PRACTICE IMPLICATIONS: These findings offer health care organizations insight into the mechanisms for building trust as physician extenders become more prominent in the health care field.

Trainee ANPs' experiences of having a clinical practice facilitator introduced into a Hospital at Night team.

BACKGROUND: The role of the advanced nurse practitioner (ANP) within Hospital at Night (H@N) teams has emerged in line with the demands of the service and the needs of patients in the out-of-hours period. The majority of ANPs with H@N teams are recruited as trainees. There is a high volume of trainees needing support against a low number of experienced ANPs. Introduction of the clinical practice facilitator (CPF) role is one way of addressing these issues. Within this evaluative study of one H@N service, the CPFs are experienced ANPs who have received additional training in the delivery of practice assessment and learner feedback. AIM: To explore the experiences and perceptions of those trainee ANPs who have had or are currently receiving support and supervision from the CPFs in an H@N service in one Scottish NHS health board. METHOD: The CPFs undertook a service evaluation following introduction of the role. Purposive sampling was undertaken whereby a descriptive questionnaire was sent to 22 eligible participants. RESULTS: 16 questionnaires were returned. Qualitative data from the questionnaire generated several themes from the participants' responses: validation of competencies, supporting wellbeing, accessibility of support, designated prescribing practitioner role and support post-qualification. CONCLUSIONS: CPFs are ideally placed to meet the required needs of trainees. Organisational commitment is key to ensuring ANPs are in optimal positions to provide support and supervision for the next generation of trainees.

The Social Ecology of Burnout: A framework for research on nurse practitioner burnout.

BACKGROUND: The U.S. health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the work environment, practice autonomy, and hierarchical leadership. PURPOSE: We explore the unique social, cultural, and political environment in which NPs work through the lens of social ecology and present the Social Ecology of Burnout (SEB) framework. METHODS: We review current burnout frameworks in the context of the NP practice environment and discuss the SEB, specifically exploring psychological safety and its influence on burnout. FINDINGS: Psychological safety, work environment, and policy are presented within the SEB and solutions which empower NPs are considered. DISCUSSION: Our framework can serve as a guide for future nursing research, practice, and policy.

Primary Care Organizational Support for Nurse Practitioner Practice and Emotional Health Care Delivery.

OBJECTIVES: Nurse practitioners (NPs) are key to delivery of primary care services. However, poor organizational support for independent NP practice, such as lack of access to clinic resources, may lead to prioritizing patient physical health over emotional health. We investigated the relationship between organizational support for independent NP practice and emotional health care delivery. METHODS: This was a secondary analysis of cross-sectional survey data collected from 397 NPs in 2017. We measured organizational support for independent NP practice using the independent practice and support subscale of the NP Primary Care Organizational Climate Questionnaire. Emotional health care delivery was measured by asking NPs how frequently they addressed emotional concerns of patients. We utilized multilevel mixed effects linear regression models, adjusting for NP and practice covariates. RESULTS: Controlling for NP age, gender, marital status, race, and ethnicity, along with practice setting and size, as the independent practice and support score increased, NPs reported addressing emotional concerns of patients more frequently (beta = 0.34, 95% confidence interval = 0.02-0.66, P = 0.04). This indicates that as organizations provided more support for independent NP practice, NPs were able to more frequently address emotional concerns of patients. CONCLUSIONS: Organizational support for independent NP practice is associated with addressing emotional concerns of patients. To support NP practice, primary care organizations should ensure that NPs manage patients independently and have access to ancillary staff and support for care management.

Burnout, job satisfaction, and turnover intention among primary care nurse practitioners with their own patient panels.

BACKGROUND: Nurse practitioners (NPs) can enhance NP care and improve access to care by autonomously managing their patient panels. Yet, its impact on workforce outcomes such as burnout, job satisfaction, and turnover intention remains unexplored. PURPOSE: To estimate the impact of NP panel management on workforce outcomes. METHODS: Structural equation modeling was conducted using survey data from 1,244 primary care NPs. NP panel management was categorized into co-managing patients with other providers, both co-managing and autonomously managing, and fully autonomous management. DISCUSSION: Fully autonomous management led to more burnout than co-managing (B = 0.089, bias-corrected 95% bootstrap confidence interval [0.028, 0.151]). Work hours partially (27%) mediated this relationship. This findings indicate that greater autonomy in panel management among NPs may lead to increased burnout, partially due to longer work hours. CONCLUSION: Interventions to reduce work hours could help NPs deliver quality care without burnout.

