Major theme: Overall meaning
Having Genuine NP Practice
The shared commonality of how the researcher and participants
in this study understood the overall meaning of
their autonomy was interpreted as Having Genuine NP
Practice. This interpretation evolved through the fusion
of (a) the author’s understanding and preconceptions of
what autonomy means in practice (i.e., having freedom,
using professional judgment with the patient, and being
responsible and accountable to the patient), and (b) the
study participants’ shared meaning of autonomy in their
practice. The consensus meaning was that autonomy is
genuine (real, true) when the NP practices independently
and alone (in the exam room) with the patient. In this exclusive
NP–patient relationship, the traditional physician–
nurse relationship is supplanted by the NP–patient relationship.
This is because the NP is responsible to and accountable
to the patient and not to the physician. Having Genuine
NP Practice, then, had meaning not only for the experience
of autonomy, but also in simply being an NP. The
overall understanding of what autonomy means is facilitated
through the following answer in response to the
question, “What does autonomy mean to you [in your every
day NP practice]”