title: Surviving the proving ground: lessons in change from NP pioneers.
abstract: Increasing competition, health care complexity, threats to quality, and rapidly changing environments confront nurse practitioners (NPs) as they enter the new millennium. If NPs are to strengthen their positions as health care providers and continue to make a lasting contribution, they must exhibit proficiency in creating and managing change. Lessons gleaned from those who pioneered the NP role can provide the wisdom needed to address contemporary role challenges. The purpose of this study was to identify the strategies employed by NP pioneers who contributed to role survival and growth. This article provides a discussion of the change strategies utilized by NP pioneers and highlights their relevance to current practice issues.
authors.affiliation: Primary Care Family Nurse Practitioner Program, University of Washington School of Nursing, Seattle, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Draye
authors.forename: M A
authors.initials: MA
authors.lastname: Brown
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D003163:Competitive Behavior; D003220:Conflict, Psychological; D004465:Economic Competition; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D007857:Leadership; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000523:psychology*; D015404:Nursing Methodology Research; D009936:Organizational Innovation; D017009:Professional Autonomy; D011361:Professional Competence; D011795:Surveys and Questionnaires; D014861:Washington