Determined Persistence: Achieving and Sustaining Job Satisfaction among Nurse Practitioners

Nurse practitioners have been delivering high quality health care in the United States since the 1960s. Since then, nurse practitioners have had an increasingly important role in the healthcare system. Based on earlier research, an important source of job satisfaction for nurse practitioners (NPs) is their ability to provide quality care to patients. Major sources of dissatisfaction include a lack of autonomy, professional relationships with physicians and administrators, and administrative lack of knowledge of the role. The purpose of this research was to explore NPs\u27 perception of job satisfaction and to develop a conceptual understanding of job satisfaction using grounded theory. A theoretical sample of 15 nurse practitioners participated in individual face to face interviews with the researcher. The participants were asked to discuss their reasons for becoming nurse practitioners and to describe events or reasons that provided the individual NP with job satisfaction. The nurse practitioners identified organizational factors that contributed to either job satisfaction or dissatisfaction. Determined persistence, a core concept that was developed from the data, accounts for the variation in NP experience with job satisfaction and dissatisfaction. Two related key concepts, being valued as a professional and providing holistic patient care, were described are two sources of job satisfaction. The NPs often sought to maintain job satisfaction by reconciling their own role expectations with those of the healthcare organization. There are several implications for nurse educators, nurse administrators, and nurse practitioners. During the NPs\u27 educational program, educators must discuss role expectations and sources of role strain and role ambiguity. For example, role ambiguity may result from organizational barriers that limit enactment of the NP role leading to role strain. In order to retain NPs within the healthcare organizations administrators must understand the sources of job satisfaction of NPs. Lastly, NPs must understand their responsibility in educating administrators about the role. As a NP, self-advocacy is necessary to promote the role within the healthcare organization and membership in professional organizations promotes the role through collective advocacy