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Aim: Gain insight into the process of shared decision-making (SDM) in daily hospital care for patients with dementia from nurses' perspectives., Design: Explorative qualitative design., Methods: In-depth digital interviews were conducted with 14 registered nurses between June and November 2022. A phenomenological approach was applied using Colaizzi's seven-step method., Results: Five themes were identified in the data: (1) SDM in daily care: How shared decision-making is applied; (2) Nurses' perceptions and competence: How nurses perceive and manage SDM; (3) Nurses' roles and advocacy: The evolving roles of nurses and their advocacy efforts, (4) Recognition of dementia and its impact: How nurses recognize and manage dementia; and (5) Interventions to support SDM: Strategies and interventions to facilitate SDM., Conclusion: This study highlights the complexity of SDM in patients with dementia. It demonstrates the importance of the involvement of relatives, omission of patient goals in discussions and perceived deficiencies of nurses. The early identification of dementia, evaluation of nuanced capacity and targeted communication are essential. Further research and enhanced training are required to improve care in this context., Impact: Potential areas for further research on SDM in nurses involving patients with dementia include investigating the effects of integrating goal discussions into SDM training for nurses, overcoming barriers to SDM competence, and challenging the idea that SDM is solely the responsibility of physicians. These findings highlight the need for policies that encourage interdisciplinary collaboration, address misconceptions and recommend training programmes that focus on applying SDM to the daily care of patients with dementia, thereby improving the overall quality of patient care., Reporting Method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background:  Nurses in Eswatini are best positioned to assist adolescents living with HIV to disclose their status to others. Nonetheless, it is evident that many nurses are not actively involved in the disclosure process., Aim:  The aim of this study was to explore the process of nurses in preparing adolescents for self-disclosure and describe the role of policymakers in enabling adolescents to disclose their HIV status to others., Setting:  The study was conducted in four facilities, one from each of the four regions of the country, after getting ethical clearance from a Public University Higher Degrees Ethics Committee and the Eswatini Health and Human Research Review Board., Methods:  In-depth interviews were conducted on 28 participants: 24 nurses and 4 policymakers. The three steps of open, axial and selective coding were used to analyse data until theoretical saturation was achieved., Results:  Adolescents were assisted to disclose by providing them with HIV information to empower them, encouraged to enrol in teen club because it created a conducive environment for peer-to-peer support, and they were given ongoing psychosocial support to prepare them for self-disclosure. Adolescent HIV management workshops were not routinely done because such training relied on funders., Conclusion:  Nurses are not preparing adolescents satisfactorily to disclose. Prioritising the training of nurses would lead to a remarkable increase in the rate of HIV self-disclosure by Swati adolescents.Contribution: This study is the first of its kind in Eswatini, and the results will contribute to the review of HIV management guidelines and promote adolescent self-disclosure.

Aims: This study aimed to describe nurses' experiences caring for patients who use medicinal cannabis. For the purpose of this study, the term 'medicinal cannabis' is used to describe cannabis-based products that are sourced legally or illegally., Design: Qualitative study using thematic analysis., Methods: Eleven registered nurses explored their experiences caring for patients using medicinal cannabis in the Australian healthcare sector. Semistructured interviews were via telephone, Zoom or face to face. Transcribed interview data were analysed using the six phases of thematic analysis., Results: The nurses' experiences of caring for patients who use medicinal cannabis were described in three themes; 'Searching for predictable processes of regulation, access and use of medicinal cannabis', 'One conundrum after another' and 'There is a lot to learn'. Overall, nurses described feeling underprepared to care for patients who use or want to use medicinal cannabis in the Australian healthcare sector., Conclusion: The results indicate that nurses want to have meaningful discussions with patients about the use of medicinal cannabis, yet do not always have the confidence to do so. Nurses sought their own education on how to better support patients. All participants echoed the need for education. The nurse's role in caring for and supporting patients using medicinal cannabis could improve the patient experience., Implications for the Profession And/or Patient Care: Nurses play an essential role in improving the patient's experience and advocating for those using or wanting to discuss medicinal cannabis as a part of holistic care. Defining the nurse's role in effectively caring for patients can begin by providing evidence-based education to nurses. Including nurses in policy development and beginning to understand the legal and regulatory implications for nurses are important., Impact: This is the first study presenting current issues for nurses who care for patients using medicinal cannabis in Australian healthcare systems., Reporting Method: COREQ guidelines were adhered to for this study., No Patient or Public Contribution: For this research project on the experiences of registered nurses caring for patients using medicinal cannabis, we did not engage members of the patient population or the general public., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

The role of nurses in leading the design and delivery of primary health care services to address health inequities is growing in prominence, specifically in rural Australia. However, limited evidence exists to inform nurse-led primary health care in this context. Based on a focus group with nursing executives and semi-structured interviews with registered nurses we describe nurse experiences of leading the design of a primary health care service in rural Australia and nurse transition to and practice in this service. Nurse experiences were analysed using reflexive thematic analysis. The study reveals the centrality of relational integration in service design and nurse acquisition of relational practice as it relates to nurse to care recipient and nurse to nurse relationships. Tensions between primary health care nurses and their peers, and resultant de-valuing of primary health care practice, are described. The acquisition of nurse professional agency draws attention to investments required to position nurses to lead and sustain care innovations external to hospital settings. The authors propose that relational approaches may provide nurses with the opportunity to reframe their leadership and service contributions towards community literate primary health care provision and provide a pathway to professional emancipation from constrained practice expectations., (© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.)

