International Nursing Review
ORIGINAL ARTICLE
Experiences on Role Transition Among Nurse Prescribers
Jonna Suominen1 Leena Salminen2 Marja Renholm3 Virpi Sulosaari4 Heli Virtanen5
1University of Turku; Laurea University of Applied Sciences, Turku, Finland 2Health Pedagogy at University of Turku, Turku University Hospital, Turku,
Finland 3Helsinki and Uusimaa Hospital District, Helsinki, Finland 4University of Turku; University of Applied Sciences of Turku, Turku, Finland
5University of Turku; Turku University Hospital, Turku, Finland
Correspondence: Jonna Suominen (jmksuo@utu.fi)
Received: 10 February 2025 Accepted: 30 May 2025
Funding: The authors received no specific funding for this work.
Keywords: competence | inductive content analysis | non-medical prescribing | nurse prescribing | qualitative research | role transition
ABSTRACT
Aim: The aim was to describe the experiences of nurse prescribers on role transition during nurse prescriber education and
working in a new role.
Background: Nurse prescribing has increased globally, bringing a new importance for nursing. Transition into a new nursing
role can be motivating, satisfying, and empowering. However, it can also be stressful and complex. It is important to know how
the role transition from a nurse to a nurse prescriber could already be facilitated during studies and the first working years in a
new role. As little work has been conducted on this topic, there is a gap in this research area.
Methods: This phenomenological study was implemented with 14 Finnish nurse prescribers using semi-structured individual
interviews. The data were analyzed with inductive content analysis.
Findings: Altogether, this study identified four main categories for experiences on role transition. These main categories are in
role transition during nurse prescribing education (1) learning decision-making; (2) meaningfulness of studies during education
and at the beginning of nurse prescriber role at work; (3) development of expertise; and (4) significant change in work.
Discussion: The meaningfulness of the learning and learning decision-making are important in role transition during nurse
prescribing education. There is a significant development of expertise and change in work procedures during the transition from
a nurse to a nurse prescriber.
Conclusions and Implications for Nursing: Nurse prescriber education has a key role in the transition experience from
registered nurse to nurse prescriber. It is also possible that healthcare units do not utilize nurse prescribers effectively.
1 Introduction
Nurse prescribing has increased worldwide, bringing a new
importance for nursing. According to the International Council
of Nurses (ICN), nurse prescription is in use in 45 countries.
Fourteen European countries have nurses with prescription
authority. Globally, nurse prescribing as an extended role of
nurses has been seen as part of the role of nurse practitioners (NP)
(ICN 2021). Nurse prescribers provide holistic and efficient care
for patients (Hammarberg et al. 2024) so that they obtain access
to care quickly and therefore the outcomes for patients have
improved (ICN 2021; Laapio-Rapi et al. 2019). However, there are
differences in nurse prescribing education between countries. In
Canada, nurse prescribing is a part of NP education, while in
other countries, it is an additional education on a master’s level,
for example, in the UK and Finland (ICN 2020).
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly
cited.
© 2025 The Author(s). International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.
International Nursing Review, 2025; 72:e70047
https://doi.org/10.1111/inr.70047
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Finnish nurse prescribing education (45, the European credit
transfer and accumulation system (ECTS) and European Qual-
ifications Framework (EQF) 7) consists of learning to be inde-
pendent in clinical decision-making. The decision-making is
based on a comprehensive health and physical assessment of
the patient, pharmacology, prescribing the medicine, pathology,
legislation, and ethical questions. Decisions have a focus on
the whole person and are based on evidence-based guidelines
(Finnish National Core Curriculum for nurse Prescriber Educa-
tion 2023; ICN 2020).
2 Background
Role transition refers in this study to the nurse role transition
from the registered nurse to the nurse prescriber. The extended
role of nurse prescribing has enhanced the attractiveness of a
nursing career and elevated both autonomy and professional
status, which in turn contributes to an enhanced reputation of
the profession (Haririan et al. 2022; Wit et al. 2024). The role
expansion allows nurse prescribers to deliver more holistic and
person-centered care and therefore increase the efficiency of
patient care (Hammarberg et al. 2024). Furthermore, the job
satisfaction of nurses has increased, alongside the opportunities
for enhanced collaboration with multi-professional colleagues
(Hammarberg et al. 2024; Wit et al. 2024).
