Advanced Practice Registered Nurses' Work Environment Perceptions in Hospitals: A Cross-Sectional Survey.

AIM Examine work environment differences between hospital certified nurse practitioners (CNP) and certified registered nurse anesthetists (CRNAs) BACKGROUND: Nurse work environments impact patient and nurse outcomes. How differing advanced practice nurse (APRN) roles influence work environments is unknown. METHODS Multi-level cross-sectional survey design. APRNs (n=490) completed the APRN Organizational Climate Questionnaire, and Psychological Ownership Questionnaire. Nurse executives (N=24) reported on Scope of Practice, and Institutional Voice. Descriptive, t-test, chi-square, and linear and mixed effects regression statistical tests were employed. RESULTS CNPs reported better organizational climate and job ownership than CRNAs. The largest effects involved relationships with physicians, control over practice, and independent practice. Among CNPs, a significant positive relationship was observed between relations with physicians and work engagement. In CRNAs, a similar positive relationship between physician relations and work engagement was only observed for those working in higher scope of practice settings; not for those working in more restrictive settings. CONCLUSIONS Significant differences exist in the perceived work environments between CNPs and CRNAs that may be related to differences in job design and historical relations with physician colleagues. IMPLICATIONS FOR NURSING MANAGEMENT Efforts to improve APRN work environments in hospital settings should consider differing CRNA and CNP perspectives.