Existing challenges to the legitimacy of mental health nursing in the United Kingdom and beyond have stimulated a critical self-reflection and discourse around the mental health nursing role, forcing the profession to question its identity and critically re-evaluate its position within the wider healthcare arena. In this discussion paper, I suggest that the current difficulties in conceptualising mental health nurse identity arise from our role being inherently interwoven with distinctive challenges and unique needs of our service users. Emerging from this idea is that the 'being' (and the 'doing') of mental health nursing is firmly situated within the sphere of intersubjective relations. Drawing upon Hegel's ideas of reciprocal recognitive relations, to support the notion that our profession's role and purpose are better understood when defined in relation to the work that we do with our service users, I argue that it is in the understanding (and even embracing) of intersubjectivity as a core principle of mental health nursing, where we might not just better understand ourselves but also know how to shift asymmetric relations with our service users towards those which are more commensurate and mutually beneficial., (© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.)

Background: Professional identity in nursing (PIN) is a multifaceted construct that evolves throughout one's nursing career. As new knowledge about PIN emerges, the influence of diversity, equity, inclusion, and belonging (DEIB) becomes increasingly vital in shaping a nurse's identity., Method: Bronfenbrenner's ecological systems theory is used to illustrate the complex, reciprocal, and intersecting influences of DEIB in the transformational process of becoming a nurse., Results: The authors provide an in-depth analysis of the nexus of DEIB and PIN conceptual model, examine reciprocal relationships between DEIB and the individual and collective PIN, offer a detailed case study for the application of DEIB and PIN, and make recommendations for implementing the conceptual model., Conclusion: The model may be used to integrate DEIB and PIN by nurses in all settings. [ J Contin Educ Nurs. 2024;55(10):493-499.] .

Abstract: Patient-centered care (PCC), a term coined decades ago, is a key but challenging focus of nursing practice. The history, development, and current dialogue about PCC along with biblical perspectives on caregiving, wisdom, and discernment help nurses who follow Christ to offer compassionate PCC. Strategies are proposed for meaningfully engaging patients and families as active participants in healthcare. The Christian nurse can best provide consistent, effective PCC by remaining Christ-centered., (Copyright © 2024 InterVarsity Christian Fellowship.)

Aim: To explain and understand leading care close to older persons in community home care from the perspective of registered nurses (RNs)., Background: Leading care close to older persons in home care is an overlooked and not well-described phenomenon. In home care, specific demands are placed on the registered nurse, as responsible for leading care guided by the older person's expectations and desires., Design: A reflective lifeworld hermeneutic approach grounded in the philosophy of phenomenology and hermeneutics. The study followed the COREQ checklist., Methods: Individual interviews were conducted with nine RNs working in community home care in a community in western Sweden. The data were analysed with a lifeworld hermeneutic approach., Results: The findings present four partially interpreted themes: leading with respect in a shared space, leadership that involves existential questions of life, balancing responsibility enables preservation of autonomy and challenges in maintaining a patient perspective. The partially interpreted themes conclude in a main interpretation: The patient perspective as an anchor when balancing responsibility for another person in an existential vulnerability of life., Conclusion: Leading care means being both close to the patient and at a distance when caring is performed through the hands of others. Ethical demands are placed on RNs as they encounter the vulnerability of the older person., Relevance to Clinical Practice: The findings can contribute to a greater understanding of the meaning of RNs as leaders and may have an impact for decision makers and policies to create conditions for leadership that contributes to dignified care for older persons in community home care., Patient of Public Contribution: Registered nurses working in community home care participated in data collection., (© 2024 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: General hospitals in China have been establishing General Practice Departments (GPD). Although General Practice Nurses (GPNs) are an important part of this medical system, their training has not been synchronised. This study explored the working status of nurses in GPDs in general hospitals in Beijing to provide a theoretical basis for the training and development of GPNs in China., Methods: We conducted in-depth, individual interviews with outpatient nurses at 19 hospitals in Beijing between March and April 2021. We employed a qualitative analysis to interpret participant narratives and used a codebook thematic analysis to analyse the interview data and extract themes., Results: The analysis revealed four themes: (i) a lack of full-time GPNs in GPDs of most tertiary hospitals, (ii) the inability of GPNs to fully express their potential and skills owing to their limited roles, (iii) insufficient standardised patient education provided by nurses in GPDs, and (iv) a lack of systematic and relevant training for nurses working in general practice settings., Conclusions: To promote the development of GPNs, GPDs in general hospitals in China should hire full-time GPNs, define their job duties in alignment with their values, and provide standardised training to strengthen their core competencies., (© 2024. The Author(s).)

