A Naturalistic Inquiry Into the Lived Experience of Nurse Practitioners Who Have Full Practice Authority

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Full Practice Authority (FPA) is one of three types of practice authority that a nurse practitioner (NP) can obtain through state licensure, depending on the state where the NP plans to practice. The American Academy of Nurse Practitioners (AANP) explains that FPA entails “…the authorization of nurse practitioners to evaluate patients, diagnose, order, and interpret diagnostic tests, initiate, and manage treatments - including prescribing medications – under the exclusive licensure authority of the state board of nursing” (AANP, 2022, Policy Briefs section). To date, there are 29 FPA states and territories, 16 reduced practice states, and 11 restricted practice states. The purpose of the study, “A Naturalistic Inquiry Into the Lived Experiences of Nurse Practitioners with Full Practice Authority,” was to explore the everyday experience of the FPA NP using Naturalistic Inquiry (NI). NPs were recruited through electronic mail (e-mail) requests using e-mail addresses obtained from the state Board of Nursing in FPA states. Eleven NPs were interviewed, and data collection followed a semi-structured interview format, with analysis resulting in the emergence of the following themes: (a) autonomy, (b) confidence, (c) collaboration/support system (d) standard credentialing/licensure process, (e) legislation, (f) accessibility and flexibility in patient care, (g) new FPA NP education and research, (h) limitations, (i) reimbursement. The participants indicated FPA is a positive experience in their practices, but limitations to practice and inconsistencies in regulation still exist as the United States, including the District of Columbia and U.S. territories. This study can offer information and insights about the experience of practicing with FPA to the NP who has yet to obtain FPA as all states progress towards FPA for NPs.