Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Diane K. Whitehead

Abstract

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and Resources and NP-Physician Relations were comparable (M = 3.00, SD = 0.86; M = 2.98; SD = 0.73). NPs scored lowest on Professional Visibility (M = 2.74, SD = 0.76) and NP-Administration Relations (M = 2.63, SD = 0.79). Recommendations included optimization of NPs as advance practice nurses, establishing adequate administrative and clinical support, provision for interprofessional team development and function, distribution of standardized information about the NP role across and within institutions, and further exploration of NPs' experiences related to work hours and agency culture. Positive social change was supported as the NP practice model was extended throughout the current health care system, contributing to the shifting health care narrative/culture (from illness-focused care to wellness-focused care), and demonstrating full appreciation of patient/client-centeredness.

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