The team is a fundamental and structuring dimension of care, founded on the principles of complementarity, interdependence, and shared objectives and responsibilities towards the patient. As a result of the pandemic and the rationalization of public hospitals, teams are faced with changes in the role of supervisors and the arrival of new figures such as advanced practice nurses. While these changes can bring new dynamism and questioning of practices, they can also be destabilizing. The institution must preserve the role of the team and its members., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The psychiatric care team offers comprehensive, personalized support, raising public awareness, promoting mental equilibrium and combating stigmatization. Its role includes collaboration, communication, designing adapted treatment plans and creating a climate of trust to influence the quality of care. In this way, she contributes to a more inclusive and caring society. As such, her own state of well-being deserves special attention. However, they often work in a highly degraded ecosystem that can be likened to psychiatry in a war zone., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Aim: This study intends to investigate whether, how and when service-oriented high-performance work systems (SHPWSs) drive nurses' extra-role service behaviour., Design: This was a quantitative cross-sectional study conducted with matched nurse-patient participants., Method: We tested hypotheses using data from 284 nurses and their matched 566 patients. The data were collected in 2019. We conducted a set of hierarchical regression analyses to test our hypotheses., Results: The results showed that SHPWSs have a positive impact on job crafting, which, in turn, mediates the link between SHPWSs and extra-role service behaviours. Additionally, the influence of professional identification moderates these relationships. Specifically, SHPWSs are significantly and positively associated with job crafting among highly professionally identified nurses. The indirect effect is significantly positive when nurses strongly identify with their profession but not significant when their professional identification is low., Conclusion: The results indicated that SHPWSs can elicit job crafting among higher professional identifiers, which further increases extra-role service behaviours towards patients., Impact: Our research emphasizes the significance of HRM themes in the healthcare service industry and their direct impact on healthcare personnel. Shifting from a management-centric to an individual-centric perspective, we focus on the proactive role of nurses. Furthermore, this study enhances the understanding of the boundary conditions for the effectiveness of SHPWSs., Patient or Public Contribution: Nurses and their mated patients from a Chinese hospital contributed to this study by completing the survey., (© 2024 John Wiley & Sons Ltd.)

Competing Interests: The author declares no conflicts of interest.

Aim: Consolidate and synthesize evidence on working nurse-parent experiences of parenthood., Background: Demands in healthcare strain the workforce, causing burnout and high turnover rates, especially among nurses. Balancing work and family responsibilites is even more challenging for nurse-parents., Introduction: Nursing is highly stressful, and the experiences of nurse-parents are under-researched highlighting the need to better understand and support nurse-parents in their dual roles., Methods: Seven databases (PubMed, Embase, CINAHL, PsycINFO, ProQuest, Scopus, and Web of Science) were systematically searched for published and unpublished primary qualitative studies. Extracted data were meta-summarized and synthesized using Sandelowski and Barroso's approach., Findings: Twelve peer-reviewed studies, conducted between 2007 and 2022, investigated the challenges faced by 339 female nurse-parents across various countries. The meta-synthesis revealed two main themes: (a) Clashes of dual roles, and (b) Accept, adapt, and compromise, which were supported by six subthemes. Nurse-parents struggled with dual roles, often neglected self-care, and experienced work-family conflicts. However, they learned to accept their situations, adapt by seeking help from family, friends, and colleagues, and compromise on career aspirations to prioritize their families. The importance of organizational support and flexibility in accommodating their dual roles was emphasized., Discussion: Female nurse-parents face challenges in balancing their dual roles, resulting in fatigue, compromised self-care, and limited social interactions. The culture of self-sacrifice in nursing contributes to these challenges, impacting patient safety. Supportive interventions like mindfulness programs and exercise classes can promote well-being. Staffing shortages and shift work further affect the work-life balance for nurse-parents., Conclusion and Implications for Nursing and Health Policy: Creating a supportive work environment for nurse-parents is crucial. Family-friendly shifts revised parental leave policies, and improved childcare support are needed. Supporting nurse-parents benefits their well-being and enhances patient care. Collaboration between healthcare organizations and policymakers is essential to address workforce shortages and implement changes., (© 2023 International Council of Nurses.)

This commentary addresses structural violence - an overlooked and unrecognized harm within nursing. Structural violence within nursing practice refers to the violent impacts of racism, classism, homophobia, and transphobia as well as other biases on vulnerable and underprivileged groups. As one of the largest and most trusted health professions, collectively nursing has the power to leverage their influence to mitigate the harmful effects of structural violence when caring for LGBTQ+ youth., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Published by Elsevier Inc.)

