The significance of this study helps to close the gap between theory and practice of NP transitions. Little is known about NP-specific “transition to practice” programs that originate from academia. Some employers offer NP residencies or “transition to practice” orientations, but they have very limited, competitive enrollment and only open to those employed with the organization. It is important to determine the benefits of offering an academic-based solution for a greater number of NP graduates prior to or concurrent with their first NP employment. This study sought and has begun to fill this need.
The primary purpose of this qualitative descriptive study was to identify facilitators and barriers of the successful transition to FNP clinical practice. A secondary purpose was to evaluate the effectiveness of this unique academic-based NP Fellowship designed and implemented by the researchers to ease the transition to practice for their former FNP students.
The research question for this study was: What is the lived experience of family nurse practitioners’ transition into clinical practice?
Methods:
To evaluate the overall success of the academic-based NP Fellowship, the faculty researchers conducted a qualitative descriptive study to evaluate transitional experiences of FNPs during their first year in practice. Institutional Review Board approval was obtained from the university where the researchers are currently employed and where the NPs previously attended.
After obtaining their informed consent, a focus group of five participants from the academic-based NP fellowship were interviewed to share their transition experiences. Of those five participants, three remain in their first NP position and the remaining two have either changed positions or were planning to over the next few weeks. The focus group was conducted on the university campus for approximately two hours and was not recorded. The faculty researchers took notes during the focus group which were later reviewed first independently and then, jointly for common themes.
Interview questions were:
Describe your first year in practice.
What parts of your transition were successful? What plants were challenging? Why?
Why did you think you were successful? Was there something specific that prepare you?
How did you overcome the challenges? What resources if any would have helped you achieve an easier transition in that experience?
What would you do differently over this past year in regards to your transition?
Describe the support you received from your organization.
What recommendations would you make to a new NP graduate?
What benefits if any did you gain from participation in the NP fellowship?
Results:
From the focus group of participants who completed an academic-based NP Fellowship program, three essential themes became evident in the data analysis: role preparation, role initiation, role acquisition. These themes described the essence of the NPs transition to their first year in practice.
- Role preparation: Role preparation was the theme that described the participants’ active engagement in securing the resources they needed to have a successful transition to practice.
- Role initiation: The theme of role initiation was encompassed the myriad of feelings that new NP graduates experience in their first year of practice.
- Role acquisition: The final theme, role acquisition, communicated a sense of achievement – a successful transition to NP.
Conclusion:
Given that the topic of academic-based NP fellowships is scarce within the current literature, the implications from the findings in this study are promising. Immediate implications for nursing education are evident. Nurse educators can be empowered to offer similar opportunities for their NP graduates. There are growing residency experiences for RN graduates that have been extremely successful but limited offerings for NPs who also have a challenging transition to practice. The implications for nursing education include strengthening nursing curricula to include topics that help in the transition during the first year as well as providing support to NP graduates to ensure success on the certification exams and employment, both important measures for accreditation of NP programs.
The academic-based NP fellowship described in this study is unique to any other offerings noted within the current literature. Findings from a focus group of participants noted that the residency was an effective tool in helping to ease their transition to practice from RN to NP. Participants moved through phases as described by three themes: role preparation, role initiation, and role acquisition. The first two themes (role preparation and role initiation) received their foundation within the academic-based NP fellowship with the third theme (role acquisition) occurring after the fellowship ended. Topics presented in the fellowship were timely and relevant to the needs of the graduate NP and set the stage for a successful transition. Based on the findings of this study, it is recommended that future academic-based NP fellowships be offered, expanded, and studied to determine their impact on nursing practice.
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