title: Experiences of pioneer nurse practitioners in establishing advanced practice roles.
abstract: OBJECTIVE
  To describe pioneers' experience of establishing the nurse practitioner (NP) role, and their experiences in maintaining and building the NP role in the contemporary practice environment.
  
  
  METHODS
  The study sample included 50 middle-aged women currently practicing in Washington State as licensed advanced practice nurses, who began the NP role during 1965-1979.
  
  
  METHODS
  This descriptive study included interviews and focus groups to gather data about the nurses' early experiences. Interpretative methods of grounded theory were used in data collection and analysis.
  
  
  RESULTS
  The central organizing theme, Advancing Autonomy to Make a Difference, was manifested through six broad themes: Breaking Free, Molding the Clay, Encountering Obstacles, Surviving the Proving Ground, Staying Committed, and Building the Eldership.
  
  
  CONCLUSIONS
  Autonomy was requisite to practice to one's full potential and maintain commitment over time. The data findings show the evolution of advanced nursing practice in the United States and provide guidance for nurses who are working to establish advanced practice nursing in other countries.
authors.affiliation: University of Washington, School of Nursing, Seattle, WA, USA. mabrown@u.washington.edu
authors.forename: Marie Annette
authors.initials: MA
authors.lastname: Brown
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Draye
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D008008:Licensure, Nursing; D008389:Marketing of Health Services; D008875:Middle Aged; D016294:Models, Nursing; D008960:Models, Psychological; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000523:psychology*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D010558:Personnel Loyalty; D017009:Professional Autonomy; D011795:Surveys and Questionnaires; D014861:Washington