Nurse practitioner: redefining the role of the community nurse?

Currently there is considerable uncertainty regarding the future for community nurses in the United Kingdom (UK). Within the present social and political context the development of the nurse practitioner is examined as one possible means of redefining the role of some community nurses. The historical development of the nurse practitioner in the United States of America (USA) and the UK reveals that such a role has, previously, been a response to changing health trends and to deficits in the provision of care to communities. The evolution of an independent nurse practitioner role is suggested as a way forward for different groups of community nurses and should enable them to meet the health demands of people in a variety of settings. The 'needs' of patients and clients and a multidisciplinary approach are emphasized as being important to the redefinition of community nursing roles. The preparation of community nurses as nurse practitioners would have obvious implications for community education; this matter is briefly discussed. The future of nursing as a whole is set to change; it is imperative that all nurses delivering patient care in this arena should examine the changing needs of society in the context of political reform, and consider how their roles may be developed and redefined.     

Nurse practitioner: reflecting on the future

The role of the nurse practitioner was first conceptualized in the late 1960s. Today, there are approximately 70,000 nurse practitioners in practice, they receive third-party insurance reimbursements, and they are in many specialty practices, as well as working in primary care practices promoting health and disease prevention. In the future, economics will shape our health care industry, placing a greater demand for nurse practitioners in this trillion-dollar marketplace. This article explores the evolving role of the nurse practitioner in education, practice, and research to meet the challenges of the health care needs into the 21st century.     

Nurse practitioner education: learning from students

AIM: To describe the experiences of nurse practitioner (NP) students at Bournemouth University. METHOD: Grounded theory methodology guided the data collection and analysis. A theoretical model was constructed that represented 'role transition' for NP students. RESULTS: The social environment of the participants affected role transition and learning and two major categories were evident: experience in the workplace and experience in the academic environment. A third category, 'pioneering spirit', described the participants' personal attributes that influenced their transformation. CONCLUSION: The results have prompted a review of the current curriculum, mode of delivery and teaching resources. The findings have implications for current and future courses and demonstrate the value of eliciting the students' view.     

Nurse practitioner liability and authority

Nurse practitioners are being held to a higher professional standard. No longer can nurses assume that their practice is protected by physicians and hospitals. Current trends indicate that nurse practitioners are accountable for their actions and are liable for malpractice. Legislation regulating the practice of nurse practitioners varies from state to state; differing opinions among nurses, physicians, and legislators account for some of these variances. The ultimate goal of the health care professions is the delivery of safe, effective, cost-efficient health care. Nurse practitioners are helping to achieve this goal.     

Nurse practitioner peer review: process and evaluation

PURPOSE: To describe the initiation and evaluation of a nurse practitioner (NP) peer review program for a group of 15 NPs practicing at a Veteran's Affairs Medical Center. DATA SOURCES: Using a standardized review form, 15 NPs performed a peer review on a total of 163 medical records; each review was re-reviewed by 2 researchers who were also NPs. To determine the congruency of the reviews among the 15 NPs, the data were analyzed with Intraclass correlations (ICC) and ANOVA. CONCLUSIONS: A relatively low ICC (r = 0.37) was found for the 15 NPs. The ANOVA indicated that there were significant differences among the NPs (F = 11.92, p < .0001). IMPLICATIONS FOR PRACTICE: The outcome of a peer review process depends upon the motivation and values of the NPs, practice sites, and standardization of the format, as well as the degree of collective participation. Peer review can reveal charting deficiencies as well as identify topics for continuing education and risk management programs.