An Academic-Based Nurse Practitioner Fellowship Program: A Pilot Project Designed to Ease Nurse Practitioner Transition to Practice

Graduate nurse practitioners (NPs) face numerous challenges transitioning from registered nurse to advanced practice nurse.  They may struggle with role identification, communication and teamwork as well as other professional issues.  Nurse practitioner residency programs have been developed at a few locations across the country.  These programs are rare and generally found only at larger organizations.  Because many NPs are hired individually in small practice settings, NP faculty at a small private university in northeast Florida developed an academic based Nurse Practitioner Fellowship designed to ease the transition to practice for graduating NPs. 

A theoretical framework titled From Limbo to Legitimacy was used to develop the program.  This model consists of four major categories: Laying the Foundation, Launching, Meeting the Challenge and Broadening the Perspective.  Subcategories include negotiating the bureaucracy feeling like an imposter, gaining confidence.  Nurse practitioner faculty used the model to identify three themes that informed the curriculum for the fellowship: evidence based practice, communication and teamwork, and professional development. 

The Nurse Practitioner Fellowship will begin within one month of graduation from an NP program and consist of meeting one evening per month as well as non-synchronous online discussions.  The expected duration of the program is four months.  Subject matter will include negotiations, scope of practice, billing, credentialing, measuring outcomes, and specific patient scenarios.  Participants will be free to bring forth any issues or topics that present while practicing.  It is expected that participants will be at various stages of transition as some may be still seeking NP employment whereas others will have already begun practicing as an NP. 

Success of the program is measured through use of three instruments administered at the program’s start and end.  The first instrument is a demographic questionnaire that evaluates the participant’s age, gender, race, highest educational level, years working as an RN and specialty setting as an RN.  The second instrument is the Casey Fink Graduate Nurse Experience Survey (Casey et al., 2004). This survey evaluates role transition and consists of five sections: demographic information, skills, procedure performance including assessment of comfort/confidence, organizing–prioritizing ability, perceived support, patient safety, personal stress, communication leadership, professional satisfaction, and job satisfaction.  The last instrument measures job satisfaction and uses the McCloskey Mueller Satisfaction Scale (1990). This instrument is a multidimensional questionnaire measures satisfaction in 8 domains: satisfaction with extrinsic rewards, scheduling, family/work balance, co-workers, interaction, professional opportunities, praise/recognition, and control/responsibility.