title: A game of snakes and ladders: negotiating the 'ups and downs' of endorsement as a nurse practitioner in Australia.
abstract: BACKGROUND
  Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging.
  
  
  OBJECTIVE
  This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives.
  
  
  METHODS
  Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings.
  
  
  RESULTS
  The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice.
  
  
  CONCLUSIONS
  This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time.
authors.affiliation: a School of Nursing & Midwifery, Faculty of Health & Medicine , The University of Newcastle , Callaghan , NSW 2308 , Australia.
authors.forename: Lorna
authors.initials: L
authors.lastname: MacLellan
authors.affiliation: a School of Nursing & Midwifery, Faculty of Health & Medicine , The University of Newcastle , Callaghan , NSW 2308 , Australia.
authors.forename: Isabel
authors.initials: I
authors.lastname: Higgins
authors.affiliation: a School of Nursing & Midwifery, Faculty of Health & Medicine , The University of Newcastle , Callaghan , NSW 2308 , Australia.
authors.forename: Tracy
authors.initials: T
authors.lastname: Levett-Jones
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence; D003406:Credentialing / Q000266:history* / Q000331:legislation & jurisprudence*; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008008:Licensure, Nursing / Q000266:history* / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D009722:Nurse Practitioners / Q000266:history* / Q000331:legislation & jurisprudence*; D024802:Nurse's Role / Q000266:history*; D019982:Organizational Case Studies
keywords: Australia; endorsement; legislation; nurse practitioners; regulation