The Scope of Practice of Rural Nurse Practitioners in Central Illinois

Lisa L. Lovgren, Illinois Wesleyan University

Abstract

In today's atmosphere of escalating health care costs, limited access to health care, and changes in the health care delivery systems, it is necessary to evaluate the roles and responsibilities of non-physician health care providers. The advanced Nurse Practitioner is one such health care professional who currently provides vital services to the public. However, utilization of Nurse Practitioners has been limited within Illinois. The purpose of this study was to: 1) examine current perceived roles of rural Central Illinois Nurse Practitioners, and 2) determine perceived practice-related changes and trends for the future. Qualitative data was collected from three nurse practitioners in Central Illinois. Semi-structured audiotaped interviews were transcribed verbatim. Transcripts were analyzed using a constant-comparative approach outlined by Strauss & Corbin (1990). Data was subjected to three stages of analysis that resulted in saturated themes. Initially, individual statements and phrases were extracted and coded followed by reorganization of the codes into relevant categories. Finally, each category was compared with all the other codes and thematic patterns emerged. Five stages of career evolution emerged from the data, including 1) Foundational Experiences; 2) Transition; 3) The Beginning Practice; 4) Current Practice; and 5) Future Practice. In addition, each Nurse Practitioner evaluated her experience as a Practitioner, which resulted in career satisfaction based on a foundation in nursing. Nurse Practitioners perceive little change now and in the future related to practice parameters such as providing health education, maintenance of health in persons with chronic and acute illness, and health promotion focusing on the physical and emotional aspects of wellness. However, they are seeking legal validation for their practice in the areas of prescriptive authority, direct third party reimbursement and recognition via state nurse practice laws. With renewed understanding of the roles of the Nurse Practitioner, health care providers will be able to collaborate and form coalitions that will aid in the accessibility to quality health care.