Journey to advanced practice: Exploring the process used by neonatal nurse practitioner students in choosing to enter graduate school




Brand, Melinda Colleen

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Purpose:To describe the experiences of Neonatal Nurse Practitioner (NNP) students regarding their decision to become an NNP. Subjects: Eleven NNP students were interviewed during their first year of study regarding their decision to become NNPs. Design: This was a qualitative study using guided interview questions to gather information regarding the process used to decide to become NNPs and enroll in graduate school. Methods: This study used grounded theory methodology to conduct and analyze interview transcripts. Interviews were conducted between October 2011 and September 2012 and were analyzed simultaneously through constant comparison methodology. Results:Four main themes were identified: recognizing the NNP role, deciding to stay in the NICU, deciding to become NNPs, and readiness to enter the NNP role. The core category was choosing career advancement to the NNP role. Conditions needed to support this theme include working in an NICU, liking thework, being motivated by personal goals, timing as to family and finances, and the availability of online NNP programs. Strategies employed to proceed with the decision-making process included gathering information through observation and social interaction with practicing NNPs regarding both the role and available NNP programs, examining career options for the best fit, and the ongoing development of a support system that included family, coworkers (especially NNPs), and fellow students. Limitations: The study was restricted to two geographic locations and only included students enrolled at online universities. Implications for Practice: The role of NNP has low visibility outside of the NICU arena. Engaging undergraduate nursing students in discussion of advanced practice opportunities might be an initial step in garnering interest in NICU practice and the NNP role. NNPs were recognized mentors by the majority of study participants, and this role should be taught in NNP programs and developed in the workplace. Institutional support seldom went beyond verbal encouragement and tuition reimbursement. A cost-benefit analysis of supporting nurses to become NNPs compared to recruiting costs might be beneficial as well as promoting the value-added effects of continuing education of NNP students as they continue to practice as staff nurses while attending graduate school.



Nursing, Health and environmental sciences, Education, Career decisions, Neonatal nurse practitioners