Job Satisfaction and Empowerment of Self-Employed Nurse Practitioners: A Mixed Methods Study

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Background and Purpose: Self-employed nurse practitioners (NPs) have been part of the American health care landscape since the 1980s, owning practices throughout the United States. The purpose of this study was to explore the lived experience of self-employed NPs, focusing on their level of job satisfaction and perceived level of empowerment.

Methods: The study was a convergent-parallel designed, mixed-method study, utilizing a survey and semi-structured interviews. The survey included the Misener Job Satisfaction Survey (MJSS) and Conditions of Work Effectiveness Questionnaire II (CWEQ-II)

Conclusions: A total of 142 surveys and 13 interviews were completed and analyzed. Nurse practitioners in private practice are both satisfied and empowered, irrespective of practice environment. The more empowered, the higher their level of job satisfaction. Over 40% practiced with full practice authority, in a rural location and 50% had over 10 years’ experience as both an RN and NP. Their experience in private practice was explored further in the interviews.

Implications: This study identifies barriers to job satisfaction and empowerment in self-employed NPs, including physician oversight and lack of business management education. Continuing work to remove, restrictive and reduced state regulatory environments, as well as education on business management, may increase the number of NPs in private practice, expanding access to health care for the American people.