The Acute-Care Nurse Practitioner

From the moment it was first proposed, the role of the nursepractitioner has been steeped in controversy. In the fields of bothnursing and medicine, the idea that a nurse practitioner can, to somedegree, serve as a replacement for the physician has sparked heateddebates. Perhaps for that reason, des [...]
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From the moment it was first proposed, the role of the nursepractitioner has been steeped in controversy. In the fields of bothnursing and medicine, the idea that a nurse practitioner can, to somedegree, serve as a replacement for the physician has sparked heateddebates. Perhaps for that reason, despite the progress of the nursepractitioner movement, NPs have been reluctant to speak aboutthemselves and their work, and their own vision of their role has thusremained largely invisible. Current research is dominated byinstrumental and economic modes of discourse and tends to focus on theclinical activities associated with the role. Although informationabout demographics, educational preparation, position titles, reportingrelationships, and costs of care contribute to our understanding, whatwas missing was an exploration of the lived experience of the nursepractitioner, as a means to deepen that understanding as well as ourappreciation for their role."The Acute-Care Nurse Practitioner" is based on in-depthinterviews with twenty-six nurse practitioners working in acute-caresettings within tertiary-care institutions all across Canada. Employinga hermeneutic approach, Rashotte explores the perspectives from whichNPs view their reality as they undergo a transformational journey ofbecoming--a journey that is directed both outward, into the world, and inward, into the self. We learn how, in their struggle to engage ina meaningful practice that fulfills their goals as nurses, theirpurpose was hindered or achieved. In large part, the story unfolds inthe voices of the NPs themselves, but their words are complemented bydescriptive passages and excerpts of poetry that construct an animatedand powerful commentary on their journey. Poised between two worlds, NPs make a significant contribution to the work of their colleagues andto the care of patients and families. "The Acute-Care NursePractitioner" offers an experiential alternative to conventionaldiscourse surrounding this health care provider's role.