Critical analysis of the evolution of a Canadian nurse practitioner role.

The purpose of this paper is to critically analyze the evolution of a nurse practitioner (NP) role in Canada using the province of Ontario as an example. Two theoretical models are used to highlight the historical development of this role and provide direction for further NP role development. The evolution of the NP role encompasses 2 critical phases: initiation and discontinuation (early 1970s to mid-1980s) and establishment and impasse (early 1990s to the present). Current barriers to the full integration of NPs within primary health care include the lack of a workable and stable funding plan for NPs, restrictions on scope of practice, work-related tensions between physicians and NPs, and lack of public and professional awareness of the role. Nurses can address these barriers through advocacy, lobbying, and public education.