Revisiting the role of the nurse practitioner in the 1990s: a Canadian perspective

The role of the nurse practitioner was first introduced in the North American health care scene in the early 1960s. In the 1970s, the concept of an expanded practice role for nurses was gaining interest in Canada. The impetus for development of the role in the United States was stimulated by a shortage of physicians. In Canada, the original nurse practitioner (NP) movement was influenced by the changing role of the nurse, the debate over a new category of health care worker in the United States (the physician assistant), and a perceived physician shortage. Canadian nurses saw the NP role as an opportunity to expand their scope of practice. This role expansion into traditional medical areas of practice was operationalized in various settings largely outside of the tertiary care sector. The role was controversial at times in terms of title and role function. However, it did present the nursing profession with an opportunity to demonstrate the impact nurses have on the health status of Canadians.