The Lived Experience of Nurse Practitioners in Independent Practice

Purpose:

The purpose of this qualitative phenomenological study was to explore the lived experience of Nurse Practitioners (NP) in independent practice.  

The aim was to give NPs a voice to express their individual experience, provide an inductive description of the lived experience, and gain understanding of the essence of being an independent practitioner.

Methods:

The purpose of this qualitative, phenomenological inquiry was to explore the lived experience of the nurse practitioners in independent practice.  A hermeneutic phenomenological inquiry was used to reveal the experiences from data grounded in the perceptions and experiences of nurse practitioners with this practice background.  This research was guided by van Manen’s (1990) phenomenological approach.  Selecting a method of choice is a necessity that is guided by the research question and the purpose of the study.  If a matter of frequency or significance motivates the research question, then a quantitative methodology must be used.  Quantitative research is associated with positivism and a focus on the scientific method.  The results are associated with generalizability and the epistemological assumption in quantitative research is that knowledge is objective and can be developed deductively from hypothesis testing.  Hence, while quantitative inquiry is able to answer the “what,” it fails to address the “why” (Munhall, 2010).  On the other hand, if the interest of the research question centers on what it is like to experience a phenomenon, then the approach must be qualitative.  This is the case for this study: “What is the lived experience of a nurse practitioner in independent practice?”  Therefore, the chosen method for this study is van Manen’s hermeneutic phenomenology.

Results:

From the experiences of the 17 NPs in independent practice, four themes were identified: questioning – dissatisfaction with traditional medical practice; self-directing – need for control; transforming – finding a niche; and achieving fulfillment.  Findings were correlated using Starck’s (1985) theory of meaning.

Conclusion:

Nurse practitioners in this study assessed the changing health care market environment and found a way to improve personal and functional outcomes.  They developed a creative process of carving out a small part of the health care market by aligning their unique skills to match the needs of a population whose health care needs were not being fulfilled.  NPs in this study viewed having total control over their practice as a necessary component if they were to step out as an alternative provider of health care. Their determination and professional confidence in the desired result paid off with the result leading to a successful practice and a sense of achievement.