The expanded role nurse. A dissenting viewpoint

This article presents a dissenting view of the expanded role nurse in light of contemporary nursing theory. Nursing has moved beyond the vision of expanded practice as conceptualized by provincial and federal nursing associations more than two decades ago. A body of scientific knowledge has emerged which distinguishes nursing practice as unique, and there is a trend away from practice based upon the medical model. The expanded role nurse represents a retreat to physician-dominated, medical model practice and runs counter to the goal of theory-based practice. It is suggested that the concept of the physician's assistant is an appropriate response to cutbacks in medical residents rather than the delegation of medical functions to nurses. If nursing is to survive into the 21st century, theory-based practice must be firmly established and expanded through research. It is proposed that the expanded nursing role as presented in the literature is incompatible with theory-based nursing practice and diminishes the hope for autonomous professionhood.