The Shuler Nurse Practitioner Practice Model: A Theoretical Framework for Nurse Practitioner Clinicians, Educators, and Researchers, Part 1

Journal of the American Academy of Nurse Practitioners (Impact Factor: 1.02). 12/1992; 5(1):11 - 18. DOI: 10.1111/j.1745-7599.1993.tb00835.x


Because nurse practitioners (NPs) have expanded their nursing knowledge and skills into medicine they need a model that reflects this expanded role. This article presents the Shuler Nurse Practitioner Practice Model, which is wellness-oriented and suggests how patient interaction, assessment, intervention, and evaluation should occur.

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    • "Compared to the UK, Canada and the USA, Australia has been slow to introduce the NP role. Inadequacies of the traditional nursing model and the traditional medical model as the basis for NP practice have sparked a paradigm shift among some, with the emergence of the Shuler Nurse Practitioner Practice Model [20]. This model builds on the Anderson Model [21] from the late 1970s, which emphasised joint decision making in the context of a holistic approach to the person being treated. "
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    ABSTRACT: The Australian Medical Association is strongly opposed to the nurse practitioner (NP) role with concerns that NPs may become doctor substitutes without the requisite training and education that the medical role demands. Despite this, NPs have been heralded by some as a potential solution to the access block, workforce shortage and increased demand affecting emergency departments (EDs). The purpose of this study was to determine the perception of NPs by medical staff working in Australian EDs. Semi-structured telephone interviews were conducted with closed and open-ended questions. Participants were drawn from a representative stratified sample of two city, two metropolitan and two provincial hospitals of each State/Territory. A total of 95 doctors from 35 EDs participated in this study including 36 Departmental Directors; 36% of participating Directors indicated having an NP on staff. Doctors were strongly opposed to the statement that NPs could replace either nurses or other prevocational doctors; 71 interviewees commented on the role of NPs in the ED. Thematic analyses revealed polarised views held by doctors. Eight major themes were identified, the most common being that there is a lack of clarity of the NP role definition, their scope of practice and differentiation from the medical role. Although ED NPs represent a highly skilled professional group their role is poorly understood by ED doctors. Opposition to the NP role is a significant barrier to the introduction of great numbers of ED NPs as a strategy to overcome the medical workforce shortage. The online version of this article (doi:10.1007/s12245-010-0214-8) contains supplementary material, which is available to authorized users.
    Full-text · Article · Dec 2010 · International Journal of Emergency Medicine
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    ABSTRACT: Nurse practitioners' unique contributions to primary care can be demonstrated more clearly if clinicians would adhere to a theoretical framework that reflects their combined nursing and medical role. This article explicitly delineates the process of utilizing the Shuler Nurse Practitioner Practice Model in clinical practice.
    No preview · Article · Mar 1993 · Journal of the American Academy of Nurse Practitioners
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    ABSTRACT: In this pilot study, family planning practices and risk for unintended pregnancy among 50 homeless women residing in the downtown area of Los Angeles were investigated through the retrospective analysis of data collected through a wholistic clinic intake questionnaire. Those women who were least likely to use a birth control method in this study were Black, used cocaine daily, had multiple sources of emotional support, were satisfied with their sex lives, and reported access problems to family planning services (p≤ .05). Furthermore, over half of the total sample was at risk for unintended pregnancy. These at risk women were more likely to be separated from their children (p≤ .05), report current (p≤ .05) and past (p≤ .01) drug problems, have multiple sex partners (p≤ .001), engage in prostitution (p≤ .01), have a past history of sexually transmitted diseases (p≤ .05), and were least likely to be satisfied with their sex lives (p≤ .05). The findings suggest that homeless women are in great need of family planning health services, and that such services should be combined with vocational, social service, and drug treatment programs.
    No preview · Article · Dec 1994 · Journal of the American Academy of Nurse Practitioners
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