How nurse practitioners implement their roles

Objective. This is a report of a qualitative health research study examining how nurse practitioners construct and implement their roles. Methods. In-depth interviews and a focus group discussion were conducted to obtain narrative data from nurse practitioners from a variety of clinical backgrounds. Data were analysed utilising the principles of grounded theory. Subjects. Seven nurse practitioners participated in face-to-face interviews and six participated in a focus group discussion. Results. The central process of ‘developing legitimacy and credibility’ is achieved through the processes of: ‘developing Clinical Practice Guidelines’, ‘collaborating with the multidisciplinary team’, ‘communicating’, and ‘transitioning to practice’. Conclusion. Policy makers and those responsible for operationalising nurse practitioner roles need to support the central process of developing legitimacy and credibility vital for successful implementation. First, this involves enabling a supportive and informed process of Clinical Practice Guideline development. Second, key inter-disciplinary relationships need to be identified to facilitate collaboration and sources of mentorship for nurse practitioners. Finally, an identified period of transition will facilitate identification, development and implementation of the above processes. What is known about the topic? The contemporary role of the nurse practitioner was introduced to provide a flexible, innovative, integrated care strategy, providing increased continuity of nursing care at an advanced practice level. Implementation of the role of the nurse practitioner can be challenging and is influenced by several identified barriers and facilitators. What does this paper add? This paper adds an understanding of workplace relationships and processes, which are integral to the construction and implementation of nurse practitioner roles. The interplay of these processes and relationships support the central process of ‘developing legitimacy and credibility’. What are the implications for practitioners? This paper provides a clear guide for policy makers and those responsible for operationalising nurse practitioner roles in regard to the requirements underpinning successful role development and implementation.