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The transition of nurse practitioners to changes in prescriptive authority
Louise Kaplan1, Marie-Annette Brown
1Washington State University, College of Nursing, Vancouver, WA 98686, USA. kaplanla@wsu.edu
Summary
Nurse practitioners (NPs) experience a complex transition when gaining prescriptive authority for controlled substances. This process involves emotional and professional adjustments beyond legislative changes, highlighting the need for comprehensive preparation.
Area of Science:
- Nursing Practice
- Pharmacology
- Healthcare Policy
Background:
- Nurse practitioners (NPs) play a crucial role in patient care, including the management of conditions requiring controlled substances.
- Understanding the factors influencing NPs' decisions and experiences with prescribing controlled substances is essential for optimizing healthcare delivery.
- The scope of practice for NPs, particularly concerning prescriptive authority, is continually evolving and varies by jurisdiction.
Purpose of the Study:
- To explore nurse practitioners' (NPs) decision-making processes regarding obtaining prescriptive authority for controlled substances.
- To describe the lived experiences of NPs who provide or prescribe controlled substances.
- To examine the relationship between NPs' perceived professional autonomy and their prescriptive authority for controlled substances.
Main Methods:
- Qualitative study utilizing twelve focus groups with approximately 100 nurse practitioners (NPs).
- Participants were recruited from continuing education conferences.
- Grounded theory methodology was applied for data collection and analysis of transcribed discussions.
Main Results:
- A central theme of "Letting go and taking hold" emerged, characterizing the transition to prescribing Schedule II-IV medications.
- Three dimensions of this transition were identified: Resisting change, Ambivalent about change, and Embracing change.
- NPs' experiences highlight that professional transition extends beyond legislative changes.
Conclusions:
- The transition to prescribing controlled substances is a complex professional and emotional journey for NPs, not solely a legislative event.
- Effective role development and professional autonomy require proactive preparation for expanded scopes of practice, anticipating legislative changes.
- Addressing the nuances of professional transition can facilitate the achievement of fully autonomous NP practice.
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