Identifying the practice characteristics of advanced practitioners in acute and critical care settings

This paper reports the results of a longitudinal, qualitative study into the role transition of advanced nurse practitioners (ANPs) in the UK. Following the completion of a Master's Degree in Health Studies programme, eleven ANPs working in high-dependency and acute care settings completed a purpose-designed 'role development diary' for the first six months they practised in their new role. In the diary, ANPs recorded the nature and focus of practice activities, identified the components of their practice perceived to be 'advanced', and documented the factors that influenced role implementation and development. Once completed, the diaries were subjected to a comparative analysis, which revealed that the level of patient dependency and the type of clinical environment had a direct bearing on the nature and extent of certain aspects of role performance. The findings also indicated that, whilst practitioners identified multiple components in their roles, priority was initially given to the acquisition and development of technical and diagnostic skills. It was concluded that variations in the performance of ANPs could be attributed not only to the nature of the clinical environment, but prevailing personal, political and organizational agendas.