Nurse Practitioner Job Satisfaction and the Healthy Work Environment.

The purpose of this study was to explore the influence of organizational factors on the Acute Care Nurse Practitioner (ACNP) role implementation. A descriptive correlational design, incorporating quantitative and qualitative methods for data collection was used. The sample of convenience consisted of 57 ACNPs assigned to various medical and surgical programs within acute care hospitals. Ten ACNPs participated in the unstructured qualitative interviews. In addition to the interviews, data pertinent to various organizational factors, including role formalization, receptivity of the role by others, perceived autonomy, role strain, and additional factors that may interfere with role implementation, were collected through a self-report structured questionnaire. A four-diary day was completed to gather data on role implementation. Descriptive and correlational statistics were used to analyze the quantitative data. The qualitative data were content analyzed. The ACNPs engaged most frequently in activities reflective of the clinical practice component of the role and less frequently in the non-clinical components (i.e., education, administration, and research). Results of the quantitative and qualitative analyses indicated that lack of formal clear job description, conflicting demands and expectations, lack of receptivity of the role by others, lack of autonomy, and increased workload were negatively correlated with the ACNP role implementation. The ACNP role implementation varies across practice settings. This variability should be accounted for when examining outcomes of ACNP care.

What Acute Care Nurse Practitioners Should Understand About Reimbursement

Saluting Acute Care NPs

Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave. This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices. This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression. The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction. Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan. To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system.

NPs Must Adhere to State Scope-of-Practice Regulations

Advanced Practice Nursing Scope of Practice for Hospitals, Acute Care/Critical Care, and Ambulatory Care Settings

Advanced Practice Nursing Scope of Practice for Hospitals, Acute Care/Critical Care, and Ambulatory Care Settings: A Primer for Clinicians, Executives, and Preceptors

Family Nurse Practitioner or Acute Care Nurse Practitioner in the Emergency Department?

Should There be Laws Mandating Nurse Practitioner/Patient Ratios?

During the Acute Care Interest Group Forum held on June 18, 2005, at the American Academy of Nurse Practitioner's Conference, it was identified that information on educational options for acute care nurse practitioner (ACNP) practice was needed, particularly for NPs who may have had other educational preparation but who were now working in acute care practice settings. As a result, a workgroup was formed to compile information on educational options for ACNP practice, including post-master's programs. Web site descriptions of ACNP programs (n= 70) and, as needed, phone calls to ACNP programs to obtain information on program offerings including post-master's and distance-learning options. Educational options for ACNP practice include master's and post-master's programs, along with national certification. A growing number of educational programs offer post-master's options as well as distance-learning formats for coursework. NPs interested in obtaining ACNP education, including those with other NP specialty education who are now working in acute care settings, have a number of choices for pursuing ACNP practice. NPs working in acute care need to ensure that their educational preparation meets the requirements set forth by the scope of standards for ACNP practice and national requirements and state regulations.

As the role of the Acute Care Nurse Practitioner (ACNP) gains more recognition, ACNPs as well as prospective employers are eager to incorporate the position into a practice setting. Because the role is in its infancy, there has been limited experience from which to draw on to provide guidance in ACNP role implementation within a practice, either private or institutional. This article will provide foundational information and strategies on how to integrate the ACNP role into a practice setting. These strategies will be useful to not only the ACNP, but also nurse administrators, case managers, clinical nurse specialists, and nurse educators in acute and critical care who are responsible for seeking innovative ways to maintain seamless quality and cost-effective patient care.

Extracorporeal Membrane Oxygenation: Opportunities for Expanding Nurses' Roles.

The link between organizational culture, organizational trust, job satisfaction, and team-based practice among nurse practitioners (NPs) has not been examined simultaneously. To identify the effects of organizational culture, organizational trust, and other factors on NPs such as job satisfaction and team-based practice. We used a cross-sectional design with a national sample. Data were collected using an online survey of 1,100 NPs working in acute care settings. The survey included demographic and working characteristics, the Organizational Culture Scale, the Organizational Trust Scale, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), and the NP-physician relations (NP-PR) subscale of the Nurse Practitioner Primary Care Organizational Climate (NP-PCOCQ). Multiple regression analysis with a stepwise selection method explored potential factors that influence job satisfaction and team-based practice. A learning environment, psychological safety, senior leadership support, commitment to the organization, and the organizational culture and trust were positively associated with higher job satisfaction, which accounted for 49.2% of the variance in NPs' job satisfaction. Organizational trust, commitment to the organization, and learning environment promoted better team-based practice significantly. Also, NPs working a fixed shift pattern showed higher levels of team-based practice. These factors accounted for 23.66% of variances in team-based practice. Organizational culture and organizational trust affect the job satisfaction and team-based practice of NPs in acute care practices. Implications for Nursing Management. Acute care hospitals are encouraged to develop policies to enhance a learning environment, a supportive organizational culture, and trust in NPs' practice.

The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.

Acute care comprises a significant amount of health care delivery, and demand for hospital care is forecasted to grow. Nurse practitioner (NP) roles evolved from primary care to meet patients' acute care needs. Nurse practitioners increasingly assume inpatient roles. Yet, growth of the acute care NP workforce is not widely described, and this knowledge can inform future workforce growth. To describe the growth in the inpatient, acute care NP workforce. This study used a repeated cross-sectional design to analyze data from the US National Sample Survey of Registered Nurses (1988-2022) and the National Sample Survey of NPs (2012) to describe acute care NP workforce size, demographic, education, and practice characteristics. Descriptive statistical analyses accounted for the complex survey design and weighting and generated national workforce estimates. The acute care NP workforce increased 836% (3,243-30,368 NPs) from 1988 to 2022. Yet, a growing proportion of inpatient NPs are not acute care certified. The workforce became more demographically diverse with advanced education. They also provide care in more wide-ranging clinical practice areas. Over the past 3 decades, a novel acute care NP role evolved into an essential role in inpatient settings. However, there are opportunities to increase the utilization of acute care NPs. This research highlights growth in the acute care NP workforce and opportunities for acute care NPs to improve access to care in inpatient settings. Educators, employers, and policymakers can support the ongoing integration of acute care NPs in inpatient care.