Factors Influencing the impact of nurse practitioners' clinical autonomy: a self determining perspective.

AIM: To explore factors that influence the impact of nurse practitioners' clinical autonomy with a self-determining perspective. BACKGROUND: Worldwide, there is a significant demand for healthcare professionals such as the nurse practitioner in meeting some healthcare needs across patients' lifespans. Factors influencing nurse practitioners clinical autonomy can impact the full utilisation of the role in practice. INTRODUCTION: Limited evidence exists that describes or researches nurse practitioner clinical autonomy. Instead, there is a focus in the literature on strategic debates, role confusion and nurse practitioners reporting the straddling between nursing, allied heath professionals and medicine in the provision of healthcare services. DESIGN: A cross-sectional study design was used in a purposive sample in a national sample of nurse practitioners in Ireland across a full range of healthcare settings. Additionally, the survey included open comments sections to capture qualitative comments by the nurse practitioners themselves. METHODS: Self-determination theory is rooted in an organismic dialectical stance. This study used a convenience sample of n = 148 from a total sample of n = 448 (33%) of the population. The Dempster Practice Behavioural Scale and an initially validated advanced nursing practice clinical autonomy scale were used. Open comments were analysed by thematic analysis. STROBE Standards guidelines for cross-sectional studies were followed, and COREQ guidelines were followed for writing qualitative research. RESULTS: The study findings demonstrated that the more clinical experience the nurse practitioner had, the higher their levels of clinical autonomy. The previous length of nursing experience did not impact nurse practitioner clinical autonomy levels. However, average experience of nurse practitioner' in this study was 3-10 years. No significant differences existed between the reported gender, nurse practitioners' clinical autonomy and decision-making. 1:40 female and 1:9 male nurse practitioners undertook a doctorate or PhD-level education. No advanced nurse practitioner identified as non-binary. Gender and organisational culture considerations can influence nurse practitioners clinical autonomy. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study highlights intrinsic motivators that support nurse practitioners in providing innovative healthcare: competence, relatedness and clinical autonomy. Countries credentialing, regulations professional standards and healthcare policy positively influence nurse practitioner clinical autonomy. Nurse practitioners' clinical autonomy is championed when health policy and organisational stakeholders intrinsically collaborate. A disconnect between health policy organisational culture extrinsically influences lower levels of nurse practitioners' clinical autonomy. CONCLUSION: The findings underline the positive impact of nurse practitioner clinical autonomy. A recommendation of this study is to continue to measure impact of clinical autonomy and develop nurse practitioners' self-determination strategies around the role and integrity of their levels of intrinsic clinical autonomy.

Targeted Neonatal Echocardiography Performed by Nurse Practitioners in the NICU: Attitudes and Perceptions of the Healthcare Team.

BACKGROUND: Targeted neonatal echocardiography (TNE) and hemodynamic consultation have typically been performed by physicians. The Stollery Children's Hospital neonatal intensive care unit (NICU) expanded their TNE training program to include neonatal nurse practitioners (NNPs), the first in North America. PURPOSE: This study examines the thoughts and perceptions of clinicians about the incorporation of NNPs providing TNE and hemodynamic consultation and investigates key facilitators and challenges for consideration when planning future training, expansion of service in Edmonton, or beyond. METHODS: In this descriptive study using qualitative methodology, purposive sampling was used to invite NICU clinicians to participate. Using a semistructured topic guide, a focus group and 2 individual interviews were conducted. RESULTS: Participants were supportive of NNPs. Advantages included increased access to service, acquisition and retention of skills, provision of patient-centered care, and leveraged interpersonal relationships in the decision-making process. Key aspects of program expansion included climate and culture of the NICU, presence of adequate patient volume, and resources to support training. IMPLICATIONS FOR PRACTICE AND RESEARCH: Support across disciplines and the collaborative working nature of the NICU are key factors in the success of the program's development and implementation. Benefits of having NNPs on the TNE team were clearly expressed. Benefits to the health system included rapid access to hemodynamic information allowing for care based on specific pathophysiology and additional local capacity to perform TNE and reducing demand on other trained providers. Additional research could consider parental views of NNPs performing TNE and hemodynamic consultation as well as the accuracy of diagnosis between the NNPs and physician group.

