Shifting patterns of practice: nurse practitioners in a managed care environment

Area of Science:

• Nursing Practice
• Healthcare Management
• Qualitative Research

Background:

• Managed care significantly impacts healthcare delivery.
• Understanding nurse practitioner (NP) perspectives is crucial for effective healthcare systems.
• The evolving landscape of managed care presents unique challenges for NPs.

Purpose of the Study:

• To explore nurse practitioner (NP) perceptions of managed care.
• To understand how managed care influences daily NP practice.
• To identify NP strategies for responding to the changing managed care environment.

Main Methods:

• Qualitative study utilizing in-depth interviews with 14 NPs.
• Data collected and analyzed over 18 months using purposive sampling and constant comparison.
• Member checks ensured data validity and trustworthiness.

Main Results:

• NPs experience a conflict between business and professional ethics.
• Strategies are employed by NPs to reconcile this ethical tension with core nursing values.
• Practice setting, workplace dynamics, and years of experience influence NP perspectives on managed care.

Conclusions:

• NPs actively manage the integration of business principles and professional nursing values.
• Understanding these tensions is key to supporting NPs in managed care settings.
• Tailored strategies may be needed based on NP practice context.