Recently I’ve had numerous conversations where people ask about the experiences of nurse practitioners in education, postgraduate training, and practice. Basically, who are they and what do they do? How are their experiences different from other health care professionals? I realized that the underlying theme was the professional identity of nurse practitioners. 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.
I was thinking about these conversations as I read my favorite blog, Maria Popova’s weekly post, Brain Pickings. This week Popova explored writings by philosophers and scientists as they reflect on the transformative experiences that result from friendships; how we “co-create each other and recreate ourselves”. Popova describes trail-blazing 1800’s female astronomer, Maria Mitchell, who discovered a comet and was a prolific author. Mitchell wrote: “Whatever our degree of friends may be, we come more under their influence than we are aware.” She advocated “balanced relationships… that are distributed among many people, each fulfilling a different need.”
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.
Family, friends and colleagues impact who we are and who we become. Mentors, colleagues, and those we serve impact how nurse practitioners approach their professional practice as compassionate, patient-centered, highly competent health care providers. An implicit goal of postgraduate training is to provide an explicit setting where the influence of faculty, mentors and peers fosters the continued emergence and development of a professional identity.
Let’s go back to Maria Mitchell’s observation about having a balance in one’s relationships — having a constellation of people who offer differing gifts of wisdom, insight, humor, loyalty, or happiness. One of the benefits of postgraduate training is the safe learning environment designed to tackle increasing levels of complexity and challenge. With faculty, preceptors and mentors providing a professional (and personal) safety net, trainees can witness and try out different approaches to being a professional. They will discover their individual ‘best fits’ for patient management; balancing personal and professional lives; keeping current; and leading an inter-professional team; all under the umbrella of being a nurse practitioner. Interacting with diverse, highly qualified faculty/providers, administrators and staff is an essential component of a trainee’s experiential learning.
On the flip side, the experience of serving as faculty, preceptor or mentor can be transformative as well. Personally, I find that being a mentor and faculty member has served as a focused driver in keeping me current with evidence, principles and practice; with emerging professional and discipline-based issues; and with the national funding/legislative scene. In a classic generational example, whatever capabilities I have with technology are a direct result of transformative interactions with colleagues of all ages and disciplines, trainees, consultants (and, of course, my grandchildren!)
Now to connect the dots between accreditation and the honing of a professional identity. The primary purpose of accreditation is to protect the public, including the ‘learners’. It is a privilege to have the trust of future colleagues as they gain expertise and shape their professional identities. Ensuring the quality of that experience is important.
Accreditation, whether for an academic program or for NP postgraduate training provides a mechanism to measure quality. The creation of the NNPRFTC’s accreditation standards for postgraduate training is an example of the transformative power that results from balanced collaboration. Each of the fifteen original authors shared a passion for best practices and quality. Each person also had a different professional and personal perspective. Multiple areas of expertise included: specialty and subspecialty care in various settings; academic leadership at every level; facilitation skills and project management; programmatic innovation; administrative and operational finesse. The “chemistry” of the group transformed multiple individual perspectives into a cohesive set of expectations that support a balanced, nuanced platform for enhancing the knowledge, attitudes and skills of novice practitioners.
If we are open to them, transformative relationships happen across one’s career trajectory and across one’s lifetime. As we welcome the incoming class of trainees, embrace the opportunities for transformation.
In closing, consider the first verse from Emily Dickinson’s Hope is the Thing with Feathers
Hope is the thing with feathers
That perches in the soul,
And sings the tune without the words,
And never stops at all.
Until next time, wishing you peace and wellness,