In this research, role transition is defined according to Duchscher
and Widney (2018) and described by the stages of transition-
by-transition shock model. In this model, the scope is on phys-
ical, intellectual, emotional, developmental, and sociocultural
changes. The focus is on relationships, roles, responsibilities,
knowledge, and performance expectations of the person who is
in role transition. Role transition can be divided into three stages:
doing, being, and knowing. In the first phase, doing, nurses
attend to learn and integrate the new work. In the second phase,
nurses begin to feel comfortable in their new role and they start
questioning the healthcare system. In the third phase, nurses
reach professional identity and independence (Duchscher and
Widney 2018).
In the role transition process, nurses critically analyze their own
previous knowledge, conceptions, and basic assumptions in the
light of new knowledge. This leads to the transformation of their
knowledge and thinking. This process includes social process,
problem orientation, and the complexity of problems (Liitos
et al. 2012). Learners construct knowledge based on individual
experiences, beliefs, and attitudes. In so doing, they are adding
new knowledge to previous subjective knowledge (Rannikmäe
et al. 2021).
The transition to the advanced nursing role can be complex,
and stressful career change can be challenging personally and
professionally and cause mixed emotions. Learning new com-
petencies and new reasoning skills takes time (Barnes et al.
2021; MacLellan et al. 2015). Nurses have demonstrated positive
attitudes, understanding, and motivation toward their emerging
role as nurse prescribers (Fox et al. 2022; Haririan et al. 2022).
In the new role as a nurse prescriber, clinical decision-making
transitions to another level compared with working as a nurse,
and this can be a complex process. Nurse prescribers use both
independent and collaborative decision-making. They facilitate
and evaluate new knowledge and alternatives in their clinical
autonomy (Levy-Malmberg et al. 2024). They are capable of
applying competencies in both familiar and new situations,
having good teamwork, demonstrating creativity, possessing a
high level of self-efficacy, understanding how to learn, and
identifying factors that influence the scope of practice (Hako
et al. 2023). Learning new competencies and new reasoning skills
takes time and role transition can be challenging when registered
nurses move up to the next level in their competence (MacLellan
et al. 2015). However, there is a lack of research concerning role
transition during nurse prescriber education and working in a
new role.
3 The Aim of the Study
The aim of this study was to describe nurse prescribers’ experi-
ences of role transition during nurse prescriber education and
the first working years in a new role. The goal of this study is
to strengthen the knowledge and achieve an understanding of
the nurse prescriber role transition. The research questions were:
What experiences are associated with the transition from the
registered nurse to the nurse prescriber during nurse prescriber
education?What experiences do nurse prescribers have as regards
role transition?
4 Methods
4.1 Study Design
This study is associated with phenomenology, which is reflected
in the study’s aim, the research questions and the lived expe-
riences of nurses described about role transition during their
prescribing education and also working in new roles (Gray 2021,
van Manen 2017). This descriptive study was implemented by
semi-structured interviews.
4.2 Study Setting and Recruitment
The study setting involved semi-structured interviews with par-
ticipants from June 2022 to December 2023 to explore their
experiences in the study aim by the principal researcher. The
interviews were conducted with TEAMS connection, at a time
that was convenient for the participants and in a friendly
atmosphere.
Recruiting participants for interviews was purposive, providing
in-depth knowledge concerning the study questions (Gray 2021),
and it was implemented in different ways. The recruitment
notificationwas published through a nurse prescribers’ electronic
newsletter published by a Finnish nurse prescribers’ association
and their Facebook group. In the first recruitment notification,
the inclusion criteria for participants were as follows: the par-
ticipant had to be a registered nurse, have the right to prescribe
medicines, and have been doing this work for one to two years.
Eight interviewees were recruited in this round. After this, it
was decided to extend the working experience to three years.
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Therefore, the recruitment notification was published for a sec-
ond and third time to achieve more interviewees. Moreover, the
researcher gave a short speech concerning research recruitment
at a seminar for nurse prescribers. Interviewees and seminar
participants were asked to circulate the information concerning
research, afterwhich a snowball effectwas used (Gray 2021). After
these actions, the researcher obtained six more interviews. There
were 14 nurse prescribers enrolled in the study.
