Perceptions of the nurse practitioner in the hosptial setting

Abstract

The practice of nurse practitioners (NPs) has evolved over the last 60 years. This evolution has taken the NP from practicing mainly in a family-practice setting into various other settings such as the hospital environment. The knowledge and associated role of the NP is often confusing for healthcare professionals. The purpose of this project was to gain insight from Medical Doctors (MDs) and Doctors of Osteopathy (DOs) regarding their perception of NP scope of practice, educational background, and appropriate utilization in the hospitalist's position. A Likert-scale questionnaire was deployed to MD and DO providers from two different facility types in central and eastern Montana using a snowball sampling method. The two facility types were hospitals that currently utilize NPs in their inpatient settings and hospitals that do not utilize NPs in their inpatient settings in Montana. A total of 51 questionnaires were sent out with a response rate of 47%. Along with demographic data, the questionnaire included three umbrella themes: MDs'/DOs' perceptions regarding the NPs' educational background, NPs' scope of practice, and the utilization of NPs in a hospital setting. The results from the questionnaire suggest that MDs/DOs do not understand the differing roles or educational processes of the APRN, specifically the Family Nurse Practitioner (FNP) versus the Acute Care Nurse Practitioner (ACNP). The results also showed strong support by MDs/DOs for the NP to work in a hospital setting, especially in urban areas. These findings support the need for changes in organizational hiring and regulatory policy consistent with independent state APRN practice regulations and the LACE Consensus Model. Enhancing hiring practices can lead to increased educational opportunities for MDs/DOs regarding the various APRN roles, afford an organization the opportunity to hire an APRN that is appropriately licensed to work in a hospital setting, and provide clarity between the FNP and ACNP roles.