Beginning practice in rural Honduras : one nurse practitioner's perceptions and experiences

The purpose of this qualitative study was to explore how a Master's prepared nurse practitioner began to translate her education into practice during her first post-graduate year. The study explored the nurse practitioner's experiences and perceptions of her role within the context of rural Honduras.

The nurse practitioner selected for the study was a December 1987 graduate of a university in the southeastern United States who began working as a medical missionary in the mountains of Northern Honduras in July 1988. Ethnographic research methods were chosen to provide a holistic view of the nurse practitioner's perceptions and experiences within the community where she began clinical practice. Data collection entailed fieldwork, which continued from mid-September through December, 1988. The data included formal and informal interviews, participant observation, and artifact collection. Following fieldwork, holistic content analysis was systematically employed to describe the culture of the nurse practitioner in this setting.

The findings of the study are presented within the framework of Kramer's (1974) theory of reality shock. Conflict developed between the participant/nurse practitioner's high expectations of her role and her actual experiences within the setting. The nurse practitioner experienced this reality shock in three realms of her life in Honduras: her relationship to the Honduran community, her relationship to the missionary community, and her role as a nurse practitioner in the clinic. She utilized a variety of coping mechanisms in response to the situation. Implications of the study are discussed.