20th Century Nurse Practitioners: Enduring Success

Ann L. O'Sullivan, PhD, CRNP, CPNP, FAAN


Topics in Advanced Practice Nursing eJournal. 2004;4(3) 

In This Article

Role of the Nurse Practitioner

It is an exciting yet challenging time in nurse practitioner (NP) education. The present and future hold expanded opportunities for the NP, and educational programs must prepare graduates for these roles. Although faculty continually assess how to adapt educational programs, we should look at new models and new strategies that best fit for preparing the NP of today and tomorrow.

In April 2004, the National Organization of Nurse Practitioner Faculties (NONPF) marked 30 years that NP educators have been meeting to discuss curriculum and innovations for educational programs. Faculty from the first meeting reminisced on the issues driving the development of NP programs and the development of curriculum standards. Other early NP pioneers also joined the discussion of the challenges educators faced within nursing and higher education to advance nursing practice to a level needed in the healthcare system. The challenges were significant. The perseverance of the dedicated few in those early days began the NP movement that ensured the availability of educational programs to prepare highly qualified health professionals to meet societal needs.

The NP role has evolved significantly since those early meetings. Today, the curriculum discussions reflect the increased recognition and acceptance of the NP within the healthcare system. The NP is in demand to fulfill a multiplicity of roles, across a wide range of practice settings (chronic, acute, and primary care) and within new models of provider teams (intra- and interdisciplinary). The market seeks graduates with broad knowledge, an expansive skill base, and critical thinking skills who can fill role expectations. Health analysts predict increased use of NPs as clinicians, team and system leaders, and health promoters.[1]

The increasing breadth of practice is reflected in ever-increasing curriculum content. Looking at the competencies for NP practice identified by NONPF, one can see the progressive increase over the years.[2,3,4,5] Derived from research into the clinical practice of NPs,[6] the first competencies were grouped into 5 domains. The 1995 version of the competencies expanded into 6 domains, and NONPF added a seventh domain in 2000. Each edition of the domains and competencies reflects a review and consideration of current practice and future role opportunities.

NONPF assesses trends in healthcare practice, nursing, and higher education to inform its own development of NP educational guidelines and recommendations. In a report to the National Advisory Council on Nurse Education and Practice,[7] NONPF recommended that NP educational programs ensure that graduates have knowledge and competence in the following areas in preparation for the practice environment:

  • Systems that emphasize quality, outcomes, and safety for clients and healthcare workers;

  • Critical and creative thinking to provide healthcare access to vulnerable and underserved populations in a wide variety of settings;

  • Excellence in communication;

  • Cultural competence;

  • Finance and management;

  • Evidence-based practice and research; and

  • New technologies.

The NONPF leadership recently completed its updated 3-year strategic plan and identified several additional significant areas: (1) preparation for team practice through interdisciplinary educational experiences; (2) emphasis on a patient-centered healthcare system; (3) preparation for knowledge retrieval; and (4) increased emphasis on chronic disease management.


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