Clinical decision-making processes among graduate nurses, specialist nurses and nurse practitioners A collaborative international study.

AIM: To explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. BACKGROUND: Clinical decision-making in an emergency department environment is a complex process often occurring in times of crisis. It is an important aspect contributing to the quality of care. However, empirical research is limited regarding the decision-making process in different nursing roles. METHODS: In accordance with the consolidated criteria for reporting qualitative research, a qualitative and observational study was conducted to explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Six Registered Nurses, six Nurse Specialists and six Nurse Practitioners were observed. A total of 40 hours of observation was made at each setting according to a structured observation guideline, followed by clarifying questions. The data material was analysed by means of a qualitative manifest and latent content analysis. RESULTS: Three themes arose: acting in accordance with routines, previous experience and intuition; considering patient experience; and facilitating new alternatives based on critical thinking. The Registered Nurses mainly used the first approach, the Nurse Specialists used the first and the second approaches, and the Nurse Practitioners used all three approaches. CONCLUSIONS: The results highlight the differences in decision-making processes between these groups. Nurse Practitioners were the only group that facilitated and evaluated new alternatives using their clinical autonomy, such as stepping up and making independent and collaborative decision-making. IMPLICATION: The results can be used in countries developing advanced practice nursing education and defining their scope of practice to inform stakeholders.

Experiences of Workplace Violence in Graduate Nursing Clinical Education.

BACKGROUND: Exposure to workplace violence (WPV) is common in health care, and little is known about nurse practitioner (NP) students' experiences during graduate nursing clinical education. PURPOSE: This study described experiences of WPV among NP students during their clinical education. METHODS: We conducted a cross-sectional, quantitative survey of a random sample of NPs licensed in Texas examining graduate nursing education experiences. RESULTS: A total of 334 NPs responded, a 12% response rate. More than a quarter (27%) experienced WPV during their graduate nursing clinical experience. Preceptors were the most reported perpetrators (44%). Most NPs remained in their clinical site after their WPV experience (55%); a majority felt they had no alternative clinical placement option. CONCLUSIONS: Nurse practitioner students experience WPV, and there may be implications for educational persistence and their careers. Future work should attempt to reduce the frequency of student WPV experiences and examine implications for NP careers.

Nurse practitioner faculty attitudes about interprofessional education.

BACKGROUND: Nurse practitioner (NP) faculty attitudes toward interprofessional education (IPE) can be barriers to the shift in culture and successful implementation of IPE into nursing curricula. A paucity of studies exist comparing faculty attitudes of IPE with different educational modalities. PURPOSE: The purpose of this research is to compare NP faculty attitudes toward IPE between IPE experiences and educational modalities in NP academic programs. METHODOLOGY: A quantitative cross-sectional comparative design was used. An electronic survey was advertised to approximately 3,000 members of the National Organization of NP Faculties by email blasts to assess their attitudes toward IPE in the academic setting. RESULTS: Participating NP faculty ( n = 208) completed the survey, with a response rate of 6.9%. The results showed that NP faculty reported positive attitudes toward IPE ( M = 4.33). Nurse practitioner faculty attitudes toward IPE and participation in IPE experiences were not statistically significant ( p = .126). Nurse practitioner faculty attitudes toward IPE did not differ with the educational modality. The main effect of the NP degree program educational modality was not statistically significant, F (2, 172) = 0.74, p = .479. CONCLUSIONS: Nurse practitioner faculty are optimistic about IPE in multiple educational modalities but still have some reservations about how to implement IPE activities successfully. IMPLICATIONS: The NP faculty attitudes and barriers to IPE curricular development in all educational modalities must be addressed to prepare NP students to be competent collaborative practice-ready providers on graduation.

Relationship between work-related psychosocial factors and self-leadership in advanced nurse practitioners: A cross-sectional study.

