Conceptualizing nurse practitioner role ambiguity: A dual-perspective for contemporary nurse practitioner practice

BACKGROUND: The sustained well-being of the nurse practitioner (NP) workforce is threatened by pervasive role ambiguity. This ambiguity is frequently cited as a barrier to successful professional integration and practice. Although existing literature acknowledges this issue, it lacks a formal definition within the context of NP practice. This omission prevents targeted evaluation of its true impacts and the development of effective interventions. PURPOSE: The purpose of this article is to present a concept analysis of role ambiguity within the NP context. METHODOLOGY: Rodgers' evolutionary concept analysis was used. A targeted integrative literature review was conducted across PubMed, CINAHL, and Scopus. This process resulted in 29 articles selected for thematic analysis. RESULTS: The analysis revealed NP role ambiguity manifests as both an internal professional identity conflict and an externally imposed issue driven by systemic barriers. The derived working definition is a state of confusion or lack of clarity regarding the practice authority, scope of practice, abilities, and educational preparation of NPs experienced not only by NPs themselves but also by health care consumers, other health care staff, administrators, and the public ultimately leading to decreased job satisfaction, difficulties in professional identity formation, and the marginalization of NPs. Key attributes include conflict over scope of practice and the discrepancy between the anticipated and actual NP role. Antecedents span legal, organizational, and financial barriers, with consequences such as underutilization and burnout. CONCLUSIONS: These findings require recognizing NP role ambiguity as an externally imposed systemic challenge that generates internal conflict. IMPLICATIONS: Nurse practitioners should leverage this clarified definition to advocate for broader professional recognition and guide the implementation of external strategies, such as targeted education campaigns and policy advocacy, to support professional sustainability.