According to DeNisco and Baker (2021), nursing education has transitioned from an apprentice style of education to one that involves an education built in liberal arts requiring the development of critical thinking abilities. Even the term advanced nursing practice has been shrouded in considerable uncertainty until a watershed seems to have been reached for a definition that indicates master’s-prepared nurses who provide direct clinical care and to include the roles of nurse practitioner (NP), certified nurse–midwife (CNM), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS) (DeNisco & Baker, 2021). The 2010 report by the Institute of Medicine (IOM) that identified the need for nurses to be positioned as vanguards of health care and strongly advocating for allowing advanced practice registered nurses to practice to the full scope of their skills and the removal of barriers to enable forward movement of nurses and the nursing profession paved the way for the advancement of nursing (Stewart, 2021).
The nurse practitioner practice is thought to have emerged in the 1960s taking cue from Lilian Wald’s nurses of the 1800s and was developed to provide primary care underserved population (Stewart, 2021). In 1965, Loretta Ford and Henry Silver formally developed the role of nurse practitioner to advance the nursing profession and to respond to the need for providers in rural, underserved areas (Stewart, 2021). DeNisco and Baker (2021) affirmed that the role evolved out of the unavailability of primary care physicians to take care of pediatric populations with educational preparation changing from the initial 3 to 12 months to the present-day master’s degree as the entry-level education for nurse practitioner specialties.
Formal midwifery training was also necessitated to solve an urgent need to curb high maternal and infant mortality rates which led to the establishment of the first nurse–midwifery school in 1925 by Mary Breckenridge. Today, all nurse–midwifery trainings are college and university level programs which culminate in the DNP degree. The practice of midwifery requires licensed and independent certified nurse–midwives and certified midwives (CMs) who are autonomous primary care providers with prescriptive authority to manage women’s health, that concentrate on pregnancy, childbirth, the postpartum period, care of the newborn, family planning, and gynecologic needs of women (DeNisco & Baker, 2021).
Having evolved more than 150 years ago, nurse anesthetists are another licensed independent practitioners who autonomously deliver care in collaboration with surgeons, dentists, podiatrists, anesthesiologists and other healthcare professionals (DeNisco & Baker, 2021).
DeNisco and Baker (2021) averred that there is a national initiative to improve access to high-quality but cos-effective health care. This directive is bound to necessitate the advent of many new and yet to be conceived roles for nurses. Newly identified nursing roles such as nurse navigators and healthcare coaches, have been instituted and may require advanced degrees and certification. There are thriving care coordination opportunities for nurses throughout the continuum of care (DeNisco & Baker, 2021).
References
DeNisco, S. M., & Baker, A. M. (2021). Advanced Practice Nursing: essential knowledge for the profession (4th ed.). (S. M. DeNisco, Ed.) Burlington, Massachusetts: Jones & Bartlett.
Stewart, J. G. (2021). Advanced Practice Nursing: essential knowledge for the profession. (S. M. DeNisco, Ed.) Burlington, Massachusetts: Jones & Bartlett.
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