Objectives: Preventable adverse events (PAEs) occur across the healthcare spectrum; and, unfortunately, errors, adverse events, and PAEs are common in pediatric care. Historically, the role of disclosure of PAEs to patients and their families occurred between the dyad of physician and patient, with physicians assuming the responsibility of disclosure. In recent years, a trend toward a multidisciplinary team-based approach has emerged in some institutions, yet the role of pediatric nurses within the team disclosing a PAE is not fully understood. Given the unique relationship between pediatric nurses and their patients and their families, it is essential to understand does the literature tell us about the role of pediatric nurses during PAE disclosure?, Methods: The Arksey and O'Malley scoping review method guided this study protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews framework guided reporting., Results: The final sample included five articles for synthesis: none reported or described a specific role for pediatric nurses during PAE disclosure., Conclusions: There is a gap in the literature on the role of pediatric nurses during PAE disclosure. Two themes emerged from this review: the use of a team-based approach to disclosure, and the need to provide emotional support to the pediatric patient and their family. There is a need for additional investigation into the role of pediatric nurses as part of a team-based disclosure process and how pediatric nurses currently provide, or desire to provide, emotional support to the patient and their family., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The change from clinical nurse specialist to nurse practitioner model with emphasis on the biomedical prescriber role significantly affected graduate education/practice., Aim/method: This article reports solutions, lessons learned, and insights from faculty in a four-year Workforce Development Project supported by an academic-practice partnership. Lessons learned that are shared as administrative and clinical practice insights include use of experiential learning platform and interaction process recordings, confirmation of the state of nurse psychotherapy blocks to clinical placements, movement toward a salutogenic psychosocial nursing process, changing student evaluation language of preceptors, and implementation of an Advanced Practice Nursing model for clinical supervision., Results: The educational hypothesis that in-person experiential learning in a workshop format with live simulations is critical to the professional development of psychiatric mental health advanced practice nursing is supported. Resistance to the cultural change operationalized through the curriculum is described. Five student reflections exemplify progress made as a result of this program., Conclusion: This program with its enduring educational frame was an opportunity to regain a historical momentum as nurse leaders in mental health care. There is significant interest and commitment to learning the nurse-psychotherapist and consultation-liaison roles., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: The change from a clinical nurse specialist to nurse practitioner model has significantly affected graduate education and practice because of emphasis on the dominant biomedical prescriber role, marginalizing the nurse-psychotherapy and consultation-liaison roles fundamental to quality psychiatric advanced practice nursing practice., Aim/method: We report on a four-year Workforce Development Project supported by an academic-practice partnership to restore formation and skill building of the marginalized roles. Part One focuses on program design, the curriculum for nine specialty courses, and the teaching and learning community approach that promotes engagement, faculty commitment, and preceptor recruitment and retention; the creative faculty staffing model is described., Results: The educational frame described includes highlights of teaching/learning strategies drawn from the history of professional formation curriculum rooted in salutogenesis and belonging science, existentialism, solution-focused therapy, modeling and role modeling theory, and Peplau's Interpersonal Relations ., Conclusion: There is significant interest and commitment to learning the nurse-psychotherapist and consultation-liaison roles., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: Early career nurses (ECNs) can be expected to assume shift charge nurse leadership roles quickly upon entering practice. Since the emergence of the COVID-19 pandemic, junior nurses may find their leadership capabilities tested further as the challenges of leadership are made increasingly complex in the context of an infectious disease outbreak., Purpose: The purpose of this qualitative study was to explore early career registered nurses' (RNs) experiences of engaging in shift charge nurse roles in hospital settings., Methods: This study used an interpretive descriptive (ID) approach. Semi-structured, in-depth interviews were conducted with 14 RNs across Ontario, who had up to three years of experience and who had engaged in a shift charge nurse role in a hospital setting. Recruitment and data collection took place from January to May 2021 during the COVID-19 pandemic. Interviews were recorded, transcribed, and analyzed following the principles of content analysis., Results: Content analysis of the 14 participant interviews revealed four main themes: nominated and necessitated into leadership , diverse and demanding responsibilities, factors that help and hinder , and leadership as an impactful experience ., Conclusions: Study findings provide insights into potential strategies to support ECNs in shift charge nurse roles, during the remaining course of the COVID-19 pandemic and beyond. Greater support for nurses who engage in these roles may be achieved by promoting collaborative unit and organizational cultures, prioritizing leadership training programs, and strengthening policies to provide greater clarity regarding charge nurse role responsibilities., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The evolution of the role of the Professional Nurse Coach (NC) in recent years has been an empowering and innovative model for health and wellness for individuals, groups, communities, and populations. The relationships, requirements, and responsibilities of NC supervision to date, however, have not been fully examined. The aim of NC supervision is to provide feedback on the coaching process, and confidently guide the new NC to utilize creative problem-solving techniques and interventions. Themes emerge in supervision that can help expand competence and skills of coaching. Additionally, knowledge gaps may become apparent that would require further exploration or education. Articles on clinical supervision within the confines of nursing and other related disciplines do not highlight the challenges, responsibilities, or contractual obligations of the NC-Supervisor relationship. Without clear guidelines and identifiable themes within the supervisory experience, there are inconsistent parameters and confusion around supervision. This article will address the need for a consensus of a competency framework for NC clinical supervision and recommend a baseline strategy for guideline development. The article is relevant to the competencies associated with the ANA Standards of Professional Performance required for certification as an NC.

The nursing profession has a long history of advocating for social justice and health equity, and both values profoundly infuse nursing ethics, theory, and education. Homecare nursing occurs between the patient's daily life at home and the public health care system. Therefore, homecare nurses ideally possess insight into the living conditions and social determinants of health that their patients experience. This interpretive phenomenological study explores the strategies employed by homecare nurses to fight health inequity and advance social justice. Data were collected through participant observations, situational interviews, and small group interviews with 12 homecare nurses from two municipalities. Three analytical approaches were used: paradigm cases, exemplars, and thematic analysis. The data identified two primary strategies homecare nurses use to circumvent, solve, and mitigate the negative consequences of social determinants of health on patients' care and treatment: "Negotiating practice" and "Aligning practice." "Negotiating practice" ensures that care and treatment are delivered in a way acceptable to all involved. "Aligning practice" ensures cohesion, progression in the treatment and care trajectory, and support for patients and relatives in navigating the system. Both strategies are part of nurses' largely hidden work, reflecting the nursing profession's position as nested between the individual patient and the system., (© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.)

