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Understanding nurse practitioner autonomy

Weiland, Sandra A. PhD, APRN-CNP, FNP1

Journal of the American Association of Nurse Practitioners: February 2015 - Volume 27 - Issue 2 - p 95–104
doi: 10.1002/2327-6924.12120

Purpose: This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care.

Data sources: A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis.

Conclusions: Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role.

Implications for practice: The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role.

1Sole Proprietor, Tri-County Family Health Clinic, Wapanucka, OklahomaTexas Woman's University, College of Nursing, Denton, Texas

Received: 8 May 2012; accepted: 28 January 2013

Correspondence Sandra A. Weiland, PhD, APRN-CNP, FNP, Route 5, Box 940, Coalgate, OK 74538. Tel: 214-779-0922 (Cell Phone); E-mail:

© 2015 American Association of Nurse Practitioners
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