Introducing Nurse Practitioners Into Norwegian Primary Healthcare-Experiences and Learning

Nurse practitioners (NPs) are well established internationally, and Norway is now in the first phase of implementing their role. The aim of this study was to describe the reflections of nurse leaders and general practitioners (GPs) on the establishment of the new NP role in primary healthcare.

This study was qualitative and longitudinal. Written reports and audio recordings from 11 meetings with nurse leaders and GPs during 3 years in 3 municipalities were analyzed by a thematic analysis.

Four themes were identified: the need for enhanced clinical competence among registered nurses, the need for reorganization of advanced practice, the need for negotiating professional barriers, and demanding economic situations. Nurse leaders and GPs were generally positive toward NPs, but they had difficulty in clarifying their roles and how to organize them in the existing work models. This was due to economic pressures, different needs in departments, and shift work. Nurse leaders and GPs agreed that NPs should not replace physicians but perform the tasks of advanced practice nursing in a more expert way. Nurse leaders also wanted NPs to be a resource for registered nurses. It was important to gain trust in the new role not only of GPs but also of registered nurses.

It is extremely important that an implementation group is proactive in finding a suitable model for the implementation process. Clarification of the roles, tasks, and responsibilities of NPs at an early implementation stage could make the process easier.