237chapter TEN
Role Strain in the Doctorally
Prepared Advanced Practice Nurse:
The Experiences of Doctor of Nursing
Practice Graduates in Their Current
Professional Positions—An Updated
and Current View
Mary Ellen Smith Glasgow , Rick Zoucha , and Catherine Johnson
It is suggested that a role is the manifestation of behavior appropriate to an individual’s
position (Sveinsdottir, Biering, & Ramel, 2006). The Doctor of Nursing Practice (DNP)
degree is a relatively new degree, created in 2004; therefore, the role of the doctoral
advanced practice nurse (DAPRN) is not yet clearly defined in many settings (Nichols,
O’Connor, & Dunn, 2014; Udlis & Mancuso, 2015). Nichols, O’Connor, and Dunn, (2014)
observed that chief nursing officers (CNOs) are not well versed in the clinical outcomes
of DNP practice or the population health outcomes that may be impacted by DNP-
prepared providers. Udlis and Mancuso (2015) reported that confusion and disagree-
ment about the DNP continues despite the rapid and steady growth of DNP programs.
As a result, new DAPRNs may experience role stress in their new role. Psychologists,
sociologists, and empirical researchers have conceptualized role stress from different
perspectives (Hardy & Conway, 1978; Kahn, Wolf, Quinn, Snock, & Rosenthal, 1964;
Lazarus, 1967). Hardy and Conway (1988) classified the dimensions of role stress spe-
cifically for health care professionals. These dimensions are role conflict, role ambiguity,
role overload, role incompetence, and role incongruity. Among the many dimensions of
role stress, most researchers have focused on the impact of role ambiguity or role con-
flict on personal or organizational outcomes; however, the role of the nurse has not been
the focus of the research (Chen, Chen, Tsai, & Lo, 2007).
Role s tress can arise from different patterns of mismatch in expectations, resources,
capabilities, and values about the role (Chen et al., 2007). In an organization, an individ-
ual’s role stress refers to “stress formed by the combined expectations of an individual’s