The paper seeks to explore what is needed to change the role of giving patient’s care to patient care prescription during the transition from a Registered Nurse (RN) to the Family Nurse Practitioner (FNP). For a successful journey, a thorough academic preparation at graduate level is needed. The preparation involves acquisition of new skills and knowledge, changes in roles as well as having the scope of practice. The journey of graduate nurse education is not only a time of great inspiration but it is also a time when students face challenges in their pursuit to meet the demands of education and start to change from registered nurse to the family nurse practitioner. The paper will provide transition process knowledge and further recommends for further study by using the role of family nurse practitioner, education of graduate nursing as well as theories of transition.
In most cases, the transition of FNP from RN produces anxiety, incompetence feelings, and conflict as well as confidence loss in clinical skills. The transition of RN to FNP is described to happen in stages and phases. Brown and Olshansky (2017) conceptualized the transition by participants into a process of four stages that starts with laying nurse practitioner’s practice (NP) foundation. After finishing the education of NP that involves the preparation and sitting of the certification examination, the first stage begins. The second stage is the launch stage where new NPs commence their advanced practice nurse (APN) career. During this stage, nurses are always excited and appear as imposters in their new NP role. As time progresses, the new NP move into a stage of meeting lessened anxiety feeling challenges and further develop their confidence.
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Finally, the last stage involves widening the perspective of nurses. It is the stage that nurses acquire legitimacy and become competent in their new role.This is a stage of interdependence and awareness of the NP nurses after relating with patients and other professions. On the other hand, Heitz, Steiner, and Burman (2014) assert that the FNP transition involves 2 phases. The first phase happens at the time of graduation the second phase starts immediately after graduation and proceeds to the employment of the nurse as an FNP. During the first phase, nurses acquire new knowledge to become FNP and most of them realize the need to leave the RN role. At the second phase, nurses experience a turbulent and stressful period. They experience feelings of self-doubt, emotional imbalance, and apprehension that occur as a result of their new independent role responsibilities.
The theory of transition discusses numerous life transitions regardless of whether they are unplanned or planned; generate stress, negative or positive. It also assesses how people try to cope with stress in different ways. Transition theory was established as a framework to be used by psychologists, counselors and social workers to help adults cope with the transition in life. The theory views the transition as an endless process where people continuously experience transitions as they leave set of roles, routines, routines and form new ones. The theory is comprised of multiple factors that affect the balance of a person during the transition. These factors include available support, personal coping strategies, available support and the situation itself. The theory is made up of a three-stage model in which moving in, moving through or moving out terms are used to identify various transition process stages. The importance, impact, and ability to keep the balance differ over time in response to transition stage of a person.
At the stage of move in, the balance of transition requires an adult to be aware of the new regulations, norms of behavior, expectations and rules. The adults then start to move through the transition when he or she learns new situations and is able to tackle issues on how to effectively maintain the new situation with other parts of their lives. Moving out is the last stage which involves a number of transitions and explores what comes next. The stage is associated with grief that results from changing jobs and going back to school to prepare for unanticipated or anticipated struggles in the current role. A person copes with the transition by using 4Ss that include situation, self, support and strategies resources. The 4Ss are developed to examine assets and liability for coping with relationship transitions, personal transitions as well as situational transitions. The first S refers to what has happened and considers the trigger, timing, control, role change, transition duration, previous experiences and concurrent stress factor ( Poronsky, 2015 ). The second S of self shows the person whom the transition is happening while the third S of support indicates the available help. Finally, the fourth S of strategies provides different ways in which an individual can cope. Notably, strategies control the meaning of transitopn, enhance the situation and help in administering stress.
Based on the information in this article, it is clear to depict transition as part of life. This is because the capacity to manage transitions relies on factors such as transition nature, personality, the environment as well as the available resources and supports. Apart from being part of life, it is a process that occurs in stages or phase and involves movement from one situation to another. As a result of insufficient information in the FNP transition concept, it is important to develop a transition model that identifies main ideas of the change from RN to FNP practice. This kind of theory offers a better procedure for understanding different stages as well as the points of each transition phase presented in a complete way. In the RN to FNP transition, it is imperative to first seek information, take direct action, not take the action or develop intrapsychic behavior to cope with the transition.
References
Brown, M. A., & Olshansky, E. F. (2017). From limbo to legitimacy: A theoretical model of the transition to the primary care nurse practitioner role. Nursing research , 46 (1), 46-51.
Heitz, L. J., Steiner, S. H., & Burman, M. E. (2014). RN to FNP: A qualitative study of role transition. Journal of Nursing Education, 43, 416–420.
Poronsky, C. B. (2015). Exploring the transition from registered nurse to family nurse practitioner. Journal of Professional Nursing , 29 (6), 350-358.
