10.1177/0894318404263268 ARTICLE Scholarly Dialogue Nursing Science Quarterly, 17:2, April 2004 Scholarly Dialogue Jacqueline Fawcett, Contributing Editor Advanced Practice Nursing and Conceptual Models of Nursing Jacqueline Fawcett, RN; PhD; FAAN Professor, College of Nursing and Health Sciences, University of Massachusetts–Boston Diana M. L. Newman, RN; EdD Associate Professor, College of Nursing and Health Sciences, University of Massachusetts–Boston Margaret McAllister, RN; PhD; FNP Associate Professor, College of Nursing and Health Sciences, University of Massachusetts–Boston This column focuses on advanced practice nursing. A definition and central competency of advanced practice are given and four roles assumed by advanced practice nurses are identified. Questions related primarily to the ad- vanced practice role of nurse practitioner are raised. Two nurse scholars who teach and practice discuss their expe- riences as advanced practice nurses, with an emphasis on the importance of using a conceptual model of nursing as a guide for their practice. As we all know, the profession of nursing currently allows entry into practice via multiple routes, including hospital- based diploma programs, associate degree programs, bacca- laureate degree programs, and Doctor of Nursing (N.D.) pro- grams. The goal of all of those programs is to educate so- called generalist nurses, who are prepared to work in most, if not all, healthcare settings. Other programs, most now at the master’s degree level, prepare specialist nurses who work in particular healthcare settings and/or with particular popula- tions. Many of the master’s degree programs prepare nurses for what has come to be called advanced practice nursing. The purpose of this dialogue is to explore the meaning of ad- vanced practice nursing and the contributions made by ad- vanced practice nurses to nursing science. Two of my faculty colleagues from the University of Massachusetts Boston, Di- ana M. L. Newman and Margaret McAllister, agreed to en- gage in a discussion of their experiences as advanced practice nurses. Both Dr. Newman and Dr. McAllister have been nurse educators for many years. Both also have continued direct nursing practice throughout their nursing careers. Many Questions About Advanced Nursing Practice The idea for our discussion arose when I began to ponder the fate of nursing conceptual models and theories as the nurse practitioner movement spread throughout the United States and concomitant anecdotal reports of the elimination of master’s degree nursing program courses about nursing knowledge began to surface. At about the same time, I be- came aware of the use of the term, advanced practice nursing, in objectives for master’s degree nursing program curricula. What, I wondered, was the link between nurse practitioner education and education for advanced practice nursing? Hanson and Hamric (2003) provided an answer to my question. They defined advanced practice nursing as “the ap- plication of an expanded range of practical, theoretical, and research-based therapeutics to phenomena experienced by patients within a specialized clinical area of the larger disci- pline of nursing” (p. 205). They identified four distinct ad- vanced practice role specialties: nurse midwife, nurse anes- thetist, clinical nurse specialist, and nurse practitioner. The core competency of each specialty role, according to Hanson and Hamric, is “direct clinical practice” (p. 205). According to Hanson and Hamric, then, a nurse practitioner is an advanced practice nurse. My next question was, what activities are performed by advanced practice nurses that make their practice advanced nursing? Hanson and Hamric (2003) provided a potential an- swer. In tracing the evolution of advanced practice nursing, Editor’s Note: Any comments about this dialogue should be ad- dressed to the Editor for possible inclusion in Letters to the Editor. For other information, contact Jacqueline Fawcett, RN, PhD, FAAN, 3506 Atlantic Highway, P. O. Box 1156, Waldoboro, ME 04572; phone: (207) 832-7398; e-mail: jacqueline.fawcett@ umb.edu Nursing Science Quarterly, Vol. 17 No. 2, April 2004, 135-138 DOI: 10.1177/0894318404263268 © 2004 Sage Publications Keywords: advanced practice nursing, conceptual mod- els of nursing, nursing practice at SAGE Publications on June 18, 2015 nsq.sagepub.com Downloaded from