4.3 Data Collection
Data were collected by using individual, semi-structured inter-
views online at Microsoft TEAMS (Gray 2021). Creation of the
framework for interviews started with a literature review to
identify the concepts and provide familiarization with ongoing
research areas. After this, preliminary semi-structured interview
themes were formulated. These were discussed by two nursing
science professors and some clarification was made. After pilot
testing, the themes were found to be usable, and a pilot interview
was included in the data (Kallio et al. 2016).
It was decided to take two nurse prescribers who had three years
longer work experience than was necessary for the inclusion
criteria into the research after the interviews were transcribed.
This was because it was seen from transcriptions that their
answers were similar to the others, and they increased the depth
of information (Grove 2021).
The interviews started with two background questions and
then proceeded to two other themes. The research questions
were: What experiences are associated with the transition from
registered nurse to nurse prescriber during nurse prescriber
education? What experiences do nurse prescribers have on role
transition?
These experiences concerned the elements that are associated
with the development of decision-making skills and the transition
from registered nurse to nurse prescriber (Kotila et al. 2020, Kallio
et al. 2016). The interviews took 30–60minutes andwere recorded
and saved before transcribing. Interviews were transcribed into a
text format (Gray 2021).
4.4 Ethical Considerations
The human sciences ethical committee of the University of
Turku was applied for an ethical review statement (approval
number 15/2022). Good scientific practice, research ethics, and
participants’ rights were considered throughout the study process
(TENK 2023). Participation was voluntary and written informed
consent was obtained. Only the principal researcher had access to
participants’ names and e-mail addresses. Participants’ personal
information was destroyed immediately after the interview, as
promised in the recruitment process. Data were anonymized
(ALLEA 2023). Transcriptions were anonymized and stored on a
secured cloud server, with a password (ALLEA 2023; TENK2023).
During the entire process, the principal researcher was careful
with trustworthiness, as indicated by credibility, dependability,
and transferability in qualitative studies (Graneheim and Lund-
man 2004). The COREQ checklist was used to guide the reporting
(Tong et al. 2007).
4.5 Data Analysis and Synthesis
Data were analyzed with inductive content analysis in February
2024. The principal researcher read the transcriptions several
times to form an understanding of the data. (Graneheim et al.
2017). The analysis started with identifying meaning units that
answered the aim of the study and research questions. In the
next phase, synthesizing and coding were detailed, trying to keep
codes on the same level as the original text. In this way, the
risk was minimized as regards missing important content. In the
third phase, codes were interpreted and sorted into subcategories
(Lindgren et al. 2020). Next, similar content was searched for and
identified in order to form categories. From these 10 categories,
four main categories were formed, and from the main categories,
two combining themes (Graneheim et al. 2017). NVivo and
Exell were used to help in managing the data. (Graneheim and
Lundman 2004; Graneheim et al. 2017).
5 Findings
Finnish nurse prescribers (N = 14) participated in this study.
Participants were working in primary healthcare settings and
had prescribing experience ranging from 12 months to six years.
The working areas were from family planning to emergency
units and outpatient clinics that treat patients with conditions
such as asthma or diabetes. The experiences associated with
the role transition from nurse to nurse prescriber during nurse
prescribing education (Figure 1) were described as learning
decision-making and the meaningfulness of learning during
studies. Nurse prescribers described their experiences of role
transition (Figure 2) through experiences in the development of
expertise and the significant change in the nature of their work.
5.1 The Experiences AssociatedWith Role
Transition During Nurse Prescribing Education
5.1.1 Learning Decision-Making
The experiences associated with learning decision-making were
learning to make decisions and the significance of work dur-
ing studies. Learning to make decisions was described to be
significant as meaningful learning situations and learning new,
deepening of competence such as deeper understanding of the
subject and learning skills; the development of decision-making
through developing knowhow, increasing self-confidence and
decision-making and the meaning of the certification for self-
esteem.
The significance of work during studies was learning in the
workplace, the significance of the working community, and
increased responsibility in nursing. At the workplace, the support
of the ward manager was important. Often the nurse prescribers
experienced that the workplace managers had little knowledge
about the education they had been given.
We’ve been incredibly fortunate that our supervisor
has understood the importance of nurse prescribing
education and this opportunity for nursing. (R3)
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FIGURE 1 Experiences associated with the role transition during nurse prescribing education.
The significance of the working community during studies was
described as the positive support of workplace colleagues and
doctors. It was described as enthusiasm, endorsement, and
positive comments. However, there were also negative views
concerning nurse prescribing from doctors, like resistance and
disbelief as regards the nurses’ new skills.
