Experiences of pioneer nurse practitioners in establishing advanced practice roles.

PURPOSE

To describe pioneers' experience of establishing the nurse practitioner (NP) role, and their experiences in maintaining and building the NP role in the contemporary practice environment.

DESIGN

The study sample included 50 middle-aged women currently practicing in Washington State as licensed advanced practice nurses, who began the NP role during 1965-1979.

METHODS

This descriptive study included interviews and focus groups to gather data about the nurses' early experiences. Interpretative methods of grounded theory were used in data collection and analysis.

FINDINGS

The central organizing theme, Advancing Autonomy to Make a Difference, was manifested through six broad themes: Breaking Free, Molding the Clay, Encountering Obstacles, Surviving the Proving Ground, Staying Committed, and Building the Eldership.

CONCLUSIONS

Autonomy was requisite to practice to one's full potential and maintain commitment over time. The data findings show the evolution of advanced nursing practice in the United States and provide guidance for nurses who are working to establish advanced practice nursing in other countries.