Facilitators and inhibitors of the emergency nurse practitioner role.

Factors that facilitate or inhibit implementation of the Emergency Nurse Practitioner (ENP) role were studied. ENPs were surveyed by questionnaire. Sixty-eight (64.7 percent) responded, providing data about motivating factors influencing the decision to seek ENP education and subsequent job acceptance; current employment status; role concept; performance and autonomy; and barriers to practice. Nearly all program graduates had practiced as ENPs, but only 43 percent were doing so at the time of survey. Of the rest, a third were nurse practitioners in a nonemergency room setting (NPs), and 22 percent were practicing in other nursing roles (NNPs). Respondents were motivated to enter an ENP program by greater role credibility, autonomy, job advancement, learning new skills, and dissatisfaction with their jobs. Similarly, ENPs accepted their jobs because of the opportunity to use their new skills, available medical backup, and the location of employment. NPs and NNPs reported leaving ENP practice because of resistance from other health care providers. ENPs experienced resistance in their practice, although they believed the role was accepted by consumers and health care colleagues. They tended to perform tasks they believed appropriate to the role and not to perform tasks inappropriate to the role. Most ENPs reported role autonomy and a collaborative or independent practice. While 42 percent reported no barrier to practice, the majority of ENPs reported greater than one barrier. Resistance and legal status were the most frequently reported barriers. The need for further onsite and nationwide research on the ENP is suggested.