Introduction: Neonatal intensive care unit (NICU) nurses play a crucial role in providing infant care, as well as in bridging the communication gap with parents., Aim: Explore fathers' perceptions and interactions with nurses during their preterm infants' stay in a NICU., Design: Qualitative study using ethnographic data collection techniques., Methods: Twenty fathers of preterm infants were purposively sampled in a level III NICU in Italy. Data collection comprised 120 h of participant observation, 68 informal conversations, and 20 semi-structured interviews. Data analysis was performed using reflexive thematic analysis., Results: Analysis revealed five primary themes: (i) communication and clarity about infants' health condition and progress, (ii) inclusiveness and guidance from nurses, (iii) fathers' satisfaction with nurses' support for mother, (iv) nurses' personal attention to the babies, and (v) nurses' varied personalities., Conclusion: Nurses are crucial in facilitating father-infant bonding in the NICU. Although the content of nurse communication is critical for fathers, the delivery style becomes especially relevant during their infant's hospitalization. Discrepancies in messages and guidance can negatively impact fatherly confidence and their ability to care for their preterm infants and support partners. Thus, training that emphasizes the recognition of the unique ways that fathers exhibit distress is crucial., Relevance to Clinical Practice: Nurses play a critical role in shaping the fathers' experiences in NICU. Emphasizing clear communication and individualized care is vital. To strengthen father support in NICU settings, recommended approaches include regular training, holistic care, fostering inclusivity, emotional support, and improving bonding opportunities., Reporting Method: Adherence to the COREQ guidelines., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs ( n =23) identified the following themes: NMC standards and scope of practice; The 'cheap nurse'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.

Background: The Doctor of Nursing Practice (DNP) degree prepares nurses for engagement in practice scholarship to improve health outcomes at multiple system levels. Organizational leaders' and employers' perceptions and expectations of DNP-prepared nurses require further study. Objective: To explore the perception of organizational leaders regarding expectations and engagement of DNP-prepared nurses in practice scholarship activities. Methods: Guided by the Actualized DNP Model, a cross-sectional design was used to survey organizational leaders ( N = 87) regarding DNP-prepared nurses' engagement in practice scholarship. Results: Findings indicate that 92% ( n = 80) of participants believed practice scholarship should be an expectation of DNP-prepared nurses serving in a variety of roles. Of the 77 respondents to the scholarship engagement questions, 97.4% ( n = 75) reported that DNP-prepared nurses engaged in one or more practice scholarship activities over the past year. Conclusions: Aligning DNP practice scholarship competencies, as outlined in the American Association of Colleges of Nursing 2021 Essentials, with organizational needs, expectations, and provision of sufficient time to support these scholarship activities is needed. Implications for Nursing: Opportunities exist for DNP-prepared nurses to articulate and demonstrate their value by conducting practice scholarship through innovative advanced nursing roles to realize organizational goals. Organizational support is necessary for practice scholarship activities to transform DNP education., (© 2024 Springer Publishing Company, LLC.)

Purpose: This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic., Methods: A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke's method to identify the meaning of the participants' experiences., Results: During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows: (1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism., Conclusion: This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks., Competing Interests: The authors declared that no conflict of interest., (© 2024 Korean Society of Nursing Science.)

Background: The benefits of the Nurse Practitioner role in acute care are known however, the patient's experience of having an Orthopaedic Nurse Practitioner involved in their joint replacement care is unknown., Aim: This study aimed to explore the experience of patients undergoing a hip or knee joint replacement who had an Orthopaedic Nurse Practitioner involved in their care., Methods: This study used a qualitative descriptive design using semi-structured interviews with eleven participants. Data were analysed using Braun and Clark's six step reflexive thematic analysis framework., Results: Four themes emerged from the thematic analysis: 1) Information sharing and education; 2) Support throughout the journey; 3) Coordination of care, and 4) Reassurance., Conclusion: The role of the Orthopaedic Nurse Practitioner in supporting participants throughout their joint replacement journey provided benefits for the patient's health and recovery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Support groups and meetings are self-help gatherings that provide a unique sense of community, unconditional acceptance, and information on cancer and its treatment. This cross-sectional study examined 12 outpatient meetings within the Kerala model of palliative care, a community-based service provided to patients irrespective of disease, stage, or prognosis starting from the time of diagnosis. The study focused on the pivotal role of community nurses in facilitating these meetings, with participants including cancer patients and survivors. Using in-depth interviews (n = 52) and participant observations, this research used a qualitative approach and explored the dynamics and outcomes of outpatient meetings. Findings highlight the indispensable contributions of these community nurses serving as linchpins in providing support, guiding discussions, and offering crucial education. Outpatient meetings effectively addressed psychosocial concerns, combatted stigmas associated with cancer, and promoted informed decision making in cancer care. The study emphasizes the need for recognizing the role played by community nurses in improving psychosocial support and diminishing stigma, and ultimately the quality of life of patients and survivors through the palliative cancer care within the Kerala model. We also underscore the need for policy initiatives, resource allocation, and training programs tailored to support these frontline health care providers effectively., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