AIM: The aim of this study was to investigate the relationship between advanced nurse practitioners' self-leadership and commitment to the workplace, work engagement and influence at work. BACKGROUND: The concept of self-leadership is particularly suited to ANPs, who are required to take responsibility for their work roles. An optimum balance between the ANPs' psychosocial work environment and self-leadership may positively impact work ability in this group and can be compromised by interactions between and among these variables. DESIGN: A cross-sectional correlational study was conducted from July 2020 to August 2020 on 153 ANPs across a national health service. METHODS: The survey was distributed to respondents online. The revised self-leadership questionnaire was used to measure self-leadership, and three scales from the Copenhagen Psychosocial Questionnaire were used to measure commitment to the workplace, work engagement and influence at work. Multiple linear regression was used to examine the association between self-leadership and the psychosocial variables. RESULTS: ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. No relationship was found between self-leadership and influence at work. CONCLUSION: Improving self-leadership among ANPs by involving them in strategic leadership activities at an organizational level could be an effective strategy for optimizing the role and facilitating ANPs to contribute at an organizational level beyond the clinical interface. However, organizational support is required to ensure that ANPs practise to the full potential of their training and capability. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: This study provided new evidence of a relationship between ANPs' self-leadership and psychosocial factors. This study found that ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. Policymakers and organizational leaders can optimize the ANP role and facilitate ANPs to contribute strategically to improve care systems. This study identifies a relationship between ANPs' self-leadership and specific psychosocial variables.

Facilidades e dificuldades autorreferidas por trabalhadores de enfermagem para retorno ao trabalho após o diagnóstico de câncer / Self-reported facilities and difficulties by nursing workers for return to work after cancer diagnosis / Facilidades y dificultades autodeclaradas por trabajadores de enfermería para el regreso al trabajo después del diagnóstico de cáncer

Objetivo: analisar fatores facilitadores e dificultadores autorreferidos por trabalhadores da saúde para o retorno ao trabalho após o diagnóstico de câncer. Método: estudo descritivo transversal realizado com trabalhadores de enfermagem submetidos a tratamento de câncer, de dois hospitais públicos entre março e dezembro de 2019. Coletara-se dados sociodemográficos, do Índice para Capacidade de Trabalho e do Functional Assessment of Cancer Illness Therapy ­ General, analisados por estatística descritiva. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: entre os participantes, 81,9% eram do sexo feminino e 54,6% técnicos de enfermagem. A dor foi o principal dificultador (81,9%) e, para todos, o apoio de chefes e colegas de trabalho o principal facilitador. Identificou-se excelente capacidade para o trabalho em 45,5% e qualidade de vida média de 56. Conclusão: para o retorno ao trabalho ser possível, é necessário oferecer suporte ao trabalhador, tanto em função dos efeitos do tratamento do câncer quanto da necessidade de apoio(AU)

Objective: to analyze facilitating and hindering factors self-reported by health workers in returning to work after a cancer diagnosis. Method: cross-sectional descriptive study carried out with nursing workers undergoing cancer treatment in two public hospitals between March and December 2019. Sociodemographic data were collected, from the Work Capacity Index and the Functional Assessment of Cancer Illness Therapy ­ General, analyzed by descriptive statistics. Protocol approved by the Research Ethics Committee. Results: among the participants, 81.9% were female and 54.6% were nursing technicians. Pain was the main obstacle (81.9%) and, for everyone, support from bosses and co-workers was the main facilitator. Excellent work capacity was identified in 45.5% and an average quality of life of 56. Conclusion: for a return to work to be possible, it is necessary to offer support to the worker, both due to the effects of cancer treatment and the need of support(AU)

Objetivo: analizar los factores facilitadores y obstaculizadores autodeclarados por trabajadores de la salud en el regreso al trabajo después de un diagnóstico de cáncer. Método: estudio descriptivo transversal realizado con trabajadores de enfermería en tratamiento oncológico, en dos hospitales públicos, entre marzo y diciembre de 2019. Se recolectaron datos sociodemográficos, del Functional Assessment of Cancer Illness Therapy ­ General (Evaluación Funcional de la Terapia para Enfermedad Oncológica), analizados mediante estadística descriptiva. El Comité de Ética en Investigación aprobó el Protocolo. Resultados: entre los participantes, el 81,9% consistía en mujeres y el 54,6% en técnicos de enfermería. El dolor fue el principal obstáculo (81,9%) y, para todos, el apoyo de jefes y compañeros de trabajo fue el principal facilitador. Se identificó una excelente capacidad de trabajo en un 45,5% y una calidad de vida promedio de 56. Conclusión: para que el retorno al trabajo sea posible, es necesario ofrecer soporte al trabajador, tanto por los efectos del tratamiento del cáncer como por la necesidad de apoyo(AU)

"I had become fed up": A qualitative study of Black nurse practitioners' experiences fighting against health inequity, racism, and burnout.

