title: Caught in the middle: experiences of tobacco-dependent nurse practitioners.
abstract: OBJECTIVE
  To explore how tobacco-dependent nurse practitioners (NPs) describe their experiences with health promotion and disease prevention practices with patients who smoke.
  
  
  METHODS
  Twelve NPs who completed a graduate level NP program of study participated in face-to-face interviews and/or online chat room interviews.
  
  
  CONCLUSIONS
  Participants' responses revealed three themes relevant to their experience as tobacco-dependent clinicians with health promotion responsibilities. These themes centered around (a) living as an insider in the world of tobacco addiction, (b) having the outside-in view of living with a tobacco addiction, and (c) being caught in the middle of a tobacco addiction.
  
  
  CONCLUSIONS
  All of the tobacco-dependent participants described limited smoking-cessation interventions with their patients. A barrier to implementation of more aggressive interventions, perhaps, is the provider's own tobacco addiction. With increasing evidence that tobacco-dependent health care professionals are not adequately intervening with tobacco-dependent patients, effective strategies are needed to assist and/or support not only tobacco-dependent patients but providers as well.
authors.affiliation: Georgetown University, School of Nursing and Health Studies in Washington, DC, USA. ejh@georgetown.edu
authors.forename: Janie
authors.initials: J
authors.lastname: Heath
authors.forename: Jeannette
authors.initials: J
authors.lastname: Andrews
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Kelley
authors.forename: Jeanne
authors.initials: J
authors.lastname: Sorrell
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D019985:Benchmarking; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000458:organization & administration / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011320:Primary Health Care; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D012649:Self Concept; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires