title: Boundary work and the introduction of acute care nurse practitioners in healthcare teams.
abstract: OBJECTIVE
  This article is a report of a study of boundary work following the introduction of an acute care nurse practitioner role in healthcare teams.
  
  
  BACKGROUND
  Acute care nurse practitioners enacting their roles in healthcare teams have faced a number of challenges including a mix of positive and negative views of the acute care nurse practitioner role from healthcare team members and acute care nurse practitioner roles crossing the boundaries between the medical and nursing professions. Understanding the process by which the boundaries between professions changed following the introduction of an acute care nurse practitioner role was important since this could affect scope of practice and the team's ability to give patient care.
  
  
  METHODS
  The study was conducted in two university-affiliated teaching hospitals in Canada. A descriptive multiple case study design was used. Data were collected from March to May 2009.
  
  
  RESULTS
  Participants (N = 59) described boundary work as a process that included: (1) creating space; (2) loss of a valued function; (3) trust; (4) interpersonal dynamics; and (5) time. The development of trust among team members was essential. The co-location of team members working on common projects, and medical and nursing leadership facilitated boundary work.
  
  
  CONCLUSIONS
  The micro-level processes of boundary work in healthcare teams have important implications for the development of full scope of practice for acute care nurse practitioners, effective inter-professional teamwork and the integration of new roles in healthcare systems. Future research needs to be undertaken in different contexts, and with patients and families.
authors: Université du Québec en Outaouais, St-Jérôme,Québec, Canada. kelley.kilpatrick@uqo.ca
authors: Kelley
authors: K
authors: Kilpatrick
authors: Mélanie
authors: M
authors: Lavoie-Tremblay
authors: Judith A
authors: JA
authors: Ritchie
authors: Lise
authors: L
authors: Lamothe
authors: Diane
authors: D
authors: Doran
mesh_terms: D000208:Acute Disease / Q000451:nursing*; D001291:Attitude of Health Personnel; D002170:Canada; D016507:Cardiology Service, Hospital / Q000458:organization & administration*; D002983:Clinical Competence; D003299:Cooperative Behavior; D006801:Humans; D007400:Interprofessional Relations; D008008:Licensure, Nursing / Q000331:legislation & jurisprudence; D009722:Nurse Practitioners; D024802:Nurse's Role; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration*; D057184:Practice Patterns, Nurses' / Q000458:organization & administration; D036301:Qualitative Research