BACKGROUND: Increasing diversity in the nurse practitioner (NP) workforce is key to improving outcomes among patients who experience health inequities. However, few studies to date have examined the specific mechanisms by which NPs from diverse backgrounds address inequities in care delivery. PURPOSE: To explore Black NPs' efforts in addressing inequities, and the facilitators and barriers they face in doing so. METHODOLOGY: We conducted focus groups and interviews of Black NPs ( N = 16) in the greater Philadelphia area in early 2022, just following the height of the COVID-19 pandemic and the social unrest of the early 2020s. Data were analyzed using thematic analysis. RESULTS: Emergent themes included: Strategies Utilized to Address Health Inequities ; Burnout & the Minority Tax ; Risks & Rewards of Taking a Stance ; and Uneven Promises of Organizational Engagement . Nurse practitioners prioritized patient-centered, culturally congruent care, taking additional time to explore community resources and learn about patients' lives to facilitate care planning. Participants advocated to administrators for resources to address inequities while simultaneously navigating organizational dynamics, microaggressions, and racism. Finally, NPs identified organizational-level barriers, leading to emotional exhaustion and several participants' intent to leave their roles. CONCLUSIONS: Black NPs use a myriad of strategies to improve equity, yet frequently face substantial barriers and emotional exhaustion in doing so with little change to the inequities in care. IMPLICATIONS: The NP workforce has a critical role to play in reducing health inequities. The strategies outlined by Black NPs in this study offer a roadmap for all clinicians and health care organizations to prioritize equity in care delivery.

Barriers and facilitators to becoming an alcohol and other drug nurse practitioner in Australia: A mixed methods study.

Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation-the COM-B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM-B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia.

Enfermeiros novatos e os fatores que influenciam a adaptação ao trabalho após a incorporação ao mundo laboral / Enfermeros novatos y factores que influyen en la adaptación laboral tras la incorporación al mundo laboral / Novice nurses and factors that influence job adaptation after incorporation into the world of work

Resumo Objetivo Analisar os fatores que influenciam a adaptação ao trabalho da enfermagem hospitalar durante o período de transição dos egressos como força de trabalho em saúde em sua nova etapa. Método Estudo exploratório, transversal, que envolveu 100 enfermeiros graduados como força de trabalho de unidades hospitalares. A coleta foi realizada com um questionário na plataforma web no período de novembro de 2020 a agosto de 2021. A análise foi realizada por meio de estatística descritiva. Resultados Houve predomínio de mulheres, solteiras, com idade entre 23 e 32 anos, licenciadas e operacionais, trabalhando entre 19 meses e 2 anos. Em relação aos fatores, foram identificados três mais influentes: Autonomia; Psicológico; Funcionários. Conclusões e implicações para a prática A adaptação da equipe de enfermagem no hospital apresenta dificuldades no período de transição; os fatores internos do profissional, sejam adquiridos por meio de práticas ou desenvolvidos ao longo da vida, e a formação dos empregadores influenciam. Para melhoria, seria fundamental que os protocolos de indução garantissem a adaptação do novato e que os programas de treinamento de funcionários avaliassem a efetividade da equipe de enfermagem no hospital, até a realização da adaptação da enfermagem ao hospital.

Resumen Objetivo Analizar los factores que influyen en la adaptación laboral de enfermería en hospital, durante el período de transición de graduados como fuerza laboral en salud en su nueva etapa. Método Estudio exploratorio, transversal, participaron 100 enfermeras/os graduados como fuerza de trabajo de unidades hospitalarias. La recolección se realizó con un cuestionario en plataforma web en el período noviembre 2020 - agosto 2021. El análisis se realizó mediante estadística descriptiva. Resultados Se encontró predominancia de mujeres, solteras, de edades entre 23 y 32, licenciadas y operativas, trabajando entre 19 meses a 2 años. Respecto a los factores, se identificaron tres más influyentes, correspondientes a: Autonomía; Psicológico; Personal. Conclusiones e implicaciones para la práctica La adaptación del personal de enfermería en hospital se presenta con dificultades en el período de transición, los factores internos del profesional ya sean adquiridos mediante las prácticas como desarrollados durante la vida, y la formación de los empleadores influyen. Para la mejora, sería fundamental que los protocolos de inducción garantizarán la adaptación del novato y los programas de formación de empleados evalúen la efectividad del personal de enfermería en el hospital, hasta el logro de la adaptación de enfermería al hospital.

