The Historical Foundations of Advanced Practice Nursing: Tracing American Origins for Global Understanding

ABSTRACT

Aim(s)

To examine the historical origins of ‘advanced’ nursing as a concept.

Design

Historical analysis using primary source documentation.

Methods

Historical analysis of articles published in the American Journal of Nursing by the National League of Nursing Education from 1928 to 1950, supplemented by books and articles addressing nursing specialisation history. Articles were analysed chronologically to trace terminology development and strategic decision-making processes during this foundational period.

Results and Discussion

‘Advanced’ terminology was first introduced in 1933 by Isabel Stewart to distinguish university-based clinical specialisation from exploitative hospital ‘postgraduate courses’. The term served as a strategic tool for legitimacy and professional differentiation. World War II accelerated development through federal funding and increased specialisation demands. Louise McManus provided the first conceptual framework in 1949, defining ‘advanced’ education as ‘planned forward movement’ requiring new learning experiences beyond basic preparation. Master's degree requirements were established in 1952, creating educational structures that persist today.

Conclusion

The strategic introduction of ‘advanced’ terminology in the 1930s established foundational concepts that continue to influence contemporary advanced practice nursing development internationally.

Implications for the Profession and/or Patient Care

Understanding these historical origins enables more informed policy development for countries implementing advanced nursing roles and helps resolve ongoing definitional confusion in international nursing practice.

Impact

This research addresses the gap in historical understanding of advanced practice nursing terminology origins. Main findings reveal the strategic nature of professional language in nursing's professionalisation. The research impacts international nursing education policy and contemporary advanced nursing role development across diverse healthcare systems.

Reporting Method

This study adhered to guidelines for historical research methodology.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.