The doctors who work with us have given a lot of
positive feedback on our professional skills. (R2)
Moreover, therewas increased responsibility for nurses. Thework
of nurses had already changed during their nurse prescribing
studies, and the nurses experienced that they grew into their new
role during nurse prescribing education.
5.2 Meaningfulness of Learning During
Education
The meaningfulness of learning included teaching, meaningful
learning situations, and related factors to the progress of studies.
Teaching was experienced through the structure of studies and
actions of the educators.
Unwavering support from tutor teachers was crucial.
(R2)
During education, it was experienced that learning took place
through meaningful learning situations, the content of the
studies, learning together, and patient-centered learning situa-
tions. Examinations were meaningful, for example, the Objective
Structured Clinical Examination (OSCEs), pharmacology exami-
nations, and the final examinations.
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FIGURE 2 Nurse prescribers’ experiences on role transition.
The most memorable learning situations came from
my failures. . . I thought I knew something, and then it
turned out I didn’t. (R1)
Related factors to the progress of studies were experienced
through challenges during the studies such as the difficulty of
subjects and controlling time consumption. Thus, the factors
promoting studies were the students’ motivation for the studies,
the support of companions during studies, and coping with
studies.
Exams were difficult. (R4)
5.3 Nurse Prescribers’ Experiences on Role
Transition
5.3.1 Development of Expertise
The development of expertise was divided into two categories:
independent decision-making and active competence develop-
ment. Independent decision-making included growth in self-
confidence, belief in own actions, confidence, and expressed
pride in themselves; they had a high increase in self-esteem
and developedmore self-confidence. Nurse prescribers expressed
that they felt they had developed in their roles. However, they
also felt a fear of mistakes. Independent decision-making also
included the development of decision-making skills, such as
understanding, justifying, and the development of independent
decisions.
When knowledge is growing, grows self-confidence.
(R11)
The development of expertise can be seen as active competence
development. Nurse prescribers experienced that theywere active
knowledge seekers. They were eager for new knowledge, pur-
suing knowledge, and educating themselves in their spare time.
You have to be motivated, curious and interest in
things. (R1)
I use a lot of different databases in searching knowl-
edge. (R13)
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Active competence development was also described as learning
new competencies. Often learning and education occurred in the
workplace.
Physician on our workplace teaches us all the time.
(R14)
5.4 Significant Change in the Nature of Work
The significant change in the nature of work included three
categories: utilizing new competence in patient care, change
in the content of work, and formation of new work profile in
nursing.Utilizing newcompetencies in patient care includes deep
understanding and administration of medication management,
usage of new competencies in the assessment of the need for
treatment, and identifying the need for patient education. These
competencies were clinical examination of patients, differential
diagnostics, and assessment of the need for treatment during
an appointment or on the phone. Nurse prescribers experienced
that their capabilities of assessing the patient’s situation and
giving advice to patients over the phone were better. They experi-
enced a deeper understanding and implementation ofmedication
management and how their knowledge concerning medication
grew. They learned to prescribe, and they paid more attention
to medication management. Utilizing new skills in assessing the
need for treatment consists of working on the phone, listening to
the patientsmore intensely, developing patient education, clinical
examinations of the patient, widening the patient material and
differing diagnostics development.
If I were regular nurse, I could not do clinical examina-
tion for patients as I can now. (R5)
The change in the content of work includes career advance-
ment, making work visible, change in the nature of work, and
knowledge sharing. Nurse prescribers experiencedmore freedom
in their work. They had the opportunity to create their new
work description, had more responsibility, and took care inde-
pendently, for example, of acute care like infections, and chronic
diseases like asthma anddiabetes or blood pressure controls. They
felt their career was advancing and making their work visible,
significant, and becoming meaningful as nurse prescribers.
This is one opportunity for career advancement. . . and
to become more visible at work. (R3)
Work was more independent, the responsibility was greater than
before, and patient groups changed. Nevertheless, there were also
challenges in this change, like sleepless nights, anxiety, and fear.
Challenges were faced by the human resources department and
many nurse prescribers had to create their own work description.
Nurse prescribers also spoke about knowledge sharing. They
taught and shared a large amount of knowledge not only with
their colleagues but also outside of their working places, for
example, in nursing education.
