They're incorporating their values and experience into practice, while emphasizing an interactive practice approach. Stretching the organization's hierarchy Traditionally, staff nurses have lacked power in organizations because their professional judgment has been regarded as subordinate to physicians'. 3 ACNPs take a new place on the rungs of the hospital hierarchical infra structure. This has far-reaching implications for ACNPs, specifically in forming their practice boundaries. The ACNPs' role descriptions reveal a collaborative rather than subordinate relationship with physicians.
Participants describe a role with increased visibility, value, power, and prestige.
They address their need to be heard and the importance of their nursing background. For example, ACNPs in the study express their need for clinical expertise to achieve clinical competency in practice. Participants suggest a critical care nursing experience prerequisite. Practice is based on their experience and personal values. The power to define and establish practice boundaries is within their reach.