Professional Autonomy: Essential for Nurse Practitioner Survival in the 21st Century


  • Barbara L. Brush PhD, RN, CRNP,

    Corresponding author
    1. Adult Nurse Practitioner Family Nurse Practitioner Program Boston College School of Nursing Chesnut Hill, Massachusetts
    Search for more papers by this author
  • Elizabeth A. Capezuti PhD, RN, CRNP

    1. Gerontological Nurse Practitioner Research Assistant Professor School of Nursing University of Pennsylvania Philadelphia, Pennsylvania
    Search for more papers by this author

Address correspondence to Barbara L. Brush, PhD, RN, CRNP, 5 Pioneer Road, Arlington, MA 02174.


This article examines nurse practitioners' (NPs) professional autonomy as a critical component of future practice success and survival. Professional autonomy provides the basis for defining and negotiating NPs' work and worth in primary care. Outcome data and analyses that delineate the unique and overlapping practice roles and responsibilities of physicians and NPs will help determine the relative value of their work. Nurse practitioners practicing as physician “substitutes” risk professional survival. Nurse practitioners need to identify nursing as their practice paradigm and nurses as their professional identity.