The formation of new work profiles for nurses was seen in
colleagues’ attitudes toward their new skills and work arrange-
ments within a work unit. Colleague’s attitudes varied. They
could be supportive and trusting but also suspicious. Nurses
who did not know much about nurse prescribing had negative
attitudes toward the new roles, as did many doctors. However,
as knowledge concerning the role of nurse prescribers in the
workplace rises, the more attitudes will change to being positive.
One senior physician viewed statistics and found out
patients who were taken care by nurse prescribers got
to the appointment quickly, got their examination and
treatment quickly and went back home quickly. (R1)
Work arrangements in the workplaces were crucial. The super-
visors’ role was important. Thus, there were differences in how
new work descriptions were enabled in workplaces. Many nurse
prescribers experienced that their competencewas not used in the
proper way and felt that they could give much more expertise to
the patients’ care and to the work of the unit.
I felt that I had to remind all of the time that please give
me these patients which I can take care. (R6)
6 Study Limitations and Strengths
This study has some limitations, which are related to the sample
and to the principal researcher. This study aimed to recruit
participantswhose experiencemet the inclusion criteria. The data
collection used both direct recruitment in newsletters directed
to Finnish nurse prescribers, and in their Facebook group, a
snowballing method was also employed. It is possible that these
recruitment methods did not reach all nurse prescribers who
wouldhave been interested in participating in the research (Grove
2021). However, informative, deep, and rich data were obtained.
As a member of the Finnish Higher Education Network of Nurse
prescriber Education, there is a potential for bias due to the
principal researcher’s close relationship with nurse prescribing
education and its national development. However, this can also
be seen as a strength, and efforts were made to approach the
data with an open mind. The strengths of this study were the
framework construction of the interviews and utilizing online
interviews. The framework for the semi-structured interviews
was conducted by following the guidelines for qualitative semi-
structured interviews (Kallio et al. 2016). Online interviews
offered flexibility to both the researcher and participants (Gray
2021).
7 Discussion
The findings describe nurse prescribers’ experiences of role
transition during nurse prescriber education and at the beginning
of their work as nurse prescribers. Understanding the role
transition from registered nurse to nurse prescriber is important
both from the viewpoint of education and implementing the
nurse prescriber role into practice. Nurse prescribers described
their experiences of transition to new roles comprehensively
and in detail. With inductive content, the analysis defined two
main themes as regards how nurse prescribers described the
role transition to the new role: these themes were experiences
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associated with the role of transition during nurse prescribing
education and nurse prescribers’ experiences of role transition.
The experiences associated with role transition during nurse
prescribing studies were learning decision-making and themean-
ingfulness of learning during education. The importance of
education in the transition to a new role was described concretely
by nurse prescribers. They described different kinds of learning
situations, which were important during education, for example,
learning together and OSCE exams. Nurse prescribers described
that during education, it was important to talk and compare
different nursing practices and encourage each other. OSCE
exams were described as being difficult but educational. In these
exams, nurse prescribers realized that they are really stepping
into a new role, in which there are new skills that they have to
develop and they have to make decisions concerning patients’
treatment. Similar findingswere found in a study byMontgomery
et al. (2021), where the OSCEs were seen to be not only useful
to learning and education as a tool for clinical competence
but also beneficial in the improvement of clinical competence
and knowledge. However, OSCEs were also seen as challenging,
as they caused stress and anxiety, but were not found to be
intimidating (Montgomery et al. 2021).
There were also thoughts concerning competencies before nurse
prescriber education. Students have at least three years of work
experience, butmany students havemuchmore, and they are very
capable and competent registered nurses. It is not easy to be a stu-
dent again and notice that there is a lack of knowledge concerning
the new nursing area. The work experience before starting nurse
prescribing education is important for nurse prescriber students.
This way, they understand nursing phenomena; they recognize
the roles between physicians and registered nurses, and they can
create and grow to a new role as a nurse prescriber: a role that
is between nurses and physicians. Nurse prescribing education
takes about one year (45 ECTS) depending on the students and
their situation.With these study findings, it can be seen that nurse
prescriber students go through role transition during one year of
nurse prescribing education (Duchscher and Widney 2018), but
the new role transition, to some extent, starts againwhenworking
in the new role.
