Nicolson Paula, Burr Jennifer, Powell Jenny
University of Sheffield, ScHARR (School for Health and Related Research), Sheffield, UK.
J Clin Nurs. 2005 Jul;14(6):727-38. doi: 10.1111/j.1365-2702.2005.01137.x.
The aims of this research were to identify (a) the educational and working experiences and (b) subsequent training needs of graduates of one ANNP course in the UK. The objectives were (a) to assess the medium to long-term impact of the training programme on the professional development of the respondents; (b) identify potential areas of excellence and (c) areas for improvement in this and other training programmes for ANNPs.
Neonatal intensive care continues to be a rapidly changing area of work. Nurses and doctors in neonatal intensive care units (NICUs) have to be skilled equally in interpersonal communications and technical expertise. The Advanced Neonatal Nurse Practitioner (ANNP) training programme was introduced in 1992 in the UK in the broader political context of extending nursing roles in a range of specialties. The role of the neonatal intensive care nurse had expanded elsewhere previously, particularly in North America as a response to medical staffing crises where the practice and the training/education programmes were expanded during the 1970s/1980s and continued to evolve to encompass an advanced role for the neonatal nurse practitioner.
This was a study of five cohorts of graduates from one university course training programme for advanced neonatal practitioners (ANNPs) to explore their experiences of their role as ANNPs in the context of changes and developments in the British National Health Service and their own personal and professional development.
This study employs mixed methods (interviews, focus groups and a survey) and forms of data analysis (qualitative and quantitative) to explore the experiences of the transition to becoming an advanced practitioner. Data were collected from a sample of five cohorts; members of the current course team and the nursing and medical staff at one NICU which employs many of these graduates.
Most graduates value their course experience and the ANNP role and the findings suggest that confidence about practice develops naturally with postcourse experience. However, the more experienced and confident ANNPs frequently reported increased inter-professional role confusion/conflict with junior doctors, and some consultants particularly where there are only one or two ANNPs overall in the team.
There are personal and professional benefits to individual nurses who have had this training. However more attention needs to be paid to ongoing professional development particularly the management of professional role relationships among all nurses and between nurses and doctors.
A focus on professional role relationships and more effective communication in the clinical setting would be of benefit to all members of multi-disciplinary teams. A greater level of day-to-day support is required for ANNPs, other neonatal nurses and junior doctors if this is to be achieved, especially in clinical settings where there are few ANNPs or the addition of these clinical specialists is relatively new.
本研究的目的是确定（a）英国一门高级新生儿护士从业者（ANNP）课程毕业生的教育和工作经历，以及（b）他们随后的培训需求。目标是（a）评估培训计划对受访者职业发展的中长期影响；（b）确定潜在的卓越领域，以及（c）本培训计划和其他针对ANNP的培训计划中需要改进的领域。
新生儿重症监护仍然是一个快速变化的工作领域。新生儿重症监护病房（NICU）的护士和医生必须在人际沟通和技术专长方面同样熟练。1992年，在英国扩大护理人员在一系列专业领域角色的更广泛政治背景下，引入了高级新生儿护士从业者培训计划。此前，新生儿重症监护护士的角色在其他地方已经扩大，特别是在北美，作为对医疗人员短缺危机的回应，在20世纪70年代/80年代，实践以及培训/教育计划得到了扩展，并继续发展以涵盖新生儿护士从业者的高级角色。
这是一项对来自一所大学高级新生儿从业者（ANNP）课程培训计划的五组毕业生的研究，以探讨他们在英国国民医疗服务体系的变化和发展背景下作为ANNP的角色经历，以及他们个人和职业的发展。
本研究采用混合方法（访谈、焦点小组和调查）以及数据分析形式（定性和定量）来探索向高级从业者转变的经历。数据从五组样本中收集；包括当前课程团队的成员以及一所雇佣了许多这些毕业生的NICU的护理和医疗人员。
大多数毕业生重视他们的课程经历和ANNP角色，研究结果表明对实践的信心会随着课程后的经历自然发展。然而，经验更丰富、更自信的ANNP经常报告与初级医生之间职业角色的混淆/冲突增加，在一些团队中，特别是在只有一两名ANNP的情况下，与一些顾问之间也存在这种情况。
接受过这种培训的个体护士在个人和职业方面都有收获。然而需要更多地关注持续的专业发展，特别是所有护士之间以及护士与医生之间职业角色关系的管理。
关注临床环境中的职业角色关系和更有效的沟通将对多学科团队的所有成员有益。如果要实现这一点，需要为ANNP、其他新生儿护士和初级医生提供更高水平的日常支持，特别是在ANNP较少或这些临床专家的加入相对较新的临床环境中。
