Poster - #VH-39348 - Keywords: psychiatric nurse practitioner marginalization stigma intersectionality resilience well being

THE EXPERIENCE OF MARGINALIZATION AMONG PSYCHIATRIC ADVANCED PRACTICE NURSES: A CROSS-SECTIONAL STUDY

Danielle Morgan, PhD, APRN; Jessica Rainbow, PhD, RN; CNE[1]; Shawn Gallagher, PhD, APRN[1]; Graciela Silva, PhD, MPH, RN[1]; Julie Armin, PhD[1]
[1]University of Arizona

ABSTRACT:
ABSTRACT Background: APRN provider marginalization negatively impacts patient care outcomes, provider health, and ultimately the fiscal stability of health care systems. Insight into the dynamics that mitigate marginalization and optimize resilience within the nursing community will inform intervention innovation aimed at sustaining provider health and professional fulfillment. Purpose: The purpose of this study was to describe and compare the differences in marginalization and resilience within the psychiatric APRN community while describing the potential role marginalization may have had in the psychiatric APRN’s resilience, interactions with their patients, professional community, career trajectory, and well-being. Methods: A purposive sample of clinically practicing psychiatric APRNs were invited to complete a demographic survey, the Englund Marginality Index (EMI), the Connor-Davidson Resilience Scale-10 (CD-RISC-10), and 4 open-ended questions. Data were analyzed using descriptive and inferential statistics. Qualitative content and constant comparative analysis were used to analyze open-ended questions and appreciate themes. Theoretical Framework: Theory of Intersectionality Results: Age, race, and ethnicity predicted EMI, while terminal academic degree predicted CD-RISC-10. Content analysis of qualitative data added trust, distrust, and provider relationships to coded themes. Implications: Global mental health provider and nursing shortages are increasing across clinical and academic domains. Stigma is common when nurses interact with those with mental illness. As both psychiatric and non-psychiatric RNs seek advanced practice training, they may grow biases, providing the fertile breeding ground for marginalization and the community of oppressed group dynamics, historically identified in nursing. Key findings point to addressing biases within the nursing profession, healing the splintered physician: APRN relationship and distrust in healthcare, and initiating an ontological renaissance within the APRN profession. Preserving provider health by innovating interventions that target early academic acculturation, may lead to less provider attrition and greater retention, thus continuing to address our national nursing and skilled psychiatric provider shortages.