The Lived Experience of Critical Care Nurses Transitioning into an Advanced Critical Care Practitioner Role – an Interpretative Phenomenological Analysis

Bishop, Sharon

The Lived Experience of Critical Care Nurses Transitioning into an Advanced Critical Care Practitioner Role – an Interpretative Phenomenological Analysis

Bishop, Sharon (2026) The Lived Experience of Critical Care Nurses Transitioning into an Advanced Critical Care Practitioner Role – an Interpretative Phenomenological Analysis. Doctoral thesis, Birmingham City University.

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Abstract

Advanced practice roles are increasingly being introduced in response to changing healthcare needs and service/ workforce demands. Ongoing debate regarding the nature and paradigm positioning of advanced practitioners continues, particularly for roles such as the Advanced Critical Care Practitioner. This role has evolved and is operationalised within the medical framework although it is undertaken by registrants from other professional backgrounds who may bring their own values to the role. This study is the first to investigate the lived experience of critical care nurses who transition into Advanced Critical Care Practitioner roles, with particular focus on nurses' perceptions and construction of their own professional identity and positionality within the wider healthcare team following the transition.

Adopting an Interpretative Phenomenological Analysis methodology facilitated the focus on the lived experience and lifeworld of each participant. Eight semi-structured interviews were conducted with purposively recruited nurse Advanced Critical Care Practitioners from across the United Kingdom. Consistent with the philosophical principles of Interpretative Phenomenological Analysis, idiographic interpretation of individual experiences was completed, prior to cross-case analysis which sought to discover convergence and divergence.

Three Group Experiential Themes have emerged which answer the research question:

1. “An explosion of a role” – navigating the transition
2. “There to care” – negotiating their identity and place
3. “I think it will get better, won’t it?” – vulnerability, concern and hope

Drawing on Bourdieu’s conceptual thinking tools (1990; 2000), the concept of hysteresis has provided a framework for understanding the change to the nurses’ own habitus, identity and sense of positionality within the field. Transition was compounded by a complexity of personal, situational and professional factors. Both the inter- and intra-relational encounters with other members of the nursing and medical teams directly impacted on the participants. Of significance was the level of disconnection and disruption experienced between the participants and other nurses, particularly senior nurses. However, participants employed strategies to utilise their nursing identity and habitus, creating a hybrid position which enables them to draw on both paradigms of nursing and medical practice in their Advanced Critical Care Practitioner role.

This study offers a novel insight into how nurses transition into advanced practice roles, particularly for roles with a stronger medical identity such as the Advanced Critical Care Practitioner role. It challenges the critical view that such roles are sought by professionals who want to attain a greater medical positioning, thus leaving their heritage identity behind. The findings offer a range of recommendations for professional nursing practice, organisational workplace culture and planning, and research in consideration of nurses’ professional identity, support and positionality within the healthcare team.

Item Type:	Thesis (Doctoral)
Dates:	Date Event 12 March 2026 Accepted
Uncontrolled Keywords:	Advanced practice; professional identity; critical care; nursing;
Subjects:	CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific) CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-09 - others in nursing
Divisions:	Doctoral Research College > Doctoral Theses Collection Nursing and Midwifery > Midwifery and Children's Health
Depositing User:	Louise Muldowney
Date Deposited:	08 Apr 2026 08:35
Last Modified:	08 Apr 2026 08:35
URI:	https://www.open-access.bcu.ac.uk/id/eprint/16956