Practice Collaboration Perspectives among Ambulatory Care Nurse Practitioners in Virginia

Introduction: Advanced Practice Registered Nurses (APRNs) have assumed more clinical practice responsibilities and are serving as population health leaders. In addition to clinical practice, the APRN’s leadership involvement with their physician and administrator colleagues at the decision-making table is necessary for inter-professional collaboration and organizational alignment. Bridging the gap between administration and practice is complicated by historical antecedents, professional boundaries, and organizational cultures. Provider-specific leadership that supports scope of practice and defines institutional regulations may guide the APRN’s path to the administrative table. This study examined how one group of APRNs, nurse practitioners (NPs), perceive leadership opportunities, define collaborative partnerships, and describe involvement in the non-clinical aspects of the practice organization.
Purpose: The constructs of partnerships, practice equity, accountability, ownership, and power as defined by the shared nursing governance model and Kanter’s theory of structural empowerment were used to develop a questionnaire that examined leadership characteristics and concepts utilized in NP ambulatory practice settings in Virginia.
Method: A twenty-five mixed method questionnaire was emailed to NP members of the Virginia Council of Nurse Practitioners.
Discussion: Data from 108 questionnaires were analyzed. Seventy percent of respondents do not have a shared governance model associated with their practice setting. The information from this research provides a platform for NP groups to open dialog with health care institution executives about accountability limitations within organizations as well as advocate for advanced practice provider-specific leadership.
Keywords: advanced practice registered nurses, shared governance, role development, theory of structural empowerment.