Advanced Practice Nurses’ Perceptions of the Lived Experience of Power

Abstract

“Power” is a concept that has been discussed by nurse scholars and leaders within the nursing literature. The literature surrounding power concurs that power is necessary within the practice of nursing so that nurses are able to support patients and move the profession of nursing forward. There is a scarcity of research, however, regarding nurses’ perception of power within their own practices. Advanced practice nurses (APNs) are in positions in which they apply graduate education, specialized knowledge, and expertise to improve health care outcomes. Therefore, a qualitative study using an interpretive hermeneutic phenomenological approach was undertaken to discover APNs’ lived experience of power within their practices. In-depth, tape-recorded interviews were conducted with eight APNs from a large tertiary care facility. All of the participants agreed to a follow-up interview to review the summary of the study results. van Manen’s (1990) approach was used to analyze the data by subjecting the transcripts to a thematic analysis and reflective process. The overarching theme of the interviews is “building to make a difference” and the APNs’ perceived that this happened by “building on,” building with,” and “building for.” The APNs built on their knowledge and expertise, built with others in relationships and built for the capacity to make a difference. Power was a part of the everyday practices of these APNs and was described as “soft power,” a power that they shared to bring about change for the better. This shared power was reflected back on them resulting in increased power within their practices, a process described by the APNs as power creep.