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Exploring the relationship between nursing identity and advanced nursing practice: An ethnographic study.
Helen Anderson1, Yvonne Birks2, Joy Adamson3
1Department of Health Sciences, Faculty of Sciences, University of York, York, UK.
Journal of Clinical Nursing
|January 1, 2020
Summary
Intra-professional relationships significantly impact advanced nursing practice. Negative interactions, like discounting and othering, destabilize advanced roles, highlighting the need for strategies to support professional identity.
Area of Science:
- Nursing
- Healthcare Professions
- Professional Identity
Background:
- Advanced nursing practice is growing globally.
- Lack of support for advanced practice within nursing may cause underutilization and retention issues.
- The influence of professional identity on advanced practice barriers is under-researched.
Purpose of the Study:
- To explore the relationship between professional nursing identity and advanced practice.
- To examine intra-professional relationships between advanced nurse practitioners (ANPs) and nursing colleagues.
Main Methods:
- Ethnographic methodology utilizing participant observation and semi-structured interviews.
- Data collected from 9 ANPs and 5 nursing colleagues in primary care settings.
- Thematic framework analysis guided by professional identity theories.
Main Results:
- Three themes emerged: Conciliating Nursing (ANPs fostering positive relationships), Vertical Discounting (colleagues undermining ANPs, and vice versa), and Lateral Othering (ANPs undermining other ANPs).
- Vertical Discounting and Lateral Othering were found to destabilize advanced practice.
- Intra-professional dynamics significantly shape the landscape of advanced nursing practice.
Conclusions:
- Intra-professional relationships and the wider nursing profession influence advanced practice.
- Threats to professional identity, particularly weak identity among practitioners, exacerbate a lack of support.
- Developing strategies informed by professional identity theories is crucial to support advanced practice.
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