Nurse prescribers’ experiences of role transition consist of the
development of expertise and significant change in the nature
of their work. Nurse prescribers experienced that they are
competent in many ways. They described how their competence
has increased; they can perform clinical examinations of patients,
and they understand what the findings mean, and based on
these, they make their conclusions and decisions concerning the
patient’s health. They have been listening to lungs and checked
ears before as registered nurses, but after nurse prescriber
education they have extended their knowledge, and they can
make differential diagnostics. Nurse prescribers described how
these competencies help them when working in emergencies, at
appointments, and on the phone; in all these areas, they are more
confident. Nurse prescribers also recognize when they must send
patients for a physician’s evaluation. Nurse prescribers described
their motivation and understanding toward more demanding
duties in their new role. Nurse prescribing education seems to
provide a good foundation for the role transition from nurse to
nurse prescriber. These findings can be seen in studies by Fox
et al. (2022) concerning improved patient healthcare experience;
by Hammarberg et al. (2024) regarding holistic, effective, and
patient-centered care; and by Wit et al. (2024) regarding the
positive impact on professional autonomy.
There is still resistance from physicians to nurse prescribing.
Nurse prescribers described situationswhere some physicians did
not believe in their new skills or thought that nurse prescribers
would take some easier patients from them as Wit et al. (2024)
also found in the Netherlands. We need both professions to
manage our patients and health care. Fortunately, in the study by
Hammarberg et al. (2024),most nurse prescribers have supportive
colleagues in physicians, managers, and nurses. In this study,
it was found that nurse prescribers had at least one supportive
colleague, either a physician, a nurse manager, or a colleague.
There is still much to do in implementing the nurse prescriber
role into the workplace. At healthcare centers and workplaces,
very often these new competencies of nurse prescribers are not
recognized, which is why they might be underutilized. Nurse
prescribers see their work with new skills could be utilized in
manyways.Hence, this can be the reason nurse prescribers in this
study suggested that it would be important for healthcareworkers
and the staff in workplaces to familiarize themselves with nurse
prescriber education.
When these findings were compared with the transition-by-
transition shock model, nurse prescribers experienced intellec-
tual, emotional, developmental, and sociocultural changes, but
not physical changes. There were also changes in relationships,
roles, and responsibilities with colleagues, managers, and physi-
cians. Nurse prescribers also experienced changes in knowledge
and performance expectations. Considering the three stages
(doing, being, and knowing) of role transition, there can be seen
experiences with learning and integrating new competencies into
the new work (doing). Nurse prescribers’ feelings concerning
their new role varied between comfortable and uncomfortable,
and there were questions about how the healthcare system uti-
lizes nurse prescribers (being). They attained a new professional
identity and partial independence depending on how work-
places organized the work of the nurse prescribers (knowing)
(Duchscher and Widney 2018).
8 Conclusion
Nurse prescribers experienced role transition by increasing and
extending their competence in their work. They describe them-
selves as highly motivated, but they recognized their competence
boundaries. According to this study, it is possible that healthcare
units do not recognize the new competencies nurse prescribers
have, and that is why they are underutilized. Nurse prescribing
education is an important part of the role transition experience
from registered nurse to nurse prescriber. It is not easy for
experienced nurses to note that there is a lack of knowledge
concerning the newnursing area. Themeaningfulness of learning
and learning decision-making are important in this process.
With this knowledge, it is possible to develop nurse prescriber
education and competencies, and in this way, we can improve
patient safety and the quality of nurse prescribing. It could be
beneficial to research the transition in healthcare units.
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9 Implications
This research provides a new perspective on the role tran-
sition from the nurse to the nurse prescriber. During nurse
prescriber education, learning decision-making and meaning-
fulness of learning are important issues. It is important to use
comprehensive learning methods in nurse-prescribing education
to help nurses transition into nurse prescribers. It is crucial to
deliver information concerning nurse prescribers’ competencies
to healthcare units, to doctors, and to nursingmanagers.With this
knowledge, the experience of nurse prescribers in the workplace
could be enhanced during their education and their new role as
nurse prescribers could be utilized effectively. During the first
working years in a new role, the development of expertise and
significant change in the nature of work are important issues.
These findings also describe the experiences of nurse prescribers’
development in clinical competencies and might help in the
implementation of this new role in practice. The findings can
be used in developing strategies for nurse prescriber education
and the implementation of nurse prescriber roles in healthcare
practices.
