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Success and Professional Identity

Understanding How Postgraduate Training Influences Novice NPs

Candice Rettie, PhD 2 100

If you have read other blogs in this series, you know that I am frequently inspired by nature. The harvest moon was in full glory this past week, signaling farmers that it is time for harvest.  Birds and butterflies are migrating south, individually and in sky-darkening flocks. Hurricanes are rampaging through warm waters. Each day the hours of darkness increase.  All are signs of nature’s seasonal transition. 


Piaget and Kuhn each conceptualized transitions as essential steps in forward progress.  Beginning with Piaget's notion of transition -- successful transitions are characterized by 'important changes in how the [novice NP] thinks’.  Then layering on Kuhn's notion of a paradigmatic shift -- [earlier ways of practice] are 'replaced by new and different’ ways of functioning as a [confident and experienced healthcare professional.] Let’s explore how transitions occur in nurse practitioner postgraduate training programs.  These programs provide deliberate, structured opportunities for navigating the novice practitioners’ transition from newly minted to seasoned practitioner through opportunities designed to develop relevant “attitudes, beliefs and standards” that correspond with  a “clear understanding of the responsibilities of being a health care provider.” A useful nursing skill acquisition model is provided by  Patricia Benner’s stage theory of clinical competency that describes RNs' progression from novice to expert nurse. The concept of novice NPs moving through five levels of proficiency is applicable to the evolution of a novice NP’s professional identity.  Read more to learn about two recent studies that describe this developmental progression from novice NP to confident practitioner.

Nurse Practitioner’s Professional Identity

The Importance of Faculty, Mentors and Colleagues

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The process of developing a professional identity begins in undergrad, grows exponentially in graduate school, postgraduate training and professional practice, and continues throughout one’s career. It occurred to me that perhaps there is a unique aspect to the voluntary postgrad training year with its explicit focus on intensive clinical training, training to high performance models of care, and professional development in the context of a structured, transformative experience that builds on and adds to earlier experiences.  Existing relationships continue to develop while strong new bonds are formed with each cohort.   Novice NPs interact with others in a professional setting.  They embark, individually and as a cohort, on their life-long journey of re-creating and refining their professional identities – their shared, unique and individual, interpretations and expressions of their professional roles as nurse practitioners.  

Solar Eclipse and Enlightenment

Knowledge and Understanding Bridge Fear

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As I think back to current events that are fueled by radically differing world views that condone intolerance, my wish is that mutual experiences of this eclipse might serve as a shared reference point that brings together unlikely conversational partners.  While we may see the same event, our perspectives differ as do our interpretations of what we witness.  Using principles of evidence-based science and decision-making as a basis for civil discourse, we can explore the reality of varying observations and analysis; contribute to a meaningful and shared understanding of events; and avoid fueling discord, superstition, and fear.

A Balanced Life

The Challenge of Modeling Wellness

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Erene Stergiopoulos is an author, an educational researcher, a decade-long cancer patient and now a third-year medical student at the University of Toronto. She recently wrote about the cloak of superhuman invulnerability that is worn by many in the helping professions.  Erene expressed eloquently how experiencing life as a patient has informed her view of healthcare and had a positive impact on her role as a future provider.  She notes that in medical education, students learn about disease, but not what it’s like to live with disease.  

Illness can serve as a crucible reminding us of the gifts of human frailty – a capacity for compassion and empathy.  

In our roles as mentors, teachers and colleagues, let’s model maintaining good health.  When we are ill, take time to heal.  When we are exhausted, make time to rest.  When we need to be replenished spiritually, seek solace. When we haven’t connected with those we care for, remember that time past is time lost. Take your vacation time and encourage your trainees to do the same.  

Life Lessons Learned from Bird Watching

Patience, Persistence and Seizing the Moment

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Wildlife provides a frequent reminder of the virtues of practice, persistence, and seizing the moment. Fledgling purple martins fly in dance-like synchrony as they perfect their aeronautic skills.  In the span of one second, the blue heron shifts from prolonged and absolute stillness to a startling, almost invisible spearing of a hapless crab.   Simultaneously I witness demonstrations of beauty, patience, practice, precision, and expertise. 

On a daily basis, preceptors and trainees act with patience and model compassion in spirit, informed delivery of healthcare, and precision in action.  Trainees persist until it good practice becomes rote and can be activated immediately when needed – they develop the clinical ‘muscle memory’ skills to delivery competent healthcare upon demand.  The intent is to serve others with intelligence and competence, grace and dignity, tact and compassion.  

This is the time of year for transitions.  Purple martin fledglings fly.  Students graduate.  New residents prepare for their capstone year of professional polishing.  Novice nurse practitioners culminate their metamorphosis into confident practitioners.

 I’d like to remember and acknowledge the gift that nurse practitioners bring to healthcare.


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