BACKGROUND: Blended roles in advanced practice nursing have generated much discussion but little study. As role modifications emerge in nursing, there is a need to explore their implementation.

OBJECTIVE: This descriptive study examined the experiences of nurses who were implementing blended roles as psychiatric clinical specialists and adult nurse practitioners.

DESIGN: Four master of science in nursing and 10 postmasters nurses who had been practicing in blended roles for 1 to 2 years were interviewed about their experiences in implementing their roles. Interviews were tape recorded, transcribed, and content analyzed.

RESULTS: Respondents believed they were practicing holistically, were able to appropriately integrate physical and psychological care of the patient, and found chronic psychiatric patients to have more complex physical illnesses than they had anticipated. In addition, the advanced practice nurses were satisfied with their roles, felt supported by their physician preceptors, and described cross-consultation with physicians and nonpsychiatric nurse practitioners.

CONCLUSIONS: There are roles for advanced practice nurses who blend clinical specialist and adult nurse practitioner skills in the care of psychiatric and primary care patients.