Running head: TRANSITIONING TO AN ADVANCED NURSING ROLE

Transitioning to an Advanced Nursing Role

Gabriel L. Laney
Ferris State University

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Abstract
The transition to a graduate level nursing degree is one that is typically done for nurses who have
aspirations to leave the bedside. The nurse administrator role is specifically highlighted in this
paper as the particular goal in mind. Obtaining a graduate degree requires the understanding of
various principles of nursing. One such principle is that of nursing knowledge and the unique
philosophies that surround it. It was found that ideologies of nursing knowledge could be
confusing and difficult to understand for some. However, it was found that for the advanced
nurse to be a successful leader one could use simple concepts of knowledge such as that of
person, health, environment, and nursing. Finally, to fully develop as a nurse administrator it was
found that critical thinking is what ties it all together.

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Transitioning to an Advanced Nursing Role

As a Bachelor of Science (BSN) prepared Registered Nurse (RN) furthers their education
by seeking out a Master of Science (MSN), there are many transformations that must take place
for her or him to meet the requirements of this degree. A specific body of knowledge must be
fully understood before this RN can be deemed ready for an advanced nursing role.
Understanding this body of knowledge is very important but being able to translate that into
practice is the key between the BSN nurse and the MSN nurse. The purpose of this paper is to
discuss the expectations that must be met for a nurse administrator and what is required to
transition to that role.
Nursing Knowledge
Fawcett & Lee (2014) state that the BSN nurses are considered appliers of knowledge
and take a passive stance in that sense. MSN nurses however are labeled as creators of
knowledge and are actively engaged in this goal. Fawcett & Lee (2014) also go on to say that
knowledge application and production is a circular process and all members of the nursing
profession are involved in this including the BSN nurses. BSN nurses learn knowledge at a basic
level during their undergraduate training. As a new nurse, their focus is clinical and involves
basic assessment skills, pharmacology, nursing procedures, and time management skills. Nursing
theory is explored on a broad level and might include some big picture themes.
So the question is, what is nursing knowledge? This question is one that is debated on
starting with the entry level MSN student and appears to also include the advanced nursing
theorist. Clark (2010) argues that definitions for nursing knowledge are not very clear and can
even be confusing. Clark (2010) even goes so far as to suggest that there is vast denial of what

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nursing is and instead theorists force a counterfeit nursing language that stems from either
medical or unworkable, non-propositional, philosophical sources (p.403). While this is an
extreme case of the denial of a uniform body of nursing knowledge, it does appear to suggest that
there is a disagreement within the field of what that knowledge is. Nursing knowledge may not
be able to be unanimously agreed upon by the entire profession, but individuals can choose the
nursing knowledge that he or she will utilize in their practice.
If one can look past the confusion and the debates, they can then see that there is a bigger
picture to be understood. While it is not easy to describe nursing knowledge and there is no clear
definition to be found, there are types of nursing knowledge that can be utilized in practice. It is
assumed that nursing can generally be accepted as a profession that utilizes knowledge and
strategies to enhance the quality of life for the communities and populations that it serves.
Mantzoukas & Jasper (2007) identified five types of nursing knowledge that each nurse
develops: personal practice knowledge, theoretical knowledge, procedural knowledge, ward
cultural knowledge and reflexive knowledge (p.318). For the purpose of this discussion, only
personal practice knowledge and theoretical knowledge will be focused on. Mantzoukas &
Jasper (2007) state that personal knowledge is obtained through interaction and experience. This
is knowledge that each individual nurse gains through their time spent with patients. This type of
knowledge can definitely be described as the title suggests: personal. Personal interactions help
nurses form a caring relationship with each patient and aide in developing trust between the two
(Mantzoukas & Jasper, 2007). Mantzoukas & Jasper (2007) describe theoretical knowledge as
knowledge that is gained through study such as in nursing school and its conceptualized as
required of all nurses. They go on to explain that this is factual knowledge and it is measurable
and quantifiable.

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The knowledge types described by Mantzoukas & Jasper (2007) are ones that should be
easily acceptable. Personal and theoretical nursing knowledge are staples of nursing practice and
there is little to debate in that matter. While some theorists focus on the philosophical and
complex nursing knowledge, others attempt to simplify it with easy to understand language that
translates into nursing practice. The MSN nurse must discern the difference between bodies of
knowledge and theories and be able to transcend these differences to become a leader and an
expert.
Significance of Unique Knowledge
Knowledge is necessary for the success of all professions. Without theories, facts, rules,
and guidelines professionals would have no ground to build on. This is especially true of the
nursing profession. Nursing has unique bodies of knowledge that are used to guide practice and
give its practitioners the tools and resources to be successful. Some of these tools can be very
basic and some can be very complex. The two concepts of personal knowledge and theoretical
knowledge as described by Mantzoukas & Jasper (2007) are basic tools that help nurses at the
entry level. The frustration exhibited by Clark (2010) about the confusion of nursing knowledge
can be attributed to more complex and philosophical tools. Thorne et al. (2002) describes these
philosophical definitions of knowledge as inherently complex intellectual and interactional
domains that distinguish expert nursing from the mere doing of tasks (p.1257). Nevertheless,
the advanced practice nurse must extinguish the mere doing of tasks as described by Thorne et
al. (2002) and reach a greater understanding of nursing.
Nursing knowledge specifically helps nurses develop expectations and shows patterns
that provide reason for nursing practice (Carper, 1978). Reasoning and expectations are what
make nurses capable of treating patients. Recognition of what needs to be intervened on is

