Objective: To present a model of advanced nursing practice based on a narrative analysis of advanced practice stories provided by nurses. Design: Using narratives depicting their clinical practice, nurses were asked to provide illustrations of advanced practice. Analysis of fifty nine narratives enabled exploration of aspects of advanced practice. Setting: Stories depicted contexts of advanced nursing practice including mental health, child and family health, acute and aged care. Results: Findings revealed six themes: Knowticing; Getting a doctor; Trans-action; Taleoring care; Experiencing vulnerability and Transporting: facilitating comfort and control. Three narrative aspects representing advanced practice were described: Rescue; Recognition and Responsibility; and Respect. The stories were of complex care situations relating to diverse areas of work highlighting critical incidents. Some incidents gave nurses great satisfaction whilst others were challenging. Conclusions: The findings are presented as a model of advanced practice. Both the world of advanced practice a diagrammatic representation of the findings, and the futures model of advanced nursing practice incorporate the themes that emerged from the study. They highlight the central, often invisible place of the nurse in patient care. Advanced practice nurses assume responsibility for optimising care. They believe they make a difference and they call for recognition. The models reflect the multi-dimensional nature of advanced practice, its inherent complexity, dynamism and the potential for amplification of practice roles and functions.
Australian Journal of Advanced Nursing Vol. 27, Issue 4, p. 43-53