Historical Perspectives on an Expanded Role for Nursing

Area of Science:

• Nursing History
• Healthcare Policy
• Primary Care Access

Background:

• The 2010 Institute of Medicine report, "The Future of Nursing," called for nurses to practice to the full extent of their training.
• This article examines historical precedents, key documents, and legislation shaping advanced practice nursing.
• It traces the evolution of nursing's role from early 20th-century initiatives to contemporary primary care models.

Observation:

• Pioneering nurses like Lillian Wald (Henry Street Settlement, 1893) and Mary Breckenridge (Frontier Nursing Service, 1925) significantly improved healthcare access.
• These historical models demonstrated nurses' capacity to serve diverse urban and rural populations.
• Mid-century political factors contributed to the establishment of the nurse practitioner role.

Findings:

• Historical nursing practice laid the essential groundwork for the expanded role of advanced practice nurses.
• Early nursing initiatives provide valuable lessons for developing new primary care models.
• Legislation and foundational documents have been instrumental in advancing nursing's scope of practice.

Implications:

• Understanding historical nursing contributions can inform current strategies for enhancing primary care delivery.
• The evolution of nursing roles highlights the potential for nurses to meet evolving healthcare needs.
• Lessons from past nursing innovations can guide the creation of future healthcare delivery systems.