Abstract Objective To analyze the factors that influence the job adaptation of hospital nursing, during the transition period of graduates as a health workforce in their new stage. Method An exploratory, cross-sectional study, involving 100 graduate nurses as a workforce of hospital units. The collection was carried out with a questionnaire on the web platform in the period November 2020 - August 2021. The analysis was carried out using descriptive statistics. Results There was a predominance of women, single, aged between 23 and 32, licensed and operational, working between 19 months and 2 years. Regarding the factors, three most influential were identified, corresponding to: Autonomy; Psychological; Staff. Conclusions and implications for practice The adaptation of nursing staff in the hospital presents difficulties in the transition period; the internal factors of the professional, whether acquired through practices or developed during life, and the training of employers have influence. For improvement, it would be essential that the induction protocols guarantee the adaptation of the novice and that the employee training programs evaluate the effectiveness of the nursing staff in the hospital, until the achievement of the adaptation of nursing to the hospital.

First-year experience of transitioning from registered nurse to nurse practitioner.

BACKGROUND: Transitioning to advanced practice, novice nurse practitioners need to take on new roles, learn new practice areas, and develop new skills. This process requires breaking old practices and work habits and facing new challenges. PURPOSE: To explore the nature of nurse practitioners' work experiences during the first year of transition from registered nurse to nurse practitioner. METHODS: This qualitative study was based on Husserl's phenomenological methodology. A purposive sample of 16 first-year nurse practitioners was recruited. Data were collected through in-depth interviews and analyzed by thematic content analysis. The approaches of Lincoln & Guba were applied to improve the validity of the study. RESULTS: Results showed that the first-year experience of transitioning from registered nurse to nurse practitioner fell into two overarching themes: challenge and adjustment. The challenge consists of five subthemes: "facing the expectation-reality gap," "managing others' expectations," "striving to acquire professional skills," "handling situational variability," and "bearing emotional burdens" subthemes. The adjustment includes five subthemes: "finding resources," "gaining experiences," "building relationships," "relieving stress," and "overcoming obstacles." IMPLICATIONS FOR PRACTICE: Novice nurse practitioners face many challenges as they adjust to a new role during their first year on the job. New nurse practitioners develop coping strategies to help themselves adjust to their work. They also gradually gain new resources and experiences to help them stay positive in stressful situations and restore work-life balance. The challenges of transitioning from a registered nurse to a nurse practitioner cannot be overlooked. Novice nurse practitioners need appropriate support measures to adapt to advanced practice roles.

Neonatal nurse practitioner job satisfaction, workforce environment, and mental well-being.

BACKGROUND: Increased demand for nurse practitioners emphasizes the importance of consistent and ongoing collection of data to provide a better understanding of the NNP workforce and to promote retention and recruitment of NNPs. PURPOSE: To understand how work environment and work hours influence job or career satisfaction. METHODOLOGY: The National Association of Neonatal Nurse Practitioners in collaboration with the National Certification Corporation emailed an online survey to all 6,558 certified neonatal nurse practitioners (NNPs) in 2020 with 845 (12.8%) responding. Subjects included those with responsibilities in direct patient care, transport NPs, faculty/directors, and advanced practice registered nurse coordinators/managers/administrators. RESULTS: Satisfaction with career choice as an NNP was reported as very satisfied by 58% (n = 493) and mostly satisfied by 37% (n = 310). Satisfaction with current job as an NNP was reported as very satisfied for 30% (n = 252), with 51% being mostly satisfied (n = 435). Age influenced satisfaction scores, with NNPs aged 61 years or older having a higher mean score than NNPs aged 31-40 years ( p = .041). The majority of NNPs did not use all of their available paid time off (72%; n = 609) and respondents worked an additional 248 extra hours per year. NNPs experience bullying (58%) and/or lateral violence (32%). Seventeen percent have called in sick for mental health reasons (n = 147). CONCLUSIONS: Neonatal nurse practitioners' satisfaction is multifactorial. Those who reported taking time off for self-prescribed mental health indicated less job satisfaction, more work hours, poor work/life balance, and a less-than-optimum work environment. IMPLICATIONS: Overall, NNPs are satisfied with their career choice but are less satisfied with their job choice. Understanding factors that influence mental well-being and job satisfaction will improve recruitment and retention of nurse practitioners.