This qualitative descriptive study explored school nurses' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse's role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual's immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To explore the professional identity of nursing during the COVID-19 pandemic in Iran. Professional identity guides nurses' interaction with patients. In the COVID-19 pandemic, recent developments in society's view of the nursing profession are expected to change the perception of nurses' professional identities., Design: The qualitative study used a conventional content analysis approach., Methods: Data were collected using in-depth semi-structured interviews from June 2020 to January 2021. Data analysis was performed using Landman and Granheim's analysis and Lincoln and Guba's criteria to ensure the data's rigour., Results: After analysing the 20 interviews with 17 participants, including 11 nurses with an average age of 32.63 ± 6.71 years and six varius community members with an average age of 38.66 ± 5.85 years, three main categories were formed: (1) The dual role of the media in the two subcategories (the positive role and the negative role of the media), (2) Changes in public view of nursing during the COVID-19 pandemic (respect for avoidance and understanding the value of nursing practice) and (3) Change of professional identity by showing self-sacrifice (dealing with adversity and commitment to professional obligations)., Conclusion: The image in the public view of the nursing profession during the COVID-19 pandemic media differs from before and shows self-sacrifice, professional commitment and humanity in nursing. Nurses' experience of caring during the COVID-19 pandemic has positively affected their professional identity; however, they are concerned about the instability of improving the nursing image in society., Impact: Nursing leaders and policymakers can utilize media platforms to portray the nursing profession in a positive light and emphasize the scientific capabilities of nurses. This approach goes beyond highlighting sacrifice and compassion, aiming to shift societal perceptions of nursing and bolster the professional identity of nurses., Reporting Method: We used the COREQ (COnsolidated criteria for REporting Qualitative research) checklist as a reporting method., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aim: To identify and synthesize empirical evidence on the role of healthcare leaders in the development of equitable clinical academic pathways for nurses., Design: Integrative literature review., Data Sources: Literature was searched using CINAHL, PubMed, ProQuest and Google Scholar databases., Review Methods: A total of 114 eligible articles published between 2010 and2022 were screened, 16 papers were selected., Results: Results highlighted the need for consistent national, regional, and organizational policy approaches to developing clinical academic careers for nurses. Government health departments and National Health boards must focus on increasing engagement in research and evidence-based nursing practice for high-quality patient care. Discriminatory practices and attitudes were identified as barriers. Discrimination due to gender was evident, while the impact of race, ethnicity, and other social categories of identity are under-researched. Educational leaders must unravel misconceptions about research, highlighting its relevance to patient care and bedside nurses' work. Academic leaders together with executive nurses, research funders and professional nursing bodies must create appropriately remunerated career structures. Transformative approaches are required to develop the clinical academic nurse role and understand its value in clinical practice., Conclusion: Multiple elements exist within complex systems that healthcare leaders can navigate collaboratively to develop and implement clinical nurse academic roles. This requires vision, acknowledgement of the value of nursing research and the importance of evidence-based research infrastructures., Impact: Findings highlight the collaborative role of healthcare leaders as critical to the success of critical academic careers for nurses. This review can inform those still to formalize this innovative role for nurses., Reporting Method: The review complies with the PRISMA guidelines for reporting systematic reviews. This paper contributes evidence about the healthcare leader's role in developing clinical academic pathways for nurses to the wider global clinical community., Patient or Public Contribution: No patient or public contribution was included in this review., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

To explore school nurses' roles globally through their own perceptions of what they do and how they do it and to compare the realities for the role its representation in professional literature. A comprehensive narrative literature review, using ENTREQ guidelines, with "qualitizing" of the quantitative literature, and athematic analysis was carried out. Findings were reviewed in relation toestablished theory. CINAHL, Medline, Cochrane Library, and Embase were systematically searched from 2000-2021. Included studies focused on school nurses'perceptions of their own practice. Five themes: direct care, health promotion, collaboration,support from school and health authorities and promoting the school nurses'role were found. These themes were closely aligned to the National Associationfor School Nurses' framework for 21st century practice. However, the schoolnurses signposted areas where they need support in carrying out their job tothe highest standard. School nurses are important to support thehealth needs of students while at school. They also, particularly in areas likethe United Arab Emirates where resources are being invested in the role, have a unique role to play in health promotion, leading to improved health literacy,as positive health behaviors tend to be learned young. However, worldwide, thepotential for the school nursing role needs to be recognized and supported by healthand education providers, by families and within the schools for its fullpotential to be achieved.

Objectives: to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles., Methods: this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach's alpha test, and z-test for proportion comparison were used., Results: the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership., Conclusions: the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Mental illness has been a significant public health challenge in Thailand, where there is a shortage of specialists. Consequently, community nurses (CNs) who are not specialists have been tasked with enhancing mental health outcomes in the primary care system of the country. This study aims to shed light on CNs' lived experiences of caring for psychiatric patients within the primary care units (PCUs)., Methods: A phenomenological research approach and in-depth interviews were conducted with nine CNs responsible for psychiatric patient care purposefully selected at nine PCUs in southern Thailand, including Nakhon Si Thammarat, Krabi, Phangnga, and Chumporn provinces, between March and December 2019. Data analysis was carried out using Colaizzi's method., Results: The experiences of CNs were expressed through three main themes: "Confronting role expansion in long-term psychiatric care responsibilities," "Insecurity in role ambiguity," and "Duty of supportive caring for marginalized people.", Conclusion: Thai CNs face significant stress when providing care for psychiatric patients, grappling with their acknowledged lack of specialization and essential expertise in the field. Alongside the issue, they knew that supportive caring for marginalized people is their duty to humanity. Primary care systems must recognize CNs' vital role in enhancing psychiatric patient care. Comprehensive training empowers them, fostering confidence and enabling better connections and care management. This can lead to improved patient outcomes and overall care quality., Competing Interests: None declared., (Copyright: © International Journal of Community Based Nursing and Midwifery.)