Author Contributions
Study design: JS, LS, and HV. Data collection: JS. Data analysis: JS, LS,
and HV. Study supervision: LS and HV. Manuscript writing: JS, HV, VS,
and LS. Critical revisions for important intellectual content: LS, MR, VS,
and HV. All authors approved the final version for submission.
Acknowledgments
The researcher would like to thank all the nurse prescribers who
participated in the interviews.
Open access publishing facilitated by Turun yliopisto, as part of theWiley
- FinELib agreement.
Conflicts of Interest
The authors declare no conflicts of interest.
References
ALLEA. 2023. All European Academies. The European Code of Conduct
for Research Integrity. Revised edition. ALLEA. Accessed November 11,
2024. https://allea.org/wp-content/uploads/2023/06/European-Code-of-
Conduct-Revised-Edition-2023.pdf.
Barnes, H., A. Faraz Covelli, and J. Rubright. 2021. “Development of
the Novice Nurse Practitioner Role Transition Scale: An Exploratory
Factor Analysis.” Journal of the American Association of Nurse Practi-
tioners. 34, no. 1: 79–88. https://journals.lww.com/jaanp/Abstract/9000/
Development_of_the_novice_nurse_practitioner_role.99413.aspx.
Duchscher, J., and M. Widney. 2018. “Stages of Transition and Transition
Shock.” Journal for Nurses in Professional Development 34, no. 4: 228–232.
https://doi.org/10.1097/NND.0000000000000461.
Finnish National Core Curriculum for Nurse Prescriber Education. 2023.
Finnish Higher Education Network of Nurse Prescriber Education.
Fox, A., F. Crawford-Williams, J. Ria, et al. 2022. “Is the Australian
Nursing Workforce Ready to Embrace Prescribing Under Supervision?
A Cross-Sectional Survey.” Journal of Advanced Nursing 78, no. 12:
4082–4091. https://doi.org/10.1111/jan.15367.
Graneheim, U. H., and B. Lundman. 2004. “Qualitative Content Analysis
in Nursing Research: Concepts, Procedures and Measures to Achieve
Trustworthiness.” Nurse Education Today 24, no. 2: 105–112. https://doi.
org/10.1016/j.nedt.2003.10.001.
Graneheim, U. H., B. M. Lindgren, and B. Lundman. 2017. “Methodolog-
ical Challenges in Qualitative Content Analysis: A Discussion Paper.”
Nurse Education Today 56: 29–34. https://doi.org/10.1016/j.nedt.2017.06.
002.
Gray, J. R. 2021. “Qualitative Research Methods.” In Burns & Grove’s
the Practice of Nursing Research. Appraisal, Synthesis, and Generation of
Evidence, 314–357. 9th ed. Elsevier.
Grove, S. K. 2021. “Sampling, 410–449.” In Burns & Grove’s the Practice
of Nursing Research. Appraisal, Synthesis, and Generation of Evidence. 9th
ed. Elsevier.
Hako, L., H. Turunen, and K. Jokiniemi. 2023. “Advanced Practice
Nurse Capabilities: A Mixed Methods Systematic Review.” Scandinavian
Journal of Caring Sciences 37, no. 1: 3–19. https://doi.org/10.1111/scs.13134.
Hammarberg, C., A. Abelsson, A. Arslan, and A. Willman. 2024. “Inde-
pendent and Effective Care—District Nurses’ Experiences of Prescribing
Drugs: A Systematic Qualitative Literature Review.” Nordic Journal of
Nursing Research 44. https://doi.org/10.1177/20571585241227594.
Haririan, H., D. M. Seresht, H. Hassankhani, J. E. Porter, and L.
Wytenbroek. 2022. “Nurses, Physicians and Patients’ Knowledge and
Attitudes About Nurse Prescribing.” BMC Nursing 21, no. 1: 112. https://
doi.org/10.1186/s12912-022-00888-0.
ICN. 2020. Guidelines on Advanced Practice Nursing. International
Council of Nurses.
ICN. 2021. Guidelines on Prescriptive Authority for Nurses. International
Council of Nurses..
Kallio, H., A. M. Pietilä, M. Johansson, and M. Kangasniemi. 2016.
“SystematicMethodological Review: Developing a Framework for aQual-
itative Semi-Structured Interview Guide.” Journal of Advanced Nursing
72, no. 12: 2954–2965. https://doi.org/10.1111/jan.13031.
