Nurse practitioner, though it remains a controversial concept, has been identified as a legitimate profession that provides health services worldwide (American Nurses Association 1993; NSW Department of Health 1993). The emergence of advanced practice nurses (APNs) was due to the demand for alternative timely health services that health consumers are seeking to meet their customary health service needs and the scarcity of appropriate health care services that match people’s economic situation, geographic isolation, social condition or cultural variation.
As a result, the role of nurse practitioners has become increasingly the subject of health literature, health organizations, and educational institutions. In this research, the roles of nurse practitioners are identified and described including their educational foundation, theoretical framework, application, and previous research with special focus on family nurse practitioners (FNPs). History of the role of family nurse practitioner
Early in the twentieth century, the need for more nurses and midwives to provide primary health care and family nursing services in the United States had lead to the recognition of ensuring high quality of education and in order make them familiar with health assessments, planning interventions, and evaluating outcomes, and to prepare them to be able to promote and improve the peoples’ health and wellness (McMurray, 1991).
In response to the needs in the education of health care nursing, the innovative and dynamic International Community Based Nurse Educational Program (ICNEP) was established to improve the nursing education, quality of nursing care, leadership, and number of quality nursing graduates (Andrews & Janet, 1996, pp. 60). The ICNEP was also organized to strengthen and expand health services, especially for the health of women and children.
The Frontier Nursing Service (FNS) and the Community based Nurse-midwifery Educational Program (CNEP) served as the two models for ICNEP. The FNS, started in 1925, first offered nurse-midwifery program in 1939 and it eventually expanded to the Frontier School and it integrated family nurse practitioners and nurse-midwives preparation with advanced practice of primary care in the rural setting.
It provided nurses with knowledge and skills in health care promotion and health problem prevention for mothers and families in the community (Andrews & Janet, 1996, pp. 60-61). Since the 1950s, the number of nurse practitioners (NP) in the United States has expanded due to a shortage of physicians and their preference for specialty practice over primary care practice (Mason, Leavitt, & Chaffee, 2002). Similarly, formal NP program was created to cater to the increased need for NPs to provide primary care services.
It was first developed at the University of Colorado in 1965 by Lorretta Ford and Henry Silver with an aim to train pediatric NPs and become the center for various specialty NP programs. FNP role was developed in the following decade when the Committee to Study Extended Roles for Nurses has recognized the need to expand nursing roles in order to provide equal opportunities for health services to all American citizens. FNP and other specialty programs received federal support and resulted to the evolution of the role of FNPs (Hamric, Spross, & Hanson, 2005).