Advanced Practice Nursing: Essentials of Role Development by Lucille A. Joel

By Lucille A. Joel

Famous nursing execs and educators percentage their expertise...on the evolution of the APN's position from a historic viewpoint to the current, the non-clinical wisdom invaluable for pro good fortune, and destiny concerns and demanding situations. AJN e-book of the Year2009

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175). See Chapter 4 for more discussion on this issue. We will need our renegades, rebels, and trailblazers more than ever. CONCLUSION The boundaries of practice are always malleable. They are always subject to myriad external forces— political, economic, social, and cultural—and are interpreted in different ways by different practitioners. APNs are a mixed breed; each trajectory under the umbrella of advanced nursing practice has evolved differently and under variable circumstances. This leads to vigor, strength, and diversity.

The NP educational programs of the times prepared family, adult, pediatric, maternal, school, geriatric, rural, and emergency NPs and were supported by a number of major federal agencies (Kalisch & Kalisch, 1986). Priscilla Andrews, a nurse, and John Connolly, a pediatrician, directed the Bunker Hill/Massachusetts General Nurse Practitioner program in 1968 (Pulcini & Wagner, 2001). This program, along with the Colorado program founded by Ford and Silver, aimed at producing more primary care providers for underserved children.

Certainly she had a point! Nonetheless, the movement persisted. Market demand, nursing vision, and bravery on the part of individual practitioners fostered forward movement. Members of the medical field were a major support, as was the federal government. Government support is not surprising; the need to provide primary care for the underserved is a tremendous and growing problem. The American Academy of Pediatrics provided sponsorship and supported the development of the National Association of Pediatric Nurse Associates and Practitioners (NAPNAP) as an organization to lead and certify pediatric NPs, thus providing more access to primary care services (Hobbie, 1998).

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