The nature of clinical practice in advanced practice nursing: A qualitative study

Analytical hermeneutics was used to gain a deeper understanding of how advanced practice nurses provide health care services within a holistic nursing perspective. This work provides further understanding for designing advanced practice nursing programs by articulating the nature of nursing practice with a broader and deeper scope of practice. The purpose of this research was to gain a deeper understanding of the clinical expertise exhibited through the lived experience of advanced practice nurses that develops as a result of the integration of advanced theoretical concepts, added elements of practice from other disciplines and clinical practice to create a nursing framework. What is the nature of the clinical practice of advanced practice nurses? Eight advanced practice nurses who held a graduate degree in nursing with an advanced practice focus and who currently were practicing were interviewed as the basis of the data set. Data included taped interviews of approximately 12 hours in duration.;It was discovered that advanced practice nurses are leaders in developing nursing practice through providing clinical leadership; use their authority and power to influence clinical and policy decisions; maintain a commitment to develop nursing practice; and, provide varying forms of clinical education and consultation. Nursing values and perspectives ground advanced practice nursing through values of advocacy, holism, nursing experience, deliberate use and integration of theory, along with added elements of practice and experience to create a nursing framework. The use of research is a distinguishing characteristic of advanced practice nursing. The drawing of research and practice together to drive nursing practice was clearly evident in this study. Advanced practice nurses were found to be actively conducting and using research.;The results of this study underline the need to prepare advanced practice nurses at a graduate level. Such a curriculum includes a sound basis in creating, selecting and using theoretical evidence from a strong nursing perspective. This research further emphasizes the critical importance of nursing experience in developing advanced practice nursing roles.