Origins of the nurse practitioner movement, an oral history.

摘要

Problem. There appear conflicting accounts in the literature documenting the origins of the nurse practitioner role, the initial reaction of the nursing and medical communities to this expanded role, and its impact on the professionalization of nursing by way of advanced practice education. In addition, there is a paucity of research into the roles and relationships of the founding faculty, students and NP/MD teams who were instrumental in the success of the movement and who could serve as oral historians for preserving accurately the events surrounding the advent of the role.;The purpose of the study was to accurately describe and document establishment of the NP model within nursing in order to create a foundation for better understanding of advanced practice nursing roles in the present health care system. It has added to the literature by preserving oral histories of instrumental figures involved in this revolutionary change in health care delivery.;Methodology. An oral history approach to historiography was utilized. The purposeful sample consisted of eight original participants in the movement as primary sources. They were contacted by letter and phone, informed of the study, and permission obtained for taped interviews using a systematic interview process. Tapes were transcribed and transcriptions included in the study. Both tapes and transcriptions will be archived for accessibility. Supportive papers, correspondence and files were also utilized to enhance oral histories, along with secondary sources.;Findings and conclusions. Although the origins of the nurse practitioner movement included public health nursing, primary health care and advanced clinical practice, the movement's success was assisted by the social and political agendas of the sixties, as it also helped alleviate healthcare manpower shortages. It was institutionalized at the University of Colorado as a research project and became a core curriculum under the Continuing Education Division of the School of Nursing. It was supported with grant monies, enabling role change to occur with fewer restrictions.;An interdisciplinary team approach was utilized, with nurses and physicians collaborating to empower families and deliver better care to those with limited access to primary providers. Nurse practitioners in their expanded role as midlevel providers have increased nursing's professionalization through advanced practice education and facilitated autonomy versus role diffusion by maintaining the core values of the nursing profession.