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knowledge that is indispensible for a nurse. Fawcett has described the interests of nursing or the
concepts that make up nursing as the metaparadigm concepts (as cited in Masters, 2012). Fawcett
(as cited in Masters, 2012) describes the four concepts as health, person, environment, and
nursing.
Masters (2012) describes the four concepts in a concise manner. Health is the concept
that focuses on the process of living and the process of dying. The concept of person is defined
as who is included in nursing. Environment is surroundings of the individual which include but
are not limited to physical, cultural, and socio-economical. Finally, nursing is the actions or
interventions that are carried out by the nurse on the individual.
These metaparadigm concepts developed by Fawcett are crucial for nursing because they
encompass the entirety in which nurses practice. The person is the concept that needs to be most
focused on. The person is the patient or the client that the nurse serves. The nurse empowers the
patient to be in control of their own health and well being. This empowerment gives the person
control over their health and makes them an involved member of the interdisciplinary team. The
role of the nurse may differ depending on the situation and the role cannot easily be defined
because of its ambiguity. The nurses roles function to manipulate the metaparadigm concepts to
create the best possible outcomes for the patient. This concept or this body of knowledge is
circular in nature and each portion can interact with and affect each other. The advanced practice
nurse has command of this body of knowledge and is an expert and a leader and drives success
and positive change.
Role Development
Professional growth and learning is absolutely necessary to be a successful leader and

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this process will never cease. Nurse leaders owe it to their profession to continue to strive for
more and never lose their passion for knowledge. This passion and hunger for more is what takes
an average nurse and makes them a leader and at the highest level even possibly a visionary. It is
not possible to get to this level without advanced education, certifications, staying abreast of the
field by reading scholarly articles, and most importantly having a very clear goal in mind. I have
a personal goal of reaching an executive level of leadership in nursing for a large organization.
Obtaining my BSN was the first step and my MSN in nursing administration is the next step in
reaching my goal. I have obtained a PCCN certification, as I am a nurse supervisor on a
Progressive Care floor and been involved in multiple committees, teams, and process
improvement projects. Along with my education, these behaviors are consistent with what is
required to be successful in reaching my goal.
ANA (2009) defines the nurse administrator as a registered nurse who orchestrates and
influences the work of others in a defined environment, most often healthcare focused, to
enhance the shared vision of an organization or institution (p.3). Understanding the mission of
an organization and having a clear view of the bigger picture is essential for the nurse
administrator to be successful. The bigger picture can be viewed as a puzzle with multiple pieces
that need to coordinate and fit together in order for the whole puzzle to succeed.
The administrator may be involved with only one piece of the puzzle such as the nurse
supervisor or nurse manager. These individuals have a great understanding of the bigger picture
and how their puzzle piece fits in with the whole and how to keep that piece aligned with the
direction of the organization. Leaders at this level tend to all be BSN trained with a high
percentage of them MSN trained or pursuing an MSN. At a higher level, the nursing directors
and nursing executives may control multiple pieces of the puzzle or potentially even the whole

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puzzle. These nurses are almost all MSN prepared with a large majority of them doctoral
prepared at some larger organizations (ANA, 2009).
Transitioning to the role of nurse administrator requires not only tolerance, but
acceptance of change and even being able to embrace this change. ANA (2009) states that nurse
administrators must have a keen sense of the need for change and react with courage, fortitude,
and wisdom (p.23). The healthcare system is constantly faced with diversity on multiple levels.
In the current age, reimbursement for healthcare services is a big-ticket issue and political debate
and it is important for nurse administrators to be constantly vigilant for innovative solutions to
this problem. The day-to-day for a nurse administrator can include running units or hospitals
with inadequate numbers of staff, critically high patient admissions, low patient admissions, or
other patient nurse ratio concerns that require big change and most importantly effective
leadership.
All of these skills and management abilities required by the nurse administrator can be
attributed the ability to be a critical thinker. Pascarella & Terenzini (as cited in Drennan, 2009)
define critical thinking as the ability to identify central issues and assumptions in an argument,
recognize important relationships, make correct inferences from data, deduce conclusions from
information or data provided, interpret whether conclusions are warranted on the basis of the
data given, and evaluate evidence. The advancement of nursing education comes with the goal
in mind of advancing ones critical thinking abilities. In a study by Drennan (2009) a tool was
created for measuring the critical thinking abilities of nurses at various levels. He found that
nurse graduates from a Masters program had significantly higher critical thinking scores than
nurses who were entering into the program. This strong work is evidence that obtaining an MSN
is essential for nurse administrators to be successful and be effective leaders.

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Conclusion
The purpose of this paper was to discuss the expectations for a nurse administrator and
what is required to transition to that role. The MSN prepared nurse is shown to have all the tools
necessary to be a successful nurse administrator and an effective leader. These leaders have
command of nursing knowledge and have highly developed critical thinking abilities that allow
them to be engaging, empowering, problem solvers, and motivational for those that they work
with. The MSN nurse must be able to sort through various nursing theories and bodies of
knowledge and be able to articulate them in a way that can be carried out in the healthcare
setting.

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Referenes
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