The evolving role of primary care nurse practitioners

The nursing profession has come a long way in its evolution over the years. During the 1700s, nursing was primarily seen as a menial task associated with cleaning, sweeping, and feeding patients in hospitals. Nurses had very limited involvement in patient care. However, as hospitals started to develop during this period, the need for more assistance became evident, leading to the emergence of the nursing career as we know it today.

From its humble beginnings in the 1700s to the present day, nursing practice has undergone significant changes in terms of education, scope of work, diversity, leadership participation, and patient care. Understanding the history and transformation of nursing allows us to appreciate the progress made and to anticipate future improvements. Let’s have a look at some of the major changes in nursing. 

Advanced education

One notable change is the increased education among nurses. In the past, a significant portion of nurses held only associate degrees. However, in recent years, there has been a shift toward pursuing bachelor’s degrees in nursing. The US Bureau of Labor Statistics reports approximately 41.5% of nurses now hold bachelor’s degrees, while those with associate degrees are 20%. This trend highlights the recognition of the importance of higher education in nursing.

Moreover, there has been a growing motivation among nurses to further their education and expertise by pursuing doctoral degrees. The American Association of Colleges of Nursing (AACN) reports an increase in the number of nurses going for doctorate degrees in nursing. This shift toward advanced degrees is driven by the desire to enhance nursing practice and meet evolving healthcare needs. 

A wider scope of duties

Alongside the increased level of education, nurses have also taken on more comprehensive and complex roles in healthcare. The traditional image of nurses following doctors’ orders and providing bedside care has evolved significantly. Nurses are now equipped with knowledge and training that allow them to perform various tasks without constant physician supervision. As a result, nurses with advanced certifications have a competitive advantage when going for the highest paying nursing careers on offer. Carson Newman University has online MSN and post-master’s FNP programs available, making it easier for working nurses to advance their education at their convenience and excel in their career.

While the specific scope of practice may vary from state to state, Advanced Practice Registered Nurses (APRNs) have gained more autonomy in patient care. They can evaluate patients, give medication, interpret diagnostic results, make diagnoses, and even recommend treatment. This expanded scope of practice allows nurses to contribute significantly to the healthcare team and improve patient health outcomes.

In addition to these advanced practice roles, nurses also specialize in various areas depending on their assigned departments. Nurses in academia play a crucial role in training and developing future nurses, ensuring the quality of nursing education. Others take on admin and managerial positions, leading nursing departments in large healthcare institutions.

Embracing diversity

Diversity within the nursing profession has also seen significant growth over the years. Historically, nursing was predominantly a profession dominated by women. However, gender has become more diverse, with men increasingly joining the ranks of nurses. Additionally, there has been an increase in racial and ethnic diversity among nurses.

According to the National Sample Survey of Registered Nurses (NSSRN), Hispanic RNs have seen a substantial increase from 3.6% in 2008 to 10.2% in 2018. Similarly, black RNs increased from 5.4% to 7.8% during that time. These statistics indicate a positive trend toward a more diverse nursing workforce.

While progress has been made, there is still room for improvement, particularly in increasing the representation of Asian nurses. Efforts should be made to ensure equal opportunities and support for nurses from all backgrounds, fostering a profession that truly reflects the diversity of the communities they serve.

Empowered leadership

The increased educational level in nurses has also led to increased confidence and leadership participation within the profession. Nurses are now recognized as valuable contributors to the transformation of the healthcare industry. Their expertise, knowledge, and skills are vital in ensuring that healthcare teams work together to improve patient outcomes.

Nurses have a unique perspective on medical and surgical operations, making them well-positioned to lead teams and advocate for positive changes in the healthcare system. They play a vital role in assessing the effectiveness and cost-efficiency of activities within healthcare settings, contributing to the overall improvement of patient care. Furthermore, nurses are instrumental in ensuring job satisfaction among team members, which ultimately leads to increased employee retention.

Leveraging technology

Advancements in technology have revolutionized the nursing profession, allowing nurses to provide even better care to their patients. Automation has streamlined mundane tasks, enabling nurses to focus more on direct patient interactions and outcomes. Robots and other technological innovations have eased the burden of repetitive tasks, freeing up nurses’ time to provide more personalized care and emotional support to patients.

With the integration of electronic health records (EHRs) and digital health solutions, nurses can access patient information more efficiently, collaborate with other healthcare professionals, and make informed decisions. Technology has also facilitated remote patient monitoring, telehealth consultations, and the use of mobile applications, expanding the reach of nursing care beyond traditional healthcare settings.

As nursing continues to evolve, it is essential for students and practicing nurses to stay updated and adapt to the changes in the profession. Embracing lifelong learning and professional development is crucial to providing high-quality patient care and remaining at the forefront of healthcare advancements.

To prepare for the future, nurses can explore specialized areas of nursing, such as critical care, gerontology, informatics, or oncology. These specializations offer opportunities for career growth and enable nurses to deepen their expertise in specific areas of interest.


The nursing profession has experienced significant evolution throughout history. From its humble beginnings to the present day, nursing has transformed into a highly respected and diverse field. Advancements in education, expanding roles, increasing diversity, empowered leadership, and technological innovations have all contributed to shaping the profession. As nurses continue to adapt and embrace change, the future of nursing holds immense potential for further growth, improvement, and a positive impact on patient care.

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