Kotila, J., A. Axelin, L. Fagerström. et al. 2020. New Roles for Nurses:
Quality to Future Welfare and Health Care Services. Finnish Nurse
Association. Accessed October 15, 2024. https://sairaanhoitajat.fi/wp-
content/uploads/2020/01/new-roles-for-nurses.pdf.
Laapio-Rapi, E., J. Tulonen-Tapio, J. Ukko, and H. Rantanen. 2019.
“Diverse Experiences of Nurse Prescribing.” Lääkärilehti 74, no.
23: 1503–1508. (In Finnish). Accessed January 1, 2025. https://www.
laakarilehti.fi/tieteessa/alkuperaistutkimukset/sairaanhoitajien-
laakkeenmaaraamisesta-vaihtelevia-kokemuksia/.
Levy-Malmberg, R., E. Boman, D. Lehwaldt, L. Fagerström, and E. B.
Lockwood. 2024. “Clinical Decision-Making Processes Among Graduate
Nurses, Specialist Nurses and Nurse Practitioners a Collaborative Inter-
national Study.” International Nursing Review 71: 224–231. https://doi.org/
10.1111/inr.12951.
Liitos, H.-M., E. Kallio, and P. Tynjälä. 2012. “Transformations Toward
Mature Thinking: Challenges for Education andLearning.” InTransitions
and Transformations in Learning and Education, edited by P. Tynjälä M.-
L. Stenström, and M. Saarnivaara, 51–66. Springer. Accessed October 12,
2024. https://link.springer.com/book/10.1007/978-94-007-2312-2.
Lindgren, B.-M., B. Lundman, and U. H. Graneheim. 2020. “Abstraction
and Interpretation During the Qualitative Content Analysis Process.”
International Journal of Nursing Studies 108: 103632. https://doi.org/10.
1016/j.ijnurstu.2020.103632.
MacLellan, L., T. Levett-Jones, and I. Higgins. 2015. “Nurse Practitioner
Role Transition: AConceptAnalysis.” Journal of theAmericanAssociation
ofNurse Practitioners 27, no. 7: 389–397. https://doi.org/10.1002/2327-6924.
12165.
Montgomery, A., H.-C. Chang, M.-H. Ho, P. Smerdely, and V. Traynor.
2021. “The Use and Effect of OSCES in Post-Registration Nurses: An
Integrative Review.” Nurse Education Today 100: 104845. https://doi.org/
10.1016/j.nedt.2021.104845.
8 of 9 International Nursing Review, 2025
 14667657, 2025, 2, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1111/inr.70047 by D
uodecim
 M
edical Publications Ltd, W
iley O
nline Library on [04/08/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on W
iley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Rannikmäe, M., J. Holbrook, and R. Soobard. 2021. “Social Construc-
tivism: Jerome Bruner.” In Science Education in Theory and Practice.
An Introductory Guide to Learning Theory, edited by B. Akpan and T. J.
Kennedy, 259–275. Springer Texts in Education. https://doi.org/10.1007/
978-3-030-43620-9.
TENK. 2023. The Finnish Code of Conduct for Research Integrity and
Procedures forHandlingAllegedViolations of Research Integrity inFinland.
FinnishNational Board onResearch Integrity TENK.AccessedNovember
11, 2024. https://tenk.fi/sites/default/files/2023-11/RI_Guidelines_2023.
pdf.
Tong, A., P. Sainsbury, and J. Craig. 2007. “Consolidated Criteria for
Reporting Qualitative Research (COREQ): A 32-Item Checklist for Inter-
views and FocusGroups.” International Journal for Quality inHealth Care
19, no. 6: 349–357. https://doi.org/10.1093/intqhc/mzm042.
van Manen, M. 2017. “But Is It Phenomenology?” Qualitative Health
Research 27, no. 6: 775–779. https://doi.org/10.1177/1049732317699570.
Wit, R. F., A. J. E. de Veer, K. de Groot, R. S. Batenburg, and A. L.
Francke. 2024. “Task Shifting in Dutch Nursing Practice: A Repeated
Cross-Sectional Analysis of Nurses’ Experiences.” Journal of Advanced
Nursing 80, no. 11: 4593–4602. https://doi.org/10.1111/jan.16173.
9 of 9
 14667657, 2025, 2, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1111/inr.70047 by D
uodecim
 M
edical Publications Ltd, W
iley O
nline Library on [04/08/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on W
iley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License