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Abstract
This dissertation explores and examines the factors that influence perceptions of nurse practitioners (NPs) toward their work and profession. This study uses both qualitative and quantitative data. This project relies on interviews with nurse practitioners who work in primary care non-hospital settings to explore their perceptions of their roles and professional identity. Additionally, these interviews are analyzed to understand the participant's perceptions of how autonomy and job satisfaction are created and conceptualized through their lived experiences. The second source of data, the National Survey of Primary Care Physicians and Nurse Practitioners 2012, is a cross-sectional data set of Physicians and Nurse Practitioner primary care providers in the United States. These data are used to examine further the factors that influence job satisfaction and autonomy.
The inductive analysis shows that NPs engage in dual-boundary work; that is, they maintain their nursing identity while carving out a unique provider role that is different from that of a physician. Additionally, interview data showed that NPs place a high value on the interactions in the clinical space. NPs shared narratives of social interactions with co-workers and patients that, in turn, create perceptions of satisfaction. Additionally, these data show nuanced perceptions of autonomy, including unanticipated views on when and how and NP should gain autonomy from medical supervision.
Lastly, the quantitative analysis highlights two important influences. First, the amount of time spent on tasks does not influence feelings of satisfaction and that it is the perception of that time that matters most. That is, when nurse practitioners feel that the time they spend is the right amount of time, this influences satisfaction, regardless of the quantity of time. Lastly, the computerization of medical records profoundly impacts perceptions of autonomy and job satisfaction. While computerization makes the work easier, it also reduces satisfaction and perceptions of autonomy.
INDEX WORDS: Nurse Practitioner, Job autonomy, Job satisfaction, Profession boundaries, Emergency Medical Records
The inductive analysis shows that NPs engage in dual-boundary work; that is, they maintain their nursing identity while carving out a unique provider role that is different from that of a physician. Additionally, interview data showed that NPs place a high value on the interactions in the clinical space. NPs shared narratives of social interactions with co-workers and patients that, in turn, create perceptions of satisfaction. Additionally, these data show nuanced perceptions of autonomy, including unanticipated views on when and how and NP should gain autonomy from medical supervision.
Lastly, the quantitative analysis highlights two important influences. First, the amount of time spent on tasks does not influence feelings of satisfaction and that it is the perception of that time that matters most. That is, when nurse practitioners feel that the time they spend is the right amount of time, this influences satisfaction, regardless of the quantity of time. Lastly, the computerization of medical records profoundly impacts perceptions of autonomy and job satisfaction. While computerization makes the work easier, it also reduces satisfaction and perceptions of autonomy.
INDEX WORDS: Nurse Practitioner, Job autonomy, Job satisfaction, Profession boundaries, Emergency Medical Records