The transition from registered nurse to nurse practitioner

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University of New Brunswick


Objectives: The meta-synthesis provides a collective qualitative understanding of the transition experience from a registered nurse (RN) to a nurse practitioner (NP). This understanding assists the NP student in the transition, offers recommendations for graduate programs, and addresses a mentorship relationship that offers benefits to the student and mentor. Design: Published qualitative studies about the transition from RN to NP were selected in order to integrate their findings in a meta-synthesis. Data Sources: Databases were searched including CINAHL, MEDLINE, Google Scholar, and Psych Info. Review Methods: The following search terms were used: Nurse Practitioner OR Advanced Nursing AND role transition, primary health care, and transition models. Findings along with direct quotes were extracted from the studies and thematic analysis was used within an interpretative framework. Results: Three studies were included in the meta-synthesis. The central theme was a shift from an insecure NP to a confident, autonomous practitioner which involved a progression through the following four phases throughout the first year of practice: 'laying the foundation'; 'launching'; 'meeting the challenge'; and 'broadening the perspective' (Brown & Olshansky, 1997). Conclusion: New NPs felt overwhelmed and uncertain in the initial phases of transition. These challenges are related in part to the difficulty of letting go of previous nursing expertise and immersion into an entirely different clinical role. The transition requires an identity shift which can take one year or more. Novice NPs need academic guidance, supportive clinical settings, and a sense of connection with one another throughout the transition to continue with the success of the NP role.