Keeping the Nurse in the Nurse Practitioner
Our current ANS featured article is titled “Keeping the Nurse in the Nurse Practitioner Returning to Our Disciplinary Roots of Knowing in Nursing” by Sylvia K. Wood, DNP, ANP-BC, AOCNP. In this article, Dr. Wood examines the factors that have shaped nurse practitioner education and provides the case for restoring nursing roots as central in the future. The article is available for download while it is featured – we welcome your comments and responses to this challenge! Here is a message from Dr. Wood about her work:
Attending the 50th Anniversary 2019 Case Western Reserve theory conference, I was deeply moved to listen to the wise voices of nurse theorists leading our profession, warning us of current threats in losing our disciplinary perspective. Having attended an open session for the Future of Nursing 2020-2030 just two days earlier, and journey as a Ph.D. candidate, created a confluence of events that compelled me to bring this article forward. It is my honor to present it in this issue of ANS. As a nurse practitioner and nurse educator, I have witnessed both the loss of nurse theory-driven practice and diminished presence in our curricula. This article provides a historical background for the context of the issue, existing challenges for academic educators are presented with an analysis of the current literature and recommendations are offered.
For many years in NP practice, these questions never left my mind, what is it that NPs know and do that make them so distinct from other providers and why is their care so valuable in its own right? Why is what they know not made visible? I often observed that NPs, including myself, could not find the words to explain our nursing, our nursing knowledge, how this nursing knowledge shaped what we did in practice, or trace that knowledge back to nursing theory and nursing science. Nevertheless, the result of our NP care significantly improved patients’ health outcomes, healing, wellness, wholeness, and quality of life.
As NP practice has become more sophisticated, there has been a necessary expansion of education from other sciences and health-related disciplines. However, there is a decreasing emphasis on the theoretical foundations of nursing and nursing science, unmooring practice from its anchor to nursing. The result obscures not only NPs’ identity, and the relevance of our practice compared to other providers, but the nurse-sensitive patient outcomes as a consequence of it. The theoretical basis of nursing knowledge (nursology) is what distinguishes nurse practitioners from other health care providers and drives the results associated with it.
2020 is the Year of the Nurse and Midwife. It is also a critical time when the demand for NPs is on the rise, and NPs are advocating for full practice authority. Therefore, in honoring our contract with society, we have an ethical and moral obligation to know, articulate and demonstrate the scientific foundation underpinning the distinction of our practice by returning to our disciplinary roots of knowing in nursing to keep the nurse in the nurse practitioner.
The autonomy of a profession rests more firmly on the uniqueness of its knowledge, knowledge gathered ever so slowly through the questioning of scientific inquiry. Nursing defined by power does not necessarily beget knowledge. But knowledge most often results in the ascription of power and is accompanied by autonomy (Fuller, 1978, p. 701).
Fuller, S. (1978). Holistic man and the science and practice of nursing. Nursing Outlook, 26, 700-704