New Graduate PMHNP Transition to Practice Program

Abstract

The purpose of this project was to identify facilitators and barriers to novice PMHNP role transition in Arizona and provide recommendations for a new graduate psychiatric-mental health nurse practitioner (PMHNP) transition plan for a clinical agency/project partner. Core concepts for this project included novice, expert, PMHNP, transitions, nurse practitioner (NP) role transition, facilitators, and barriers. Meleis’ Transitions Theory was the theoretical framework supporting the project. Applying Transitions Theory to NP role transition, PMHNP role transition is a situational transition mediated by facilitators and inhibitors (barriers), patterns of response, and outcome indicators. Methods: A descriptive, cross-sectional anonymous survey was administered to PMHNPs in Arizona (N=24). The survey consisted of a valid and reliable instrument for this population which measures NP role transition: The Nurse Practitioner Role Transition Scale (NPRTS). Eleven additional custom survey questions sought to identify statistically significant relationships between pre-certification and post-certification antecedents and participants’ NPRTS score data. Pre-certification antecedents queried about included: working in another NP role prior to PMHNP certification; the number of clinical hours in one’s PMHNP educational program; years of previous psychiatric nursing experience; years of previous medical nursing experience; and the degree of supervised, full practice during PMHNP clinical rotations. Post-certification antecedents in the survey included: receiving a formal orientation; participating in a residency or fellowship program; receiving informal mentoring or formal mentoring; months/years of PMHNP experience; and state of residence during the PMHNP role transition experience. Findings: A statistically significant relationship was found for one antecedent: formal orientation during the NP role transition experience. Participants’ comments were solicited in an open text-question asking them to describe any additional factors that facilitated or acted as barriers to their role transition experience. Content analysis supported informal and formal mentoring as role transition facilitators. Implications: Implementing a formal orientation and formal or informal mentoring into agencies’ novice PMHNP transition plans or programs is supported by a synthesis of the literature for NP role transition and this project’s findings. Recommendations for a new graduate PMHNP transition plan for the project’s clinical partner are provided and sustainability is discussed.