Aims: To shed light on the process of advocacy in the context of community health nursing, through a methodology inspired by the epistemologies of the South., Design: We conducted a collaborative ethnography in a community health centre in Canada., Methods: de Sousa Santos' epistemologies of the South, a typology of advocacy and main themes from historic research informed the methodology. Data were collected between 2016 and 2018 through 420 h of fieldwork observations and three group discussions, including a collective process to co-construct interpretations with participants. Twenty-one nurses participated in the study., Results: Nurses had sufficient work flexibility to practice advocacy actions focused on individuals and groups. They also engaged in attempts at policy reform in the form of defending access to appropriate care and changing the mode of care organization. However, these were curbed by bureaucracy and administrative rules, resulting in the eventual dismissal of health promotion actions and experiences of moral distress., Conclusion: Despite the political climate of their work environment impeding social justice agendas, nurses' advocacy practices showed a persistence of moral values and ideals in coherence with the regional nursing legacy., Implications for the Profession And/or Patient Care: Acting at the organizational level and involving field nurses in decision making are potential avenues for increasing policy advocacy efficacy., Impact: Examining contexts through another epistemic lens and methods of research drawing on history and anthropology has shed light on a process of advocacy. This research shows that organizations need to equip themselves with mechanisms to promote the sharing of realities between nurses, thereby building collective advocacy., Reporting Method: The research adheres to the EQUATOR guidelines with SRQR and COREQ methods., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

The knowledge domain of professional identity in nursing is the analysis and application of information derived from experiences, critical reflection, and scientific discovery from nursing and other disciplines. Knowledge guides role clarity, decision-making, and advocacy. Key concepts described in this column include mindset, innovation, clinical judgment, and reflection. [ J Contin Educ Nurs. 2024;55(7):328-330] .

Aim: To explore what is known about the lived experiences of novice nurse educators, including preparation or support strategies that may assist this transition., Background: Despite the crucial role of nurse educators in healthcare, the literature lacks clarity about the role and the preparation and support of nurse clinicians to transition into novice nurse educator roles., Design: Scoping review METHODS: A scoping review was carried out according to the Joanna Briggs Institute Methodology for Scoping Reviews. The Cumulative Index of Nursing and Allied Health Literature Complete (CINAHL), Medline (OVID), EMBASE, APA PsycINFO and Google Scholar databases were searched for English language sources of evidence between 1992 and 2022. Sources of evidence related to nursing education, transition, lived experience, preparation and support were included., Results: Fifty-two sources of evidence met the inclusion criteria with most originating in the United States and situated in the academic setting. There were 20 different titles used to identify nurse educators and a lack of clarity relating to the role and its expectations. There was alignment found between the lived experiences of novice nurse educators and Duchscher's transition shock model with a variety of preparation and support recommendations identified to mitigate this transition shock., Conclusion: Clinical nurses transitioning into novice nurse educator roles have a predominantly negative experience that aligns with Duchscher's transition shock model. Although recommendations exist for support and preparation strategies to ease this transition shock, further research is required to establish which of these strategies are effective, especially for novice nurse educators in clinical settings outside of the United States., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To explore Danish women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process., Design: A qualitative study using semi-structured, individual interviews with a phenomenological-hermeneutic approach., Methods: Interviews were conducted with 13 women with experience in opting out of cervical cancer screening. Women were recruited through a public flyer and interviewed virtually or by phone. The interviews were analysed using the theory of interpretation from Paul Ricoeur and consisted of three levels: naïve reading, structural analysis, and critical discussion and analysis. The present study adheres to the COREQ guidelines., Results: The women experience various personal causes for opting out of cervical cancer screening, such as low accessibility of screening appointments, discomfort during the smear test, fear of being sick, and insufficient information about the relevance of screening to the individual woman. The perceived disadvantages of screening outweighed their perceived advantages. The women's experiences did not include the role of the nurse in the procedures and knowledge sharing related to cervical cancer screening. However, nurses were described as having good communicative and relational qualifications relevant to being involved in cervical cancer screening., Conclusion: It was challenging for the women to weigh the advantages and disadvantages of cervical cancer screening and thus to make an informed decision about participation. They expressed a need for more information on which to base their decision. This places nurses in a much needed, yet unexplored, role of identifying and lowering potential personal barriers that may outweigh the women's perceived benefits of participating in screening., Implication for the Profession And/or Patient Care: Nurses should play a more active role in cervical cancer screening such as improving general knowledge and facilitating two-way communication about its relevance., Reporting Method: The present study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

The events of October 7, 2023, marked a turning point for Israel, plunging the nation into a state of existential dread and uncertainty due to an ongoing conflict. The nursing profession is multifaceted and can encompass simultaneously diverse roles within various settings, including direct patient care, education, and research. In regular times, there is a delicate balance between mastering these three roles. Yet, in times of war, there is a threat to this balance. The manuscript highlights the personal, unique struggles of nursing doctoral students balancing clinical duties, teaching responsibilities, and research commitments during a war. The authors reflect on their experiences and challenges related to clinical-professional, academic, and personal dimensions as doctoral students. The manuscript highlights the connection between significant events and the resilience and determination among nursing doctoral students and future generations of academics. It provides recommendations to help attenuate the additional stresses experienced by nurses during war. These interventions will not mitigate the complexity and challenges of juggling our multiple professional roles. However, the awareness of these challenges can lead to growth and achievement in patient care, professional and personal development, and academic excellence., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The reality of death and dying is a central facet of life, often surrounded by feelings of sadness, fear and uncertainty. Nurses have an essential role in caring for people who are approaching the end of life and their families, while being mindful of the current demands and challenges in health and social care services. In this article, the author suggests that being more open to the reality of death as part of life may assist nurses in being more attuned to the personal needs of those who are dying. The article emphasises the importance of considering each person's symptoms and concerns through the lens of compassion to address pain, fear and distress. While the focus is on caring for people who are approaching the end of life, the author asserts that there is much that nurses can learn from those they care for about the beauty of life and the naturalness of death., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

A crucial domain of professional identity in nursing is the area of values and ethics. Comprising a set of core values and principles, values and ethics are used to guide nurse conduct. Professional development specialists can use the nursing code of ethics and organizational structure and examples to teach nurses the values and ethics domain of professional identity in nursing. [ J Contin Educ Nurs . 2024;55(6):279-281.] .

