Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Susan L. Dean-Baar, Ph.D., RN FAAN


Susan L. Dean-Baar, Ph.D., RN FAAN

Roberta Lavin, Ph.D., FNP-BC, FAAN

Fredric A. Metzger, Ph.D.



The impact of the transition to full practice authority (FPA) on job satisfaction and job stress has not been previously described in the literature.


Job satisfaction, job stress, and practice transition stress data was collected from a sample of 33 Advance Practice Registered Nurses (APRN) working at the VA St Louis Health Care System using Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS), National Institute of Occupational Safety and Health Generic Job Stress Questionnaire (NIOSH-GJSQ), and student-developed practice transition stress questionnaire during the initial phase of FPA transition.


APRNs were minimally satisfied to satisfied. Job stress from work conflict, role ambiguity, intragroup conflict, and intergroup conflict has a significant negative effect on job satisfaction (p < .001) and perceived control, and task control has a positive effect (p < 001). Practice transition stress had a negative effect on overall satisfaction (p < .01). Misaligned APRNs were different from aligned APRN in the level of role conflict (p < .01) and percentage of positive emotions toward full practice authority (p < .05).


FPA transition does generate stress and emotions. Practice transition stress experienced was in a positive response pattern. Job stress from work conflict, role ambiguity, intragroup conflict, and intergroup conflicts have a more significant impact on job satisfaction than the transition to FPA. Individual and organization interventions were developed.

Implication for Practice

Strategies for supporting APRNs when transitioning to FPA, reducing job stress by decreasing conflict at work, increase task and decision control, and ensuring APRNs are in alignment with the Consensus Model is needed. These actions may improve APRN job satisfaction.

OCLC Number


Included in

Nursing Commons