Abstract
To examine and explore organisational and role conditions that promote or inhibit job satisfaction and workplace well-being for advanced practice nurses. The advanced practice role is common across the world. Research shows it is well regarded by patients and improves patient outcomes, but there is little evidence about what the role is like for nurses. A subsample of an existing cohort of advanced practice nurses were invited for interview. Twenty-two nurses were interviewed over the phone. Interviews transcripts were analysed using thematic analysis. Four themes were derived from the data; 'the advanced nurse role and professional identity', 'feeling exposed', 'support for the advancement of the role' and 'demonstrating impact'. Nurses report considerable dissatisfaction with role identity and concerns relating to isolation on a daily basis, and these negatively affect well-being. However, they also identified significant satisfaction with the role, particularly when well supported and able to recognize the unique contribution that they made to the lives of patients and to their organisations. Clear role definitions, provision of high-quality clinical supervision and addressing issues of isolation are likely to improve the job satisfaction of advanced practice nurses.
Highlights
Advanced Practice Nurses (APNs) are established across the globe (International Council of Nurses, 2008; Schober et al, 2020)
Four super-ordinate themes were derived from the data: ‘the APN role and professional identity’, ‘feeling exposed’, ‘support for the advancement of the APN role’ and ‘demonstrating impact’
Each theme relates to our primary concerns about the conditions, which might inhibit or promote role satisfaction, dissatisfaction and overall workplace well-being
Summary
Advanced Practice Nurses (APNs) are established across the globe (International Council of Nurses, 2008; Schober et al, 2020). A range of challenges of an organisational, relational and inter-professional nature has hampered the development of the APN role, including role ambiguity (King et al, 2017), role overload and challenges in clinical autonomy (Woo et al, 2019). The importance of the organisational embeddedness and clarity of role is further reflected in existing evidence concerning levels of job satisfaction for APNs. Role ambiguity and a lack of intra-practice collegiality have been identified as specific forms of dissatisfaction amongst senior practitioners in the USA (Faris et al, 2010). A systematic review identified extrinsic factors, such as autonomy and meaningful work, as important factors in determining levels of job satisfaction amongst APNs (Han et al, 2018).
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