Although culturally appropriate care is vital to quality of care, many barriers exist to implementing culturally appropriate care in practice. Nurse leaders are in a position where they can act toward addressing some of the barriers and engage nursing staff in strategies to promote the implementation of culturally appropriate care practices on a unit. This article is an opinion piece wherein the authors illustrate leadership strategies that advocate for and nurture a practice where nursing staff are supported to apply their culturally appropriate skills in practice., (Copyright © 2024 Longwoods Publishing.)

Purpose: Emergency department nurses work in rapidly changing environments, which can contribute to occupational stress. Emergency department nurses utilise diverse strategies to mediate the impact of stress on their daily lives. There is a paucity of qualitative research which explores emergency department nurses' experiences and perspectives of burnout. This study aimed to explore emergency department nurses' experiences of burnout. Further, the study considered how emergency nurses conceptualised burnout and the strategies they used to manage the professional and personal effects of burnout., Procedures: The COREQ research guidelines were used throughout the study from the design stage through to dissemination. Narrative inquiry was used as the underpinning theoretical framework. The researcher met individually with eight emergency department nurses from NSW hospitals to undertake a face-to-face semi-structured interview. An inductive approach was used to establish major themes within the narrative., Findings: Two major themes were established: experiencing conflicting emotions and trying to establish a personal sense of control. Emergency nurses felt passionate about their professional roles, yet encountered difficulties due to management structures, time constraints and a sense of underappreciation. The misalignment between their expectations and the reality of emergency department nursing, resulted in experiences of burnout such as dissatisfaction and frustrations at work. Consequently, these nurses adopted diverse strategies within both their professional and personal domains., Principal Conclusions: The conclusions of this study are transferable to a variety of acute health services. Health service management have a role to promote a positive workplace culture for nurses, which advocates for home life balance. This will support nurses to construct clear boundaries between professional identity and their personal lives., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The recruitment of internationally educated nurses is gaining relevance in Germany in response to the growing shortage of nurses. Differences in nursing qualifications and practices between the country of origin and of destination can irritate the professional self-concept and hinder professional integration., Purpose: The study objective was to examine the development of the professional scope of action to unfold the professional self-concept of academically qualified nurses in Germany., Methods: In accordance with the episodic interview, eight guided interviews were conducted with Filipino nurses who had migrated to Germany. Data was analyzed by thematic coding., Results: The analysis shows two dimensions that impact the professional scope of action: perceived systemic constraints in the transition process and perspectives on professional development. The recruitment and recognition process is associated with high financial and time-related uncertainties and professional devaluation experiences. Migrant nurses experience both a loss of competence and a sense of foreignness in their nursing role in Germany. In order to regain professional scope of action, strategies of continuing education and focusing on more technology-intensive nursing care areas are pursued; only a minority can adapt their self-concept to the circumstances of nursing practice in Germany., Discussion: The study results demonstrate the importance of paying attention to both the competence profile and the professional self-concept of academically educated nurses in order to offer migrant nurses professional career prospects in Germany. Especially in long-term care, this has proved to be a structural problem., Conclusion: To provide an attractive destination for international academically qualified nursing professionals in Germany, the ratification of international standards, the provision of transparent and independent information, utilization of existing nursing expertise as well as the establishment of career opportunities are recommended., (Copyright © 2023. Published by Elsevier GmbH.)

Background: Advanced practice nurses (APN) growth depends on the implementation and acceptance of APNs in each country., Introduction: Given the diversity of the different contexts and varying population health needs where APNs are developing, this study focuses on exploring the viewpoints of the multidisciplinary and management team who have worked with APNs in public hospitals in Catalonia, Spain., Methods: A cross-sectional study with previously identified APNs, health professionals, and health managers. EVOHIPA, a valid and reliable scale, was used. The STROBE checklist was followed., Findings: The results showed high levels of agreement among the 746 participants (predominantly physicians and nurses), with statements relating to the APN's contribution in enhancing care continuity and processes, resulting in safer and more patient-centered care. The results showed low levels of agreement with statements relating to legal support for the APN position, regulation, and practice scope., Discussion: The study provides discussion elements and reflection to determine the axes on which it will be necessary to act to promote APNs and their conditions of service in the context of practice within hospital teams., Conclusion: The study highlights the differences in opinion on APN roles among health professionals and managers who have worked with APNs and allows exploring expectations about current changes in workflows and clinical activities among healthcare team members., Implications for Nursing and Health Policy: Results highlight the importance of fostering a common understanding among healthcare teams to maximize the benefits of collaborative work and recognize the significant contributions of APNs within the multidisciplinary team. Health policy plays a crucial role in recognizing and promoting the contribution of APNs within hospital healthcare teams, acknowledging their autonomy and expertise in improving patient outcomes., (© 2023 International Council of Nurses.)

Aim(s): To understand the experiences of advanced practice nurses working in cancer care., Design: Phenomenological qualitative study., Methods: Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software., Results: Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role., Conclusion: Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments., Implications for the Profession: These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles., Reporting Method: Reporting complied with COREQ criteria for qualitative research., Patient or Public Contributions: No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)